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Zhang Z, Robinson L, Campbell I, Irish M, Bobou M, Winterer J, Zhang Y, King S, Vaidya N, Broulidakis MJ, van Noort BM, Stringaris A, Banaschewski T, Bokde ALW, Brühl R, Fröhner JH, Grigis A, Garavan H, Gowland P, Heinz A, Hohmann S, Martinot JL, Martinot MLP, Nees F, Orfanos DP, Paus T, Poustka L, Sinclair J, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Desrivières S. Distinct personality profiles associated with disease risk and diagnostic status in eating disorders. J Affect Disord 2024; 360:146-155. [PMID: 38810783 DOI: 10.1016/j.jad.2024.05.132] [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: 01/21/2024] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers. METHODS We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47). RESULTS Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (Rc2). The first combined neuroticism (canonical loading, rs = 0.68), openness (rs = 0.32), impulsivity (rs = 0.29), and conscientiousness (rs = 0.27), with future onset of anxiety symptoms (rs = 0.87) and dieting (rs = 0.58). The other, combined lower agreeableness (rs = -0.60) and lower anxiety sensitivity (rs = -0.47), with future deliberate self-harm (rs = 0.76) and purging (rs = 0.55). Personality profiles associated with "core psychopathology" in both AN (Rc2 = 80.56 %) and BN diagnoses (Rc2 = 64.38 %) comprised hopelessness (rs = 0.95, 0.87) and neuroticism (rs = 0.93, 0.94). For BN, this profile also included impulsivity (rs = 0.60). Additionally, extraversion (rs = 0.41) was associated with lower depressive risk in BN. LIMITATIONS The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample. CONCLUSIONS The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies.
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Affiliation(s)
- Zuo Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Lauren Robinson
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Iain Campbell
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Madeleine Irish
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Marina Bobou
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Jeanne Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Yuning Zhang
- Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, United Kingdom
| | - Sinead King
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom; School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI) Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - M John Broulidakis
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA
| | - Betteke Maria van Noort
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, and AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | | | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Ulrike Schmidt
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom.
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Ladwig G, Tanck JA, Quittkat HL, Vocks S. Risks and benefits of social media trends: The influence of "fitspiration", "body positivity", and text-based "body neutrality" on body dissatisfaction and affect in women with and without eating disorders. Body Image 2024; 50:101749. [PMID: 38850713 DOI: 10.1016/j.bodyim.2024.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 04/30/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
This online experimental study investigates the effects of the social media trends "fitspiration" (images of thin-muscular women promoting health and fitness), "body positivity" (images of larger female bodies motivating women to love their bodies), and "body neutrality" (illustrations encouraging women to appreciate the body's functions) on body dissatisfaction and affect in women with and without eating disorders (ED). Women with (n = 172) and women without ED (n = 210) were randomly assigned to the conditions "fitspiration", "body positivity", and text-based "body neutrality", each comprising the presentation of 30 Instagram posts. Before and after viewing the posts, participants answered state questionnaires on body dissatisfaction and affect. The results revealed that body dissatisfaction increased after viewing "fitspiration" images and decreased after viewing "body positivity" and text-based "body neutrality" posts. Positive affect decreased following exposure to "fitspiration" and text-based "body neutrality" but remained unchanged following "body positivity". Negative affect decreased following "body positivity" and text-based "body neutrality" content but did not change following exposure to "fitspiration". There was no differential effect on women with versus without ED. This study demonstrates harmful effects of "fitspiration" on body image and affect, indicating the need for prevention programs for both women with and without ED.
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Affiliation(s)
- Gritt Ladwig
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany.
| | - Julia A Tanck
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Hannah L Quittkat
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Osnabrück University, Osnabrück, Germany
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3
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Gaiha SM, Wang M, Baiocchi M, Halpern-Felsher B. Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use. Addict Behav 2024; 156:108076. [PMID: 38838604 DOI: 10.1016/j.addbeh.2024.108076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/02/2024] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Few studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis. METHOD Cross-sectional online survey of a national convenience sample of 13-40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13-17-, 18-24-, and 25-40-year-olds. RESULTS Among 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06-1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28-2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35-1.80; <0.001), cigarettes (aOR = 1.24, 1.04-1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51-2.42; <0.001), and blunts (aOR = 1.22, 1.00-1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %). CONCLUSIONS Screening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.
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Affiliation(s)
- Shivani Mathur Gaiha
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States; Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, United States; Faculty of Pediatrics, Harvard Medical School, Boston, United States
| | - Maggie Wang
- Department of Biomedical Data Science, Stanford University, CA, United States
| | - Mike Baiocchi
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States
| | - Bonnie Halpern-Felsher
- Stanford REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, CA, United States.
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Zainal NH, Soh CP, Van Doren N. Daily stress reactivity and risk appraisal mediates childhood parental abuse predicting adulthood psychopathology severity: An 18-year longitudinal mediation analysis. J Affect Disord 2024; 358:138-149. [PMID: 38663555 DOI: 10.1016/j.jad.2024.04.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Identifying mechanisms of childhood abuse-adulthood psychopathology relations could facilitate preventive efforts, but most prior studies used cross-sectional or two-wave designs and did not test the effects of childhood maternal and paternal abuse separately. Our 18-year three-wave study thus determined if Wave 2 daily stress reactivity and risk appraisal severity mediated Wave 1 retrospectively-reported childhood maternal and paternal abuse on Wave 3 generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), alcohol (AUD), and substance use disorder (SUD) self-rated symptom severity. Longitudinal structural equation modeling was employed, adjusting for Wave 1 psychopathology severity. Higher childhood maternal and paternal abuse consistently predicted greater future daily stress reactivity and risk appraisal, and these mediators subsequently predicted increased GAD, MDD, and PD, but not AUD and SUD severity. Daily stress reactivity and risk appraisal consistently mediated the pathways between childhood maternal and paternal abuse predicting heightened adulthood GAD, MDD, and PD (Cohen's d = 0.333-0.888) but not AUD and SUD severity. Mediation effect sizes were stronger for childhood maternal (24.5-83.0%) than paternal (19.5-56.0%) abuse as the predictor. The latent interaction between Wave 1 childhood maternal and paternal abuse did not moderate the effect of Wave 1 maternal or paternal abuse on any Wave 3 adulthood psychopathology severity through Wave 2 daily stress reactivity and risk appraisal. Our research emphasizes the urgent requirement for continuous evaluation and intervention initiatives in trauma-informed care, both in inpatient and outpatient treatment settings.
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Affiliation(s)
- Nur Hani Zainal
- Harvard Medical School, Department of Health Care Policy, United States of America; National University of Singapore, Department of Psychology, Singapore.
| | - Chui Pin Soh
- National University of Singapore, Department of Psychology, Singapore
| | - Natalia Van Doren
- University of California at San Francisco, Department of Psychiatry and Behavioral Sciences, United States of America
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5
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Clark CA, Nakhid D, Baldwin-Oneill G, LaPointe S, MacIsaac-Jones M, Raja S, McMorris CA. Prevalence of co-occurring diagnoses in people exposed to alcohol prenatally: Findings from a meta-analysis. J Affect Disord 2024; 358:163-174. [PMID: 38718944 DOI: 10.1016/j.jad.2024.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis. METHOD A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators. RESULTS 82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders. LIMITATIONS While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE. CONCLUSIONS Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges.
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Affiliation(s)
- C A Clark
- Werklund School of Education, School and Applied Child Psychology, University of Calgary, Canada; Alberta Children's Hospital Research Institute (ACHRI), Canada.
| | - D Nakhid
- Alberta Children's Hospital Research Institute (ACHRI), Canada; Hotchkiss Brain Institute, University of Calgary, Canada
| | | | - S LaPointe
- Department of Psychology, University of Calgary, Canada
| | | | - S Raja
- Department of Psychology, University of Calgary, Canada
| | - C A McMorris
- Werklund School of Education, School and Applied Child Psychology, University of Calgary, Canada; Alberta Children's Hospital Research Institute (ACHRI), Canada; Department of Psychology, University of Calgary, Canada; Hotchkiss Brain Institute, University of Calgary, Canada
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6
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Bogaert L, Hallford D, Loyen E, D'Argembeau A, Raes F. Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools. Behav Res Ther 2024; 179:104543. [PMID: 38744140 DOI: 10.1016/j.brat.2024.104543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
This cluster randomized controlled trial examined the effectiveness of Positive Events Training (PET), a combined group training aimed at simultaneously improving positive autobiographical memory (AM) and episodic future thinking (EFT) among adolescents (12-16 years). Delivered as a universal school-based program, PET was compared with an active (creative writing) control group (CREAT). Effects on resilience, wellbeing, positive emotions, emotional response styles towards positive emotions (savoring, dampening), anhedonia, depressive symptoms, and multiple AM and EFT indices were examined. Adolescents (NPET = 95, NCREAT = 93) completed self-report scales at baseline, post-training and two-month follow-up. Multilevel models revealed that PET led to significant improvements in certain AM and EFT skills. Moreover, a decrease in anhedonia was observed at post-training. However, this effect did not withstand correction for multiple testing. Absence of changes in the other outcomes should be interpreted within the context of the universal school-based approach and the potential limited scope for detectable changes. Exploratory analyses suggest the importance of further investigating PET's potential in addressing positive affect dysregulations in indicated samples, and exploring perceived likelihood of generated future events and dampening as potential underlying mechanisms. Study limitations and future directions to maximize the demonstrated potential of PET are discussed.
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Affiliation(s)
- L Bogaert
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - D Hallford
- School of Psychology, Deakin University, 1 Gheringhap Road, Geelong, Australia
| | - E Loyen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - A D'Argembeau
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Belgium
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
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7
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Pérez-Esteban A, Díez-Gómez A, Pérez-Albéniz A, Al-Halabí S, Lucas-Molina B, Debbané M, Fonseca-Pedrero E. The assessment of transdiagnostic dimensions of emotional disorders: Validation of the Multidimensional Emotional Disorders Inventory (MEDI) in adolescents with subthreshold anxiety and depression. J Affect Disord 2024; 357:138-147. [PMID: 38685278 DOI: 10.1016/j.jad.2024.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/27/2024] [Accepted: 04/21/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The transdiagnostic approach to psychopathology has emerged as an alternative to traditional taxonomic approaches. The Multidimensional Emotional Disorders Inventory (MEDI) is a specifically designed self-report to measure the transdiagnostic dimensions proposed by Brown and Barlow (2009). This study aims to analyse the psychometric properties of the MEDI scores in adolescents with subthreshold anxiety and depression. METHOD The sample consisted of a total of 476 students. The mean age was 13.77 years (SD = 1.43) (range 10 to 18 years), 73.9 % were females. Several questionnaires assessing positive affect, negative affect, mental health difficulties, and quality of life were used. RESULTS The original 9-factor structure of the MEDI was confirmed with good fit indices. Satisfactory levels of internal consistency were observed in most of the MEDI scores using McDonald's Omega, ranging from 0.58 to 0.87. The MEDI dimensions were associated with psychopathology, positive affect, negative affect, and quality of life. LIMITATIONS Reliance on self-reported data, a cross-sectional design limiting temporal assessment, and a 73.9 % female gender imbalance. CONCLUSION The MEDI scores showed adequate psychometric properties among adolescents with subclinical emotional symptoms. The results found might have potential clinical implications for conceptualization, assessment, intervention, and prevention of emotional disorders at both clinical and research levels.
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Affiliation(s)
| | | | | | | | | | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
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Amanvermez Y, Karyotaki E, Cuijpers P, Ciharova M, Bruffaerts R, Kessler RC, Klein AM, Wiers RW, de Wit LM. Sources of stress among domestic and international students: a cross-sectional study of university students in Amsterdam, The Netherlands. ANXIETY, STRESS, AND COPING 2024; 37:428-445. [PMID: 38047318 DOI: 10.1080/10615806.2023.2280701] [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: 04/04/2022] [Accepted: 11/02/2023] [Indexed: 12/05/2023]
Abstract
High perceived stress is associated with psychological and academic difficulties among college students. In this study, we aimed to investigate associations of student status (international vs domestic student in the Netherlands) with eight common sources of stress (i.e., financial, health, love life, relationship with family, relationship with people at work/ school, the health of loved ones, other problems of loved ones, and life in general). Participants were 2,196 college students (domestic: n = 1,642, international: n = 554) from two universities in Amsterdam, the Netherlands. Hierarchical linear regression analyses were used to estimate associations of student status with all eight sources of stress. Student status was significantly associated with higher levels of perceived stress in almost all life domains. International student status was significantly associated with higher perceived stress in the domains of financial situation and health of loved ones after adjusting for sociodemographic characteristics, depressive and anxiety symptoms, and other sources of stress. Findings highlight that several differences exist in the magnitude of perceived stress in certain areas between international and domestic students in the Netherlands. Consequently, it is essential to uncover the different needs of college students and develop specific strategies to deliver the most suitable services.
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Affiliation(s)
- Yagmur Amanvermez
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Anke M Klein
- Developmental and Educational Psychology of the Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Reinout W Wiers
- Addiction, Development, and Psychopathology (ADAPT) Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Leonore M de Wit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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9
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Oliver D, Chesney E, Cullen AE, Davies C, Englund A, Gifford G, Kerins S, Lalousis PA, Logeswaran Y, Merritt K, Zahid U, Crossley NA, McCutcheon RA, McGuire P, Fusar-Poli P. Exploring causal mechanisms of psychosis risk. Neurosci Biobehav Rev 2024; 162:105699. [PMID: 38710421 DOI: 10.1016/j.neubiorev.2024.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/17/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
Robust epidemiological evidence of risk and protective factors for psychosis is essential to inform preventive interventions. Previous evidence syntheses have classified these risk and protective factors according to their strength of association with psychosis. In this critical review we appraise the distinct and overlapping mechanisms of 25 key environmental risk factors for psychosis, and link these to mechanistic pathways that may contribute to neurochemical alterations hypothesised to underlie psychotic symptoms. We then discuss the implications of our findings for future research, specifically considering interactions between factors, exploring universal and subgroup-specific factors, improving understanding of temporality and risk dynamics, standardising operationalisation and measurement of risk and protective factors, and developing preventive interventions targeting risk and protective factors.
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Affiliation(s)
- Dominic Oliver
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - George Gifford
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sarah Kerins
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paris Alexandros Lalousis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Yanakan Logeswaran
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Kate Merritt
- Division of Psychiatry, Institute of Mental Health, UCL, London, UK
| | - Uzma Zahid
- Department of Psychology, King's College London, London, UK
| | - Nicolas A Crossley
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK
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10
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Lannoy S, Ohlsson H, Stephenson M, Sundquist J, Sundquist K, Edwards AC. Mediational pathways between aggregate genetic liability and nonfatal suicide attempt: A Swedish population-based cohort. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32974. [PMID: 38366742 PMCID: PMC11147698 DOI: 10.1002/ajmg.b.32974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/24/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
Despite recent progress in the genetics of suicidal behavior, the pathway by which genetic liability increases suicide attempt risk is unclear. We investigated the mediational pathways from family/genetic risk for suicide attempt (FGRSSA) to suicide attempt by considering the roles of psychiatric illnesses. In a Swedish cohort, we evaluated time to suicide attempt as a function of FGRSSA and the mediational effects of alcohol use disorder, drug use disorder, attention-deficit/hyperactivity disorder, major depression, anxiety disorder, bipolar disorder, and non-affective psychosis. Analyses were conducted by sex in three age periods: 15-25 years (Nfemales = 850,278 and Nmales = 899,366), 26-35 years (Nfemales = 800,189 and Nmales = 861,774), and 36-45 years (Nfemales = 498,285 and Nmales = 535,831). The association between FGRSSA and suicide attempt was mediated via psychiatric disorders. The highest mediation effects were observed for alcohol use disorder in males (15-25 years, HRtotal = 1.60 [1.59; 1.62], mediation = 14.4%), drug use disorder in females (25-36 years, HRtotal = 1.46 [1.44; 1.49], mediation = 11.2%), and major depression (25-36 years) in females (HRtotal = 1.46 [1.44; 1.49], mediation = 7%) and males (HRtotal = 1.50 [1.47;1.52], mediation = 4.7%). While the direct effect of FGRSSA was higher at ages of 15-25, the mediation via psychiatric disorders was more prominent in later adulthood. Our study informs about the psychiatric illnesses via which genetic liability operates to impact suicide attempt risk, with distinct contributions according to age and sex.
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Affiliation(s)
- Séverine Lannoy
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Mallory Stephenson
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
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11
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Fernandez CC, Maddock J, Patalay P, Fett AK, Pitman A, Vaughan L, Krenz K. Proximity to high streets, social isolation and social support in British adolescents: A longitudinal analysis of sociospatial influences on social connectedness using geospatial data. Health Place 2024; 88:103260. [PMID: 38735152 DOI: 10.1016/j.healthplace.2024.103260] [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: 01/31/2024] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
High streets have been shown to be central to socio-economic activity, given their diverse residential, leisure, and commercial activities. This study explores the link between adolescent social isolation and proximity to, and land use mix in, high streets. Hypothesising that greater distance from high streets might increase social isolation, measured via social activities, friend contact frequency, and social support, we used multilevel modelling with data from the Millennium Cohort Study. We did not observe a relationship between proximity to high streets and these social isolation indicators, suggesting that high streets may either not significantly influence adolescent social engagement or that young people are willing to travel greater distances.
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Affiliation(s)
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK
| | - Praveetha Patalay
- MRC Unit for Lifelong Health and Ageing, UCL, London, UK; Centre for Longitudinal Studies, Social Research Institute, UCL, London, UK
| | - Anne-Kathrin Fett
- Department of Psychology, City, University of London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Laura Vaughan
- The Space Syntax Lab, Bartlett School of Architecture, UCL, London, UK
| | - Kimon Krenz
- The Space Syntax Lab, Bartlett School of Architecture, UCL, London, UK
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12
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Adams KL, Mandy W, Catmur C, Bird G. Potential mechanisms underlying the association between feeding and eating disorders and autism. Neurosci Biobehav Rev 2024; 162:105717. [PMID: 38754718 DOI: 10.1016/j.neubiorev.2024.105717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/26/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
There is a reliable association between autism and Feeding and Eating Disorders. Concerningly, where these two conditions co-occur, clinical outcomes of Feeding and Eating Disorders are significantly worse, and treatment less effective, than when the Feeding and Eating Disorders occur in neurotypical individuals. Problematically, the reason for the association between autism and Feeding and Eating Disorders is poorly understood, which constrains advances in clinical care. This paper outlines several possible mechanisms that may underlie the observed association and suggests ways in which they may be empirically tested. Mechanisms are split into those producing an artefactual association, and those reflecting a genuine link between conditions. Artefactual associations may be due to conceptual overlap in both diagnostic criteria and measurement, Feeding and Eating Disorders causing transient autistic traits, or the association being non-specific in nature. A genuine association between autism and Feeding and Eating Disorders may be due to common causal factors, autism directly or indirectly causing Feeding and Eating Disorders, and Feeding and Eating Disorders being a female manifestation of autism.
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Affiliation(s)
- Kiera Louise Adams
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - William Mandy
- Division of Psychology and Language, University College London, London, UK
| | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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13
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Bottenhorn KL, Sukumaran K, Cardenas-Iniguez C, Habre R, Schwartz J, Chen JC, Herting MM. Air pollution from biomass burning disrupts early adolescent cortical microarchitecture development. ENVIRONMENT INTERNATIONAL 2024; 189:108769. [PMID: 38823157 DOI: 10.1016/j.envint.2024.108769] [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: 11/20/2023] [Revised: 05/08/2024] [Accepted: 05/21/2024] [Indexed: 06/03/2024]
Abstract
Exposure to outdoor particulate matter (PM2.5) represents a ubiquitous threat to human health, and particularly the neurotoxic effects of PM2.5 from multiple sources may disrupt neurodevelopment. Studies addressing neurodevelopmental implications of PM exposure have been limited by small, geographically limited samples and largely focus either on macroscale cortical morphology or postmortem histological staining and total PM mass. Here, we leverage residentially assigned exposure to six, data-driven sources of PM2.5 and neuroimaging data from the longitudinal Adolescent Brain Cognitive Development Study (ABCD Study®), collected from 21 different recruitment sites across the United States. To contribute an interpretable and actionable assessment of the role of air pollution in the developing brain, we identified alterations in cortical microstructure development associated with exposure to specific sources of PM2.5 using multivariate, partial least squares analyses. Specifically, average annual exposure (i.e., at ages 8-10 years) to PM2.5 from biomass burning was related to differences in neurite development across the cortex between 9 and 13 years of age.
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Affiliation(s)
- Katherine L Bottenhorn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Department of Psychology, Florida International University, Miami, FL, USA.
| | - Kirthana Sukumaran
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Megan M Herting
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
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14
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Loades ME, Cliffe B, Perry G. Frontline professionals' use of and attitudes towards technology to support interventions for adolescents with depression symptoms: A mixed methods survey. Clin Child Psychol Psychiatry 2024; 29:1087-1099. [PMID: 37931245 PMCID: PMC11188557 DOI: 10.1177/13591045231212523] [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: 11/08/2023]
Abstract
METHOD Cross-sectional survey of a convenience sample of professionals in the UK (N = 115, including low intensity practitioners, GPs, education staff, school nurses). The survey included rating scales and free text boxes. Quantitative data were analysed descriptively, and we used reflexive thematic analysis for the qualitative data. RESULTS Frontline professionals rate their technological competence as good and have favourable attitudes towards using technology to support adolescents with depression symptoms. They rated online resources as most useful with mild-moderate symptoms, compared to severe symptoms (t(110) = 14.54, p < .001, Cohen's d = 1.49). Technology was viewed as important to bridge the needs-access gap and professionals were interested in learning about online SSIs due to usefulness (r = .32, p < .001). CONCLUSION Technology, such as SSIs, are of interest to mental health professionals and may be useful for supporting adolescents with depression. Future research should explore the use of SSIs for treating adolescent depression.
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Affiliation(s)
| | | | - Grace Perry
- Department of Psychology, University of Bath, UK
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15
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Suleri A, Rommel AS, Neumann A, Luo M, Hillegers M, de Witte L, Bergink V, Cecil CAM. Exposure to prenatal infection and the development of internalizing and externalizing problems in children: a longitudinal population-based study. J Child Psychol Psychiatry 2024; 65:874-886. [PMID: 38158849 PMCID: PMC7616076 DOI: 10.1111/jcpp.13923] [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] [Accepted: 09/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND A large body of work has reported a link between prenatal exposure to infection and increased psychiatric risk in offspring. However, studies to date have focused primarily on exposure to severe prenatal infections and/or individual psychiatric diagnoses in clinical samples, typically measured at single time points, and without accounting for important genetic and environmental confounders. In this study, we investigated whether exposure to common infections during pregnancy is prospectively associated with repeatedly assessed child psychiatric symptoms in a large population-based study. METHODS Our study was embedded in a prospective pregnancy cohort (Generation R; n = 3,598 mother-child dyads). We constructed a comprehensive prenatal infection score comprising common infections for each trimester of pregnancy. Child total, internalizing, and externalizing problems were assessed repeatedly using the parent-rated Child Behavioral Checklist (average age: 1.5, 3, 6, 10, and 14 years). Linear mixed-effects models were run adjusting for a range of confounders, including child polygenic scores for psychopathology, maternal chronic illness, birth complications, and infections during childhood. We also investigated trimester-specific effects and child sex as a potential moderator. RESULTS Prenatal exposure to infections was associated with higher child total, internalizing, and externalizing problems, showing temporally persistent effects, even after adjusting for important genetic and environmental confounders. We found no evidence that prenatal infections were associated with changes in child psychiatric symptoms over time. Moreover, in our trimester-specific analysis, we did not find evidence of significant timing effects of prenatal infection on child psychiatric symptoms. No interactions with child sex were identified. CONCLUSIONS Our research adds to evidence that common prenatal infections may be a risk factor for psychiatric symptoms in children. We also extend previous findings by showing that these associations are present early on, and that rather than changing over time, they persist into adolescence. However, unmeasured confounding may still explain in part these associations. In the future, employing more advanced causal inference designs will be crucial to establishing the degree to which these effects are causal.
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Affiliation(s)
- Anna Suleri
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mannan Luo
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lotje de Witte
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Charlotte A. M. Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Biomedical Data Sciences, Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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16
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Reed SE, Kerr DCR, Snyder FJ. Latent profile analysis of college students' alcohol and cannabis co-use patterns after recreational cannabis legalization. Addict Behav 2024; 154:108021. [PMID: 38520816 DOI: 10.1016/j.addbeh.2024.108021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE Evidence is mixed on how young adults' cannabis and alcohol use and co-use patterns have changed following recreational cannabis legalization (RCL). Incorporating measures of frequency and intensity of use we examined changes in college students' use and co-use patterns following RCL. METHOD Four-year college students (n = 845,589) ages 18-24 years participated in the National College Health Assessment between 2008 and 2018, including students from 7 states that enacted RCL and 42 that did not. Latent profile analyses identified six patterns of use from four indicator variables tapping frequency of cannabis use and frequency and intensity of alcohol use: Abstainers, Light Alcohol Only, Heavy Alcohol Only, Predominantly Heavy Cannabis Use, Moderate Co-use, and Heavy Co-use. RESULTS Regression models that adjusted for time and person- and institution-level covariates indicated that students' exposure to RCL was associated with lower odds of being in the two alcohol-only use classes, higher odds of being in the Predominantly Heavy Cannabis Use, Heavy Co-Use and Abstainers classes, and was not significantly related to Moderate Co-Use class membership. CONCLUSIONS RCL was positively associated with patterns of frequent cannabis use and frequent and intense co-use but also with abstinence. Use of alcohol-only became less prevalent after RCL. Research on how RCL influences the prevalence of problematic patterns of substance use will inform and improve prevention efforts.
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17
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O’Shea J, James R, Nicholls D, Downs J, Hudson LD. Prevalence, severity and risk factors of psychiatric disorders amongst sexual and gender diverse young people during the COVID-19 pandemic: A systematic review. Clin Child Psychol Psychiatry 2024; 29:1213-1227. [PMID: 38290723 PMCID: PMC11188558 DOI: 10.1177/13591045241229751] [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: 02/01/2024]
Abstract
Before the COVID-19 pandemic, the prevalence and severity of psychiatric disorders among sexual and gender diverse (SGD) young people was greater than in their heterosexual/cisgender peers. We systematically reviewed literature examining the prevalence, severity, and risk factors for psychiatric disorders among SGD young people aged 25 and under during the pandemic. Four databases (MEDLINE, PsycInfo, Scopus and Web of Science) were searched. Eligibility criteria were studies assessing prevalence rates, mean symptomology scores and risk factors of psychiatric disorders using contemporaneous screening measures or diagnosis. Thirteen studies of mixed quality were identified. Most studies indicated SGD young people were at high risk of experiencing several psychiatric disorders including depressive and generalised anxiety disorder compared to the general population. This group also experienced more severe symptomology of various psychiatric disorders compared to their heterosexual/cisgender peers. Risk factors included those specific to the pandemic along with factors that led to greater risk before the pandemic. This systematic review has indicated evidence of heightened risk of psychiatric disorders among SGD young people during the COVID-19 pandemic. It is important for clinicians to acknowledge the needs of SGD young people, working with them to co-develop more inclusive care as they deal with the pandemic's fallout.
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Affiliation(s)
- Jonathan O’Shea
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Rachel James
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, UK
| | - James Downs
- Faculty of Eating Disorders, Royal College of Psychiatrists, UK
| | - Lee D Hudson
- Population, Policy and Practice Department, UCL GOS Institute of Child Health, UK
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18
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Sheikh A, Jacob J, Vostanis P, Ruby F, Spuerck I, Stankovic M, Morgan N, Mota CP, Ferreira R, Eruyar Ş, Yılmaz EA, Fatima SZ, Edbrooke-Childs J. What Should Personalised Mental Health Support Involve? Views of Young People with Lived Experience and Professionals from Eight Countries. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01382-2. [PMID: 38907740 DOI: 10.1007/s10488-024-01382-2] [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: 04/23/2024] [Indexed: 06/24/2024]
Abstract
Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14-24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities.
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Affiliation(s)
| | - Jenna Jacob
- Anna Freud, 4-8 Rodney Street, London, N1 9JH, UK.
- Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Panos Vostanis
- School of Media, Communication and Sociology, University of Leicester, University Road, Leicester, UK
| | | | - Inga Spuerck
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Milos Stankovic
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Nicholas Morgan
- Euro Youth Mental Health, The Carling Building, Coopers Yard, Off, Market Pl, Hitchin, SG5 1AR, UK
| | - Catarina Pinheiro Mota
- University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
- Center for Psychology, University of Porto, Porto, Portugal
| | - Rúben Ferreira
- University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
| | - Şeyda Eruyar
- Department of Psychology, Necmettin Erbakan University, Köyceğiz, Meram, Konya, 42140, Turkey
| | - Elmas Aybike Yılmaz
- Department of Psychology, Necmettin Erbakan University, Köyceğiz, Meram, Konya, 42140, Turkey
| | - Syeda Zeenat Fatima
- Hussaini Foundation-Child and Adolescent Development Program, Karachi, Pakistan
| | - Julian Edbrooke-Childs
- Anna Freud, 4-8 Rodney Street, London, N1 9JH, UK
- Clinical, Educational and Health Psychology, University College London, London, UK
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19
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Milbourn H, McCartney D, Richmond A, Campbell A, Flaig R, Robertson S, Fawns-Ritchie C, Hayward C, Marioni RE, McIntosh AM, Porteous DJ, Whalley HC, Sudlow C. Generation Scotland: an update on Scotland's longitudinal family health study. BMJ Open 2024; 14:e084719. [PMID: 38908846 DOI: 10.1136/bmjopen-2024-084719] [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: 06/24/2024] Open
Abstract
PURPOSE Generation Scotland (GS) is a large family-based cohort study established as a longitudinal resource for research into the genetic, lifestyle and environmental determinants of physical and mental health. It comprises extensive genetic, sociodemographic and clinical data from volunteers in Scotland. PARTICIPANTS A total of 24 084 adult participants, including 5501 families, were recruited between 2006 and 2011. Within the cohort, 59% (approximately 14 209) are women, with an average age at recruitment of 49 years. Participants completed a health questionnaire and attended an in-person clinic visit, where detailed baseline data were collected on lifestyle information, cognitive function, personality traits and mental and physical health. Genotype array data are available for 20 026 (83%) participants, and blood-based DNA methylation (DNAm) data for 18 869 (78%) participants. Linkage to routine National Health Service datasets has been possible for 93% (n=22 402) of the cohort, creating a longitudinal resource that includes primary care, hospital attendance, prescription and mortality records. Multimodal brain imaging is available in 1069 individuals. FINDINGS TO DATE GS has been widely used by researchers across the world to study the genetic and environmental basis of common complex diseases. Over 350 peer-reviewed papers have been published using GS data, contributing to research areas such as ageing, cancer, cardiovascular disease and mental health. Recontact studies have built on the GS cohort to collect additional prospective data to study chronic pain, major depressive disorder and COVID-19. FUTURE PLANS To create a larger, richer, longitudinal resource, 'Next Generation Scotland' launched in May 2022 to expand the existing cohort by a target of 20 000 additional volunteers, now including anyone aged 12+ years. New participants complete online consent and questionnaires and provide postal saliva samples, from which genotype and salivary DNAm array data will be generated. The latest cohort information and how to access data can be found on the GS website (www.generationscotland.org).
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Affiliation(s)
- Hannah Milbourn
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
- Centre for Medical Informatics, Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher, Edinburgh, UK
| | - Daniel McCartney
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Anne Richmond
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Archie Campbell
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Robin Flaig
- Centre for Medical Informatics, Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher, Edinburgh, UK
| | - Sarah Robertson
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
- Centre for Medical Informatics, Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher, Edinburgh, UK
| | - Chloe Fawns-Ritchie
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
- Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - Caroline Hayward
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Andrew M McIntosh
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - David J Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Heather C Whalley
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
- Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher, Edinburgh, UK
| | - Cathie Sudlow
- Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher, Edinburgh, UK
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20
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Deane AE, Elmore JS, Mayes TL, Robinson S, AlZubi Y, Wakefield SM, Trivedi MH. Shifting From Best Practice to Standard Practice: Implementing Measurement-Based Care in Health Systems. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01715-0. [PMID: 38896285 DOI: 10.1007/s10578-024-01715-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/21/2024]
Abstract
There is a high prevalence of untreated depression in adults and youth observed at the population level in the United States, and many who would benefit from treatment do not receive it. One proposed effort to increase access to care is the use of measurement-based care (MBC; repeated use of symptom measures for screening and treatment guidance) by primary care physicians to treat non-complex cases of depression. MBC has been shown to improve patient outcomes compared to care as usual, but there are barriers that need to be addressed at the health system level for effective implementation to occur. Herein we provide an overview of MBC and detail benefits and barriers of MBC implementation. Relevant considerations and guidance for implementing MBC are presented, and a case example of a health system implementing MBC is included. Though issues of reimbursement, limited human and technological resources, and resistance to systemic change are barriers to implementing MBC, effective strategies exist to overcome these barriers. In addition to helping health systems align with changes to value-based care models, effective implementation of MBC can likely improve patient outcomes and result in net financial benefits.
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Affiliation(s)
- Amber E Deane
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA
| | - Joshua S Elmore
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA
| | - Skylar Robinson
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA
| | - Yasmin AlZubi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9119, USA.
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21
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Postma MR, Vrancken S, Daemen M, Meulen IHVD, Volbragt N, Delespaul P, Haan LD, Pluijm MVD, Breedvelt JJF, Gaag MVD, Lindauer R, Berg DVD, Bockting C, Amelsvoort TV, Schwannauer M, Doi L, Reininghaus U. Working mechanisms of the use and acceptability of ecological momentary interventions: a realist evaluation of a guided self-help ecological momentary intervention targeting self-esteem. BMC Public Health 2024; 24:1633. [PMID: 38898412 PMCID: PMC11186172 DOI: 10.1186/s12889-024-19143-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of ecological momentary interventions might generate insights to improve interventions. METHODS The present study investigates the working mechanisms of the use and acceptability of an ecological momentary intervention, named SELFIE, targeting self-esteem in youth exposed to childhood trauma, and evaluates under what circumstances these mechanisms of use and acceptability do or do not come into play. A realist evaluation approach was used for developing initial program theories (data: expert interviews and a stakeholders focus group), and subsequently testing (data: 15 interviews with participants, a focus group with therapists, debriefing questionnaire), and refining them. RESULTS The SELFIE intervention is offered through a smartphone application enabling constant availability of the intervention and thereby increasing accessibility and feasibility. When the intervention was offered on their personal smartphone, this enhanced a sense of privacy and less hesitance in engaging with the app, leading to increased disclosure and active participation. Further, the smartphone application facilitates the practice of skills in daily life, supporting the repeated practice of exercises in different situations leading to the generalizability of the effect. Buffering against technical malfunction seemed important to decrease its possible negative effects. CONCLUSIONS This study enhanced our understanding of possible working mechanisms in EMIs, such as the constant availability supporting increased accessibility and feasibility, for which the use of the personal smartphone was experienced as a facilitating context. Hereby, the current study contributes to relatively limited research in this field. For the field to move forward, mechanisms of use, and acceptability of EMIs need to be understood. It is strongly recommended that alongside efficacy trials of an EMI on specific target mechanisms, a process evaluation is conducted investigating the working mechanisms of use. TRIAL REGISTRATION The current paper reports on a realist evaluation within the SELFIE trial (Netherlands Trial Register NL7129 (NTR7475)).
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Affiliation(s)
- Mary Rose Postma
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands.
- Mondriaan Mental Health Center, Heerlen, The Netherlands.
| | | | - Maud Daemen
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
| | | | - Nele Volbragt
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
- Mondriaan Mental Health Center, Heerlen, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Marieke van der Pluijm
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Josefien Johanna Froukje Breedvelt
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, London, UK
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
| | - Ramon Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location Academic Medical Center, Amsterdam, The Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
- Parnassia Academy, The Hague, The Netherlands
| | - Claudi Bockting
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropychology, School for Mental Health and Neuroscience, Maastricht University, Vijverdalseweg 1, Maastricht, 6226 NB, the Netherlands
- Mondriaan Mental Health Center, Heerlen, The Netherlands
| | | | - Lawrence Doi
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Ulrich Reininghaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, UK
- Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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22
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Correll CU, Arango C, Fagiolini A, Giordano GM, Leucht S, Salazar de Pablo G. Finding the Right Setting for the Right Treatment During the Acute Treatment of Individuals with Schizophrenia: A Narrative Review and Clinical Practice Guideline. Neuropsychiatr Dis Treat 2024; 20:1293-1307. [PMID: 38911102 PMCID: PMC11194005 DOI: 10.2147/ndt.s459450] [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: 01/13/2024] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Background Schizophrenia is most times a chronic and often debilitating illness associated with poor mental health outcomes. Early and effective treatment of schizophrenia in the most appropriate setting can make a significant difference in the long-term recovery. The aim of this narrative review was to provide suggestions and recommendations for effectively managing patients with schizophrenia during acute exacerbations and to enhance awareness and skills related to personalized medicine. Methods A panel of academics and clinicians with experience in the field of psychosis met virtually on July 13th 2023 to narratively review and discuss the research evidence and their clinical experience about the most appropriate acute treatments for patients with schizophrenia. This manuscript represents a synthesis of the panel analysis and discussion. Results First contact is very important for service users, as is finding the most adequate treatment setting. If patients present to the emergency department, which may be a traumatic setting for service users, a dedicated environment with adequate space and specialized mental health support, including personnel trained in de-escalation techniques, is recommended. A well-connected continuum of care is strongly recommended, possibly with seamless links between inpatient units, day hospital services, outpatient facilities and rehabilitation services. Ideally, this should be structured as part of a coordinated step-down service line. Treatment challenges include suboptimal response, side effects, and nonadherence, which is reduced by the use of long-acting injectable antipsychotics. Conclusion Individual circumstances, including age, gender, and presence of hostility/aggression or self-harm, cognitive impairment and negative symptoms, comorbidities (depression, substance use disorders) or associated symptoms (anxiety, insomnia), should be considered when selecting the most appropriate treatment for the acute phase of schizophrenia. Efficacy and feasibility, as well as acceptability and tolerability of treatments, require joint consideration from the early stages of schizophrenia, thereby enhancing the possibility of improved short- and long-term outcomes.
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Affiliation(s)
- Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Andrea Fagiolini
- Department of Molecular Medicine, School of Medicine, University of Siena, Siena, Italy
| | | | - Stefan Leucht
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
- Technical University of Munich, TUM School of Medicine and Health, Department of Psychiatry and Psychotherapy, Munich, Germany
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
- Child and Adolescent Mental Health Services (CAMHS) South London and Maudsley NHS Foundation Trust London, London, UK
- Department of Child and Adolescent Psychiatry Institute of Psychiatry, Psychology & Neuroscience King’s College London, London, UK
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23
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López del Hoyo Y, Elices M, Garcia-Campayo J. Mental health in the virtual world: Challenges and opportunities in the metaverse era. World J Clin Cases 2024; 12:2939-2945. [PMID: 38898837 PMCID: PMC11185398 DOI: 10.12998/wjcc.v12.i17.2939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 06/04/2024] Open
Abstract
Current rates of mental illness are worrisome. Mental illness mainly affects females and younger age groups. The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality, augmented reality, and artificial intelligence. A new three dimensional digital environment, known as the metaverse, has emerged as the next version of the Internet. Artificial intelligence, augmented reality, and virtual reality will create fully immersive, experiential, and interactive online environments in the metaverse. People will use a unique avatar to do anything they do in their "real" lives, including seeking and receiving mental health care. In this opinion review, we reflect on how the metaverse could reshape how we deliver mental health treatment, its opportunities, and its challenges.
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Affiliation(s)
| | - Matilde Elices
- Mental Health Research Group, Hospital del Mar Medical Research Institute, Barcelona 08003, Spain
| | - Javier Garcia-Campayo
- Department of Psychiatry, Miguel Servet Hospital, Aragon Institute for Health Research, University of Zaragoza, Zaragoza 50009, Spain
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24
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Ferrara M, Domenicano I, Marchi A, Zaffarami G, Onofrio A, Benini L, Sorio C, Gentili E, Murri MB, Toffanin T, Little J, Grassi L. First episode psychoses in people over-35 years old: uncovering potential actionable targets for early intervention services. Psychiatry Res 2024; 339:116034. [PMID: 38906051 DOI: 10.1016/j.psychres.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/25/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
The traditional youth-oriented design of Early Intervention Services (EIS) may lead to the exclusion of patients who have their psychotic onset later in life. A retrospective study was conducted to compare first-episode psychosis (FEP) patients who accessed treatment when aged ≤ 35 years with those ≥36+. A total of 854 patients were identified among 46,222 individuals who had access to community psychiatric services from 1991 to 2021. FEP were aged 18-65, received care between 2012 and 2021 and had a diagnosis of affective or non-affective FEP. Two groups were identified (FEP diagnosed at age ≤ 35 vs ≥ 36) and compared for sociodemographic and clinical characteristics. Most patients were diagnosed when aged ≥ 36+ (61.8%). Compared to the ≤ 35 group, older patients were more likely to be women, married and diagnosed with affective psychosis, and they were less frequently hospitalized. Long-acting injectables antipsychotics (LAI) were less frequently prescribed in the ≥ 36+ group, whereas antidepressants were more frequently prescribed compared to those aged ≤ 35. In both age groups, women were less frequently prescribed LAIs compared to men. These findings highlight the need to reorient EIS to accommodate the needs of older FEP, especially women.
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Affiliation(s)
- Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Psychiatry, Yale School of Medicine, New Haven CT, USA; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy.
| | - Ilaria Domenicano
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Aurora Marchi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giulia Zaffarami
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Alice Onofrio
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Lorenzo Benini
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Cristina Sorio
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | | | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Julian Little
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
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25
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Miles AE, Rashid SS, Dos Santos FC, Clifford KP, Sibille E, Nikolova YS. Neurodevelopmental signature of a transcriptome-based polygenic risk score for depression. Psychiatry Res 2024; 339:116030. [PMID: 38909414 DOI: 10.1016/j.psychres.2024.116030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/31/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024]
Abstract
Disentangling the molecular underpinnings of major depressive disorder (MDD) is necessary for identifying new treatment and prevention targets. The functional impact of depression-related transcriptomic changes on the brain remains relatively unexplored. We recently developed a novel transcriptome-based polygenic risk score (tPRS) composed of genes transcriptionally altered in MDD. Here, we sought to investigate effects of tPRS on brain structure in a developmental cohort (Adolescent Brain Cognitive Development study; n = 5124; 2387 female) at baseline (9-10 years) and 2-year follow-up (11-12 years). We tested associations between tPRS and Freesurfer-derived measures of cortical thickness, cortical surface area, and subcortical volume. Across the whole sample, higher tPRS was significantly associated with thicker left posterior cingulate cortex at both baseline and 2-year follow-up. In females only, tPRS was associated with lower right hippocampal volume at baseline and 2-year follow-up, and lower right pallidal volume at baseline. Furthermore, regional subcortical volume significantly mediated an indirect effect of tPRS on depressive symptoms in females at both timepoints. Conversely, tPRS did not have significant effects on cortical surface area. These findings suggest the existence of a sex-specific neurodevelopmental signature associated with shifts towards a more depression-like brain transcriptome, and highlight novel pathways of developmentally mediated MDD risk.
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Affiliation(s)
- Amy E Miles
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Sarah S Rashid
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Fernanda C Dos Santos
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kevan P Clifford
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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26
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Kong L, Nivins S, Chen X, Liang Y, Gissler M, Lavebratt C. Association of preterm birth and birth size status with neurodevelopmental and psychiatric disorders in spontaneous births. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02489-5. [PMID: 38866929 DOI: 10.1007/s00787-024-02489-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
Preterm birth (PTB) or small birth size are risk factors for certain neurodevelopmental disorders. The magnitude of these associations in spontaneous births, and of associations for combined PTB and birth size status on neurodevelopmental and psychiatric disorders is unexplored. We investigated whether PTB and small/large for gestational age (SGA/LGA), separately or combined, in spontaneous births, are associated with a wide spectrum of neurodevelopmental and psychiatric disorders. In this population-based registry cohort study, all singleton spontaneous births in Finland from 1996 to 2014 were followed until 2018 (n = 819 764). We show that PTB across gestational ages, and SGA, were associated with higher risks for anxiety disorders, intellectual disabilities, specific developmental disorders (SDD), autism spectrum disorders (ASD), attention-deficit/hyperactivity disorders (ADHD) and other emotional and behavioural disorders (F98). Most of these associations were not attributed to familial factors. Larger effect sizes were observed with lower gestational ages. Extremely PTB was associated at highest risks with intellectual disabilities (HR, 10.70 [95%CI, 8.69-13.17]) and SDD (HR, 8.91 [95%CI, 8.18-9.71]). Moreover, very preterm birth combined with SGA was associated with a higher risk for SDD (HR, 7.55 [95%CI, 6.61-8.62]) than that of very preterm or SGA birth alone. Conversely, LGA birth lowered the risk for SDD and other emotional and behavioural disorders among individuals born very preterm. In conclusion, PTB along with SGA is associated with higher risks for SDD than one exposure alone, whereas LGA lowers the risks for SDD and other emotional and behavioural disorders in individuals born spontaneously.
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Affiliation(s)
- Linghua Kong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Shandong, China
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Samson Nivins
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Xinxia Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Shandong, China
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mika Gissler
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
- Translational Psychiatry Unit, Centre for Molecular Medicine, L8:00, Karolinska University Hospital, 171 76, Stockholm, Sweden.
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27
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Lee CMY, Chai K, McEvoy PM, Graham-Schmidt K, Rock D, Betts KS, Manuel J, Coleman M, Meka S, Alati R, Robinson S. Patterns of Mental Health Service Utilisation: A Population-Based Linkage of Over 17 Years of Health Administrative Records. Community Ment Health J 2024:10.1007/s10597-024-01300-8. [PMID: 38865031 DOI: 10.1007/s10597-024-01300-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/20/2024] [Indexed: 06/13/2024]
Abstract
A cross-sectoral partnership was formed in 2021 in support of the recommendations in an audit on access to state-funded mental health services. In this first paper, we aimed to describe the demographic and service utilisation of adults with a mental health diagnosis in the Western Australian state-funded health system from 2005 to 2021. Inpatient, emergency department, specialised (ambulatory) community mental health service, and death records were linked in individuals aged ≥ 18 years with a mental health diagnosis in Western Australia. Altogether, 392,238 individuals with at least one mental health service contact between 1st January 2005 and 31st December 2021 were included for analysis. Females, Aboriginal and/or Torres Strait Islander people, and those who lived outside major cities or in the most disadvantaged areas were more likely to access state-funded mental health services. While the number of individuals who accessed community mental health services increased over time (from 28,769 in 2005 to 50,690 in 2021), the percentage increase relative to 2005 was notably greater for emergency department attendances (127% for emergency department; 76% for community; and 63% for inpatient). Conditions that contributed to the increase for emergency department were mainly alcohol disorder, reaction to severe stress and adjustment disorders, and anxiety disorders. Sex differences were observed between conditions. The pattern of access increased for emergency department and the community plus emergency department combination. This study confirmed that the patterns of access of state-funded mental health services have changed markedly over time and the potential drivers underlying these changes warrant further investigation.
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Affiliation(s)
| | - Kevin Chai
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Peter M McEvoy
- School of Population Health, Curtin University, Perth, WA, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, WA, Australia
| | | | - Daniel Rock
- WA Primary Health Alliance, Perth, WA, Australia
- Discipline of Psychiatry, Medical School, University of Western Australia, Perth, WA, Australia
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Kim S Betts
- School of Population Health, Curtin University, Perth, WA, Australia
| | | | | | - Shiv Meka
- East Metropolitan Health Service, Perth, WA, Australia
| | - Rosa Alati
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Suzanne Robinson
- Deakin Health Economics, Deakin University, Melbourne, VIC, Australia
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28
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Crump CJ, Abuelazm H, Ibrahim K, Shah S, El-Mallakh RS. An overview of the efficacy and safety of brexpiprazole for the treatment of schizophrenia in adolescents. Expert Rev Neurother 2024. [PMID: 38864423 DOI: 10.1080/14737175.2024.2367695] [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: 09/26/2023] [Accepted: 06/10/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Onset of psychotic symptoms occurs prior to age 19 in 39% of patients with schizophrenia. There are limited approved treatment options for adolescents with schizophrenia. Brexpiprazole was approved by the United States Food and Drug Administration (FDA) for treatment of schizophrenia in adolescents in 2022. AREAS COVERED Extrapolation of adult data to youth and use of pharmacologic modeling coupled with open long-term safety data were used by the FDA to approve brexpiprazole for adolescent schizophrenia. These were all reviewed herein. EXPERT OPINION D2 receptor partial agonist antipsychotic agents are preferred in the early phase of treatment of psychotic disorders. Approval of brexpiprazole in adolescent schizophrenia provides an additional option. Brexpiprazole was approved by the FDA on the basis of extrapolation of adult data without controlled trials in adolescents. This reduces placebo exposure in young people. Two previous agents (asenapine and ziprasidone) approved for adult schizophrenia failed to separate from placebo in adolescent schizophrenia studies; this partially undermines the process of extrapolation. For brexpiprazole, the paucity of data in adolescents relegates it to second-line agent. More research on brexpiprazole is needed to delineate its relative role in the management of adolescent schizophrenia.
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Affiliation(s)
- Chesika J Crump
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Hagar Abuelazm
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kirolos Ibrahim
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Shaishav Shah
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
| | - Rif S El-Mallakh
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA
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Treves N, Yakirevich-Amir N, Abu Ahmad W, Bonne O, Davidson E, Keeling K, Hall B, Dautrich T, Matok I. Characterization of Cannabis users and products and the experience of negative mental emotions following Cannabis use. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01812-0. [PMID: 38861239 DOI: 10.1007/s00406-024-01812-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 04/19/2024] [Indexed: 06/12/2024]
Abstract
There is a potential link between cannabis and mental disorders. Cannabis exposure involves in many cases negative mental emotions, which are unpleasant sensations or thoughts. Whereas mild cases of negative mental emotions inflict patient's quality of life, more severe cases lead to therapy discontinuations, or even hospitalizations and death. This study characterizes cannabis users who experienced negative mental emotions after cannabis exposure. The Releaf App database was utilized to evaluate the association between personal and cannabis use characteristics on reporting a negative mental emotion during cannabis exposure. This global mobile lets individuals track real-time cannabis experience use with cannabinoid-based products, containing data points such as gender, age, reasons for use, product type, cannabis composition, and feelings and emotions experienced after cannabis use. Multivariable logistic regression models were constructed, adjusting for potential confounders such as gender and previous experience with cannabis use. The study population comprised 4,435 users, and 34,279 sessions were collected from various countries, mainly from North America, and included in the primary analysis. Reporting on negative mental emotions was associated with users in the age group of 18-30 years. Using cannabis for a mental purpose was associated with a small increase in reporting on negative mental emotions (OR = 1.10, 95%CI [1.03-1.19]). Oral products were associated with reporting on negative mental emotions. THC-dominant products were associated with reporting negative mental emotions compared to balanced products (OR = 1.21, 95%CI [1.06-1.38]). This study suggests that some characteristics of cannabis use, such as young age and oral consumption are associated with negative mental emotions. Further studies should examine the interface between cannabis consumption, characteristics of consumers, and negative emotional experience or even long-term mental disorders.
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Affiliation(s)
- Nir Treves
- Division of Clinical Pharmacy, School of Pharmacy, The Hebrew University, Jerusalem, Israel.
| | - Noa Yakirevich-Amir
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Wiessam Abu Ahmad
- Hebrew University, Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Elyad Davidson
- Department of Anesthesia CCM and Pain Management, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - Branden Hall
- MoreBetter, Ltd. (dba Releaf App), Hyattsville, MD, USA
| | | | - Ilan Matok
- Division of Clinical Pharmacy, School of Pharmacy, The Hebrew University, Jerusalem, Israel
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Inman EM, Nkala-Dlamini B, Violari A, Kidman R. HIV Stigma, Health, and Violence: A Longitudinal Study among Adolescent Boys with HIV in Soweto, South Africa. AIDS Behav 2024:10.1007/s10461-024-04407-x. [PMID: 38856845 DOI: 10.1007/s10461-024-04407-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/11/2024]
Abstract
There are over 1.4 million adolescents living with HIV in sub-Saharan Africa, the majority of whom acquired the virus through perinatal transmission (PHIV). HIV stigma is particularly high among adolescents living with HIV and is associated with several outcomes that worsen health and increase the risk of onward HIV transmission. We tested associations between internalized HIV stigma and four of these outcomes over a one-year period among a sample of adolescent boys living with PHIV in Soweto, South Africa. Participants (N = 241) answered questions about internalized HIV stigma at baseline. They completed weekly mobile surveys over the following year to answer questions about their experiences with depression, binge drinking, medication adherence, and violence victimization. Using generalized linear mixed models, we found that baseline internalized HIV stigma was associated with increased odds of depression (OR 1.74), alcohol misuse (OR 2.09), and violence victimization (OR 1.44) and decreased odds of medication adherence (OR 0.60) over the course of a year. These outcomes negatively impact the health and wellbeing of adolescents living with PHIV and increase their risk of transmitting HIV to their partners in the future. Our findings provide novel, longitudinal evidence for the deleterious effects of HIV stigma. To improve health outcomes for adolescents with PHIV, it will be crucial to develop effective HIV stigma reduction interventions that address specific developmental, gendered, and cultural experiences.
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Affiliation(s)
- Elizabeth M Inman
- Program in Public Health, State University of New York at Stony Brook, Stony Brook, NY, 11794, USA.
| | - Busisiwe Nkala-Dlamini
- Department of Social Work, Faculty of Humanities, University of the Witwatersrand, Johannesburg, 2000, South Africa
| | - Avy Violari
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 1864, South Africa
| | - Rachel Kidman
- Program in Public Health, State University of New York at Stony Brook, Stony Brook, NY, 11794, USA
- Department of Family, Population and Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY, 11794, USA
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Wittevrongel E, Kessels R, Everaert G, Vrijens M, Danckaerts M, van Winkel R. A user perspective on youth mental health services: Increasing help-seeking behaviour requires addressing service preferences and attitudinal barriers. Early Interv Psychiatry 2024. [PMID: 38853403 DOI: 10.1111/eip.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
AIM Although the incidence of mental health problems is highest in young people, the majority do not seek help. Reducing the discrepancy between need for care and access to services requires an understanding of the user perspective, which is largely lacking. This study aimed to examine preferences for mental health service attributes and their relative importance among young people, as well as the potential impact on actual help-seeking intentions. METHODS Youth aged 16-24 years (N = 258) participated in a discrete choice experiment. In addition to choosing which service would suit their needs most out of two service options in nine choice sets, participants were asked whether they would consult the chosen service in the case of mental health problems. Demographic information was also collected, as well as their current mental health status, experience with and perceived barriers to care. Panel mixed logit models were estimated. RESULTS Young people's preferences were mostly driven by the attribute 'format', with a preference for individual rather than group therapy. Other attributes, in order of importance, were 'wait times' (short), 'cost' (low), 'healthcare professionals' expertise' (particular experience with working with youth aged 12 to 25 years), and 'location' (house in a city). However, a majority of young people would not consult the service they had indicated, mainly due to attitudinal barriers such as wanting to deal with problems on their own (self-reliance). CONCLUSIONS Addressing psychological barriers to access care should be a priority in mental health policies. Furthermore, entry point services, in particular, should be able to provide the option of individual treatment.
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Affiliation(s)
- Eline Wittevrongel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
| | - Roselinde Kessels
- Department of Data Analytics and Digitalization, Maastricht University, Maastricht, The Netherlands
- Department of Economics, University of Antwerp, Antwerp, Belgium
| | - Geert Everaert
- Neuro-Psychiatric Clinic Saint Joseph V.Z.W, Pittem, Belgium
| | - May Vrijens
- Asster Psychiatric Hospital, Sint-Truiden, Belgium
| | - Marina Danckaerts
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Developmental Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Centre for Clinical Psychiatry, Leuven, Belgium
- KU Leuven, University Psychiatric Centre (UPC), Leuven, Belgium
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Courbet O, Daviot Q, Kalamarides V, Habib M, Villemonteix T. Promoting Psychological Well-being in Preschoolers Through Mindfulness-based Socio-emotional Learning: A Randomized-controlled Trial. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01220-x. [PMID: 38850462 DOI: 10.1007/s10802-024-01220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/10/2024]
Abstract
Mental health issues in children and young people are frequent and can have enduring negative consequences. Preventive early interventions delivered at school may foster psychological well-being, and preliminary evidence suggests that mindfulness-based social and emotional learning (SEL) interventions have positive effects on children's mental health. The aim of this study was to evaluate a mindfulness-based SEL curriculum including a French adaptation of the Kindness Curriculum (KC), delivered by pre-kindergarten teachers, in a cluster randomized control trial. Sixty-four classes (761 children, aged 38-58 months) from a socio-economically disadvantaged area in France were randomly assigned to either intervention or waiting-list control conditions. Indicators of children's mental health, self-management, positive relationships with teachers and peers, emotional processing and executive functioning were collected through teacher-rated questionnaires, standardized observations, and behavioral tasks. Results in the whole sample indicated a positive effect of the intervention on children's mental health, including a reduction in emotional, conduct and peer relationship problems, and a reduction in teacher-child conflicts. No significant effects were found on the other indicators. Heterogeneity analyses revealed stronger effects of the intervention on several indicators for children who had a teacher with lower level of teaching experience, for children with lower baseline mental health and for older children. This program therefore appears as a promising early school-based intervention promoting mental health and positive relationships, especially in a subgroup of at-risk preschool-aged children.
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Affiliation(s)
- Ophélie Courbet
- Laboratory of Psychopathology and Processes of Change [LPPC], Université Paris 8 - Paris Lumières [UPL], Saint-Denis, France
| | - Quentin Daviot
- Abdul Latif Jameel Poverty Action Lab [J-PAL], Paris School of Economics, Paris, France
| | - Victoire Kalamarides
- Laboratory of Psychopathology and Processes of Change [LPPC], Université Paris 8 - Paris Lumières [UPL], Saint-Denis, France
| | - Marianne Habib
- DysCo Laboratory, Université Paris 8 - Paris Lumières [UPL], Saint-Denis, France
| | - Thomas Villemonteix
- Laboratory of Psychopathology and Processes of Change [LPPC], Université Paris 8 - Paris Lumières [UPL], Saint-Denis, France.
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Wang J, Wang T, Cheng Y. Resilience as a moderator of the relationship between stress and different symptom dimensions of depression in adolescents with a history of childhood maltreatment: A multi-wave longitudinal study. CHILD ABUSE & NEGLECT 2024; 154:106888. [PMID: 38850746 DOI: 10.1016/j.chiabu.2024.106888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Although childhood maltreatment is a key risk factor for the development of psychopathology including depression in later life, not all children who have been maltreated subsequently become depressed. OBJECTIVE The study aimed to examine the potentially moderating influence of resilience on the relationship between daily stress and different symptom dimensions of depression in adolescents with a history of childhood maltreatment. PARTICIPANTS AND SETTING A sample of students (n = 999) aged 12-16 years from middle schools with a history of childhood maltreatment participated in this study. METHODS A multi-wave longitudinal study was conducted over 12 months. At baseline, adolescent participants completed standardized self-report measures of resilience, depression, and daily stress. The measures of depression and stress were re-administered every three months for the subsequent 12 months. Multi-level modeling was undertaken to analyze the data. RESULTS In adolescents with a history of childhood maltreatment, lower resilience scores were associated with greater increases in depressed affect, absence of positive affect and somatic symptom, but not the interpersonal concerns symptom dimensions of depression following daily stress. Resilience is therefore as one explanation for the discrepant findings regarding the relationship between stress and different symptom dimensions of depression, especially with regard to the stress-related depressive dimensions. CONCLUSION Resilience appears to moderate the relationship between daily stress and depression and protect against developing depression in children who have been maltreated. Findings provide potential explanation for the effectiveness of resilience-related therapy in treating depressive symptoms.
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Affiliation(s)
- Junyi Wang
- School of Teacher Education, Nanjing University of Information Science & Technology, Nanjing 210044, China.
| | - Tingting Wang
- Shanghai Xingzhi Experimental Middle School, Shanghai, China
| | - Yuqin Cheng
- Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
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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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Xiao Z, Robertson S, Long E, Flaig R, Kirby L, Romaniuk L, Murray A, Whalley H. Loneliness in the Digital World: protocol for a co-produced ecological momentary assessment study in adolescents. BMJ Open 2024; 14:e087374. [PMID: 38844398 PMCID: PMC11163606 DOI: 10.1136/bmjopen-2024-087374] [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: 04/08/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Loneliness has been identified as an important public health issue, peaking during adolescence. Previous research has suggested that social interaction is a key factor in loneliness, and positive social interaction can act as a protective factor against loneliness. However, it is unclear whether there are differing impacts of in-person and online social interaction on adolescents' loneliness and mental health. Ecological Momentary Assessment (EMA) designs are ideally suited for better understanding these associations. METHOD AND ANALYSIS In the 'Loneliness in the Digital World' study, we will use a co-developed EMA design to capture daily social interactions, loneliness and mental health such as positive and negative emotions, depression and anxiety in approximately 200 adolescents aged 12-15 years. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the associations between online and in-person social interaction and feelings of loneliness. The results can help inform interventions to support adolescents with high levels of loneliness and poor mental health. ETHICS AND DISSEMINATION We received the ethics approval for the data collection from The Academic and Clinical Central Office for Research and Development, followed by the College of Medicine and Veterinary Medicine Ethics panel at University of Edinburgh, and finally reviewed by East of Scotland Research Ethics Service. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders such as teachers.
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Affiliation(s)
- Zhuoni Xiao
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Sarah Robertson
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Emily Long
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Robin Flaig
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
| | - Liz Kirby
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Liana Romaniuk
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Aja Murray
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Heather Whalley
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Nivins S, Sauce B, Liebherr M, Judd N, Klingberg T. Long-term impact of digital media on brain development in children. Sci Rep 2024; 14:13030. [PMID: 38844772 PMCID: PMC11156852 DOI: 10.1038/s41598-024-63566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024] Open
Abstract
Digital media (DM) takes an increasingly large part of children's time, yet the long-term effect on brain development remains unclear. We investigated how individual effects of DM use (i.e., using social media, playing video games, or watching television/videos) on the development of the cortex (i.e., global cortical surface area), striatum, and cerebellum in children over 4 years, accounting for both socioeconomic status and genetic predisposition. We used a prospective, multicentre, longitudinal cohort of children from the Adolescent Brain and Cognitive Development Study, aged 9.9 years when entering the study, and who were followed for 4 years. Annually, children reported their DM usage through the Youth Screen Time Survey and underwent brain magnetic resonance imaging scans every 2 years. Quadratic-mixed effect modelling was used to investigate the relationship between individual DM usage and brain development. We found that individual DM usage did not alter the development of cortex or striatum volumes. However, high social media usage was associated with a statistically significant change in the developmental trajectory of cerebellum volumes, and the accumulated effect of high-vs-low social media users on cerebellum volumes over 4 years was only β = - 0.03, which was considered insignificant. Nevertheless, the developmental trend for heavy social media users was accelerated at later time points. This calls for further studies and longer follow-ups on the impact of social media on brain development.
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Affiliation(s)
- Samson Nivins
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Bruno Sauce
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Magnus Liebherr
- Department of General Psychology: Cognition, University Duisburg-Essen, Duisburg, Germany
| | - Nicholas Judd
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Torkel Klingberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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Grimmond T, King T, LaMontagne AD, Oostermeijer S, Harrap B, Newberry-Dupé J, Reavley N. Workplace-related determinants of mental health in food and bar workers in Western, high-income countries: A systematic review. Am J Ind Med 2024. [PMID: 38837271 DOI: 10.1002/ajim.23620] [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: 09/29/2023] [Revised: 05/08/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This review synthesizes evidence from etiologic and intervention studies of workplace-related determinants of mental health in workers in food and bar workers in the hospitality industry in Western high-income countries. METHODS Peer-reviewed literature published between January 2000 and August 2023 was gathered from five bibliographic databases. Any study design was eligible. Study quality was assessed using the Joanna Briggs Institute tools for appraisal. RESULTS A narrative analysis was conducted for 26 included studies (total n = 15,069 participants) across Australia (3), Ireland (1), Norway (1), Spain (2), the United States (17) and the United Kingdom (2). Individual and task-related factors such as high emotional job demands and low job control were associated with high burnout and depression. Uncivil and hostile interpersonal interactions with customers, management, and colleagues were found to contribute to poor mental health outcomes, including depression, anxiety, and burnout. CONCLUSION Findings from included studies highlight the impact of workplace culture, including management practices and workplace social support, on mental health. Organization-level interventions may therefore be most effective for addressing individual, interpersonal, and organizational determinants of mental health in food and bar occupations, particularly when implemented as part of broader organizational efforts to support health and wellbeing. Industry-wide policy changes may also be necessary to address structural concerns, including job and financial insecurity, job strain and access to benefits, such as secure sick leave and minimum contract hours.
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Affiliation(s)
- Tessa Grimmond
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Anthony D LaMontagne
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
- Institute for Health Transformation & School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Sanne Oostermeijer
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Benjamin Harrap
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Jackson Newberry-Dupé
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicola Reavley
- Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
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Liu YC, Liao YT, Lin KH. The relationship between schizophrenia or schizoaffective disorder and type 1 diabetes mellitus: a scoping review of observational studies. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024:10.1007/s40211-024-00499-y. [PMID: 38833151 DOI: 10.1007/s40211-024-00499-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/11/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Both schizophrenia and type 1 diabetes mellitus (T1D) are known as immune-related disorders. We systematically reviewed observational studies to explore the relationship between schizophrenia or schizoaffective disorder and T1D. METHODS A preliminary search of articles was completed using the following databases: Airiti Library, CINAHL Complete (via EBSCOhost), OVID MEDLINE, Embase, and PubMed. Two researchers independently assessed each study's quality based on Joanna Briggs Institute (JBI). A narrative review summarized the potential relationship between the two diseases. RESULTS Eleven studies were included in the final analysis. Six observational studies investigated the risk of schizophrenia and schizoaffective disorder in patients with T1D. Two studies showed negative correlations, one showed no correlation, and three showed positive correlations. On the other hand, five studies reported the prevalence of T1D in patients with schizophrenia. Two of them showed positive associations, and three others showed no association. Although the majority of the included studies suggested a positive association between the two medical conditions, these studies were still too heterogeneous to draw consistent results. CONCLUSION We found conflicting results regarding the bidirectional relationship between schizophrenia or schizoaffective disorder and T1D. These may stem from differences in study design, sampling methods, or definition of diagnoses, which are essential aspects to consider in future research.
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Affiliation(s)
- Yi-Chun Liu
- Department of Psychiatry, Changhua Christian Children's Hospital, 500, Changhua, Taiwan
- Department of Psychiatry, Changhua Christian Hospital, 500, Changhua, Taiwan
- Department of Healthcare Administration, Asia University, 413, Taichung, Taiwan
- Department of Eldercare, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yin-To Liao
- Department of Psychiatry, China Medical University and China Medical University Hospital, 413, Taichung, Taiwan
| | - Kuan-Han Lin
- Department of Healthcare Administration, Asia University, 413, Taichung, Taiwan.
- Asia University, No.500, Lioufeng Road, 41354, Taichung City, Wufeng District, Taiwan.
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Vita G, Tavella A, Ostuzzi G, Tedeschi F, De Prisco M, Segarra R, Solmi M, Barbui C, Correll CU. Efficacy and safety of long-acting injectable versus oral antipsychotics in the treatment of patients with early-phase schizophrenia-spectrum disorders: a systematic review and meta-analysis. Ther Adv Psychopharmacol 2024; 14:20451253241257062. [PMID: 38831918 PMCID: PMC11145998 DOI: 10.1177/20451253241257062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
Background Long-acting injectable antipsychotics (LAIs) have advantages over oral antipsychotics (OAPs) in preventing relapse and hospitalization in chronically ill patients with schizophrenia-spectrum disorders (SSDs), but evidence in patients with first-episode/recent-onset, that is, early-phase-SSDs is less clear. Objectives To assess the relative medium- and long-term efficacy and safety of LAIs versus OAPs in the maintenance treatment of patients with early-phase SSDs. Method We searched major electronic databases for head-to-head randomized controlled trials (RCTs) comparing LAIs and OAPs for the maintenance treatment of patients with early-phase-SSDs. Design Pairwise, random-effects meta-analysis. Relapse/hospitalization and acceptability (all-cause discontinuation) measured at study-endpoint were co-primary outcomes, calculating risk ratios (RRs) with their 95% confidence intervals (CIs). Subgroup analyses sought to identify factors moderating differences in efficacy or acceptability between LAIs and OAPs. Results Across 11 head-to-head RCTs (n = 2374, median age = 25.2 years, males = 68.4%, median illness duration = 45.8 weeks) lasting 13-104 (median = 78) weeks, no significant differences emerged between LAIs and OAPs for relapse/hospitalization prevention (RR = 0.79, 95%CI = 0.58-1.06, p = 0.13) and acceptability (RR = 0.92, 95%CI = 0.80-1.05, p = 0.20). The included trials were highly heterogeneous regarding methodology and patient populations. LAIs outperformed OAPs in preventing relapse/hospitalization in studies with stable patients (RR = 0.65, 95%CI = 0.45-0.92), pragmatic design (RR = 0.67, 95%CI = 0.54-0.82), and strict intent-to-treat approach (RR = 0.64, 95%CI = 0.52-0.80). Furthermore, LAIs were associated with better acceptability in studies with schizophrenia patients only (RR = 0.87, 95%CI = 0.79-0.95), longer illness duration (RR = 0.88, 95%CI = 0.80-0.97), unstable patients (RR = 0.89, 95%CI = 0.81-0.99) and allowed OAP supplementation of LAIs (RR = 0.90, 95%CI = 0.81-0.99). Conclusion LAIs and OAPs did not differ significantly regarding relapse prevention/hospitalization and acceptability. However, in nine subgroup analyses, LAIs were superior to OAPs in patients with EP-SSDs with indicators of higher quality and/or pragmatic design regarding relapse/hospitalization prevention (four subgroup analyses) and/or reduced all-cause discontinuation (five subgroup analyses), without any instance of OAP superiority versus LAIs. More high-quality pragmatic trials comparing LAIs with OAPs in EP-SSDs are needed. Trial registration CRD42023407120 (PROSPERO).
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Affiliation(s)
- Giovanni Vita
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Angelantonio Tavella
- Department of Translational Biomedicine and Neuroscience, University of Bari ’Aldo Moro’, Bari, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Federico Tedeschi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona. c. Villarroel, 170, 08036 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Segarra
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Bilbao, Spain
| | - Marco Solmi
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, ON, Canada
- SCIENCES Lab, Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Christoph U. Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
- The Zucker Hillside Hospital, Department of Psychiatry, 75-59 263rd Street, Northwell Health, Glen Oaks, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
- The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Northwell Health, New Hyde Park, NY, USA
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
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Fusar-Poli P, Estradé A, Esposito CM, Rosfort R, Basadonne I, Mancini M, Stanghellini G, Otaiku J, Olanrele O, Allen L, Lamba M, Alaso C, Ieri J, Atieno M, Oluoch Y, Ireri P, Tembo E, Phiri IZ, Nkhoma D, Sichone N, Siadibbi C, Sundi PRIO, Ntokozo N, Fusar-Poli L, Floris V, Mensi MM, Borgatti R, Damiani S, Provenzani U, Brondino N, Bonoldi I, Radua J, Cooper K, Shin JI, Cortese S, Danese A, Bendall S, Arango C, Correll CU, Maj M. The lived experience of mental disorders in adolescents: a bottom-up review co-designed, co-conducted and co-written by experts by experience and academics. World Psychiatry 2024; 23:191-208. [PMID: 38727047 PMCID: PMC11083893 DOI: 10.1002/wps.21189] [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: 05/13/2024] Open
Abstract
We provide here the first bottom-up review of the lived experience of mental disorders in adolescents co-designed, co-conducted and co-written by experts by experience and academics. We screened first-person accounts within and outside the medical field, and discussed them in collaborative workshops involving numerous experts by experience - representing different genders, ethnic and cultural backgrounds, and continents - and their family members and carers. Subsequently, the material was enriched by phenomenologically informed perspectives and shared with all collaborators. The inner subjective experience of adolescents is described for mood disorders, psychotic disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, anxiety disorders, eating disorders, externalizing disorders, and self-harm behaviors. The recollection of individuals' past histories also indexes the prodromal (often transdiagnostic) features predating the psychiatric diagnosis. The experience of adolescents with mental disorders in the wider society is described with respect to their family, their school and peers, and the social and cultural context. Furthermore, their lived experience of mental health care is described with respect to receiving a diagnosis of mental disorder, accessing mental health support, receiving psychopharmacological treatment, receiving psychotherapy, experiencing peer support and mental health activism, and achieving recovery. These findings can impact clinical practice, research, and the whole society. We hope that this co-designed, co-conducted and co-written journey can help us maintain our commitment to protecting adolescents' fragile mental health, and can help them develop into a healthy, fulfilling and contributing adult life.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University, Munich, Germany
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK
| | - Cecilia M Esposito
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - René Rosfort
- S. Kierkegaard Research Centre, University of Copenhagen, Copenhagen, Denmark
| | - Ilaria Basadonne
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Milena Mancini
- Department of Psychological Sciences, Health and Territory, G. D'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Giovanni Stanghellini
- Department of Health Sciences, University of Florence, Florence, Italy
- Diego Portales University, Santiago, Chile
| | - Jummy Otaiku
- Young Person's Mental Health Advisory Group, King's College London, London, UK
| | | | - Lucas Allen
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | - Judy Ieri
- Global Mental Health Peer Network, Nairobi, Kenya
| | | | | | - Phides Ireri
- Global Mental Health Peer Network, Nairobi, Kenya
| | - Ephraim Tembo
- Global Mental Health Peer Network, Lusaka, Zambia
- University of Zambia, Lusaka, Zambia
| | | | | | - Noah Sichone
- Global Mental Health Peer Network, Lusaka, Zambia
| | - Candy Siadibbi
- Global Mental Health Peer Network, Lusaka, Zambia
- Psychology Association of Zambia, Lusaka, Zambia
| | | | - Nyathi Ntokozo
- Global Mental Health Peer Network, Bulawayo, Zimbabwe
- Youth Support Network Trust, Bulawayo, Zimbabwe
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Valentina Floris
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Martina M Mensi
- National Neurological Institute, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- National Neurological Institute, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bonoldi
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer, CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Kate Cooper
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Solent NHS Trust, Southampton, UK
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 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
| | - Sarah Bendall
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario G. Marañón, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Universitätsmedizin Berlin, Berlin, Germany
- Departments of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Ji X, Guo X, Soh KL, Japar S, He L. Effectiveness of stress management interventions for nursing students: A systematic review and meta-analysis. Nurs Health Sci 2024; 26:e13113. [PMID: 38566439 DOI: 10.1111/nhs.13113] [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: 08/23/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.
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Affiliation(s)
- Xuan Ji
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Xiaoyan Guo
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Salimah Japar
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Liping He
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
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42
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Lau SSS, Fong JWL, van Rijsbergen N, McGuire L, Ho CCY, Cheng MCH, Tse D. Emotional responses and psychological health among young people amid climate change, Fukushima's radioactive water release, and wars in Ukraine and the Middle East, and the mediating roles of media exposure and nature connectedness: a cross-national analysis. Lancet Planet Health 2024; 8:e365-e377. [PMID: 38849179 DOI: 10.1016/s2542-5196(24)00097-4] [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: 01/10/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND New global crises are emerging, while existing global crises remain unabated. Coping with climate change, the radioactive water released into the Pacific Ocean subsequent to the Fukushima nuclear accident in Japan, and the wars in Ukraine and the Middle East (hereafter referred to as the wars) as individual crises can negatively affect the psychological health of young people, but little is known about the compounded impact of multiple crises. We aimed to examine: (1) the emotional responses of young people towards each individual crisis, (2) how aggregate levels of emotional engagement in global crises might pose different potential trajectories in psychological health, and (3) the protective or exacerbating role of media exposure and nature connectedness as mediators on psychological health outcomes of young people. METHODS We conducted a cross-national online survey among young people (aged 18-29 years) from China, Portugal, South Africa, the USA, and the UK. We adopted stratified purposive sampling and distributed the survey using online platforms (www.wenjuan.com and www.prolific.com). Individuals were eligible for inclusion in our analysis if they were literate in Chinese or English and had no mental disorders diagnosed within the past 12 months. Participants were asked questions on their demographic characteristics and time spent on social media, including proportion of time exposed to media pertaining to global crises of interest, and they completed surveys based on validated scales that measure depression, anxiety, stress, and wellbeing, as well as emotional responses to each global crisis and nature relatedness. We assessed the survey results using descriptive statistics, ANOVA tests, cluster analysis for individual emotional responses, and structural equation modelling for the aggregate measure of emotional engagement towards individual global crises. FINDINGS Between Oct 20 and Nov 3, 2023, 2579 individuals participated in the survey, of whom 400 participants from each country (200 male and 200 female participants) were included in our analysis (mean age 24·36 years [SD 2·86]). The mean emotional engagement varied between the global crises of interest (on a scale from 0 to 68, where 0 indicates no emotional response and 68 indicates strong emotional responses across 17 different emotions; wars: 32·42 [SD 14·57]; climate change: 28·79 [14·17]; radioactive water: 21·26 [16·08]), and emotional engagement also varied by country; for instance, for respondents from China, mean emotional engagement in radioactive water was relatively high (39·15 [10·72]) compared with the other countries, and for respondents from the USA, engagement with the wars was relatively low (29·45 [15·78]). We found significant variations in the level of emotional engagement between different crises, with distinct emotional profiles observed among individual countries. To assess the role of media exposure and nature connectedness on psychological outcomes, using structural equation modelling, we constructed a multi-country model comprising Portugal, South Africa, the USA, and the UK, and a standalone model for China. These models elucidated associations between emotional engagement and psychological distress and wellbeing, explaining substantial portions of the variance in both. Notably, while greater emotional engagement in the ecological crises (ie, climate change and radioactive water) generally predicted worse psychological health outcomes, we found the direction of effect for war crises to have positive outcomes for mental health in the standalone China model. Additionally, we found that media exposure mediated the negative effect of wars on psychological distress in the multi-country model, and positive psychological wellbeing in the standalone China model. Moreover, nature connectedness emerged as a potent mediator, effectively mitigating the adverse mental health effects of emotional engagement with some crises, such as radioactive water and climate change. INTERPRETATION Our findings offer valuable insights into the nuanced dynamics of emotional engagement in global crises and its implications for mental health outcomes among young people across diverse global contexts. Further research is needed to understand the contribution of ongoing and new global crises towards a compounded negative future outlook on young people's mental health to identify effective communication and intervention strategies that can mitigate the effect of this global challenge. FUNDING Research Grants Council of Hong Kong, China.
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Affiliation(s)
- Sam S S Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China; College of International Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China.
| | - Jason W L Fong
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | | | - Laura McGuire
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Cherry C Y Ho
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China; Division of Nursing Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | - Marco C H Cheng
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | - Dorothy Tse
- Department of Psychology, Edge Hill University, Ormskirk, UK
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Marquez J, Humphrey N, Black L, Wozmirska S. This is the place: a multi-level analysis of neighbourhood correlates of adolescent wellbeing. Soc Psychiatry Psychiatr Epidemiol 2024; 59:929-946. [PMID: 37606648 PMCID: PMC11116214 DOI: 10.1007/s00127-023-02531-y] [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: 11/05/2022] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE Adolescent wellbeing is a key research and policy priority, but little is known about neighbourhood-level influences. This study examined the extent to which adolescents' life satisfaction and internalising symptoms vary between neighbourhoods, and which neighbourhood characteristics are associated with individual outcomes. METHOD Baseline data from the #BeeWell cohort study in Greater Manchester (England) including 35,902 adolescents (aged 12-15) across 243 neighbourhoods were linked to neighbourhood characteristics (e.g. access to education and health services, leisure facilities) from the Co-op's Community Wellbeing Index and analysed using multi-level regression. RESULTS Neighbourhoods explained 0.61% and 1.17% of the variation in life satisfaction and internalising symptoms, respectively. Socio-demographic inequalities in these outcomes varied across neighbourhoods. Several neighbourhood characteristics were associated with wellbeing, but differences across model specifications were observed (e.g. adjusted vs unadjusted; unique associations vs grouped domains). However, higher levels of perceived wellbeing support from local people were associated with lower internalising symptoms in all models. Other characteristics associated with better wellbeing outcomes in various models included lower GP antidepressant prescription rates, and better access to health services, areas for leisure, and good places to spend free time. CONCLUSION Neighbourhoods account for a small but significant proportion of the variance in adolescent life satisfaction and internalising symptoms. Some neighbourhood characteristics (notably neighbourhood social capital) are associated with these outcomes at the individual level, and disparities in these outcomes for some groups vary across neighbourhoods. Our findings speak to the role of place as a determinant of adolescent wellbeing, with consequent implications for intervention.
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Gibler RC, Marzouk MA, Peugh J, Reidy BL, Ernst MM, Daffin ML, Powers SW, Kabbouche Samaha M, Kacperski J, Hershey AD, O'Brien H, Slater SK. Clinic-Based Characterization of Adolescents and Young Adults With Migraine: Psychological Functioning, Headache Days, and Disability. Neurol Clin Pract 2024; 14:e200294. [PMID: 38682006 PMCID: PMC11052567 DOI: 10.1212/cpj.0000000000200294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/24/2024] [Indexed: 05/01/2024]
Abstract
Background and Objectives This cross-sectional observational study retrospectively examined clinical data collected from adolescents and young adults (AYAs) seeking care in a specialty headache clinic. We characterized participants' headache characteristics and psychological functioning and examined the association between self-reported anxiety and depressive symptoms and headache frequency, severity, and disability. Methods During their clinic visit, AYAs (M age = 18.36; range = 14-32, 79.5% female) completed an intake questionnaire and reported about their headache characteristics (i.e., frequency, severity, and duration of symptoms in months), mental health history (i.e., previous diagnosis of an anxiety or depressive disorder), and utilization of emergency department (ED) services for migraine. AYAs also completed psychometrically validated screening tools for anxiety and depressive symptoms (i.e., the GAD-7 and PHQ-9). We computed descriptive statistics and examined associations among scores on psychological measures and headache characteristics, including migraine-related disability. We also tested whether individuals with clinically elevated GAD-7 and PHQ-9 scores had higher levels of disability relative to those with fewer/subclinical levels of anxiety and depressive symptoms. Results Participants (N = 283) reported more than 19 headache days per month on average, with more than 90% describing their average headache intensity as moderate or severe. Nearly half of AYAs reported severe headache-related disability. Approximately one-quarter of AYAs reported a previous diagnosis anxiety or depressive disorder diagnosis, and more than one-third scored above clinical cutoffs on the PHQ-9 and GAD-7. Higher scores on both psychological screening instruments were associated with greater headache frequency. More than 10% of patients endorsed current suicidal ideation; this was not related to headache-related disability. Participants reported a high degree of ED utilization for headache; these rates were unrelated to endorsement of psychological comorbidities. Discussion In this sample of AYAs, headache characteristics were generally unrelated to scores on measures on psychological functioning. However, the observed rates of clinically elevated anxiety/depressive symptoms and suicidality in this sample of AYAs underscore the importance of screening for psychological comorbidities in neurology clinics that serve this age group, irrespective of self-reported disability. Results also emphasize the need to expand access to behavioral health services for AYAs with headache disorders and the importance of incorporating a biopsychosocial perspective to the transition of health care from pediatrics to adult neurology practice.
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Affiliation(s)
- Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Maya A Marzouk
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Brooke L Reidy
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Michelle M Ernst
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Morgan L Daffin
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Marielle Kabbouche Samaha
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Joanne Kacperski
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Andrew D Hershey
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Hope O'Brien
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Shalonda K Slater
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
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Gex KS, Leone RM, Aungst J, Branson K, Gray KM, Tomko RL. Identifying brief intervention factors to improve cannabis related outcomes in adolescents and young adults: A systematic review of sample characteristics and intervention components. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209335. [PMID: 38490335 PMCID: PMC11090745 DOI: 10.1016/j.josat.2024.209335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/19/2023] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION Prior systematic and meta-analytic reviews observed mixed evidence for the efficacy of cannabis brief interventions (BIs). Inconsistent support for cannabis BIs may be the result of intersecting methodological factors, including intervention structure and content, participant eligibility criteria, and outcome assessment measures. The current systematic review of cannabis BI studies narratively synthesizes these data to guide intervention development decision-making in future cannabis BI studies (PROSPERO CRD42022285990). METHODS We searched PubMed/MEDLINE, PsycINFO, and CINAHL databases in January 2022 and again in June 2023 to capture newly published studies. Studies were included if they were a randomized trial, enrolled adolescents (13-17) and/or young adults (18-30), specified cannabis use and/or problems inclusion criteria, and evaluated a cannabis BI (defined as ≤4 sessions). We extracted and synthesized data on intervention characteristics (e.g., components, length/duration, modality), cannabis inclusion criteria and recruitment setting, baseline cannabis use descriptives and treatment-seeking status, and outcome assessment measures to discern if/how they may intersect to determine intervention efficacy. The Cochrane Risk of Bias Tool 2 assessed study quality. RESULTS Our search resulted in a final sample of 25 study records including 4094 participants. Recruitment setting seemed to provide an influential backdrop for how well inclusion criteria determined baseline cannabis use level, as well as for the type/length of the BI evaluated. Motivational interviewing (MI) and personalized feedback (PF) were the most frequently used BI components overall; however, some differences were observed in the proportion of BIs with reported intervention effects using MI vs. PF. Frequency of use days was the most commonly used outcome measure, although this may not be the most sensitive measure for assessing cannabis BI efficacy. CONCLUSIONS Our systematic review indicates that cannabis BI studies require greater precision in their design, giving special attention to matching the content and structure of the BI to the needs of the target population and selecting outcomes commensurate to the goals of the BI and the target population to more accurately reflect the efficacy of the BI. However, consistent with prior reviews, all included studies demonstrated at least some concerns for risk of bias, and most were at high risk.
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Affiliation(s)
- Kathryn S Gex
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States.
| | - Ruschelle M Leone
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Jenna Aungst
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States
| | - Kevin Branson
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
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Ergun-Longmire B, Greydanus DE. Ovarian tumors in the pediatric population: An update. Dis Mon 2024; 70:101691. [PMID: 38281826 DOI: 10.1016/j.disamonth.2024.101691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Research reveals that 1% of neoplasms in females under 17 years of age are ovarian neoplasms and though usually benign, malignant tumors may occur in the pediatric age group. This review considers various current concepts of these tumors including the epidemiology, risk factors, clinical presentations, diagnosis, differential diagnosis, and treatment options including the need to provide fertility-sparing surgery as well as their potential impacts on the psychological well-being of children and adolescents. We gathered data from the published articles ranging from studies, meta-analyses, retrospective studies, and reviews. We focused on the articles published in English between January 1, 2000, and August 31, 2023. Only a few articles published prior to 2000 were included for historical perspective.
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Affiliation(s)
- Berrin Ergun-Longmire
- Department of Pediatric and Adolescent Medicine, Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA.
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
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Brodeur S, Oliver D, Ahmed MS, Radua J, Venables J, Gao Y, Gigante V, Veneziano G, Vinci G, Chesney E, Nandha S, De Micheli A, Basadonne I, Floris V, Salazar de Pablo G, Fusar-Poli P. Why we need to pursue both universal and targeted prevention to reduce the incidence of affective and psychotic disorders: Systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 161:105669. [PMID: 38599355 DOI: 10.1016/j.neubiorev.2024.105669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/16/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
The effectiveness of universal preventive approaches in reducing the incidence of affective/psychotic disorders is unclear. We therefore aimed to synthesise the available evidence from randomised controlled trials. For studies reporting change in prevalence, we simulated all possible scenarios for the proportion of individuals with the disorder at baseline and at follow-up to exclude them. We then combined these data with studies directly measuring incidence and conducted random effects meta-analysis with relative risk (RR) to estimate the incidence in the intervention group compared to the control group. Eighteen studies (k=21 samples) were included investigating the universal prevention of depression in 66,625 individuals. No studies were available investigating universal prevention on the incidence of bipolar/psychotic disorders. 63 % of simulated scenarios showed a significant preventive effect on reducing the incidence of depression (k=9 - 19, RR=0.75-0.94, 95 %CIs=0.55-0.87,0.93-1.15, p=0.007-0.246) but did not survive sensitivity analyses. There is some limited evidence for the effectiveness of universal interventions for reducing the incidence of depression but not for bipolar/psychotic disorders.
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Affiliation(s)
- Sebastien Brodeur
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Département de Psychiatrie et Neurosciences, Université Laval, Canada
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK; NIHR Oxford Health Biomedical Research Centre, Oxford OX3 7JX, UK; OPEN early detection service, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK.
| | | | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain; CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Jemma Venables
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Yueming Gao
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Vincenzo Gigante
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Giulia Veneziano
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Giulia Vinci
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Edward Chesney
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Sunil Nandha
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK
| | - Ilaria Basadonne
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Valentina Floris
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
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Casares MÁ, Díez-Gómez A, Pérez-Albéniz A, Lucas-Molina B, Fonseca-Pedrero E. Screening for anxiety in adolescents: Validation of the Generalized Anxiety Disorder Assessment-7 in a representative sample of adolescents. J Affect Disord 2024; 354:331-338. [PMID: 38490592 DOI: 10.1016/j.jad.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
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Bapuji SB, Hansen A, Marembo MH, Olivier P, Yap MBH. Modifiable parental factors associated with the mental health of youth from immigrant families in high-income countries: A systematic review and meta-analysis. Clin Psychol Rev 2024; 110:102429. [PMID: 38643664 DOI: 10.1016/j.cpr.2024.102429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 02/06/2024] [Accepted: 04/04/2024] [Indexed: 04/23/2024]
Abstract
Parental factors play a major role in youth mental health and many youth in high-income countries have at least one overseas-born parent. It is, hence, important to understand how immigrant parenting is associated with youth mental health in high-income countries. Following PRISMA guidelines, this review sought to identify modifiable parental factors to inform parenting interventions to prevent mental health problems in youth aged 0-18 years whose parents migrated voluntarily for economic reasons from low and middle-income countries to high-income countries. Sixteen parental factors were identified from 56 studies that were associated with five outcomes - youth self-esteem (k = 17), general stress (k = 4), acculturative stress (k = 4), anxiety symptoms (k = 9), and depressive symptoms (k = 41). A sound evidence base was found for one or more of these outcomes associated with protective factors - caring and supportive parenting and parental monitoring; and risk factors - parent-youth acculturative and general conflict, parental withdrawal, interparental conflict, and parent mental health problems. This systematic review and meta-analysis identified immigrant parental factors that have robust associations with youth mental health outcomes. These findings can be used to inform parenting interventions and support immigrant parents in preventing youth mental health problems.
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Affiliation(s)
- Sunita Bayyavarapu Bapuji
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia
| | - Ashlyn Hansen
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia
| | - Miriam H Marembo
- Department of Econometrics & Business Statistics, Monash University, 20 Chancellor's Walk, Clayton Campus, Wellington Road, Clayton, VIC 3800, Australia
| | - Patrick Olivier
- Action Lab, Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Australia
| | - Marie Bee Hui Yap
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia.
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Geoffroy MC, Chadi N, Bouchard S, Fuoco J, Chartrand E, Loose T, Sciola A, Boruff JT, Iyer SN, Sun Y, Gouin JP, Côté SM, Thombs BD. Mental health of Canadian youth: A systematic review and meta-analysis of studies examining changes in depression, anxiety, and suicide-related outcomes during the COVID-19 pandemic. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:408-424. [PMID: 38478216 PMCID: PMC11151894 DOI: 10.17269/s41997-024-00865-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/30/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aims to describe Canadian youth mental health during the COVID-19 pandemic, focusing on changes in anxiety and depressive symptoms and suicidality. METHODS We searched four databases up to February 2023 for longitudinal or repeated cross-sectional studies reporting on changes in depressive and anxiety symptoms, suicidality, or related services utilization among young people under 25 years old residing in Canada during the COVID-19 pandemic. Random-effects meta-analyses were performed for studies comparing depressive and anxiety symptoms from before to during the first, second, and third COVID-19 waves (up to June 2021), and between COVID-19 waves. Other studies were described narratively. Risk of bias was assessed using an adapted Joanna Briggs Institute Checklist. SYNTHESIS Of the 7916 records screened, 35 articles met inclusion criteria for this review. Included studies were highly heterogeneous in design, population, and type of change investigated, and many had a high risk of bias. The meta-analyses found that depressive symptoms worsened minimally from pre-pandemic to wave 1 but returned to pre-pandemic levels by wave 2. Anxiety symptoms were broadly comparable from pre-pandemic to waves 1 and 2 but worsened from waves 1 to 3 and from pre-pandemic to wave 1 for girls. The narrative review included several studies that provided inconclusive evidence of increases in services utilization. CONCLUSION The current evidence is limited and highly heterogeneous, making it insufficient to draw definitive conclusions regarding the short- to medium-term impact of the pandemic on youth mental health in Canada. Obtaining better mental health surveillance among Canadian youth is imperative.
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Affiliation(s)
- Marie-Claude Geoffroy
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
- McGill Group for Suicide Studies, Douglas Mental Health University Institute/Douglas Research Centre, McGill University, Montreal, Quebec, Canada.
| | - Nicholas Chadi
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Samantha Bouchard
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Julia Fuoco
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Elise Chartrand
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Tianna Loose
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Anthony Sciola
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Jill T Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada
| | - Srividya N Iyer
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Ying Sun
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Sylvana M Côté
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Psychology, McGill University, Montreal, Quebec, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
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