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Borairi S, Deneault AA, Madigan S, Fearon P, Devereux C, Geer M, Jeyanayagam B, Martini J, Jenkins J. A meta-analytic examination of sensitive responsiveness as a mediator between depression in mothers and psychopathology in children. Attach Hum Dev 2024:1-28. [PMID: 38860779 DOI: 10.1080/14616734.2024.2359689] [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: 03/21/2023] [Accepted: 05/21/2024] [Indexed: 06/12/2024]
Abstract
The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b = .02) and internalizing psychopathology (b = .01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant.
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Affiliation(s)
- Sahar Borairi
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Pasco Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Chloe Devereux
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Melissa Geer
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | | | - Julia Martini
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Jennifer Jenkins
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
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2
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Lu J, Ye Y, Lou J, Zhu H, Zhou X. Associations between unintentional injuries and deliberate self-harm behaviors of children and adolescents: A school-based cross-sectional survey. Gen Hosp Psychiatry 2024; 86:67-74. [PMID: 38118378 DOI: 10.1016/j.genhosppsych.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 12/22/2023]
Abstract
While statistics from hospitals showed that the proportion of self-harm or attempted suicide kept growing among children and adolescents aged 6-17 attending the emergency department, cases of self-harm or attempted suicide dissimulated as accidents received scant attention or were neglected. This study aimed to examine associations between unintentional injuries subtypes and deliberate self-harm behaviors from a school-based large-scale survey. A school-based cross-sectional study was conducted in Anhui, China, between November 2022 to January 2023. A total of 28,013 students (aged 11-17, 5th-12th grade) from 35 primary schools, 27 middle schools, and 6 high schools were included for the present study. Unintentional injuries in the past year of children and adolescents reported by parents. Self-harm behaviors in the past year of children and adolescents was measured with one question reported by students. Children and adolescents whose parents reported their contacts with sharp instruments demonstrated the highest risk for self-harm behaviors, followed by poisoning, exposure to electric current, falls, vehicle and traffic injuries, accidental drowning and submersion, and eating foreign bodies. And these associations distributed differently among children and adolescents reporting different frequencies of self-harm behaviors. Thus, we urge attention from parents, child caregivers, and teachers on children and adolescents experiencing certain types of unintentional injuries.
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Affiliation(s)
- Jingjing Lu
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China.
| | - Ying Ye
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China.
| | - Jiaxue Lou
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China.
| | - Hui Zhu
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China.
| | - Xudong Zhou
- The Institute of Social and Family Medicine, School of Medicine, Zhejiang University, 866 Yuhangtang Rd., Hangzhou, Zhejiang 310058, PR China; The Second Affiliated Hospital, School of Medicine, Zhejiang University, 68 Jiefang Rd., Hangzhou, Zhejiang 310009, PR China.
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3
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Herrmann L, Reiss F, Becker-Hebly I, Baldus C, Gilbert M, Stadler G, Kaman A, Graumann L, Ravens-Sieberer U. Systematic Review of Gender-Specific Child and Adolescent Mental Health Care. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01506-z. [PMID: 36849848 DOI: 10.1007/s10578-023-01506-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 03/01/2023]
Abstract
Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its' approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.
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Affiliation(s)
- Lena Herrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Christiane Baldus
- German Center for Addiction Research in Childhood and Adolescence, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Gertraud Stadler
- Institute of Gender in Medicine, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Lina Graumann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistraße 52, W29, 20246, Hamburg, Germany.
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4
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Leijdesdorff SMJ, Huijs CEM, Klaassen RMC, Popma A, van Amelsvoort TAMJ, Evers SMAA. Burden of mental health problems: quality of life and cost-of-illness in youth consulting Dutch walk-in youth health centres. J Ment Health 2023; 32:150-157. [PMID: 33086874 DOI: 10.1080/09638237.2020.1836555] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Little is known about the burden of (sub-threshold) mental health problems in youth. AIM To examine the burden of mental health problems in terms of health-related quality of life (HRQoL) and cost-of-illness, for first visitors of the Dutch youth walk-in centres (@ease). METHOD A bottom-up, prevalence-based burden of disease study from a societal perspective. HRQoL was assessed through the EuroQoL (EQ-5D-5L), and cost-of-illness via items about truancy and health care utilization. RESULTS Participants (N = 80) showed a decreased HRQoL compared to the general population of Dutch youth. In the three months prior to their 1st attendance, participants skipped on average 4.11 days of school and had 1.03 health care visits, leading to total costs of €512.64 per person. Females had significantly higher health care costs and lower HRQoL. Health care use was lower in those not speaking the Dutch language. Living alone was a significant predictor of truancy (costs), and therefore total costs. CONCLUSIONS Mental health problems in youth consulting @ease have a considerable impact on the individual's HRQoL, and an economic impact on society, yet almost 75% is not receiving care. A lack of interventions in this critical period in life may have major lifelong consequences.
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Affiliation(s)
- S M J Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - C E M Huijs
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - R M C Klaassen
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands
| | - A Popma
- Department of Child and Adolescent Psychiatry, Duivendrecht, The Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Trimbos Institute Centre for Economic Evaluation and Machine Learning, Utrecht, the Netherlands
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5
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Ribeiro WS, Grande AJ, Hoffmann MS, Ziebold C, McDaid D, Fry A, Peixoto C, Miranda C, King D, Tomasi CD, Faustino C, Leone S, Moraes S, Schäfer AA, Alves V, Rosa MI, Evans-Lacko S. A systematic review of evidence-based interventions for child and adolescent mental health problems in low- and middle-income countries. Compr Psychiatry 2023; 121:152358. [PMID: 36508775 DOI: 10.1016/j.comppsych.2022.152358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 11/15/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Treatments for mental health problems in childhood and adolescence have advanced in the last 15 years. Despite advances in research, most of the evidence on effective interventions comes from high-income countries, while evidence is scarce in low- and middle-income countries (LMICs), where 90% of world's children and adolescents live. The aim of this review was to identify evidence-based interventions tested in LMICs to treat or prevent child and adolescent mental health problems. METHODS We conducted a systematic review of seven major electronic databases, from January 2007 to July 2019. We included randomised or non-randomised clinical trials that evaluated interventions for children or adolescents aged 6 to 18 years living in LMICs and who had, or were at risk of developing, one or more mental health problems. Results were grouped according to the studied conditions. Due to the heterogeneity of conditions, interventions and outcomes, we performed a narrative synthesis. The review was registered at PROSPERO under the number CRD42019129376. FINDINGS Of 127,466 references found through our search strategy, 107 studies were included in narrative synthesis after the eligibility verification processes. Nineteen different conditions and nine types of interventions were addressed by studies included in the review. Over 1/3 of studied interventions were superior to comparators, with psychoeducation and psychotherapy having the highest proportion of positive results. One-third of studies were classified as presenting low risk of bias. INTERPRETATION This review shows that different interventions have been effective in LMICs and have the potential to close the mental health care gap among children and adolescents in low-resource settings.
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Affiliation(s)
- Wagner Silva Ribeiro
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom.
| | | | | | - Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - David McDaid
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Andra Fry
- Library, London School of Economics and Political Science, London, United Kingdom
| | - Clayton Peixoto
- Universidade Estadual de Mato Grosso do Sul, Campo Grande, Brazil
| | | | - Derek King
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | | | | | - Sandra Leone
- Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
| | | | | | | | - Maria Ines Rosa
- Universidade do Extremo Sul de Santa Catarina, Criciúma, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
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6
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Garcia-Cerde R, Lopes de Oliveira CW, Ferreira-Junior V, Caetano SC, Sanchez ZM. Psychiatric Symptomatology is Associated with Polydrug Use and School Violence in Early Adolescence. Child Psychiatry Hum Dev 2023; 54:109-122. [PMID: 34398344 DOI: 10.1007/s10578-021-01228-0] [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: 03/15/2021] [Accepted: 08/02/2021] [Indexed: 01/25/2023]
Abstract
This study investigated the association between psychiatric symptoms and polydrug use, school violence, and sociodemographic factors among Brazilian early adolescents. Using the baseline data collection from the effectiveness evaluation of PROERD, a school-based drug use prevention program, implemented in 30 public schools in São Paulo (n = 2316, M age = 12.3 years, 48.5% girls), multinomial logistic regressions were performed using Strengths and Difficulties Questionnaire (SDQ) subscales as response variables, and polydrug use, school violence, and sociodemographic characteristics as explanatory variables. In most SDQ subscales, girls and older students were more likely to have psychiatric symptoms. A positive association was identified between polydrug use and psychiatric symptoms. It was found that those who suffered and perpetrated physical violence had a greater likelihood of presenting psychiatric symptoms. Preventive interventions should consider the greater vulnerability related to the mental health of girls, older students, and those who suffer and perpetrate physical violence at school.
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Affiliation(s)
- Rodrigo Garcia-Cerde
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil
| | - Camila W Lopes de Oliveira
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Valdemir Ferreira-Junior
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Sheila Cavalcante Caetano
- Departamento de Psiquiatria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570 - 1º Andar, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740, 4º Andar, São Paulo, SP, Brazil.
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7
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Swed S, Alibrahim H, Bohsas H, Nashwan AJ, Elsayed M, Almoshantaf MB, Kadri SA, Sawaf B, Albuni MK, Battikh E, Elkalagi NK, Ahmed SM, Ahmed EM, Hasan MM, Patwary MM, Shoib S, Hafez W. Mental distress links with physical activities, sedentary lifestyle, social support, and sleep problems: A Syrian population cross-sectional study. Front Psychiatry 2023; 13:1013623. [PMID: 36727085 PMCID: PMC9885115 DOI: 10.3389/fpsyt.2022.1013623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background Mental diseases are very widespread and difficult to treat, affecting around 12% of the global population in 2019. Since social interaction is crucial to human existence and loneliness has been proven to be a significant predictor of depressive symptoms, it stands to reason that social connection problems would also contribute to depression. Physical inactivity seems to weaken and aggravate insulin tolerance alterations, glucose homeostasis, and plasma triglyceride levels, thereby influencing one's mood and happiness. This suggests that physical inactivity may be a significant risk factor for mental illness. This research contributes to our understanding of the mental health situation in Syria by exploring associations between a set of measurable characteristics that may be adjusted. Methods An online quantitative cross-sectional study was conducted between March and April 2022 in Syria, using a structured questionnaire that assesses data on behaviors of health, health in general, wellbeing, and adult population quality of life. Results Among 1,224 respondents (371 men and 853 women), women have shown higher levels of mental distress, sleep issues, low engagement in structured activities, and a difficult work environment than men. Women experiencing mental anguish have reported being more sedentary, participating in less scheduled activities, and receiving less social support. Conclusions There are observable connections between high sedentary time and women experiencing mental distress. The mental health of Syrian women in distress was associated with a lack of participation in both organized activities and physical exercise in their free time. Furthermore, sleep issues and financial troubles were seen in persons with mental diseases of both males and females.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | | | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | | | - Saeed A. Kadri
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Bisher Sawaf
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | | | - Elias Battikh
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Nashaat K. Elkalagi
- Internal and Tropical Medicine Department, Faculty of Medicine, Al Arish University, Al Arish, Egypt
| | | | - Eman M. Ahmed
- Department of Obstetrics and Gynecology, Nile Valley University, Khartoum, Sudan
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India
| | - Wael Hafez
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
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8
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De Stefano R, Cedro C, Iannuzzo F, Infortuna C, Lombardo C, Pandolfo G, Muscatello MRA, Bruno A. The relationship between subthreshold psychiatric symptoms and Internet Addiction in an Italian population. Psychiatry Res 2022; 317:114914. [PMID: 37732858 DOI: 10.1016/j.psychres.2022.114914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/07/2022] [Accepted: 10/15/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Internet addiction (IA) is an emerging psychopathological entity, often comorbid with a variety of psychiatric disorders. Subthreshold psychopathology has recently emerged as a new field of research, with solid evidence highlighting its role in causing psychological distress. AIMS The study aimed to evaluate the presence of subthreshold psychopathological symptoms and IA in Italian adults recruited from the general population, searching for possible correlations between specific subclinical psychiatric disorders and internet abuse. METHODS The study was conducted by an online survey released through social networks, web advertising, institutional and professional mailing lists, and messaging services. The General 5-Spectrum Measure (GSM-V) and the Internet Addiction Test (IAT) were chosen to assess subthreshold symptoms, and IA, respectively. RESULTS Significant positive correlations between the total score of the IAT total scores and the multiple domains of GSM-5 (p <0.0001), except for the "Mania" dimension (p = 0.717). CONCLUSIONS IA is very common in subjects unaffected by major psychiatric disorders and it is associated with subthreshold psychopathological dimensions. Further studies on larger samples and the inclusion of a dimensional framework in research settings and clinical practice are needed to better understand the nature and the reciprocal relationships between IA and subthreshold psychopathology.
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Affiliation(s)
- Rosa De Stefano
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Clemente Cedro
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Fiammetta Iannuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Carmenrita Infortuna
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Clara Lombardo
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Gianluca Pandolfo
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Maria Rosaria Anna Muscatello
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Antonio Bruno
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy.
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9
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Ziebold C, Silva-Ribeiro W, King D, McDaid D, Hoffmann MS, Romeo R, Pan PM, Miguel EC, Bressan RA, Rohde LA, Salum GA, Mari JDJ, Evans-Lacko S. Utilisation and costs of mental health-related service use among adolescents. PLoS One 2022; 17:e0273628. [PMID: 36084089 PMCID: PMC9462733 DOI: 10.1371/journal.pone.0273628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background The high level of care needs for adolescents with mental health conditions represents a challenge to the public sector, especially in low and middle-income countries. We estimated the costs to the public purse of health, education, criminal justice and social care service use associated with psychiatric conditions among adolescents in Brazil; and examined whether the trajectory of psychopathology and its impact on daily life, and parental stigma towards mental illness, was associated with service utilisation and costs. Methods Data on reported service use among adolescents from a prospective community cohort (n = 1,400) were combined with Brazilian unit costs. Logistic regression and generalised linear models were used to examine factors associated with service use and associated costs, respectively. Results Twenty-two percent of those who presented with a psychiatric disorder used some type of service for their mental health in the previous twelve months. Higher odds of service use were associated with having a diagnosed mental disorder (either incident, [OR = 2.49, 95%CI = 1.44–4.30, p = 0.001], remittent [OR = 2.16, 95%CI = 1.27–3.69, p = 0.005] or persistent [OR = 3.01, 95%CI = 1.69–5.36, p<0.001]), higher impact of symptoms on adolescent’s life (OR = 1.32, 95%CI = 1.19–1.47, p<0.001) and lower parental stigma toward mental illness (OR = 1.12, 95%CI = 1.05–1.20, p = 0.001). Average annual cost of service use was 527.14 USD (s.d. = 908.10). Higher cost was associated with higher disorder impact (β = 0.25, 95%CI = 0.12–0.39, p<0.001), lower parental stigma (β = 0.12, 95%CI = 0.02–0.23, p = 0.020) and white ethnicity (β = 0.55, 95%CI = 0.04–1.07, p = 0.036). Conclusion The impact of mental health problems on adolescents’ daily lives and parental stigmatising attitudes toward mental illness were the main predictors of both service use and costs.
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Affiliation(s)
- Carolina Ziebold
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Wagner Silva-Ribeiro
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Derek King
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - David McDaid
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Mauricio Scopel Hoffmann
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
- Universidade Federal de Santa Maria, Santa Maria, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Renee Romeo
- King’s College London, London, United Kingdom
| | - Pedro Mario Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Eurípedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
- Universidade de São Paulo, São Paulo, Brazil
| | - Rodrigo Affonseca Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
- ADHD Outpatient Program & Developmental Psychiatry Program, Hospital de Clínicas de Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovanni Abrahão Salum
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jair de Jesus Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
- * E-mail:
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10
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Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil. Eur Child Adolesc Psychiatry 2022; 32:1083-1095. [PMID: 35618973 PMCID: PMC9135594 DOI: 10.1007/s00787-022-02006-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/04/2022] [Indexed: 11/21/2022]
Abstract
Brazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.
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11
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Universal process-based CBT for positive mental health in early adolescence: A cluster randomized controlled trial. Behav Res Ther 2022; 154:104120. [DOI: 10.1016/j.brat.2022.104120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/24/2022] [Accepted: 05/13/2022] [Indexed: 12/19/2022]
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Johnson JCS, Byrne GJ, Pelecanos AM. The prevalence of subthreshold psychiatric symptoms and associations with alcohol and substance use disorders: from a nationally representative survey of 36,309 adults. BMC Psychiatry 2022; 22:270. [PMID: 35428242 PMCID: PMC9012038 DOI: 10.1186/s12888-022-03834-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/08/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Our aim was to describe a broad number of subthreshold psychiatric symptoms (SPS) in a nationally representative population and evaluate associations with substance use. SPS describe groups of symptoms with significant pathology, but that do not quite meet full psychiatric diagnostic criteria. They have been associated with significant impairment and cost. METHODS The National Epidemiologic Survey on Alcohol and Related Conditions-III was a multistage, weighted, cross-sectional survey completed in the United States in 2013 comprising 36,309 noninstitutionalized adults. We report lifetime prevalence rates of 14 SPS related to mood, anxiety, trauma, eating, and personality disorders. We then evaluate associations with lifetime alcohol use disorders (AUD) and all substance use disorders (SUD) using logistic regression and adjusted odds ratios. SPS and psychiatric diagnoses were mutually exclusive (could not co-occur). RESULTS Lifetime prevalence of having at least one of 14 SPS was 57% compared with 37% for the related psychiatric disorders. This was similar for males and females, in contrast to psychiatric disorders in which prevalence was 42% in females and 31% in males. Otherwise, overall SPS and disorders had similar prevalence patterns across sociodemographic characteristics. Subthreshold personality symptoms had the highest prevalence rates (schizotypal 21.3%, antisocial 18.3%, and borderline 17.6%), followed by posttraumatic stress (13.1%). Subthreshold bipolar and depression had lifetime prevalence rates of 2.7 and 8.5%, respectively. Prevalence rates of subthreshold anxiety symptoms ranged from 2.2% (agoraphobia) to 9.8% (specific phobia). Subthreshold eating disorder related symptoms had the lowest prevalence rates (anorexia 1.5% and bulimia 1.7%). Half (seven) of the SPS had significantly increased odds of lifetime AUD. This number increased to 12 for all SUD. Subthreshold antisocial personality symptoms had the highest odds of AUD (2.2; 95% CI 2.00-2.37) and SUD (3.5; 95% CI 3.22-3.81). CONCLUSIONS We found high lifetime SPS prevalence rates and significant associations with AUD and SUD. To our knowledge, this is the first published study evaluating a broad number of SPS. This indicates possible opportunities for early intervention and prevention but requires additional research and development of infrastructure and guidelines to better understand and manage patients who experience SPS.
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Affiliation(s)
- Jeremy C. S. Johnson
- grid.1003.20000 0000 9320 7537The University of Queensland, Mental Health Centre, K Floor, Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia ,grid.416100.20000 0001 0688 4634Department of Psychiatry, Royal Brisbane & Women’s Hospital, Butterfield St, Herston, QLD 4029 Australia
| | - Gerard J. Byrne
- grid.1003.20000 0000 9320 7537The University of Queensland, Mental Health Centre, K Floor, Royal Brisbane & Women’s Hospital, Herston, QLD 4029 Australia ,grid.416100.20000 0001 0688 4634Department of Psychiatry, Older Persons’ Mental Health Service, Royal Brisbane & Women’s Hospital, Butterfield St, Herston, QLD 4029 Australia
| | - Anita M. Pelecanos
- grid.1049.c0000 0001 2294 1395Statistics Unit, QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD 4006 Australia
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Khanijahani A, Sualp K. Adverse Childhood Experiences, Neighborhood Support, and Internalizing and Externalizing Mental Disorders among 6-17 years old US Children: Evidence from a Population-Based Study. Community Ment Health J 2022; 58:166-178. [PMID: 33709281 DOI: 10.1007/s10597-021-00808-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 02/23/2021] [Indexed: 11/24/2022]
Abstract
We pooled data from four years (2016-2019) of the National Survey of Children's Health (NSCH) and included a nationally representative sample of 6 to 17 years old US children (N = 94,369; Mean age = 11.53 years, Standard Deviation [SD] = 3.53). Among 6-17-year-old US children, about 48% had a lifelong exposure to at least one of nine Adverse Childhood Experiences (ACEs), and 18.7% had a current diagnosis of at least one of four mental disorders. We examined the association between ACEs, neighborhood support, and mental disorders using several logistic regression models. More types of lifelong ACEs and lower neighborhood support were associated with a higher diagnosis of internalizing (anxiety/depression) and externalizing (ADHD/behavior problems) mental disorders (odds ratio [OR] > 1, and p < .001 for all relationships). After controlling for neighborhood support in the models, the odds ratios for ACEs attenuated but remained significant in all models regardless of mental disorder type or age group. However, the odds ratios for neighborhood support were larger for the association with ADHD/behavior problems than anxiety/depression. Moreover, odds ratios for neighborhood support levels were higher for older children (12-17 years old) compared to younger (6-11 years old) children. Higher neighborhood support appears to mitigate the adverse effects of ACEs on mental disorders, especially externalizing mental disorders (anxiety/depression) among adolescents (12-17 years old).
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Affiliation(s)
- Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Kenan Sualp
- Department of Public Affairs, University of Central Florida, Orlando, FL, USA
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Hansen AS, Christoffersen CH, Telléus GK, Lauritsen MB. Referral patterns to outpatient child and adolescent mental health services and factors associated with referrals being rejected. A cross-sectional observational study. BMC Health Serv Res 2021; 21:1063. [PMID: 34625073 PMCID: PMC8501731 DOI: 10.1186/s12913-021-07114-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 10/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Outpatient child and adolescent mental health services (CAMHS) are faced with the challenge of balancing increasing demands with limited resources. An additional challenge is high rejection rates of referrals which causes frustration for referring agents and families. In order to effectively plan and allocate available resources within CAMHS there is a need for up-to-date knowledge on referral patterns and factors associated with rejection of referrals. METHODS In this cross-sectional observational study we did a retrospective review of all referrals (n = 1825) for children (0-18) referred for assessment at the outpatient CAMHS of the North Denmark Region in 2018. RESULTS The most common referral reasons to CAMHS were attention deficit disorder (ADHD/ADD) (27.9%), autism spectrum disorder (22.4%), affective disorders (14.0%) and anxiety disorders (11.6%). The majority of referrals came from general practitioners, but for neurodevelopmental disorders educational psychologists were the primary referral source. Re-referrals constituted more than a third of all referrals (35.9%). Children in care were overrepresented in this clinical sample and had an increased risk (Adj. OR 2.54) of having their referrals rejected by CAMHS. Referrals from general practitioners were also associated with an increased risk of rejection (Adj. OR 3.29). CONCLUSIONS A high proportion of children with mental disorders have a repeated need for assessment by CAMHS. There is a need for future research on predictors of re-referral to outpatient services to identify potential targets for reducing re-referral rates as well as research on how to optimize service provision for children with a repeated need for assessment. General practitioners are the main gatekeepers to CAMHS and research on interventions to improve the referral process should be aimed towards general practitioners.
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Affiliation(s)
- Anna Sofie Hansen
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark.
| | | | - Gry Kjaersdam Telléus
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000, Aalborg, Denmark.,Psychology, Department of Communication and Psychology, Aalborg University, Rendsburggade 14, 9000, Aalborg, Denmark
| | - Marlene Briciet Lauritsen
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark
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Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis. Harv Rev Psychiatry 2021; 29:196-215. [PMID: 33979106 DOI: 10.1097/hrp.0000000000000294] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). METHODS We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. RESULTS 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. CONCLUSION Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.
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Le LKD, Shih S, Richards-Jones S, Chatterton ML, Engel L, Stevenson C, Lawrence D, Pepin G, Mihalopoulos C. The cost of Medicare-funded medical and pharmaceutical services for mental disorders in children and adolescents in Australia. PLoS One 2021; 16:e0249902. [PMID: 33836033 PMCID: PMC8034743 DOI: 10.1371/journal.pone.0249902] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine the health care costs associated with mental disorders and subthreshold mental disorders within a nationally representative sample of children and adolescents in Australia. METHOD Data were derived from the Young Minds Matter Survey (N = 6,310). Mental disorders were classified using the Diagnostic Interview Schedule for Children Version IV. Participant data were linked to administrative data on health care costs. Adjusted generalized linear regression models and two-part models were used to estimate mean differences in costs between those with a mental disorder or subthreshold disorder and those without. RESULTS Costs associated with health care attendances and medications were higher for children and adolescents with mental disorders and subthreshold mental disorders compared to those without a mental disorder. The additional population health care costs due to mental disorders amounted to AUD$234 million annually in children and adolescents, of which approximately 16% was attributed to out-of-pocket costs. Findings showed that those with subthreshold mental disorders or comorbid mental disorders have substantial additional costs of Medicare-funded medical and pharmaceutical services. CONCLUSION AND IMPLICATION Mental disorders in children and adolescents are associated with significant health care costs. Further research is needed to ensure that this population is receiving effective and efficient care.
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Affiliation(s)
- Long Khanh-Dao Le
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
- * E-mail:
| | - Sophy Shih
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Scott Richards-Jones
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Mary Lou Chatterton
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Lidia Engel
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | | | - David Lawrence
- Graduate School of Education, The University of Western Australia, Perth, Australia
| | - Genevieve Pepin
- School of Health and Social Development, Deakin University, Geelong, Australia
| | - Cathrine Mihalopoulos
- School of Health and Social Development, Deakin University, Geelong, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
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Hendriks AM, Ip HF, Nivard MG, Finkenauer C, Van Beijsterveldt CE, Bartels M, Boomsma DI. Content, diagnostic, correlational, and genetic similarities between common measures of childhood aggressive behaviors and related psychiatric traits. J Child Psychol Psychiatry 2020; 61:1328-1338. [PMID: 32080854 PMCID: PMC7754303 DOI: 10.1111/jcpp.13218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Given the role of childhood aggressive behavior (AGG) in everyday child development, precise and accurate measurement is critical in clinical practice and research. This study aims to quantify agreement among widely used measures of childhood AGG regarding item content, clinical concordance, correlation, and underlying genetic construct. METHODS We analyzed data from 1254 Dutch twin pairs (age 8-10 years, 51.1% boys) from a general population sample for whom both parents completed the A-TAC, CBCL, and SDQ at the same occasion. RESULTS There was substantial variation in item content among AGG measures, ranging from .00 (i.e., mutually exclusive) to .50 (moderate agreement). Clinical concordance (i.e., do the same children score above a clinical threshold among AGG measures) was very weak to moderate with estimates ranging between .01 and .43 for mother-reports and between .12 and .42 for father-reports. Correlations among scales were weak to strong, ranging from .32 to .70 for mother-reports and from .32 to .64 for father-reports. We found weak to very strong genetic correlations among the measures, with estimates between .65 and .84 for mother-reports and between .30 and .87 for father-reports. CONCLUSIONS Our results demonstrated that degree of agreement between measures of AGG depends on the type (i.e., item content, clinical concordance, correlation, genetic correlation) of agreement considered. Because agreement was higher for correlations compared to clinical concordance (i.e., above or below a clinical cutoff), we propose the use of continuous scores to assess AGG, especially for combining data with different measures. Although item content can be different and agreement among observed measures may not be high, the genetic correlations indicate that the underlying genetic liability for childhood AGG is consistent across measures.
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Affiliation(s)
- Anne M. Hendriks
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Hill F. Ip
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Michel G. Nivard
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Catrin Finkenauer
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Department of Interdisciplinary Social Sciences: Youth StudiesUtrecht UniversityUtrechtThe Netherlands
| | | | - Meike Bartels
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Dorret I. Boomsma
- Department of Biological PsychologyVrije Universiteit AmsterdamAmsterdamThe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
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Salazar de Pablo G, De Micheli A, Nieman DH, Correll CU, Kessing LV, Pfennig A, Bechdolf A, Borgwardt S, Arango C, van Amelsvoort T, Vieta E, Solmi M, Oliver D, Catalan A, Verdino V, Di Maggio L, Bonoldi I, Vaquerizo-Serrano J, Baccaredda Boy O, Provenzani U, Ruzzi F, Calorio F, Nosari G, Di Marco B, Famularo I, Molteni S, Filosi E, Mensi M, Balottin U, Politi P, Shin JI, Fusar-Poli P. Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis. Eur Neuropsychopharmacol 2020; 41:28-39. [PMID: 33162291 DOI: 10.1016/j.euroneuro.2020.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 10/16/2020] [Indexed: 12/31/2022]
Abstract
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.
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Affiliation(s)
- 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, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - 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, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum im Friedrichshain, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Neurosciences Department, University of Padova, Italy
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Spain
| | - Valeria Verdino
- 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 Molecular and Developmental Medicine, Division on Psychiatry, University of Siena, Italy
| | - Lucia Di Maggio
- 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 Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottone Baccaredda Boy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- 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 Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Ruzzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Calorio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Benedetto Di Marco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Famularo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Silvia Molteni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eleonora Filosi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit
| | - Umberto Balottin
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - 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; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.
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Cirillo A, Diniz E, Gadelha A, Asevedo E, Axelrud LK, Miguel EC, Rohde LA, Bressan RA, Pan P, Mari JDJ. Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries. ACTA ACUST UNITED AC 2020; 42:442-448. [PMID: 32267341 PMCID: PMC7430393 DOI: 10.1590/1516-4446-2019-0761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/01/2019] [Indexed: 12/21/2022]
Abstract
Objective: Population neuroscience is an emerging field that combines epidemiology and neuroscience to study how genes and the environment shape typical and atypical brain functioning. The objective of this study was to review key studies on population neuroscience from low- and middle-income countries (LMICs) and to identify potential gaps vis-à-vis studies conducted in high-income countries. Methods: We conducted a systematic review to search for longitudinal cohort studies investigating the development of psychiatric disorders in children and adolescents in LMICs. We performed an electronic search in the EMBASE and MEDLINE databases from inception to July 5th, 2019. Results: We found six cohorts from four countries that met our search criteria: three cohorts from Brazil, one from China, one from South Africa, and one from Mauritius. Relevant examples of findings from these studies are reported. Conclusion: Our results demonstrate the impact of the valuable science output these cohort designs promote, allowing LMICs to have a share in frontline global psychiatry research. National and international funding agencies should invest in LMIC population neuroscience in order to promote replication and generalization of research from high-income countries.
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Affiliation(s)
| | - Elton Diniz
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ary Gadelha
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elson Asevedo
- Global Mental Health Program, Columbia University, New York, NY, USA
| | - Luiza K Axelrud
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Eurípedes C Miguel
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INPD), Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Pedro Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Jair de J Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Esin IS, Turan B, Akıncı MA, Karabak M, Dursun OB. Do we need to re-think on subthreshold childhood psychiatric cases? A follow-up study. Med Hypotheses 2020; 139:109697. [PMID: 32247189 DOI: 10.1016/j.mehy.2020.109697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/18/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022]
Abstract
A remarkable number of children all over the world have psychiatric disorders, which cause severe impairments in functionality. In the development of future mental health planning, not only determining epidemiological data is sufficient, but also follow-up studies are needed. This study aimed to determine the course of subthreshold psychiatric disorders in three-year follow-up process, and whether there is a relationship between sociodemographic factors, parental attitudes and SDQ scores and the escalating escalation from SPD to psychopathology or the disappearance of SPD symptoms. This study included fifty-four children with age of 7-9 years. The Development and Well Being Assessment, structured diagnostic interview, was used to evaluate psychiatric disorders. Besides, parents were asked to fill out a socio-demographic form and the Parent Attitude Research Instrument. The mean age of children was 8.2 ± 0.8 years, and 59.3% of them were girls, and 40.7% of them were boys. At the beginning of the study, most common subthreshold psychiatric disorders were Specific Phobia with a prevalence of 3%, followed by Attention Deficit Hyperactivity Disorder 2.2%. After three-year of the follow-up period, 37% of subthreshold cases progress into psychiatric disorders. Living in a city centre in a slum and psychiatric disorder history of the family were independent risk factors for developing psychopathology. Living in a village was an effective protective factor in the disappearance of Subthreshold Psychiatric Disorder symptoms. In this study, besides the factors that may be effective in the development of psychiatric disorders, the factors that may be effective in the disappearance of Subthreshold Psychiatric Disorder symptoms were examined.
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Affiliation(s)
- Ibrahim Selcuk Esin
- Department of Child and Adolescent Psychiatry, Ataturk University, Faculty of Medicine, Erzurum, Turkey
| | - Bahadır Turan
- Department of Child and Adolescent Psychiatry, Agrı State Hospital, Agrı, Turkey
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Dr. Ali Kemal Belviranlı Obstetrics and Pediatrics Hospital, Konya, Turkey
| | - Merve Karabak
- Department of Child and Adolescent Psychiatry, Ataturk University, Faculty of Medicine, Erzurum, Turkey
| | - Onur Burak Dursun
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Faculty of Medicine, Trabzon, Turkey.
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