History of Depression, Elevated Body Mass Index, and Waist-to-Height Ratio in Preadolescent Children

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Adverse Childhood Experiences and Accelerometer-Measured Physical Activity and Sleep in Preadolescents

OBJECTIVE

To assess the relationship between adverse childhood experiences (ACEs) and objective measures of physical activity and sleep.

METHODS

Data from the baseline and 2-year follow-up of the Adolescent Brain and Cognitive Development study were analyzed (n = 6227 for physical activity; n = 4151 for sleep). ACEs were assessed by parent report at baseline (mean age 9.9 years) with 3 levels: none, exposure to 1 ACE, and exposure to 2 or more ACEs. Objective measures of physical activity and sleep were assessed with an accelerometer at 2-year follow-up (mean age 11.9 years). Multivariate linear regression analyses were used to examine the relationship between ACEs and physical activity as well as sleep, adjusting for family income and sex.

RESULTS

Compared to children with no ACEs, children with ACEs had fewer daily steps: 1 ACE (β = -323 (95% CI: -508 to -138), P < .001) and 2 or more ACEs (β = -417 (95% CI: -624 to -209), P < .001). ACEs were also associated with shorter sleep duration (minutes), although only for participants with 2 or more ACEs (1 ACE: β = -2.2 (-5.3 to 0.8), P = .16; 2 or more ACEs: β = -6.2 (95% CI: -9.6 to -2.7), P < .001). Rapid eye movement (REM) sleep specifically was reduced in participants with ACEs (1 ACE (β = -1.4 (-2.7 to -0.01), P = .05) and 2 or more ACEs (β = -2.3 (-3.8 to -0.8), P = .003).

CONCLUSIONS

There is a dose-response relationship between ACEs and reduced daily steps, total sleep duration, and REM sleep in preadolescents.

The prevalence of underweight and obesity in Chinese children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide

Background

The high rates of obesity and suicide have become serious public health problems worldwide, especially in children and adolescents with major depressive disorder (MDD). This research aimed to explore the rates of underweight, overweight or obesity, suicidal ideation and attempted suicide in hospitalized children and adolescents with MDD. Then, we analyzed the correlation between underweight or obesity and suicidal ideation and attempted suicide, and finally obtained the independent influencing factors of underweight or obesity.

Methods

A total of 757 subjects in the Third People's Hospital of Fuyang from January 2020 to December 2021 were enrolled in this study. According to the underweight, overweight and obesity screening table for school-age children and adolescents published and implemented by the health industry standard of China, all subjects were divided into different body mass index (BMI) categories. We measured fasting blood glucose (FBG) and lipid levels in all subjects and assessed suicidal ideation, attempted suicide, and the severity of depressive symptoms. The socio-demographic and clinical data were collected and analyzed by SPSS 22.0.

Results

The rates of underweight, overweight, obesity, suicidal ideation and attempted suicide were 8.2% (62/757), 15.5% (117/757), 10.4% (79/757), 17.2% (130/757), and 9.9% (75/757), respectively. Correlation analysis indicated that BMIs level was positively correlated with age, age of first hospitalization, total duration of disease, number of hospitalizations, FBG, TG (triglyceride), TC (total cholesterol), LDL (low density lipoprotein), and negatively correlated with HDL (high density lipoprotein). Binary logistic regression analysis showed that male and high level of HDL were risk factors for MDD inpatients with underweight, while high level of TG was a protective factor. Meanwhile, higher levels of FBG, TG and CGI-S were risk factors and suicidal ideation and high dose of antidepressant drugs were protective factors for obesity in children and adolescents with MDD.

Conclusion

The prevalence of underweight, obesity, suicidal ideation and attempted suicide were high in children and adolescents with MDD, and severe depressive symptoms are independent risk factors for obesity, while suicidal ideation and high dose of antidepressants may be protective factors for obesity.

Exploring joint HPA-inflammatory stress response profiles in adolescent girls: Implications for developmental models of neuroendocrine dysregulation

Prior research has struggled to differentiate cortisol stress response patterns reflective of well-regulated versus dysregulated hypothalamic-pituitary-adrenal (HPA) axis function among adolescents. Here, we show how exploring profiles of joint HPA-inflammatory stress responsivity, and linking those profiles to pubertal development and peer stress exposure may aid such distinction. Adolescent girls (N = 157, Mage  = 14.72 years, SD = 1.38) at risk for psychopathology completed assessments of salivary cortisol and pro-inflammatory cytokines (i.e., tumor necrosis factor-α, interleukin-1β, and interleukin-6) prior to and following the Trier Social Stress Test. Adolescents, a close friend, and a caregiver completed questionnaire measures of peer stress and pubertal status. Multitrajectory modeling of adolescents' cortisol and cytokine levels revealed three profiles: low cortisol response-stably low cytokine (n = 75), high cortisol response-stably moderate cytokine (n = 47), and low cortisol response-stably high cytokine (n = 35). Relative to low cortisol response-stably low cytokine, adolescents exhibiting the high cortisol response-stably moderate cytokine profile were more advanced in their pubertal development, but presented with similarly low levels of peer stress exposure. Despite showing cortisol responses that were indistinguishable from low cortisol response-stably low cytokine, adolescents exhibiting the low cortisol response-stably high cytokine profile were more pubertally advanced, but also more likely to have experienced chronic peer strain (self-report) and relational peer victimization (close friend-report). These findings thus illustrate the potential value of taking a multisystem approach to studying adolescent stress responsivity and underscore the importance of considering developmental and social factors when interpreting cortisol stress response patterns. Ultimately, such work may help inform developmental models of neuroendocrine dysregulation and related risk for psychopathology.