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Zemestani M, Ezzati S, Nasiri F, Gallagher MW, Barlow DH, Kendall PC. A culturally adapted unified protocol for transdiagnostic treatment of anxiety disorders in adolescents (UP-A): a randomized waitlist-controlled trial. Psychol Med 2024; 54:385-398. [PMID: 37458212 DOI: 10.1017/s0033291723001903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
BACKGROUND Anxiety disorders are highly prevalent and debilitating conditions that show high comorbidity rates in adolescence. The present article illustrates how Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) was adapted for Iranian adolescents with anxiety disorders. METHODS A total of 54 adolescents with comorbid anxiety disorders participated in a randomized, waitlist-controlled trial of group weekly sessions of either UP-A or waitlist control (WLC). Primary and process of change outcomes were assessed at baseline, posttreatment, and 1-month follow-up. RESULTS Significant changes were observed over time on major DSM-5 anxiety disorder symptoms (F(2, 51) = 117.09, p < 0.001), phobia type symptoms (F(2, 51) = 100.67, p < 0.001), and overall anxiety symptoms (F(2, 51) = 196.29, p < 0.001), as well as on emotion regulation strategies of reappraisal (F(2, 51) = 17.03, p < 0.001), and suppression (F(2, 51) = 21.13, p < 0.001), as well as on intolerance of uncertainty dimensions including prospective (F(2, 51) = 74.49, p < 0.001), inhibitory (F(2, 51) = 45.94, p < 0.001), and total intolerance of uncertainty (F(2, 51) = 84.42, p < 0.001), in favor of UP-A over WLC. CONCLUSION Overall, results provide a cultural application of the UP-A and support the protocol as useful for improving anxiety disorders as well as modifying of emotion regulation strategies and intolerance of uncertainty dimensions in Iranian adolescents. Future directions and study limitations are discussed.
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Affiliation(s)
- Mehdi Zemestani
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Saman Ezzati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Farzad Nasiri
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | | | - David H Barlow
- Department of Psychology, Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA
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Cao CH, Liao XL, Gamble JH, Li LL, Jiang XY, Li XD, Griffiths MD, Chen IH, Lin CY. Evaluating the psychometric properties of the Chinese Depression Anxiety Stress Scale for Youth (DASS-Y) and DASS-21. Child Adolesc Psychiatry Ment Health 2023; 17:106. [PMID: 37679819 PMCID: PMC10486035 DOI: 10.1186/s13034-023-00655-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic. METHODS Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis. RESULTS Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity. CONCLUSION Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture.
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Affiliation(s)
- Cui-Hong Cao
- School of Foreign Languages, Shandong Women's University, Jinan, 250300, China
- Faculty of Education, Qufu Normal University, Qufu, 273165, China
| | - Xiao-Ling Liao
- Faculty of Education, Jiangxi Science and Technology Normal University, Nanchang, 330031, China
| | - Jeffrey H Gamble
- Department of English, National Changhua University, Changhua, 50007, Taiwan
| | - Ling-Ling Li
- Xinjian District of Nanchang City, No.1 Senior High School, Nanchang, 330100, China
| | - Xing-Yong Jiang
- Yangan Primary School of Qionglai City, Qionglai, 611535, China
| | - Xu-Dong Li
- Gaogeng Nine-year School, Qionglai, 611533, China
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - I-Hua Chen
- Chinese Academy of Education Big Data, Qufu Normal University, Qufu, 273165, China.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
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Caqueo-Urízar A, Mena-Chamorro P, Henríquez D, Urzúa A, Irarrázaval M. The Effects of Social Determinants and Resilience on the Mental Health of Chilean Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1213. [PMID: 37508710 PMCID: PMC10378294 DOI: 10.3390/children10071213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The aim of this research was to evaluate the effects of social determinants (i.e., gender, educational vulnerability, and socioeconomic status) and resilience on the mental health of Chilean adolescents in pre-, during, and post-COVID-19 pandemic contexts. The study included a group of 684 students, ranging in age from 12 to 18 years, who were attending educational institutions in the city of Arica. The Child and Adolescent Assessment System (SENA) was used to measure mental health problems, the Brief Resilience Scale for Children and Youth (CYRM-12) was used to measure resilience, and the Vulnerability Index of Educational Institutions was used to measure educational vulnerability. The results suggest increases in depressive, anxious, and social anxiety symptomatologies over time (wave by year, 2018, 2020, and 2021). In addition, multiple linear regression models showed predictive effects of the COVID-19 pandemic, gender, vulnerability index, socioeconomic status, and resilient behaviors on mental health problems. The worsening of mental health indicators over time requires the greater coordination and integration of mental health experts in the most vulnerable educational centers.
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Affiliation(s)
| | - Patricio Mena-Chamorro
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Diego Henríquez
- Centro de Justicia Educacional CJE, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta 1270709, Chile
| | - Matías Irarrázaval
- Department of Psychiatry, Faculty of Medicine, Clinical Hospital, Universidad de Chile, Santiago 8380453, Chile
- Millennium Institute for Research in Depression and Personality, MIDAP, Santiago 8380453, Chile
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Psychiatric Disorders and Obesity in Childhood and Adolescence-A Systematic Review of Cross-Sectional Studies. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020285. [PMID: 36832413 PMCID: PMC9955505 DOI: 10.3390/children10020285] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions.
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Gómez-Restrepo C, Casasbuenas NG, Ortiz-Hernández N, Bird VJ, Acosta MPJ, Restrepo JMU, Sarmiento BAM, Steffen M, Priebe S. Role of the arts in the life and mental health of young people that participate in artistic organizations in Colombia: a qualitative study. BMC Psychiatry 2022; 22:757. [PMID: 36463167 PMCID: PMC9719131 DOI: 10.1186/s12888-022-04396-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Adolescents and young adults are vulnerable to developing mental distress. However, evidence suggests that more than half of the young people with symptoms of depression and anxiety overcome their distress within a year. However, there is little research on the exact resources that young people use and help them to recover. The aim of this study was to explore how arts activities can support the recovery of young people engaged with arts organizations in Bogota. METHODS We recruited 38 participants from two arts organizations in Bogotá and conducted six focus groups embedded within artistic workshops. The type of activities in the workshops varied reflecting the different teaching methods of the two organizations. The focus group discussions were recorded and analyzed using thematic analysis. RESULTS Five themes explained how arts activities can help young people participating in artistic organizations to overcome mental distress: i) allowing the expression of emotions; ii) helping to manage and transform emotions; iii) distracting from problems; iv) facilitating social support and relationships; and v) contributing to the identity of young people. CONCLUSIONS For young people who participate in artistic organizations, the arts are a resource for overcoming negative emotions such as anxiety, depression, and sadness. The beneficial role of arts activities includes different process of managing, expressing, and distracting from distress, and it differs depending on whether arts are perceived as a professional vocation or a hobby.
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Affiliation(s)
- Carlos Gómez-Restrepo
- grid.41312.350000 0001 1033 6040Departament of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia ,grid.41312.350000 0001 1033 6040Departament of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia ,San Ignacio University Hospital, Bogotá, Colombia
| | - Natalia Godoy Casasbuenas
- Departament of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Natalia Ortiz-Hernández
- grid.41312.350000 0001 1033 6040Departament of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Victoria Jane Bird
- grid.4868.20000 0001 2171 1133Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - María Paula Jassir Acosta
- grid.41312.350000 0001 1033 6040Departament of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - José Miguel Uribe Restrepo
- grid.41312.350000 0001 1033 6040Departament of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Bryan Alexander Murillo Sarmiento
- grid.41312.350000 0001 1033 6040Departament of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mariana Steffen
- grid.4868.20000 0001 2171 1133People’s Palace Projects, Queen Mary University of London, London, UK
| | - Stefan Priebe
- grid.4868.20000 0001 2171 1133Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
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Intolerance of uncertainty as a transdiagnostic vulnerability to anxiety disorders in youth. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pipe A, Ravindran N, Paric A, Patterson B, Van Ameringen M, Ravindran AV. Treatments for child and adolescent attention deficit hyperactivity disorder in low and middle-income countries: A narrative review. Asian J Psychiatr 2022; 76:103232. [PMID: 35987096 DOI: 10.1016/j.ajp.2022.103232] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects approximately 2-7 % of children globally and is associated with a myriad of difficulties that have long-term consequences. Most children and adolescents live in low- and middle-income countries (LMICs), but there are few reports and no consolidation of findings on ADHD treatment outcomes in this population. We conducted a review of ADHD treatment literature for children and adolescents living in LMICs. METHODS Studies were identified using databases (PsychoINFO, Pubmed, MEDLINER, EMBASE, Global Health, Academic Search Complete, Google Scholar). The initial search produced 139 articles. These were filtered for language, title, abstract, and full-text keyword identification to yield a final 20 articles to be included in this review. RESULTS Reports on outcomes of both psychological and pharmacological treatment were relatively sparse, particularly the former, which mostly referred to parent training and multimodal programs in pre-school children. Most evidence exists for the benefit of methylphenidate-IR with a few reports on other agents, including clonidine, atomoxetine, and lisdexamfetamine. Methylphenidate is the most common agent to treat ADHD in youth in LMICs. Younger age, combined subtype, and comorbid oppositional defiant disorder were associated with poorer treatment outcome. CONCLUSION Access to treatment for ADHD is overall limited in LMICs and varied among individual countries. Pharmacological treatments were generally more available than psychological interventions. Several barriers including stigma, cost, and lack of resources were reported to impact treatment acceptance. More research in LMICs is needed to improve and expand mental health services in these regions.
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Affiliation(s)
- Amy Pipe
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario N6A 5C1, Canada.
| | - Nisha Ravindran
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J 1H4 Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8 Canada.
| | - Angela Paric
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J 1H4 Canada.
| | - Beth Patterson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, Ontario, L8N 3K7 Canada; MacAnxiety Research Centre, McMaster University, 1057 Main Street West, Hamilton, Ontario, L8S 1B8 Canada.
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, Ontario, L8N 3K7 Canada.
| | - Arun V Ravindran
- Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, Ontario, M6J 1H4 Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8 Canada.
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Toyama M, Godoy-Casasbuenas N, Olivar N, Brusco LI, Carbonetti F, Diez-Canseco F, Gómez-Restrepo C, Heritage P, Hidalgo-Padilla L, Uribe M, Steffen M, Fung C, Priebe S. Identifying resources used by young people to overcome mental distress in three Latin American cities: a qualitative study. BMJ Open 2022; 12:e060340. [PMID: 35953250 PMCID: PMC9379470 DOI: 10.1136/bmjopen-2021-060340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To explore which resources and activities help young people living in deprived urban environments in Latin America to recover from depression and/or anxiety. DESIGN A multimethod, qualitative study with 18 online focus groups and 12 online structured group conversations embedded into arts workshops. SETTING This study was conducted in Bogotá (Colombia), Buenos Aires (Argentina) and Lima (Peru). PARTICIPANTS Adolescents (15-16 years old) and young adults (20-24 years old) with capacity to provide assent/consent and professionals (older than 18 years of age) that had experience of professionally working with young people were willing to share personal experience within a group, and had capacity to provide consent. RESULTS A total of 185 participants took part in this study: 111 participants (36 adolescents, 35 young adults and 40 professionals) attended the 18 focus groups and 74 young people (29 adolescents and 45 young adults) took part in the 12 arts workshops. Eight categories captured the resources and activities that were reported by young people as helpful to overcome mental distress: (1) personal resources, (2) personal development, (3) spirituality and religion, (4) social resources, (5) social media, (6) community resources, (7) activities (subcategorised into artistic, leisure, sports and outdoor activities) and (8) mental health professionals. Personal and social resources as well as artistic activities and sports were the most common resources identified that help adolescents and young adults to overcome depression and anxiety. CONCLUSION Despite the different contexts of the three cities, young people appear to use similar resources to overcome mental distress. Policies to improve the mental health of young people in deprived urban settings should address the need of community spaces, where young people can play sports, meet and engage in groups, and support community organisations that can enable and facilitate a range of social activities.
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Affiliation(s)
- Mauricio Toyama
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Natalia Godoy-Casasbuenas
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Natividad Olivar
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Luis Ignacio Brusco
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernando Carbonetti
- Department of Psychiatry and Mental Health, School of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Gómez-Restrepo
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
- Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Paul Heritage
- School of English and Drama, Queen Mary University of London, London, UK
| | - Liliana Hidalgo-Padilla
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Uribe
- Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Mariana Steffen
- School of English and Drama, Queen Mary University of London, London, UK
| | - Catherine Fung
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Zemestani M, Hosseini M, Petersen JM, Twohig MP. A pilot randomized controlled trial of culturally-adapted, telehealth group acceptance and commitment therapy for iranian adolescent females reporting symptoms of anxiety. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Olashore AA, Brooks W, Roy H, Adebayo FA, Chiliza B. Psychiatric disorders and associated risk factors in a sample of adolescents in Gaborone, Botswana: a cross-sectional study. BMC Pediatr 2022; 22:381. [PMID: 35768787 PMCID: PMC9244366 DOI: 10.1186/s12887-022-03435-7] [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: 03/07/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Despite the high proportion of adolescents living with mental health issues in low- to middle-income countries (LMICs), especially in Botswana, there is a significant deficit of local research to guide an increase in prevention and treatment. We, therefore, aimed to assess the prevalence and associated risk factors of psychiatric disorders (PD) in a sample of secondary school students in Botswana. Methods This cross-sectional study included 750 students from the 13 public secondary schools in Gaborone using a multi-stage sampling technique. The Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) was used to screen for PDs. Results The participant’s mean age was 15.26 and SD 1.57 years, with 53.6% being female. Approximately 34% had a PD, with depression being the commonest, of whom 35% were neither receiving treatment nor aware of the available services. Perinatal complications (AOR = 4.29; 95%CI: 1.04–17.70), a family history of mental illness (AOR = 2.19; 95%CI: 1.17–4.11) and substance-related problems (AOR = 1.80; 95% CI:1.22–2.65) predicted the likelihood of developing PD. Conclusions Our findings revealed that adolescents in Botswana have many mental health issues which may affect their developmental phases. A multi-sectoral collaboration is needed for the timely detection of identified risk factors and initiation of the necessary prevention and treatment measures.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana. .,Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - Wendy Brooks
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Hlanganiso Roy
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Flores J, Caqueo-Urízar A, López V, Acevedo D. Symptomatology of attention deficit, hyperactivity and defiant behavior as predictors of academic achievement. BMC Psychiatry 2022; 22:61. [PMID: 35086526 PMCID: PMC8793213 DOI: 10.1186/s12888-022-03714-8] [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: 06/09/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND It is essential to understand the factors that affect the academic achievement of schoolchildren, both in general and in terms of the major subsectors of each grade. Although symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Negative Defiant Disorder (NDD-which are commonly recognized as externalizing problems in childhood and adolescence-have been associated with lower academic achievement in the international literature, few studies have addressed this problem in Latin America. This study aimed to analyze the possible predictive relationship of attention problems, hyperactivity, and defiant behavior on academic achievement. METHODS We recruited a sample of 4580 schoolchildren (50.9% female, 1754 belonging to primary school, and 2826 to secondary school, ranging from 9 to 18 years old). This cross-sectional study used the scales pertaining to attention problems, hyperactivity, and challenging behavior from the Child and Adolescent Evaluation System. RESULTS The analysis showed that attention problems significantly affected all academic achievement areas, while hyperactivity and challenging behavior affected only some of them. The regression models explained 24% of the variability in overall academic achievement in primary school and 17% in secondary school. Other predictors included sex, age, socioeconomic level, and school attendance. CONCLUSIONS It is important to consider this symptomatology in the design of educational interventions.
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Affiliation(s)
- Jerome Flores
- Escuela de Psicología y Filosofía, Universidad de Tarapacá & Centro de Justicia Educacional, CJE, Avenida 18 de Septiembre 2222, Arica, Chile.
| | - Alejandra Caqueo-Urízar
- grid.412182.c0000 0001 2179 0636Instituto de Alta Investigación, Universidad de Tarapacá, Arica, Chile
| | - Verónica López
- grid.8170.e0000 0001 1537 5962Escuela de Psicología, Pontificia Universidad Católica de Valparaíso & Centro de Investigación para la Educación Inclusiva, Valparaíso, Chile
| | - Daniel Acevedo
- grid.412182.c0000 0001 2179 0636Escuela de Psicología y Filosofía, Universidad de Tarapacá & Centro de Justicia Educacional, CJE, Avenida 18 de Septiembre 2222, Arica, Chile
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De Nardi L, Lanzetta MA, Ghirigato E, Barbi E, Gortani G. Approach to the child with fatigue: A focus for the general pediatrician. Front Pediatr 2022; 10:1044170. [PMID: 36533226 PMCID: PMC9755349 DOI: 10.3389/fped.2022.1044170] [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: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Fatigue is a common, nonspecific complaint commonly used to describe various conditions, ranging from a vague, subjective sense of weariness to muscular weakness, fatigability, exercise intolerance or excessive daytime somnolence. Despite its high frequency in the general population, literature addressing the approach to the child with fatigue from a general pediatrician perspective is poor. We herein propose a review of the available evidence on the topic, providing a practical framework to assist physicians in dealing with the issue. METHODS Data were identified by searches of MEDLINE, UpToDate, Google Scholar and references from relevant articles. Articles published between 1990 and 2021 were considered, prioritizing systematic reviews and meta-analyses. Then, an empirically-based model of approaching the tired child was proposed according to our center experience. RESULTS To correctly characterize the meaning of fatigue reporting, specific clues from history and physical examination should be emphasized. Duration, severity, and the age at onset are to be considered. Then, specific queries about everyday activities, sleep hygiene and social domain could be useful in reaching a specific diagnosis and offering an appropriate treatment. CONCLUSIONS We suggest a pragmatic approach to fatigue in children based on age assessment, targeted questions, physical examination clues, and some laboratory first-level tests. This could provide pediatricians with a useful tool to discriminate the broad etiology of such a complaint, disentangling between psychological and organic causes. Further studies are needed to investigate the predictive value, specificity and sensitivity of this diagnostic workflow in managing the child with fatigue.
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Affiliation(s)
- Laura De Nardi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Maria Andrea Lanzetta
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elena Ghirigato
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Gortani
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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Hosseinkhani Z, Parsaeian M, Hassanabadi HR, Khoshkchali A, Alinesaei Z, Nedjat S. Mental Health Problems and the Associated Family and School Factors in Adolescents: A Multilevel Analysis. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:13-20. [PMID: 34054978 PMCID: PMC8140304 DOI: 10.18502/ijps.v16i1.5373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Mental health is one of the most important issues in adolescents’ life. Adolescents’ health is highly important, because of their role in the future. This study was conducted using multilevel analysis to investigate the risk factors at student and school levels. Method: This was a cross sectional study for which 1740 students and 53 schools were selected between February and March 2018 in Qazvin, Iran. Multistage stratified cluster sampling was used for data collection. Mental health problems were measured by the Strengths and Difficulties Questionnaire (SDQ). Emotional symptom, conduct problem, hyperactivity, peer relationship problem, and prosocial behavior were the subscales. This study used multilevel analysis to determine the association between each of the questionnaire scales and students and schools variables. Results: The prevalence of the mental health problems was 16.2%. Conduct problem was more prevalent than others (21.1%). Overall, the score of mental health problems was significantly lower in boys’ schools, in adolescents with physical activity, and in families with high socioeconomic status. Hyperactivity and emotional symptoms were significantly higher in girls’ schools. While prosocial behavior and peer relationship problems were significantly higher in boys’ schools. The association between variables and the scales of mental health problems was different.Conclusion: Results indicated desirable physical activity and socioeconomic status are effective components in the adolescents’ mental health, and, mostly girls’ schools were more vulnerable than boys’ schools. Therefore, the educational authorities and health policymakers should consider this diversity to design interventional programs and pay more attention to the high-risk adolescents in different schools.
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Affiliation(s)
- Zahra Hosseinkhani
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin, University of Medical Sciences, Qazvin, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Atefeh Khoshkchali
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Alinesaei
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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