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Jimoh-Abdulghaffaar HO, Joel IY, Jimoh OS, Ganiyu KO, Alatiba TM, Ogunyomi VO, Adebayo MS, Awoliyi VT, Agaka AO, Oyedeji AB, Kolade IA, Ojulari LS. Sex Influences Genetic Susceptibility to Depression-Like Behaviors in Chronic Unpredictable Mild Stress-Exposed Wistar Rats. Mol Neurobiol 2024:10.1007/s12035-024-04348-5. [PMID: 39012445 DOI: 10.1007/s12035-024-04348-5] [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: 02/20/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Abstract
Depression is one of the most common mood disorders among psychiatric diseases. It affects about 10% of the adult population. However, its etiopathogenesis remains poorly understood. Exploring the dynamics of stress-susceptibility and resilience will help in understanding the molecular and biological mechanisms underlying the etiopathogenesis of depression. This study aimed to determine the differences and/or similarities in factors responsible for susceptibility to depression-like behaviors in male and female Wistar rats subjected to chronic unpredictable mild stress (CUMS). Sixty Wistar rats (30 male and 30 female) weighing between 120 and 150 g were used for this study. The rats were divided into two sub-groups: control (10) and test (20) groups. Rats in the test groups were subjected to CUMS. Depression-like behaviors were assessed using light-dark box, sucrose preference, and tail suspension tests. Rats that showed depression-like behaviors following the behavioral tests (CUMS-susceptible group) were sacrificed, and their hippocampi were excised. Genomic deoxyribonucleic acid (gDNA) was purified from the hippocampal samples. Purified gDNA was subjected to whole genome sequencing (WGS). Base-calling of sequence reads from raw sequencing signal (FAST5) files was carried out, and variants were called from alignment BAM files. The corresponding VCF files generated from the variant calling experiment were filtered. Genes were identified, their impacts estimated, and variants annotated. Functional enrichment analysis was then carried out. Approximately 41% of the male and 49% of the female rats subjected to CUMS showed significant (p < 0.05) depression-like behaviors following assessment on behavioral tests. WGS of the hippocampal DNA revealed 289,839 single nucleotide polymorphisms variant types, 7002 insertions, and 34,459 deletions in males, and 1,570,186 single nucleotide polymorphisms variant types, 109,860 insertions, and 597,241 deletions in female Wistar rats. Three genes with high-impact variants were identified in male and 22 in female Wistar rats, respectively. In conclusion, female Wistar rats are more susceptible to depression-like behaviors after exposure to CUMS than males. They also have more gene variants (especially high-impact variants) than male Wistar rats.
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Affiliation(s)
| | - Ireoluwa Yinka Joel
- Department of Biochemistry, Federal University of Agriculture, Makurdi, Benue State, Nigeria
| | | | - Kaosara Oyinola Ganiyu
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Temidayo Micheal Alatiba
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Victory Oluwaseyi Ogunyomi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Muhammed Salaudeen Adebayo
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Victoria Tolulope Awoliyi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Adamah Olamide Agaka
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Aminat Bolatito Oyedeji
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Ifeoluwa A Kolade
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Lekan Sheriff Ojulari
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
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Hennefield L, Denton EG, Chen PG, Sheftall AH, Ayer L. Preteen Suicide Risk Screening in the Pediatric Outpatient Setting: A Clinical Pathway. J Acad Consult Liaison Psychiatry 2024:S2667-2960(24)00065-X. [PMID: 38908827 DOI: 10.1016/j.jaclp.2024.06.003] [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: 08/28/2023] [Revised: 04/26/2024] [Accepted: 06/12/2024] [Indexed: 06/24/2024]
Abstract
We are in a youth mental health crisis with unprecedented and staggeringly high rates of suicidal ideations and suicide behaviors in preteens. In the United States, 14.5% of children aged 9-10 have experienced suicidal thoughts and behaviors, including 1.3% with a suicide attempt. American Academy of Pediatrics guidelines call for universal suicide risk screening of youth aged 12 years and older during preventative health care visits and screening in preteens aged 8-11 years when clinically indicated. However, what constitutes a clinical indication at 8-11 years can be difficult to systematically detect, and pediatric practitioners may not be equipped with necessary age-specific assessment tools. This is compounded by the lack of emphasis on preteen suicide risk screening (and focus on adolescents), which leaves practitioners without age-appropriate resources to make clinical determinations for at-risk preteens. The objective of this project was to develop an evidence-informed suicide risk screening pathway for pediatric practitioners to implement with preteen patients in outpatient settings. Suicide risk assessment in younger children (<8 years) is also briefly addressed. We convened a group of researchers and practitioners with expertise in preadolescent suicide, pediatric medicine, behavioral health screening integration with primary care, and child development. They reviewed the empirical literature and existing practice guidelines to iterate on a multi-informant clinical suicide risk screening pathway for preteens that includes both caregivers and preteens in the screening process. We also developed tools and accompanying guidelines for a preteen suicide risk screening workflow and risk determination to aid practitioners in deciding who, when, and how to screen. Finally, we provide scripts for introducing suicide risk screening to caregivers and preteens and to discuss screening findings.
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Affiliation(s)
- Laura Hennefield
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO.
| | - Ellen-Ge Denton
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY
| | | | - Arielle H Sheftall
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY
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Mallya A, Koppad R, Kumar P. Depression, anxiety, and stress among urban and rural adolescents in Shivamogga, Karnataka. F1000Res 2024; 12:1583. [PMID: 38948506 PMCID: PMC11211729 DOI: 10.12688/f1000research.139603.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 07/02/2024] Open
Abstract
Background: Currently there are 1.3 billion adolescents worldwide, which makes up 16% of the world population. Over 20% of adolescents around the world are thought to have behavioural or mental health issues. Addressing mental health issues is very important for the promotion of positive health in adolescents. Methods: The objective of our study was to estimate the prevalence of depression, anxiety, and stress among adolescents in urban and rural areas of Shivamogga. A cross-sectional study was conducted among 350 adolescents aged 16 to 19 years each from urban and rural areas of Shivamogga. Results: Depression, anxiety and stress were found to be 23.1%, 29.4% and 26.6% in urban areas and 19.1%, 24% and 21.1% in rural areas respectively. Conclusions: About a quarter of the adolescent population suffers from depression anxiety and stress. Adopting and implementing better education and health policies are necessary to enhance adolescent mental health.
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Affiliation(s)
- Ajay Mallya
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Raghavendraswamy Koppad
- Department of Community Medicine, Shivamogga Institute of Medical Sciences, Shivamogga, Karnataka, 577201, India
| | - Praveen Kumar
- Department of Community Medicine, Shivamogga Institute of Medical Sciences, Shivamogga, Karnataka, 577201, India
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Lee YJ, Kweon YS, Kang YH, Yoon KH, Lee MS, Bhang SY, Hong HJ. Suicide warning signs that are challenging to recognize: a psychological autopsy study of Korean adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:41. [PMID: 38528559 DOI: 10.1186/s13034-024-00731-1] [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: 10/29/2023] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND In South Korea, the leading cause of youth death has been suicide for about 20 years. In this study, we conducted a multi-method psychological autopsy to identify the psychiatric diagnosis, developmental history, personality traits, family history, school life, warning signs of suicide, and risk factors related to suicide for the first time in Korea. METHODS This was a postmortem, retrospective, and descriptive study of 36 adolescents who died by suicide between August 2015 and July 2021 in South Korea. We obtained qualitative and quantitative data from the Korean Psychological Autopsy of Adolescent, conducted by the Suicide and School Mental Health Institute, the official student mental health policy-focused research institute of the Korean Ministry of Education. RESULTS The adolescents comprised equal percentage of girls and boys. Approximately half of the deaths (55.6%) occurred at home and most (72.2%) involved jumping from a height. Most of the adolescents (97.2%) had one major psychiatric disorder before death, with depressive disorder being the most prevalent (75%). They were at a high risk for internet addiction before death. The most common personality trait was avoidance (28.6%), followed by submissiveness (27.3%). Half of the parents reported that the adolescents were satisfied with their school life and the teachers observed that they had no behavioral problems. One year before death, seven (19.4%) adolescents injured themselves and five (13.9%) had attempted suicide. Most of the deceased (80.6%) had expressed suicide warning signs to their families within one year before death. Adolescents had a long experience of family-related adverse events. CONCLUSIONS Most of the adolescents had mental health disorders and expressed suicidal intentions using verbal and nonverbal signs. However, it was challenging for families to recognize the risk signs because of adolescents' personality traits or a good school life. To prevent adolescent suicide, adolescents, parents, and teachers need to be educated to recognize signs of suicide warning signs and equipped to guide adolescents to appropriate care.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, College of Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Yong-Sil Kweon
- Department of Psychiatry, College of Medicine, The Catholic University, Seoul, Republic of Korea
| | | | - Kyung Hee Yoon
- School Mental Health Resources and Research Center, Seoul, Republic of Korea
| | - Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Republic of Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
- Eulji Psychiatry and Medical Science Center, Eulji University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hyun Ju Hong
- Suicide and School Mental Health Institute, Anyang, Republic of Korea.
- Department of Psychiatry, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang, 14068, Republic of Korea.
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Papsdorf R, Genuneit J, White LO, Radeloff DM. [Suicides among children, adolescents, and young adults during the COVID-19 pandemic - An analysis of police data from three German federal states]. PSYCHIATRISCHE PRAXIS 2024; 51:79-83. [PMID: 37813365 DOI: 10.1055/a-2171-4889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The COVID-19 pandemic severely affected young people, resulting in increased psychological distress and rising prevalence rates for mental disorders. There is concern that completed suicides have increased in addition to the observed increase in suicide attempts. METHOD The study is based on the police crime statistics (01/2017 to 12/2022) of three federal states in Germany, representing 13% of Germany's overall population. Suicide counts and rates for the child, teenage, adolescent, and young adult age groups were compared between the pre-pandemic and pandemic periods using chi-squared tests. RESULTS 860 people under age 30 died from suicide. Suicide rates did not differ between the pre-pandemic and pandemic periods in any of the age groups studied. CONCLUSION So far, there has been no discernible increase in suicides among young Germans. Ongoing suicide monitoring is recommended.
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Affiliation(s)
- Rainer Papsdorf
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universität, Leipzig
| | - Jon Genuneit
- Pädiatrische Epidemiologie, Universitätsklinikum Leipzig
| | - Lars Otto White
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universität, Leipzig
| | - Daniel Matthias Radeloff
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universität, Leipzig
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Luo J, Chen Y, Tao Y, Xu Y, Yu K, Liu R, Jiang Y, Cai C, Mao Y, Li J, Yang Z, Deng T. Major Depressive Disorder Prediction Based on Sleep-Wake Disorders Symptoms in US Adolescents: A Machine Learning Approach from National Sleep Research Resource. Psychol Res Behav Manag 2024; 17:691-703. [PMID: 38410378 PMCID: PMC10896099 DOI: 10.2147/prbm.s453046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
Background There is substantial evidence from previous studies that abnormalities in sleep parameters associated with depression are demonstrated in almost all stages of sleep architecture. Patients with symptoms of sleep-wake disorders have a much higher risk of developing major depressive disorders (MDD) compared to those without. Objective The aim of the present study is to establish and compare the performance of different machine learning models based on sleep-wake disorder symptoms data and to select the optimal model to interpret the importance of sleep-wake disorder symptoms to predict MDD occurrence in adolescents. Methods We derived data for this work from 2020 to 2021 Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide Phase I Study from National Sleep Research Resource. Using demographic and sleep-wake disorder symptoms data as predictors and the occurrence of MDD measured base on the center for epidemiologic studies depression scale as an outcome, the following six machine learning predictive models were developed: eXtreme Gradient Boosting model (XGBoost), Light Gradient Boosting mode, AdaBoost, Gaussian Naïve Bayes, Complement Naïve Bayes, and multilayer perceptron. The models' performance was assessed using the AUC and other metrics, and the final model's predictor importance ranking was explained. Results XGBoost is the optimal predictive model in comprehensive performance with the AUC of 0.804 in the test set. All sleep-wake disorder symptoms were significantly positively correlated with the occurrence of adolescent MDD. The insomnia severity was the most important predictor compared with the other predictors in this study. Conclusion This machine learning predictive model based on sleep-wake disorder symptoms can help to raise the awareness of risk of symptoms between sleep-wake disorders and MDD in adolescents and improve primary care and prevention.
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Affiliation(s)
- Jingsong Luo
- School of Nursing, The Chengdu University of Traditional Chinese Medicine, Sichuan, 610000, People's Republic of China
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yuxin Chen
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yanmin Tao
- School of Nursing, The Chengdu University of Traditional Chinese Medicine, Sichuan, 610000, People's Republic of China
| | - Yaxin Xu
- School of Nursing, Tongji University, Shanghai, 200000, People's Republic of China
| | - Kexin Yu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Ranran Liu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yuchen Jiang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Cichong Cai
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yiyang Mao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Jingyi Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Ziyi Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Tingting Deng
- School of Nursing, The Chengdu University of Traditional Chinese Medicine, Sichuan, 610000, People's Republic of China
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Baumeister-Lingens L, Rothe R, Wolff L, Gerlach AL, Koenig J, Sigrist C. Vagally-mediated heart rate variability and depression in children and adolescents - A meta-analytic update. J Affect Disord 2023; 339:237-255. [PMID: 37437729 DOI: 10.1016/j.jad.2023.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/09/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Depression is one of the most common mental disorders and a leading cause of disability worldwide. In adults, depression is characterized by decreased vagal activity (vagally-mediated heart rate variability; vmHRV), while vmHRV is inversely correlated with depressive symptoms. In children/adolescents, a 2016 synthesis (4 studies, 259 individuals) found similarly decreased vmHRV in clinical depression, but no significant association between depressive symptoms and vmHRV (6 studies, 2625 individuals). Given the small number of studies previously considered for synthesis and the rapidly growing evidence base in this area, a meta-analytic update was warranted. METHOD A previous review was updated by a systematic literature search to identify studies that (a) compared vmHRV in clinically depressed children/adolescents with non-depressed controls and (b) reported associations between vmHRV and depression severity. RESULTS The search update identified 5 additional studies for group comparison (k = 9 studies in total, n = 608 individuals in total) and 15 additional studies for correlational meta-analysis (k = 21 studies in total, n = 4224 individuals in total). Evidence was found for lower resting-state vmHRV in clinically depressed children/adolescents compared to healthy controls (SMD = -0.593, 95 % CI [-1.1760; -0.0101], I2 = 90.92 %) but not for a significant association between vmHRV and depressive symptoms (r = -0.053, 95 % CI [-0.118; 0.012], I2 = 65.77 %). Meta-regression revealed a significant association between depressive symptoms and vmHRV as a function of sex. LIMITATIONS The samples considered are highly heterogeneous. Data on the longitudinal association between vmHRV and depression are currently lacking. CONCLUSION The present findings support the use of vmHRV as a biomarker for clinical depression in children/adolescents.
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Affiliation(s)
- Luise Baumeister-Lingens
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Roxana Rothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Lena Wolff
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Alexander L Gerlach
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
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Li H, Hou L, Wang D, Wu Q, Li H, He W, Li S, Pang J, Zhang Y, Ma Q, Li C, Cheng J. Response rate and safety of antidepressants combined with electroconvulsive therapy in adolescent depression: Real-world clinical application. J Affect Disord 2023; 339:98-103. [PMID: 37390926 DOI: 10.1016/j.jad.2023.06.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/25/2023] [Accepted: 06/26/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND METHODS: This study included 210 depression patients receiving antidepressants and ECT. The symptoms of depression were examined with the Hamilton Depression Scale (HAMD) and Clinical Global Impressions Scale (CGI) at baseline and the end of treatment. Response and safety were compared among adolescent and adult patients. RESULTS For adolescents, the response rate (much improved or very much improved) was 80.9 %, and CGI-Severity (CGI-S), HAMD, and suicide factor scores were significantly changed as compared to baseline (P < 0.001), results of which were similar to the adult group. There were no significant differences in HAMD, CGI scores between adolescent and adult depression before or after treatment (P > 0.05). Notably, adolescents expressed stronger suicidal intent than adults, and ECT observably relieved it. Side effects (memory problems, headache, nausea/vomiting, muscle soreness) in adolescents were not statistically different from those in adults (P > 0.05). LIMITATIONS As data were derived from a single center, the generalizability of results may be limited, and the potential factors affecting the efficacy of ECT were not further explored. CONCLUSION Antidepressants combined with ECT are associated with high response rate and safety for treating depression, regardless of age. A stronger expression of suicide ideation was observed in depressed adolescents, and side effects of ECT were similar to the adults.
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Affiliation(s)
- Hong Li
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Lingzhi Hou
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Dong Wang
- Department of Geriatric Psychiatry, Suzhou Mental Health Center, Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou 215000, China
| | - Qijin Wu
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Haijin Li
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Wen He
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Sheng Li
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Jianyue Pang
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yanyan Zhang
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Quangang Ma
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Cai Li
- Department of Pharmacy, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou 450052, China.
| | - Jun Cheng
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Parida D, Prasad P, Sahu P, Krishna SK, Joshi A, Dabar D, Verma S. Prevalence and Correlates of Depression Among School-Going Adolescents in the Urban Schools of Central India: A Cross-Sectional Study. Cureus 2023; 15:e44088. [PMID: 37750148 PMCID: PMC10518062 DOI: 10.7759/cureus.44088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Adolescence is defined as the phase of development that occurs between childhood and adulthood. Presently in India, 243 million populations are staring at the crossroads of transition from childhood to adulthood. Physical, emotional, and social issues unique to this age group make them vulnerable to various mental problems. So, we conducted this study to quantify the current burden of depression in adolescents and its possible causes. MATERIALS AND METHODS The present community-based cross-sectional study was conducted in the middle and late adolescent participants aged 14-19 years from 52 sections (clusters) of 9th to 12thclasses comprising a total of 1412 students with a multistage cluster sampling method. In total four sections (clusters), and one participant of class 9th, 10th, 11th, and 12th were chosen from 13 preselected schools. The questionnaire consisted of socio-demographic details, screen time, physical activity, etc., and the DASS-42 scale was used to determine the prevalence of depression. Results: We found that the prevalence of depression in our study participants was around 39%. It was classified as 16.9%, 16.7%, 5.1%, and 0.5% participants respectively having mild, moderate, severe, and extremely severe depression. Mother's education was a statistically significant determinant for depression among these adolescents. CONCLUSION The study concludes that the prevalence of depression (including mild, moderate, severe, or very severe) among school-going adolescents is 39%. We hereby recommend that a holistic approach should be followed involving parents and teachers with the help of school counselors to tackle and curb this problem.
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Affiliation(s)
- Darshan Parida
- Department of Community Medicine, Index Medical College, Hospital & Research Centre, Indore, IND
| | - Pankaj Prasad
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, IND
| | - Pushpendra Sahu
- Department of Community Medicine, Government Medical College, Satna, IND
| | - Subba Krishna Krishna
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Guwahati, IND
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, IND
| | - Deepti Dabar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, IND
| | - Sudhir Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, IND
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Roemer J, Klein A, Horneff G. Prevalence and risk factors of depressive symptoms in children and adolescents with juvenile idiopathic arthritis. Rheumatol Int 2023:10.1007/s00296-023-05323-4. [PMID: 37039854 DOI: 10.1007/s00296-023-05323-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
Depression is a serious disorder disproportionately affecting people with chronic diseases, yet, to date is rarely recognized comorbidity in pediatric rheumatology clinical routine care. The aim of this study was to investigate the prevalence of depressive symptoms and depression in children with Juvenile idiopathic arthritis (JIA) and to identify associations to risk factors. Depressive symptoms were assessed using the Beck's Depression Inventory (BDI)-Fast Screen Questionnaire validated for ages 13 and older and confirmed by the BDI or Hamilton Depression Scale. A cross-sectional analysis of 148 patients attending the rheumatology outpatient clinic of the Asklepios Children's Hospital Sankt Augustin between January 2018 and May 2019 was performed. Possible associations between routinely assessed parameters of disease activity and treatment were analysed. 148 JIA patients (71.5% female), median age 14.7 years, were included. The prevalence for depressive symptoms was 13% and for depression 9.5%, of which 71.4% were newly identified with depression. Significant associations with depressive symptoms included rheumatoid factor negative polyarthritis, higher pain scores, functional limitations, higher disease activity, decreased general well-being, higher number of medications taken and not being in remission. In addition, poor treatment response (persistent pain despite therapy) and failure to achieve minimal activity/remission of disease despite intensified therapy with biologics correlated significantly with depressive symptoms. Depressive symptoms are an important comorbidity in JIA. Early recognition and treatment of psychological distress is essential to prevent deterioration in quality of life and long-term prognosis. Consequently, treat-to-target principles should include mental health as a therapeutic goal.
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Affiliation(s)
- Johanna Roemer
- Centre for Pediatric Rheumatology, Department of Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
- Institute of General Medicine, University Hospital of Cologne, Cologne, Germany.
| | - Ariane Klein
- Centre for Pediatric Rheumatology, Department of Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany
- Department of Pediatric and Adolescents Medicine, University Hospital of Cologne, Cologne, Germany
| | - Gerd Horneff
- Centre for Pediatric Rheumatology, Department of Pediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany
- Department of Pediatric and Adolescents Medicine, University Hospital of Cologne, Cologne, Germany
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11
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Bui C, Lin LY, Lin CJ, Chiu YW, Chiou HY. Association between clustering of unhealthy behaviors and depressive symptom among adolescents in Taiwan: A nationwide cross-sectional survey. Front Public Health 2023; 11:1049836. [PMID: 36969645 PMCID: PMC10035074 DOI: 10.3389/fpubh.2023.1049836] [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: 09/22/2022] [Accepted: 02/15/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundAmong Taiwanese adolescents, how the clustering of unhealthy behaviors, including insufficient physical activity, screen-based sedentary behavior and frequent sugar-sweetened beverage consumption affecting depressive symptom remains unclear. This study aims to examine the cross-sectional association between clustering of unhealthy behaviors and depressive symptom.MethodsWe analyzed 18,509 participants from the baseline survey of the Taiwan Adolescent to Adult Longitudinal Survey in 2015. The outcome was depressive symptoms, and the main exposures were insufficient physical activity, screen-based sedentary behaviors and frequent sugar-sweetened beverage consumption. Generalized linear mixed models were performed to find key factor associated with depressive symptom.ResultsDepressive symptoms were common among participants (31.4%), particularly in female and older adolescents. After adjustments for covariates including sex, school type, other lifestyle factors and social determinants, individuals exhibiting clustering of unhealthy behaviors were more likely (aOR = 1.53, 95% CI: 1.48–1.58) to exhibit depressive symptoms than those who have no or only one unhealthy behavior.ConclusionsClustering of unhealthy behaviors is positively associated with depressive symptom among Taiwanese adolescents. The findings highlight the importance of strengthening public health interventions to improve physical activity and decrease sedentary behaviors.
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Affiliation(s)
- Chung Bui
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Department of Health Communication and Education, Quang Ninh Provincial Center for Disease Control (CDC), Ha Long, Vietnam
| | - Li-Yin Lin
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Chun-Ji Lin
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ya-Wen Chiu
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ya-Wen Chiu
| | - Hung-Yi Chiou
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- *Correspondence: Hung-Yi Chiou
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12
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Tham SG, Hunt IM, Turnbull P, Appleby L, Kapur N, Knipe D. Suicide among psychiatric patients who migrated to the UK: a national clinical survey. EClinicalMedicine 2023; 57:101859. [PMID: 36895802 PMCID: PMC9989630 DOI: 10.1016/j.eclinm.2023.101859] [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: 10/10/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Within the UK, limited research has examined migration and suicide risk. To assist with tailoring mental health care to the needs of different migrant groups, it is important to identify the clinical profile and antecedents to suicide. METHODS We focussed on two groups of migrants: those resident in the UK for less than 5 years (recent migrants) and those seeking permission to stay in the UK. Data on mental health patients who died by suicide in the UK between 2011 and 2019 were obtained as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. FINDINGS 13,948 patients died by suicide between 2011 and 2019: 593 were recent migrants with 48 seeking permission to stay in the UK. The overall suicide rate between 2011 and 2017 for patients seeking to stay was 23.8/100,000 (95% CI 17.3-32.1). There was some uncertainty around this estimate but it appeared higher than the general population suicide rate of 10.6/100,000 population (95% CI 10.5-10.7; p = .0001) for the same period. A higher proportion of migrants were from an ethnic minority group (15% recent migrants vs. 70% seeking to remain vs. 7% non-migrants) and more were viewed as at low long-term risk of suicide (63% recent migrants vs. 76% seeking to remain vs. 57% non-migrants). A higher proportion of recent migrants died within three months of discharge from psychiatric in-patient care (19% vs. 14%) compared to non-migrants. Proportionally more patients seeking to remain had a diagnosis of schizophrenia and other delusional disorders (31% vs. 15%) and more had experienced recent life events compared to non-migrants (71% vs. 51%). INTERPRETATION A higher proportion of migrants had severe or acute illness at the time of their suicide. This may be linked to a range of serious stressors and/or lack of connection with services that could have identified signs of illness early. However, clinicians often viewed these patients as low risk. Mental health services should consider the breadth of stressors migrants may face and adopt a multi-agency approach to suicide prevention. FUNDING The Healthcare Quality Improvement Partnership.
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Affiliation(s)
- Su-Gwan Tham
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
- Corresponding author. National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, 2nd Floor Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK.
| | - Isabelle M. Hunt
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Pauline Turnbull
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Louis Appleby
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nav Kapur
- National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, University of Bristol, Bristol, UK
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13
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Zheng M, Guo X, Chen Z, Deng J, Hu M. Association between interpersonal relations and anxiety, depression symptoms, and suicidal ideation among middle school students. Front Public Health 2023; 11:1053341. [PMID: 36866094 PMCID: PMC9971595 DOI: 10.3389/fpubh.2023.1053341] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/16/2023] [Indexed: 02/16/2023] Open
Abstract
Objective This study aimed to explore the relationship between different types of interpersonal relationships and anxiety symptoms, depressive symptoms, and suicidal ideation and discusses the impact of different grades among middle school students. Methods The Patient Health Questionnaire Depression Scale, the Chinese version of the Generalized Anxiety Scale, suicidal ideation questions, and interpersonal relations items were used to measure the depression symptoms, anxiety symptoms, suicidal ideation, and interpersonal relations of the participants. The variables of anxiety symptoms, depressive symptoms, suicidal ideation, and interpersonal relations were screened using the Chi-square test and principal component analysis. AMOS17.0 constructs the path of the association between interpersonal relations and depressive symptoms, anxiety symptoms, and suicidal ideation. Results The mother-child relationship had direct impacts of -0.06, -0.07, and -0.06 on anxiety symptoms, depressive symptoms, and suicidal ideation. On anxiety symptoms, depressive symptoms, and suicidal ideation, the direct impacts of the father-child relationship were -0.09, -0.03, and -0.08. Moreover, the direct effects of peer relationships on depressive symptoms were -0.04, whereas the direct impact of teacher-student relationships on anxiety and depressive symptoms were -0.10 and -0.09. Further pathway analysis based on grade level showed that in the junior high school model, the direct effect of the mother-child relationship on anxiety and depressive symptoms was -0.18 and -0.16. The direct impact of the father-child relationship on depressive symptoms and suicidal ideation was -0.08 and 0.09. The direct effect of peer relationships on depressive symptoms was -0.08, and the direct impact of the teacher-student relationship on anxiety symptoms was -0.06. In the high school model, the direct effect of the mother-child relationship on suicidal ideation was -0.07, while the direct impact of the father-child relationship on anxiety, depression, and suicidal ideation was -0.10, -0.07, and -0.12, respectively. In addition, the direct effects of peer relationships on anxiety and depression were -0.06 and -0.05, and the direct impact of teacher-student relationships on anxiety and depression was -0.10 and -0.11. Conclusion The father-child relationship affects suicidal ideation and depression the most, followed by the mother-child relationship, the teacher-student interaction, and the peer relationship. The teacher-student relationship influences anxiety symptoms the most, followed by the father-child and mother-child relationships. The association between interpersonal interactions and anxiety, depressive symptoms, and suicidal ideation varied significantly across grade levels.
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Affiliation(s)
- Meixin Zheng
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiaoyan Guo
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhiyan Chen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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14
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Moretta T, Kaess M, Koenig J. A comparative evaluation of resting state proxies of sympathetic and parasympathetic nervous system activity in adolescent major depression. J Neural Transm (Vienna) 2023; 130:135-144. [PMID: 36629967 DOI: 10.1007/s00702-022-02577-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/17/2022] [Indexed: 01/12/2023]
Abstract
Major depressive disorder (MDD) is associated with autonomic nervous system (ANS) dysfunction, characterized by decreased parasympathetic (PNS) and increased sympathetic (SNS) activity. Although findings on reduced PNS activity in adult MDD have been replicated in adolescents, comprehensive studies assessing PNS and SNS proxies in underage patients with MDD are scarce. Proxies of resting PNS (heart rate variability (HRV) and SNS activity (skin conductance response [SCR] and salivary alpha amylase [sAA], as well as mixed activity (heart rate [HR]) were collected in adolescents with MDD (n = 29) and non-depressed controls (n = 29). Primary analyses addressed differences between groups and correlations with depression severity. Patients with MDD showed significantly decreased HRV (g = - 0.87; 95% CI [- 1.39; - 0.35]) and increased HR (g = 0.66; 95% CI [0.14; 1.18]). Proxies of pure SNS activity showed no significant differences between groups. HR (positive) and HRV (negative) were significantly correlated with self- and clinician-rated depression severity. Alterations of ANS activity are evident in adolescent MDD, but characterized by decreased PNS activity only. We found no evidence for altered SNS activity. Findings suggest that ANS dysfunction early in the course of MDD might be predominantly driven by decreased PNS activity.
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Affiliation(s)
- Tania Moretta
- Department of General Psychology, University of Padua, Padua, Italy
| | - Michael Kaess
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. .,Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Köln, Germany.
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15
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Martin F, Holtmann M, Legenbauer T. Better safe than sorry: Divergent error-related negativity and error positivity in shame-prone adolescents. Int J Psychophysiol 2022; 182:81-89. [DOI: 10.1016/j.ijpsycho.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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16
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Zadjali F, Al-Futaisi A, Al-Hosni A, Al-Huseini S, Crommelin M, Mirza H. The Parental and Children Report of the Prevalence of Depressive Symptoms in Children and Adolescents Amid the COVID-19 Pandemic: A Cross-Sectional Study From Oman. Int J Public Health 2022; 67:1604474. [PMID: 36090839 PMCID: PMC9453753 DOI: 10.3389/ijph.2022.1604474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: Studies from the past decades have shown that mood disorders are common during childhood and adolescence. This study aimed to estimate the point prevalence of depression in Omani children and adolescents during social distancing and lockdown and identify the risk factors for developing depressive symptoms during the COVID-19 pandemic. Methods: This is an analytical cross-sectional study conducted in May 2020, in which all young Omani people attending a mainstream school aged 8–18 years old were eligible to participate. Parents were asked to complete the online survey, which consisted of the parent version of the Mood and Feelings Questionnaire (MFQ-Parent). In addition, the option of a self-reported version (MFQ-Self) was provided in cases where children preferred to fill out the survey themselves. Logistic regression was used to identify the contributing socio-demographic variables associated with depressive symptoms. Results: A total of 445 participants completed the MFQ, out of which 72.1% were parents, and 27.9% were children, adolescents and young people. 13.9% of children and adolescents exhibited depressive symptoms during the COVID-19 pandemic in Oman. The presence of depressive symptoms was associated with increased food intake (OR 1.81, 95% CI 1.00–3.29, p-value <0.05), longer use of smartphones (OR 2.72, 95% CI 1.56–4.73, p-value <0.001), whereas additional entertainment activities during lockdown were protective against depression (OR 0.35 95% CI 0.19–0.64, p-value <0.001). Conclusion: This study from Oman concurs with recent reports of depression being common during the COVID-19 pandemic. Concerted efforts are needed to mitigate this trend and identify high-risk groups during the lockdown period.
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Affiliation(s)
- Fahad Zadjali
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Amna Al-Futaisi
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Amira Al-Hosni
- Department of Behavioural Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Salim Al-Huseini
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Maarten Crommelin
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Hassan Mirza
- Department of Behavioural Medicine, Sultan Qaboos University Hospital, Muscat, Oman
- *Correspondence: Hassan Mirza,
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17
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Ashworth E, Provazza S, McCarthy M, Saini P. Children and Young People Presenting in a Pediatric Emergency Department in North-West England in Suicidal Crisis: An Exploratory Case Series Study. Front Psychiatry 2022; 13:892939. [PMID: 35546930 PMCID: PMC9081675 DOI: 10.3389/fpsyt.2022.892939] [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: 03/09/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is a leading cause of death among children and young people (CYP) worldwide, and rates have been increasing in recent years. However, while evidence exists regarding factors associated with suicide and self-harm, there is limited information publicly available on the CYP who present in suicidal crisis. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in an Emergency Department at a pediatric hospital in North-West England between March 2019 and March 2021 (n = 240). Clinical records were extracted and audited to explore demographic data, methods of recording patient attendance, the clinical pathways available and the patterns of pathway usage, and differences in CYP presentations before and after the COVID-19 pandemic. Attendees were mostly White females, with a mean age of 13.5 years, and 24% had a diagnosed special educational need. "Social/social problems" was the most commonly used code for recording attendance (38%), and pathways varied depending on code used. A range of parental and familial factors were also identified. There were more CYP presenting with self-harm in addition to suicide ideation after the pandemic began (43 vs 27% pre-pandemic). This study provides the first clear insight into CYP who seek help at a North-West Emergency Department for suicidal crisis, and work is now needed to develop effective prevention strategies tailored toward the groups most at-risk.
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Affiliation(s)
- Emma Ashworth
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
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18
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The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective. Nutrients 2022; 14:nu14051107. [PMID: 35268082 PMCID: PMC8912662 DOI: 10.3390/nu14051107] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/03/2023] Open
Abstract
Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.
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19
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Tang S, Reily NM, Arena AF, Batterham PJ, Calear AL, Carter GL, Mackinnon AJ, Christensen H. People Who Die by Suicide Without Receiving Mental Health Services: A Systematic Review. Front Public Health 2022; 9:736948. [PMID: 35118036 PMCID: PMC8804173 DOI: 10.3389/fpubh.2021.736948] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction The majority of people who die by suicide have never seen a mental health professional or been diagnosed with a mental illness. To date, this majority group has largely been ignored, with most existing research focusing on predictors of suicide such as past suicide attempts. Identifying the characteristics of people who die by suicide without receiving services, often with a fatal first attempt, is crucial to reduce suicide rates through guiding improvements to service pathways and “just in time” interventions. Methods In this systematic review, PsycInfo, PubMed, CINAHL, and Web of Science were searched for peer-reviewed articles published from 1980 to 1st March 2021. Included studies examined predictors of non-receipt of formal mental health services among people who died by suicide. Data were extracted from published reports and the quality of included studies was assessed using a modified version of the Joanna Briggs Institute Checklist for Analytical Cross Sectional Studies. This review was registered with PROSPERO, CRD 42021226543. Results Sixty-seven studies met inclusion criteria, with sample sizes ranging from 39 to 193,152 individuals. Male sex, younger or older age, and rural location were consistently associated with non-receipt of mental health services. People not receiving mental health services were also less likely to have a psychiatric diagnosis, past suicidal behavior or contact with general health services, and more likely to use violent means of suicide. There was some evidence that minority ethnicity and psychosocial stressors were associated with service non-receipt. Conclusion People who die by suicide without receiving mental health services are likely to have diverse profiles, indicating the need for multifaceted approaches to effectively support people at risk of suicide. Identifying the needs and preferences of individuals who are at risk of suicide is crucial in developing new support pathways and services, and improving the quality of existing services. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021226543.
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Affiliation(s)
- Samantha Tang
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Samantha Tang
| | - Natalie M. Reily
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Andrew F. Arena
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J. Batterham
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Alison L. Calear
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Gregory L. Carter
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | | | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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20
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Berger C, Dück A, Gest S, Jonas L, Kölch M, Martin F, Reis O, Schroth J, Legenbauer T, Holtmann M. Possible Effects of Bright Light Therapy on Electroencephalogram-Vigilance in the Treatment of Depression in Adolescents: A Pilot Study. Front Psychiatry 2022; 13:820090. [PMID: 35633803 PMCID: PMC9133446 DOI: 10.3389/fpsyt.2022.820090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronotherapeutic treatments for depression, such as bright light therapy (BLT), are non-invasive and produce almost no side effects. However, study evidence for reliable neurobiological changes associated with treatment response is still rare. Several studies using EEG-vigilance indicate higher arousal and a later decline during resting state in adult depressive patients compared to healthy controls. To our knowledge, there are no study reports on EEG-vigilance in depressive youth to date. METHODS A total of 11 adolescents with depression receiving BLT were compared to 11 age and gender-matched patients with depression receiving treatment as usual (TAU). The BLT was administered in the morning for 2 weeks on five consecutive days per week. The depressive symptomatology was assessed using the Beck Depression Inventory (BDI-II) and the resting state electroencephalogram (EEG) of 20 min was recorded. EEG and BDI-II were assessed before and after 10 days of treatment. Vigilance level and vigilance decline were estimated using the VIGALL toolbox. RESULTS Brain arousal increased after 10 days of bright light therapy in adolescents with depression. Severe depressive symptoms were associated with higher brain arousal levels; the BDI-II sum score correlated negatively with the amount of drowsiness. LIMITATIONS The sample size was small and participants' brain arousal at baseline was not matched and differed between BLT and TAU groups. CONCLUSION The BLT might have an additional effect on brain arousal. EEG-vigilance seems to be a reliable and valid marker for neurobiological changes that are probably associated with depression and its treatment and, therefore, might be of clinical relevance.
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Affiliation(s)
- Christoph Berger
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Alexander Dück
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Stephanie Gest
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Lena Jonas
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Michael Kölch
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Franziska Martin
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Olaf Reis
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Jennifer Schroth
- Department for Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Tanja Legenbauer
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Martin Holtmann
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
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21
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Astrup H, Myhre MØ, Kildahl AT, Walby FA. Suicide After Contact With Child and Adolescent Mental Health Services-A National Registry Study. Front Psychiatry 2022; 13:886070. [PMID: 35615447 PMCID: PMC9124860 DOI: 10.3389/fpsyt.2022.886070] [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: 02/28/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has shown a strong association between suicide and mental disorders, and people in contact with services for mental health and substance use are known to be at high risk of suicide. Still, few studies have previously described suicide among young people in contact with Child and Adolescent Mental Health Services. AIM The aim of this study is to examine the prevalence of contact and suicide rates by gender and age groups, and to describe patient demographics and service utilization in secondary mental health services. METHODS All young people in contact with Child and Adolescent Mental Health Services in the year prior to death in the period 2008-2018 were identified by linking the Norwegian Cause of Death Registry and the Norwegian Patient Registry. We estimated the prevalence of contact and suicide rates among those with and without contact, by gender and age groups. Characteristics of treatment contact were compared between boys and girls. Variables with significant differences were entered into a multivariate logistic regression model using gender as an outcome. RESULTS More girls (39.7%) than boys (11.8%) had contact with Child and Adolescent Mental Health Services in the year prior to death. Among girls, suicide rates per 100,000 patients increased linearly in the age groups 10-13, 14-16, and 17-19 years: 5, 22, and 38 per 100,000 patients, respectively. Among boys, the suicide rate increased sharply from 7 per 100,000 patients in the age group 14-16 years to 40 per 100,000 patients in the 17-19-year-old group. In the age-adjusted multivariate model, boys were 4.07 (1.22-14.44, p = 0.024) times more likely to have terminated contact at the time of death. CONCLUSION This study shows gender differences in both suicide rates and service utilization among young people in contact with Child and Adolescent Mental Health Services before suicide, and future studies should focus on identifying the causes of these gender differences in service contact.
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Affiliation(s)
- Helene Astrup
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Martin Ø Myhre
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anine T Kildahl
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fredrik A Walby
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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22
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Gonzalez-Urdiales P, Kuppermann N, Dalziel SR, Prego J, Benito J, Mintegi S. Pediatric Intentional Self-poisoning Evaluated in the Emergency Department: An International Study. Pediatr Emerg Care 2021; 37:e1631-e1636. [PMID: 32541402 DOI: 10.1097/pec.0000000000002141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicide is a growing public health problem during late childhood and adolescence. The leading method of suicide attempts in this age group is intentional self-poisoning. A first self-poisoning episode is a strong predictor of subsequent suicide and premature death. The objective of this study was to analyze the presentation and management of children younger than 18 years with intentional self-poisonings admitted to an emergency department (ED) in a global research network of pediatric EDs. METHODS We performed a secondary analysis of a large, international, multicenter, cross-sectional prospective registry of childhood poisoning presentations to 105 EDs in the Pediatric Emergency Research Networks (PERN) network. Data collection started at each ED between January and September 2013 and continued for 1 year. RESULTS During the study period, we included 1688 poisoning exposures. Of these, 233 (13.8%) were intentional self-poisonings, with significant variation between regions. Female/male ratio was 4.7/1 and most occurred at home. The most common toxicants were therapeutic drugs, mainly psychotropics and analgesics. Ninety patients (38.6%) gave a history of a previous episode of intentional self-poisoning. Sixty-three children (27.0%) were not assessed by a psychiatric service nor transferred to a psychiatric inpatient facility. No patient died. There was significant variation in the involved toxicants and interventions among EDs in different global regions. CONCLUSIONS Most intentional self-poisoning presentations to pediatric EDs globally are related to intentional ingestions of therapeutic drugs at home by females. Best practices have to be translated into care to guarantee the best outcomes of these patients.
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Hunt IM, Richards N, Bhui K, Ibrahim S, Turnbull P, Halvorsrud K, Saini P, Kitson S, Shaw J, Appleby L, Kapur N. Suicide rates by ethnic group among patients in contact with mental health services: an observational cohort study in England and Wales. Lancet Psychiatry 2021; 8:1083-1093. [PMID: 34762843 DOI: 10.1016/s2215-0366(21)00354-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent evidence on suicide rates among psychiatric patients from minority ethnic backgrounds is scarce. We aimed to examine suicide rates among minority ethnic psychiatric patients and describe their social and clinical characteristics. METHODS We did a retrospective observational cohort study on a national case-series of patients in England and Wales who died by suicide within 12 months of contact with mental health services between 2007 and 2018. Data were collected as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. Suicide rates and standardised mortality ratios (SMRs) were estimated for South Asian (Indian, Pakistani, and Bangladeshi), Black African, Black Caribbean, Chinese, and White patients. FINDINGS A total of 698 patients in the four minority ethnic groups of South Asian, Black Caribbean, Black African, and Chinese were included (482 [69%] men; 216 [31%] women; mean age 41 years [SD 14·9, range 12-91] and compared with 13 567 White patients (9030 [66·6%] men; 4537 [33·4%] women; mean age 48 years [SD 15·8, range 10-100]). Rates and SMRs for suicide among minority ethnic patients were lower than for White patients (2·73 deaths, 95% CI 2·68-2·78) per 100 000 population. Differences were found between ethnic groups with higher suicide rates in Black Caribbean patients (1·89 deaths [95% CI 1·55-2·23] per 100 000 population) and lower rates in South Asian patients (1·49 deaths [1·33-1·64] per 100 000 population). There was an increase in rates among White patients in 2007-12 followed by a fall but no change among other ethnic groups. Schizophrenia was more common among Black African patients (54%) and Black Caribbean patients (44%), while affective disorder was more common among South Asian patients (41%). Minority ethnic patients overall showed markers of social adversity and received higher intensity care yet were viewed by clinicians as at lower risk than White patients. INTERPRETATION Effective approaches to prevention might differ between minority ethnic groups. Clinicians and the services in which they work should be aware of the common and distinct social and clinical needs of minority ethnic patients with mental illness. FUNDING The Healthcare Quality Improvement Partnership.
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Affiliation(s)
- Isabelle M Hunt
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK.
| | - Nicola Richards
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; Synergi Collaborative Centre, University of Oxford, Oxford, UK
| | - Saied Ibrahim
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Pauline Turnbull
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kristoffer Halvorsrud
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR ARC North Thames, Department of Applied Health Research, University College London, London, UK
| | - Pooja Saini
- School of Psychology, Liverpool John Moore's University, Liverpool, UK
| | - Sadie Kitson
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jenny Shaw
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Louis Appleby
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Nav Kapur
- National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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24
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Papsdorf R, von Klitzing K, Radeloff D. [Suicides Among Adolescents in a Major German City]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 50:93-104. [PMID: 34749520 DOI: 10.1024/1422-4917/a000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Suicides Among Adolescents in a Major German City Abstract. Objective: Adolescent suicide is a major contributor to the overall mortality in this age group. This study examined sex and age differences in suicide methods. Method: The investigation is based on death certificates from the years 1996 to 2019 of the city of Leipzig and includes all suicides in the age group under 25 years. The impact of sex and age on the method and location of suicide was examined using chi square statistics. Moreover, we verified the association between suicides and death by drug overdose through statistical regression. Results: 140 suicides were included in the study. The suicide methods differed between the age groups (χ² = 17,878; p = .022). Individuals under 21 years of age committed suicide almost exclusively by strangulation, jumping from heights, railway suicide, or deliberate intoxication. With the onset of early adulthood, the spectrum of methods expanded. Suicide methods were also different between the sexes (χ² = 35,166; p < .001): Male adolescents preferred highly lethal methods such as strangulation, whereas in female adolescents intoxication was the leading method of suicide, with a predominance of antidepressants. The annual rates of suicide and death by drug overdose were found to correlate (Pearson correlation = 0,571, p = .004). Minors (χ² = 3.125, p = .077) tended to avoid their own residential environment as a place of suicides compared to adults. Conclusion: When assessing the individual suicide risk and weighing safeguarding measures in clinical practice, the differences shown in the choice of methods should be taken into account.
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Affiliation(s)
- Rainer Papsdorf
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
| | - Kai von Klitzing
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
| | - Daniel Radeloff
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
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25
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Childhood Psychological Maltreatment and Depression among Chinese Adolescents: Multiple Mediating Roles of Perceived Ostracism and Core Self-Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111283. [PMID: 34769803 PMCID: PMC8583377 DOI: 10.3390/ijerph182111283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 12/27/2022]
Abstract
Previous studies have primarily focused on the separate mediating role of interpersonal context or personal characteristics in the relationship between childhood psychological maltreatment and depression, neglecting the combined effects, which have limited ecological validity. Therefore, this study investigated the multiple mediating roles of perceived ostracism and core self-evaluation in the relationship between childhood psychological maltreatment and depression. A total of 1592 Chinese adolescents (51.1% boys), ranging in age from 11 to 15 years (M = 13.23, SD = 0.96), completed a self-report questionnaire regarding demographics, psychological maltreatment, perceived ostracism, core self-evaluation and depression. A multiple mediation model was tested using Model 6 of the PROCESS macro. After controlling for the variables of gender and age, the results indicated that perceived ostracism and core self-evaluation parallelly and sequentially mediated the link between psychological maltreatment and depression. The multiple mediation model could account for 55% of the total effect. In conclusion, the current study helps us better understand the mechanisms of depression caused by psychological maltreatment, and contributes to preventing and intervening in depression among Chinese adolescents.
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26
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Bhat AS, Boersma C, Meijer MJ, Dokter M, Bohlmeijer E, Li J. Plant Robot for At-Home Behavioral Activation Therapy Reminders to Young Adults with Depression. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2021. [DOI: 10.1145/3442680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescents with depression who participate in behavioral activation therapy may find it hard to be motivated to perform tasks at home that their therapists recommend. We describe the initial design and usability evaluation of a home device (“PlantBot”) that could be used to remind young adults with depression at home of their behavioral activation therapy-related tasks. The prototype features electronics in a two-layer base, with a fake plant on top and supported using the Amazon Echo voice agent. We use an online panel study to evaluate the usability of our system with youth with past depression (
N
= 30). Initial findings highlight the device’s usability, potential benefit, and attractiveness of the plant component, as well as multiple improvements to be made.
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Affiliation(s)
| | | | | | | | | | - Jamy Li
- University of Twente, The Netherlands
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27
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Cortisol response to acute psychosocial stress in ADHD compared to conduct disorder and major depressive disorder: A systematic review. Neurosci Biobehav Rev 2021; 127:899-916. [PMID: 34089765 DOI: 10.1016/j.neubiorev.2021.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/26/2021] [Accepted: 06/01/2021] [Indexed: 01/15/2023]
Abstract
BERNHARD, A., J. S. Mayer, N. Fann, and C. M. Freitag. Cortisol response to acute psychosocial stress in ADHD compared to Conduct Disorder and Major Depressive Disorder: A systematic review. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2020. - Heterogeneous alterations of the cortisol stress response in Attention-deficit/hyperactivity Disorder (ADHD) were recently reported by a systematic literature review. To investigate the moderating effect of frequent psychiatric comorbidities, we systematically searched for studies on cortisol stress response to psychosocial stress in ADHD compared to Conduct Disorder (CD) and Major Depressive Disorder (MDD) following PRISMA guidelines. EBSCOhost and PubMed databases were searched in July 2020, employing relevant keywords. Nineteen studies met inclusion criteria. While blunted cortisol stress response was consistently reported in individuals with CD and/or Oppositional Defiant Disorder (ODD), alterations of cortisol stress response were less pronounced in ADHD. Consistently blunted cortisol stress response in ADHD was only found in children with comorbid CD/ODD. Results on cortisol stress response in children and adolescents with MDD were mixed, and no indication for influence of comorbid MDD on cortisol stress response in ADHD was found. Taken together, altered cortisol stress response in ADHD is driven by comorbidity with disruptive behavior disorders. Limitations of previous research and suggestions for future studies are discussed.
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28
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Sagar R, Selvakumar N. Prevalence of Depression in Indian Adolescents. Indian J Pediatr 2021; 88:427-428. [PMID: 33825129 DOI: 10.1007/s12098-021-03750-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Nivedhitha Selvakumar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
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29
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Online Peer Counseling for Suicidal Ideation: Participant Characteristics and Reasons for Using or Refusing This Service. PSYCH 2021. [DOI: 10.3390/psych3020007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
[U25] is a German online-peer-counseling service for adolescents with suicidal ideation, who typically do not seek or receive adequate counseling. We conducted an online survey in order to compare persons who receive online counseling by [U25] compared to those who are visitors of [U25] websites but do not (yet) receive counseling. Via online survey, all visitors to the [U25] websites were invited to fill in a questionnaire on sociodemographic data, utilization reasons, and barriers. Our final sample consisted of n = 318 counseling clients, n = 1127 persons who have not yet sought help but intend to do so (“prospective clients”), and n = 444 persons who do not consider [U25] counseling for themselves (“refusers”). Clients were more often female and showed positive attitudes toward online counseling. Low perceived need for counseling was the most frequent barrier reported by the refusers, whereas fear of stigma and practical barriers were rarely reported; younger and male refusers reported needing to write down one’s problems as a barrier more often. Self-selection might reduce generalizability of our results. Online counseling can facilitate receiving psychosocial support for young persons with suicidal ideation, particularly if barriers are addressed.
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30
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Blodgett JM, Lachance CC, Stubbs B, Co M, Wu YT, Prina M, Tsang VWL, Cosco TD. A systematic review of the latent structure of the Center for Epidemiologic Studies Depression Scale (CES-D) amongst adolescents. BMC Psychiatry 2021; 21:197. [PMID: 33874939 PMCID: PMC8054366 DOI: 10.1186/s12888-021-03206-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has not been established in adolescents. This review aimed to investigate the factor structure of the CES-D in adolescents. METHODS We searched Web of Science, PsychINFO and Scopus and included peer-reviewed, original studies assessing the factor structure of the 20-item CES-D in adolescents aged ≤18. Two independent researchers screened results and extracted data. RESULTS Thirteen studies met the inclusion criteria and were primarily from school-based samples in the USA or Asia. Studies that conducted confirmatory factor analysis (CFA; n = 9) reported a four-factor structure consistent with the original factor structure; these studies were primarily USA-based. Conversely, studies that conducted exploratory factor analysis (EFA) reported distinct two or three factor structures (n = 4) and were primarily based in Asia. LIMITATIONS Studies in a non-English language and those that included individuals aged > 18 years were excluded. Ethnic or cultural differences as well as different analytical methods impacted generalisability of results. The use of CFA as the primary analysis may have biased towards a four-factor structure. CONCLUSIONS A four-factor CES-D structure was an appropriate fit for adolescents in Western countries; further research is required to determine the fit in in Asian countries. This has important implications for clinical use of the scale. Future research should consider how cultural differences shape the experience of depression in adolescents.
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Affiliation(s)
- Joanna M. Blodgett
- grid.268922.50000 0004 0427 2580MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Brendon Stubbs
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Melissa Co
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Yu-Tzu Wu
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Matthew Prina
- grid.13097.3c0000 0001 2322 6764King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Vivian W. L. Tsang
- grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Theodore D. Cosco
- grid.4991.50000 0004 1936 8948Oxford Institute of Population Ageing, University of Oxford, Oxford, UK ,grid.61971.380000 0004 1936 7494Gerontology Research Centre, Simon Fraser University, Vancouver, Canada
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31
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Ma W, Wu W, Fu R, Zheng S, Bai R, Lyu J. Coincident Patterns of Suicide Risk Among Adult Patients with a Primary Solid Tumor: A Large-Scale Population Study. Int J Gen Med 2021; 14:1107-1119. [PMID: 33790640 PMCID: PMC8006911 DOI: 10.2147/ijgm.s300740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Suicide rate is much higher in cancer patients than in general population. This study examined the suicide risk in survivors of primary solid tumor across 19 cancer sites considering risk coincident patterns based on area-based SES indicators. Methods A retrospective search of the SEER database was conducted. Independent risk factors for suicide were identified using the Cox proportional-hazards model. Exploratory factor analysis and cluster analysis were used to create coincident patterns of SES factors. Results Suicide risk was higher for patients with a primary solid tumor who were older, male, white, unmarried, had no insurance, poorly differentiated, distant metastasis and did not undergo active treatment (especially surgery). The suicide risk was higher for patients living in areas with economic and education disadvantage, high levels of immigration and crowding, and high levels of residential instability. Concomitant presence of high economic and education disadvantage, high immigration and crowding levels and low residential instability, showed the highest risk of suicide. Conclusion In order to mitigate suicidal risk, clinicians should pay more attention to patients who are older, male, white, not married, high levels of cancer severity, not received active treatment (especially surgery), and having no insurance. Identifying coincident patterns of suicide help further screen high suicidal risk patients based on area-based socioeconomic status.
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Affiliation(s)
- Wen Ma
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Rong Fu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Ruhai Bai
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
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32
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Does Young Adults' Neighborhood Environment Affect Their Depressive Mood? Insights from the 2019 Korean Community Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031269. [PMID: 33572580 PMCID: PMC7908501 DOI: 10.3390/ijerph18031269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/30/2022]
Abstract
The rates of depression among young adults have been increasing in high-income countries and have emerged as a social problem in South Koreans aged 19–34. However, the literature is unclear on whether the neighborhood environment that young adults live in affects the onset and severity of their depressive symptoms. This study analyzed data from the 2019 Korean Community Health Survey (KCHS) using the Tobit model to identify the effect of the neighborhood environment on young adults’ depressive moods. Controlling for other corresponding factors, young adults’ neighborhood environment satisfaction affected their depression, and natural environment satisfaction (32.5%), safety level satisfaction (31.0%), social overhead capital (SOC), environment satisfaction (30.2%), trust between neighbors satisfaction (20.1%), and public transportation environmental satisfaction (12.2%) affected young adults’ depressive moods. Of these, natural environment satisfaction (32.5%), safety level environment satisfaction (31.0%), and SOC environment satisfaction (30.2%) affected young adults’ depressive mood to a similar extent. This implies that many young adults in South Korea live in inadequate neighborhood conditions. This research contributes to the literature by identifying the specific environmental factors that affect young adults’ depressive moods.
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33
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Karukivi J, Herrala O, Säteri E, Tornivuori A, Salanterä S, Aromaa M, Kronström K, Karukivi M. The Effectiveness of Individual Mental Health Interventions for Depressive, Anxiety and Conduct Disorder Symptoms in School Environment for Adolescents Aged 12-18-A Systematic Review. Front Psychiatry 2021; 12:779933. [PMID: 34955926 PMCID: PMC8695927 DOI: 10.3389/fpsyt.2021.779933] [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: 09/20/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mental health problems are a major health issue for children and adolescents around the world. The school environment allows adolescents to be reached comprehensively and on a low threshold, making it a potential environment for mental health interventions. The aim of this review was to describe interventions delivered by health-care workers in school environment for individual adolescents aged 12-18 with mental health problems and to assess the effectiveness of these interventions. Methods: This systematic review was conducted in adherence with the PRISMA guidelines. Altogether 349 studies were screened and 24 of them were included in full text assessment. Eight studies were included in the qualitative synthesis. Only in three studies the intervention was compared to another intervention or the study setting included a control group. Five of the interventions were based on cognitive-behavioral therapy and three on other approaches. In seven studies, one of the main response variables was based on assessment of depressive symptoms and/or a depressive disorder. The quality of the studies was limited with notable risk for bias for some studies. Results: Based on reported symptom reductions, for most of the interventions, the results were good. Symptom reductions were also typically achieved in a rather low number of sessions (12 or less) supporting the feasibility of these type of interventions in school environment. However, the lack of use of control groups and actual comparisons between the interventions, limit the possibility to draw firm conclusions regarding their effectiveness and thus, the results should be interpreted with caution. Confirming the effectiveness of the studied interventions requires more robust evidence and thus, improving the quality of studies in the school environment is encouraged.
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Affiliation(s)
- Johanna Karukivi
- Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Outi Herrala
- Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Elina Säteri
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
| | - Anna Tornivuori
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
| | - Sanna Salanterä
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
| | - Minna Aromaa
- Department of Public Health, University of Turku, Turku, Finland.,Outpatient Clinic of Children and Adolescents, Turku, Finland
| | - Kim Kronström
- Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Max Karukivi
- Department of Adolescent Psychiatry, Turku University Hospital, University of Turku, Turku, Finland.,Psychiatric Care Division, Satakunta Hospital District, Pori, Finland
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Dietary antioxidants and fibre intake and depressive symptoms in Iranian adolescent girls. Public Health Nutr 2020; 24:5650-5656. [PMID: 33256873 DOI: 10.1017/s1368980020004838] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate the cross-sectional association between dietary intakes of antioxidants and fibre and depressive symptoms among Iranian adolescent girls. DESIGN A cross-sectional population-based study. SETTING Primary schools in two different cities located in northeastern Iran (Mashhad and Sabzevar). PARTICIPANTS A total of 988 adolescent girls aged 12-18 years were included in the study. RESULTS Subjects with no or minimal depression symptoms had significantly higher dietary intakes of α-carotene (P = 0·01), β-carotene (P = 0·006), lutein (P = 0·03) and vitamin C (P = 0·04) when compared with subjects with mild-to-severe depression symptoms. Soluble dietary fibre and insoluble dietary fibre intakes were also significantly higher in healthy adolescents compared with those with depression symptoms (P < 0·001). In multivariate-adjusted model 2, the OR (95 % CI) of depressive symptoms were 0·61 (95 % CI 0·37, 1·01), 0·42 (95 % CI 0·26, 0·69), 0·50 (95 % CI 0·31, 0·79), 0·71 (95 % CI 0·44, 1·15), 0·51 (95 % CI 0·32, 0·82) and 0·42 (95 % CI 0·25, 0·68) for the highest v. lowest quartile of vitamin C, β-carotene, α-carotene, lutein, soluble dietary fibre and insoluble dietary fibre cereal intakes, respectively. CONCLUSIONS Dietary intake of some antioxidants and dietary fibre intake was inversely associated with depression symptoms among Iranian adolescent girls.
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35
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Frey M, Obermeier V, von Kries R, Schulte-Körne G. Age and sex specific incidence for depression from early childhood to adolescence: A 13-year longitudinal analysis of German health insurance data. J Psychiatr Res 2020; 129:17-23. [PMID: 32554228 DOI: 10.1016/j.jpsychires.2020.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Epidemiological studies indicate a disproportionate increase of depression incidence among adolescent girls, compared with boys. Since results regarding the age of onset of this sex difference are heterogeneous, this study aimed to investigate this difference on a large and representative sample. A second investigation sought to clarify whether there is a relevant sex difference in prepubertal onset of depression regarding the further course. METHODS Health insurance data of 6-18-year-old Barmer insured patients, representing a 7.9% sample of the German population born in 1999 (N = 61.199), were analyzed. The incidence of depression episodes (ICD-10 F32.x) was evaluated. Subsequently, the absolute and relative risk of a depression diagnosis (F32.x/F33.x) in early/late adolescence was analyzed based on the diagnosis of depression in primary school age in unstratified and stratified univariate analyses performed in SAS. RESULTS From 13 years of age, we found a significantly higher incidence of depressive disorders in girls than in boys. More than a fifth of the children with a depression diagnoses in primary school age had a depression relapse in early or late adolescence (early: 23.2%; 95% CI 19.6-26.9/late: 22.9%; 95% CI 19.3-26.5). Boys with depression in primary school age have a significantly higher relative risk for a depression relapse in late adolescence than girls (boys RR 4.2, 95% CI 3.3-5.2, girls RR: 2.1, 95% CI 1.7-2.7). LIMITATIONS The analysis is based on administrative data. Low sensitivity for depression in primary care setting and low service utilization leads to an underestimation of the incidence. CONCLUSIONS During puberty the risk for a first depressive episode increases more steeply in girls than in boys. Childhood depression has a high risk of relapse for both sexes, but is much more pronounced for boys.
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Affiliation(s)
- Michael Frey
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
| | - Viola Obermeier
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Rüdiger von Kries
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
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Schwartzman JM, Corbett BA. Higher depressive symptoms in early adolescents with Autism Spectrum Disorder by self- and parent-report compared to typically-developing peers. RESEARCH IN AUTISM SPECTRUM DISORDERS 2020; 77:101613. [PMID: 32802155 PMCID: PMC7423017 DOI: 10.1016/j.rasd.2020.101613] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Depression is more prevalent among male early adolescents with Autism Spectrum Disorder (ASD) than their typically- developing (TD) peers, but findings are limited to two male-only studies. Therefore, a broader understanding of depressive symptoms among both male and female early adolescents with ASD in larger samples is needed. Self- and parent-ratings are frequently used, yet rater differences may emerge and provide unique insights. METHOD Ratings of adolescent depressive symptoms were examined among 230 early adolescents (10:0-13:5 years) with and without ASD using self- (Children's Depression Inventory, Second Edition; CDI-2) and parent- report (Child Behavior Checklist; CBCL) measures. The influence of diagnostic group (ASD vs. TD) and rater (early adolescent vs. parent) on ratings were examined with Full Scale IQ and sex as covariates. Additionally, the reliability and strength of agreement between raters were examined. RESULTS Higher depressive symptoms were reported by both raters in the ASD group (Borderline range) compared to the TD group (Average range). The interaction of diagnostic group and rater was nonsignificant, but significant main effects emerged. Sex was a significant covariate, but Full Scale IQ was not. The reliability and strength of agreement between raters in the ASD group only were not significant. CONCLUSIONS Findings suggest that depressive symptoms may be higher in both male and female early adolescents with ASD across self- and parent- reports. However, measurement of depression in ASD may be complicated by nonsignificant reliability and strength of agreement between raters. Results have implications for screening and intervention for early adolescents with ASD.
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Affiliation(s)
- Jessica M. Schwartzman
- Vanderbilt University Medical Center, 1601 23 Avenue South, Nashville, TN, United States 37212
| | - Blythe A. Corbett
- Vanderbilt University Medical Center, 1601 23 Avenue South, Nashville, TN, United States 37212
- Vanderbilt Kennedy Center, 110 Magnolia Circle, Nashville, TN, United States 37203
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Zhou X, Guo J, Lu G, Chen C, Xie Z, Liu J, Zhang C. Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis. Psychiatry Res 2020; 289:113002. [PMID: 32438210 DOI: 10.1016/j.psychres.2020.113002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/17/2022]
Abstract
In this study, we evaluated the efficacy of mindfulness-based stress reduction (MBSR) for young people with anxiety symptoms. We used many databases, including PubMed, PsycINFO, Web of Science, EMBASE, CINAHL and Cochrane Library (from inception to May 2019). We included randomized controlled trials (RCTs) comparing MBSR with various control conditions, including didactic lecture course, health education, treatment as usual, didactic seminar and cognitive behavioral program in young people with anxiety symptoms. Finally, we selected fourteen studies comprising 1489 participants comparing with control conditions. The meta-analysis suggested that MBSR significantly reduced anxiety symptoms compared to control conditions at post-treatment (Standardized Mean Difference, SMD = -0.14, 95% CI -0.24 to -0.04). However, the effect of MBSR on anxiety symptoms in young people may be affected by different intervention duration, especially the significance in a short-term intervention (less than 8 weeks). In addition, the meta-analysis indicated publication bias for anxiety symptoms. Using the trim-and-fill method, we found the adjusted standardized mean difference, which indicated that MBSR was still significantly superior to the other control conditions. The sensitivity analysis showed that the result was reliable. Current evidence indicates MBSR has superior efficacy compared with control conditions in treating young people with anxiety symptoms. Based on this, we suggest there is a significant effect of MBSR on young people with anxiety symptoms, especially the effects of long-term intervention for future studies.
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Affiliation(s)
- Xiang Zhou
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Jieyu Guo
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
| | - Guangli Lu
- School of Business, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China.
| | - Chaoran Chen
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China.
| | - Zhenxing Xie
- School of Basic Medicine, Henan University, Kaifeng, Henan, 475004, China
| | - Jiangmin Liu
- North Sichuan Medical College, Nanchong, Sichuan, 637000, China
| | - Chuning Zhang
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Jinming Avenue, Kaifeng, Henan, 475004, China
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Ghaziuddin N, Shamseddeen W, Gettys G, Ghaziuddin M. Electroconvulsive Therapy for the Treatment of Severe Mood Disorders During Adolescence: A Retrospective Chart Review. J Child Adolesc Psychopharmacol 2020; 30:235-243. [PMID: 32125885 DOI: 10.1089/cap.2019.0054] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: Electroconvulsive therapy (ECT) is a well-recognized treatment of refractory mood disorders in adults. However, relatively little is known about its use for similar conditions in adolescents. Based on a chart review, we describe its use and outcome in a sample of adolescents with severe, refractory mood disorders (unipolar or bipolar disorder) hospitalized in an academic medical center. Methods: The sample was drawn from referrals to an adolescent psychiatry service. After obtaining approval from the ethics board, medical records of 54 adolescents with refractory mood disorder were examined. Participants (males 24, females 30; mean age 15.8 ± 1.5 years) had received their first course of ECT before the age of 18 years during the period 1996-2010. Response to treatment was examined after the initial treatment and during a 1-year follow-up. Results: Following the index course of ECT (mean number of treatments = 13.7 ± 6.3), a 52.8% response rate (defined as a Clinical Global Impressions [CGI] score ≤2) was noted, while 15.1% achieved remission (CGI = 1). The response rate was 82.4% after a 1-year follow-up with a remission rate of 23.5%. The Children's Depression Rating scores declined significantly from pre-ECT to the end of the index course (70.7 ± 16.4 to 52.5 ± 18; p ≤ 0.00). A reduction in suicidal ideation and self-injurious behaviors along with increased school attendance was noted. Cognition, monitored by the Mini-Mental State Examination, did not decline significantly. Minor side effects were limited to the day of the treatment. Prolonged seizures (>2 minutes) were common during ECT (74% of subjects experienced one or more). The only side effect noted at the 1-year follow-up was self-reported memory loss involving events during and around the index treatment course. Conclusions: In this severely impaired sample of adolescents, ECT was found to decrease suicidal behavior, reduce depressive symptoms, and improve overall functioning, as indexed by school attendance at follow-up after 1 year. Prospective studies using large samples are needed to determine its effectiveness and safety in refractory mood disorders in adolescents.
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Affiliation(s)
- Neera Ghaziuddin
- Department of Psychiatry, University of Michigan Hospitals, Ann Arbor, Michigan, USA
| | - Wael Shamseddeen
- Department of Psychiatry, University of Michigan Hospitals, Ann Arbor, Michigan, USA.,Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Gettys
- Department of Psychiatry, Rosalind Franklin University, North Chicago, Illinois, USA
| | - Mohammad Ghaziuddin
- Department of Psychiatry, University of Michigan Hospitals, Ann Arbor, Michigan, USA
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Kautz MM, Coe CL, McArthur BA, Mac Giollabhui N, Ellman LM, Abramson LY, Alloy LB. Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents. Brain Behav Immun 2020; 86:43-52. [PMID: 30822466 PMCID: PMC6710165 DOI: 10.1016/j.bbi.2019.02.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 11/23/2018] [Accepted: 02/22/2019] [Indexed: 12/14/2022] Open
Abstract
This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology, Temple University, United States
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, United States
| | | | | | | | - Lyn Y Abramson
- Department of Psychology, University of Wisconsin-Madison, United States
| | - Lauren B Alloy
- Department of Psychology, Temple University, United States.
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Prevalence of emotional, behavioural problems and ego resilience among tea tribe adolescents living in Dibrugarh district of Assam. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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The Burden of Depression in Adolescents and the Importance of Early Recognition. J Pediatr 2020; 218:265-267.e1. [PMID: 31932020 DOI: 10.1016/j.jpeds.2019.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 02/08/2023]
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Mohan G, Kandaswamy DK, Chikkaharohalli Ramakrishna MK. Identification of nonclinical interventions for spontaneous recovery of depression using mathematical modeling. Brain Behav 2020; 10:e01550. [PMID: 32026616 PMCID: PMC7066340 DOI: 10.1002/brb3.1550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 01/04/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In order to make a risk or vulnerability assessment of major depressive disorder (MDD) in adolescents and suggest nonclinical interventions for spontaneous recovery for low-vulnerable adolescents a novel network mathematical model has been proposed. METHODS In the existing network theory, the theoretical model consists of a symptom network surrounded by the triggering factors as external field which are the cause for adolescents being diagnosed with MDD. But in our network model, the triggering external field is replaced by nonclinical interventions, easily implementable in schools and colleges with teachers as facilitators. RESULTS The four variables of subjective well-being (SWB), emotional quotient-Attention (EQ-A), emotional quotient-Clarity (EQ-C) and emotional quotient-Reparation (EQ-R) were the symptoms considered for stratification of the vulnerability. The mathematical model was created using the four symptoms and the four nonclinical interventions of technology use, physical exercise, peer pressure positive and peer pressure negative, and their inter-relationship. CONCLUSION A balance of tech use and physical exercise and of the peer pressure help maintain the adolescents in the low-vulnerability group in our study with 227 adolescents in Bangalore. Furthermore, we predict that positive peer pressure and physical exercise could increase the EQ thus suggesting a preventive model for the onset of major depressive disorder (MDD).
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Affiliation(s)
- Gayathree Mohan
- Department of Physics, MVJ Engineering College, Bangalore, India
| | - Dinesh Kumar Kandaswamy
- Department of Epidemiology and Public Health, Central University of Tamilnadu, Thiruvarur, India.,School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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Tham SG, Ibrahim S, Hunt IM, Kapur N, Gooding P. Examining the mechanisms by which adverse life events affect having a history of self-harm, and the protective effect of social support. J Affect Disord 2020; 263:621-628. [PMID: 31744741 DOI: 10.1016/j.jad.2019.11.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/05/2019] [Accepted: 11/09/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Psychological models of suicide emphasize perceptions of negative stressors, hopelessness and self-harm as key antecedents to suicidal thoughts/acts. Such models also emphasize the potential protective role of social support in these pathways. However, such pathways have not been tested using population level data. Hence, this study aimed to redress this gap. METHODS Questionnaire data regarding 24,444 patient suicide deaths were analysed. All individuals died between 1996 and 2015 and were seen by secondary mental health services in England within 12 months before their death. Mediation analyses, using fitted logistic regression models, investigated direct and indirect pathways between negative stressors, hopelessness and a proxy measure of suicide, namely, self-harm history. In addition, the buffering effects of social support were examined in these pathways. RESULTS There was a direct effect of negative life events on suicidal behaviors. Supporting contemporary psychological models of suicide, a mediated effect via hopelessness and a protective effect of social support were identified. Social support buffered the pathway between stressful life events and hopelessness, with hopelessness decreasing as social support increased. LIMITATIONS Causal inferences are inappropriate as the design was cross-sectional. A proxy measure of suicidality was utilized (history of self-harm) as all individuals had died by suicide. CONCLUSIONS This is the first time that population data has been used to test psychological pathways to suicidal acts involving negative stressors, hopelessness and social support. Psychological interventions should focus on increasing social support following negative life events together with ameliorating perceptions of hopelessness.
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Affiliation(s)
- Su-Gwan Tham
- The National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, University of Manchester, UK; Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Saied Ibrahim
- The National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, University of Manchester, UK; Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Isabelle M Hunt
- The National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, University of Manchester, UK; Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Nav Kapur
- The National Confidential Inquiry into Suicide and Safety in Mental Health, Centre for Mental Health and Safety, University of Manchester, UK; Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, UK
| | - Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK; Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, UK.
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Benjet C, Albor YC, Bocanegra ES, Borges G, Méndez E, Casanova L, Medina-Mora ME. Incidence and recurrence of depression from adolescence to early adulthood: A longitudinal follow-up of the Mexican Adolescent Mental Health Survey. J Affect Disord 2020; 263:540-546. [PMID: 31744746 DOI: 10.1016/j.jad.2019.11.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/13/2019] [Accepted: 11/02/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Depression is a leading cause of disease burden around the globe, often develops during adolescence and is recurrent. Thus, disentangling risk factors for incidence from those of recurrence during adolescence is relevant and might suggest different strategies for prevention of onset than for relapse. The aim was to evaluate the relative risk of socio-demographic and clinical factors and traumatic events associated to incidence and recurrence of depression in youth from Mexico City. METHODS This is a prospective longitudinal general population survey in which 1071 respondents from the Mexican Adolescent Mental Health Survey were interviewed between the ages of 12 and 17 and again eight years later when they were between 19 and 26 years of age. The World Mental Health Composite International Diagnostic Interview evaluated incidence and persistence of major depression and risk factors. RESULTS Eight-year incidence was 12.9% while recurrence was 46.1%. Risk factors for incidence (female sex, any incident trauma, and specifically sexual abuse and an other/private event) differed from the risk factors for recurrence (childhood onset and domestic violence) with the exception of having a parent with depression, which was associated to increased risk for both. LIMITATIONS The follow-up response rate was limited by inability to locate participants at wave II. Statistical power was limited for persistence due to low rate of depression at wave I. CONCLUSIONS Intervening with both depressed and non-depressed children of parents with depression may have beneficial effects on both the development of depression as well as recurrence.
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Affiliation(s)
- Corina Benjet
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico.
| | - Yesica C Albor
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico; Universidad Cuauhtémoc Plantel Aguascalientes, Mexico
| | | | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico
| | - Enrique Méndez
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico
| | - Leticia Casanova
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico
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Weiss M, Hildebrand A, Braun-Scharm H, Weckwerth K, Held D, Stemmler M. [Are suicidal young people reached by online-counselling? Evaluation of the target group outreach of [U25] online suicide prevention]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:204-214. [PMID: 32039646 DOI: 10.1024/1422-4917/a000712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Are suicidal young people reached by online-counselling? Evaluation of the target group outreach of [U25] online suicide prevention Abstract. Objective: "[U25] Germany" is an online-counselling platform designed to help adolescents and young adults suffering from suicidal ideation or emotional crisis. The online approach and anonymous counselling by peers (young voluntary workers) instead of professionals were initiated to lower the threshold for those seeking help. This study examines characteristics of people seeking help from [U25] and estimates the outreach of the program. Method: Data from n = 1062 counselling protocols dating from 2017 were obtained. In addition, we conducted n = 13 problem-focused interviews with peer counsellors. Results: Our data indicate a good target group outreach concerning age, suicidality, and psychological burden of the clients. However, young men seek counselling by [U25] less frequently than young women. Additionally, preliminary data indicate that young people with lower educational background consult [U25] less often. Conclusions: [U25] offers a promising approach to helping young people suffering from suicidal ideation or a personal crisis. New approaches should be developed and evaluated to better reach young men and persons with a lower education background.
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Affiliation(s)
- Maren Weiss
- Lehrstuhl für Psychologische Diagnostik, Methodenlehre und Rechtspsychologie, Universität Erlangen-Nürnberg, Nürnberg
| | - Anja Hildebrand
- Lehrstuhl für Psychologische Diagnostik, Methodenlehre und Rechtspsychologie, Universität Erlangen-Nürnberg, Nürnberg
| | | | | | | | - Mark Stemmler
- Lehrstuhl für Psychologische Diagnostik, Methodenlehre und Rechtspsychologie, Universität Erlangen-Nürnberg, Nürnberg
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Wickersham A, Leightley D, Archer M, Fear NT. The association between paternal psychopathology and adolescent depression and anxiety: A systematic review. J Adolesc 2020; 79:232-246. [PMID: 31986478 DOI: 10.1016/j.adolescence.2020.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/13/2019] [Accepted: 01/12/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Paternal psychopathology is associated with various adolescent outcomes. With emotional disorders presenting a significant public health concern in the adolescent age group, the aim of this systematic review was to synthesize evidence on the relationship between paternal mental health and adolescent anxiety or depression. METHODS PubMed, Web of Science, Embase, Ovid MEDLINE, Global Health, and PsycINFO were searched for articles which primarily aimed to investigate the relationship between paternal mental health (exposure) and adolescent anxiety or depression (outcome). Articles were assessed for risk of bias, and findings are presented in a narrative synthesis. The protocol is registered on PROSPERO (CRD42018094076). RESULTS Findings from the fourteen included studies indicated that paternal depression is associated with adolescent depression and anxiety. Findings relating to other paternal mental health disorders were inconclusive. Results largely suggested that adolescent depression and anxiety is equally associated with paternal and maternal mental health. The included studies were mostly cross-sectional, and the quality of included studies was mixed. Attempts to focus on the 11-17 year age range were hampered by the variability of age ranges included in studies. CONCLUSIONS Further longitudinal research is needed to clarify the association between paternal mental health disorders other than depression, and adolescent anxiety or depression. Mechanisms in this relationship should also be further explored, and could be informed by existing models on younger children.
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Affiliation(s)
- Alice Wickersham
- King's Centre for Military Health Research, King's College London, United Kingdom; Department of Psychological Medicine, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
| | - Daniel Leightley
- King's Centre for Military Health Research, King's College London, United Kingdom
| | - Marc Archer
- King's Centre for Military Health Research, King's College London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, United Kingdom
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Mok YE, Lee JH, Lee MS. Comparison of Different Adherence Measures in Adolescent Outpatients with Depressive Disorder. Patient Prefer Adherence 2020; 14:1065-1072. [PMID: 32606621 PMCID: PMC7321686 DOI: 10.2147/ppa.s249728] [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: 02/14/2020] [Accepted: 05/26/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Adolescent depression can have a chronic course; hence, the importance of adherence to antidepressant medication for successful treatment outcomes is emphasized. This study aimed to examine different adherence measures and identify clinical factors that influence adherence in adolescent depression. PATIENTS AND METHODS A prospective study was conducted for patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition from outpatient psychiatric settings at Korea University Medical Center, Guro Hospital. Patient demographics were obtained from a questionnaire, interview, and review of chart records. Adherence was assessed by four methods (Medication Event Monitoring System [MEMS], pill count, clinical rating scale, and patient's self-report). The Toronto Side Effect Scale was used to evaluate side effects, and specific depressive symptoms were assessed using the Hamilton Rating Scale for Depression and Childhood Depression Inventory-Korean version. The Multidimensional Scale of Perceived Social Support was administered to analyze social support, and the Parenting Stress Index-Short Form was used to evaluate parental stress levels. We used concordance correlation analysis to evaluate the relationship among the four adherence measures and the relationship between adherence level and clinical factors. RESULTS Overall, the study enrolled 48 outpatients (mean age 16.33±1.93 years). The mean duration of illness was 1.27±2.17 years. Adherence rates for MEMS, clinician rating scale, pill count, and self-report after conversion to dichotomous measures were 67.5%, 48.9%, 60.0%, and 56.3%, respectively. Only the duration of illness remained significantly correlated with MEMS (r = 0.510, p =0.001). CONCLUSION Pill count exhibited a higher degree of agreement with MEMS adherence than the other two adherence measures, possibly indicating that pill count may be a considerably reliable measure of adherence. Furthermore, MEMS adherence was positively correlated with disease duration, suggesting that the longer the duration of illness, the higher the adherence.
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Affiliation(s)
- Young Eun Mok
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul, Republic of Korea
| | - Jong-ha Lee
- Department of Psychiatry, Korea University Ansan Hospital, Ansan, Gyeonggi Province, Republic of Korea
| | - Moon-soo Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul, Republic of Korea
- Correspondence: Moon-soo Lee Division of Child and Adolescent Psychiatry, Department of Psychiatry, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul08308, Republic of KoreaTel +82 2 2626 3163Fax +82 2 852 1937 Email
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Afonso Junior A, Portugal ACDA, Landeira-Fernandez J, Bullón FF, Santos EJRD, Vilhena JD, Anunciação L. Depression and Anxiety Symptoms in a Representative Sample of Undergraduate Students in Spain, Portugal, and Brazil. PSICOLOGIA: TEORIA E PESQUISA 2020. [DOI: 10.1590/0102.3772e36412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract University students have shown a significant occurrence of depression and anxiety symptoms. This epidemiological work investigated the prevalence of such symptoms in university students in Spain, Portugal, and Brazil, as well as the possible differences according to nationality and gender from a representative sample of three universities (University of Extremadura/Spain, n = 1216; University of Coimbra/Portugal, n = 426, and PUC-Rio, n = 315) in 2015. The results suggest that Brazilian students have a greater manifestation of depression symptoms, especially women, and they also presented greater symptoms of anxiety. No difference was found in the anxiety results between countries. The correlation between depression and anxiety was positive and strong. This study can be of value in social, clinical and political settings.
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Littlewood DL, Quinlivan L, Graney J, Appleby L, Turnbull P, Webb RT, Kapur N. Learning from clinicians' views of good quality practice in mental healthcare services in the context of suicide prevention: a qualitative study. BMC Psychiatry 2019; 19:346. [PMID: 31694598 PMCID: PMC6836656 DOI: 10.1186/s12888-019-2336-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/23/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Suicide and non-fatal self-harm represent key patient safety events in mental healthcare services. However, additional important learning can also be derived by highlighting examples of optimal practice that help to keep patients safe. In this study, we aimed to explore clinicians' views of what constitutes good practice in mental healthcare services in the context of suicide prevention. METHODS Data were extracted from the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) database, a consecutive case series study of suicide by people in contact with mental healthcare services. A large national sample of clinicians' responses was analysed with a hybrid thematic analysis. RESULTS Responses (n = 2331) were submitted by clinicians across 62 mental healthcare providers. The following five themes illustrated good practice that helps to: 1) promote safer environments, 2) develop stronger relationships with patients and families, 3) provide timely access to tailored and appropriate care, 4) facilitate seamless transitions, and 5) establish a sufficiently skilled, resourced and supported staff team. CONCLUSION This study highlighted clinicians' views on key elements of good practice in mental health services. Respondents included practice specific to mental health services that focus on enhancing patient safety via prevention of self-harm and suicide. Clinicians possess important understanding of optimal practice but there are few opportunities to share such insight on a broader scale. A further challenge is to implement optimal practice into routine, daily care to improve patient safety and reduce suicide risk.
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Affiliation(s)
- Donna L. Littlewood
- 0000000121662407grid.5379.8NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK ,0000000121662407grid.5379.8Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK
| | - Leah Quinlivan
- 0000000121662407grid.5379.8NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK ,0000000121662407grid.5379.8Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK
| | - Jane Graney
- 0000000121662407grid.5379.8National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Louis Appleby
- 0000000121662407grid.5379.8National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Pauline Turnbull
- 0000000121662407grid.5379.8National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Roger T. Webb
- 0000000121662407grid.5379.8NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK ,0000000121662407grid.5379.8Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK
| | - Navneet Kapur
- 0000000121662407grid.5379.8NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK ,0000000121662407grid.5379.8Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UK ,0000000121662407grid.5379.8National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, The University of Manchester, Manchester, UK ,0000 0004 0430 6955grid.450837.dGreater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Orchard F, Pass L, Cocks L, Chessell C, Reynolds S. Examining parent and child agreement in the diagnosis of adolescent depression. Child Adolesc Ment Health 2019; 24:338-344. [PMID: 32677348 DOI: 10.1111/camh.12348] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms. METHOD In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents' (n = 46) and parents' (n = 46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1997, 980) and the Mood and Feelings Questionnaire (Journal of the American Academy of Child and Adolescent Psychiatry, 27, 1988, 726). RESULTS In the clinical interview, diagnostic criteria were more often met based on the adolescent's report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report. CONCLUSION These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression and have an established pathway to services that offer assessment and treatment. Key Practitioner Message Diagnosis of depression in adolescents requires the identification of specific symptoms and can be identified using interviews or questionnaires. Previous research has suggested that parents and young people provide differing reports regarding symptoms of adolescent depression. Results indicated that diagnostic criteria were more often met based on young person report and that parents reported significantly less symptoms. Parent-child agreement about specific symptoms was found to be low. Assessment of adolescent depression should not rely solely on parental report. Young people should be encouraged and enabled to recognise symptoms of depression and be able to access mental health services.
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Affiliation(s)
- Faith Orchard
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Laura Pass
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Laura Cocks
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Chloe Chessell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Shirley Reynolds
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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