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Allemand M, Fend HA, Hill PL. Negative Emotional Reactivity and Somatic Symptoms during Adolescence Predict Adult Health and Wellbeing in Early and Middle Adulthood. J Youth Adolesc 2024; 53:1513-1528. [PMID: 38282066 PMCID: PMC11136711 DOI: 10.1007/s10964-024-01940-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
Longitudinal research is lacking with respect to how negative emotional reactivity and somatic symptoms during adolescence set the stage for later health. The aim of this longitudinal study was to examine within-person associations between negative emotional reactivity and somatic symptoms during adolescence and their effects on health and wellbeing in adulthood. Participants (N = 1527; 48.3% female) were assessed annually at the age of 12 to 16 years and at the age of 35 and 45 years. Adolescents with frequent somatic symptoms reported higher reactivity. Individual differences in levels and changes of somatic symptoms and reactivity were independently associated with adult health and wellbeing decades later. The findings underscore the importance of considering how individual differences change during adolescent development.
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Affiliation(s)
- Mathias Allemand
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.
| | - Helmut A Fend
- Institute of Education, University of Zurich, Zurich, Switzerland
| | - Patrick L Hill
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, USA
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Laumann LE, Lee J, Blackmon JE, Delcourt ML, Sullivan MC, Cruess SE, Cruess DG. Depression and anxiety as mediators of the relationship between sleep disturbance and somatic symptoms among adolescents on a psychiatric inpatient unit. Clin Child Psychol Psychiatry 2024; 29:513-525. [PMID: 37669806 DOI: 10.1177/13591045231198365] [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: 09/07/2023]
Abstract
Background: This study investigated the relationship between sleep disturbance and somatic symptoms among adolescents residing on a psychiatric inpatient unit. Given the evidence that sleep disturbance may precede the onset of depression and anxiety and the clear associations between mood and somatic symptoms, depression and anxiety were considered as potential mediators of this relationship. Gender was tested as a potential moderator of the relationship between sleep disturbance and depression and anxiety, respectively. Method: A convenience sample of 83 adolescents completed a packet of self-report measures after admission to the unit. Measures assessed depression, sleep disturbance, anxiety, and somatic symptoms. Mediation and moderation analyses were conducted using SPSS PROCESS macro. Results: With anxiety included as a covariate, the overall indirect effect of sleep disturbance on somatic symptoms through depression was significant. No significant moderation effects were found, although females reported significantly higher levels of sleep disturbance, depression, anxiety, and somatic symptoms than males. Conclusions: Results indicated that depression mediated the relationship between sleep disturbance and somatic symptoms above and beyond the effects of anxiety. These findings suggest that interventions aimed at reducing the negative effects of sleep disturbance should also target mood in this population. Individual differences including gender should be considered when developing interventions.
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Affiliation(s)
- Laura E Laumann
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jerin Lee
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Meaghan L Delcourt
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Matthew C Sullivan
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | | | - Dean G Cruess
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Gerstl B, Ahinkorah BO, Nguyen TP, John JR, Hawker P, Winata T, Brice F, Bowden M, Eapen V. Evidence-based long term interventions targeting acute mental health presentations for children and adolescents: systematic review. Front Psychiatry 2024; 15:1324220. [PMID: 38510802 PMCID: PMC10950959 DOI: 10.3389/fpsyt.2024.1324220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/12/2024] [Indexed: 03/22/2024] Open
Abstract
Background Long term intervention services have proven to be effective in improving mental health (MH) outcomes and the quality of life for children and young people (CYP). Aim To synthesize evidence on the effectiveness of long-term interventions in improving MH outcomes for CYP, 0-17 years, presenting with MH conditions. Methods A systematic search was carried out and the methodological quality of included long term MH intervention studies were assessed. Six databases were searched for peer-reviewed articles between January 2000 and September 2022. Results We found 30 studies that reported on the effectiveness of a range of long-term MH interventions in the form of (i) group therapy, (ii) multisystemic behavior therapy, (iii) general services, (iv) integrated services, (v) psychotherapy, (vi) intensive intervention services, (vii) comprehensive collaborative care, (viii) parent training, and (ix) home outreach service. Among the included studies, seven were rated as high level of evidence based on the National Health and Medical Research Council (NHMRC) levels of evidence hierarchy scale and seven were of moderate quality evidence. Others were rated as lower-quality evidence. Among the studies providing high quality evidence, most were reported for group therapy, general services, and psychotherapy studies demonstrating beneficial effects. Conclusion This systematic review provides evidence to demonstrate the benefits of a range of long-term interventions, in a range of settings, can be effective in improving MH outcomes for CYP and their families. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022323324.
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Affiliation(s)
- Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Mental Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Patrick Hawker
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
| | - Michael Bowden
- Child and Youth Mental Health, NSW Ministry of Health, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Psychological Medicine, Sydney Children’s Hospitals Network, Sydney, NSW, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Sydney, NSW, Australia
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Xie M, Zhao Z, Yan J, Cham H, Yip T. Ethnic/Racial Identity, Adolescent Sleep, and Somatic Health: Discrimination and Stress Responses as Mediating Mechanisms. J Adolesc Health 2024; 74:514-522. [PMID: 37952141 PMCID: PMC10872842 DOI: 10.1016/j.jadohealth.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 08/24/2023] [Accepted: 09/08/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE This study sought to examine whether the daily associations between ethnic/racial discrimination and stress responses served as mediators linking ethnic/racial identity (ERI), adolescent sleep health, and somatic symptoms. METHODS Data were drawn from 279 adolescents of color (69% female; 24% African Americans; 31% Asian Americans; 41% Latinx; and 4% unknown ethnicity/race; Mage = 14.31 years, SD = 0.65). Adolescents first completed an online survey about ERI exploration and commitment; and then 14-day diaries on ethnic/racial discrimination and stress responses (i.e., rumination and problem-solving coping), and finally, a post-diary survey about sleep and somatic health over the past two weeks. This study adopts slope-as-mediator mediation modeling, a novel approach highlighting the role of daily-level experiences in developmental processes by examining the day-to-day association between two variables as an explanatory mechanism. RESULTS The daily associations between ethnic/racial discrimination and two stress responses significantly mediated the link between ERI exploration and adolescents' subsequent sleep and somatic health. For ERI commitment, only the mediating pathway of the association between ethnic/racial discrimination and problem-solving coping was significant. DISCUSSION Daily responses to ethnic/racial discrimination, both adaptively and maladaptively, could in part explain the association between ERI exploration and adolescent health. Active participation in cultural activities may increase adaptive responses to ethnic/racial discrimination; meanwhile, uncertainty about ERI may lead to maladaptive reactions such as rumination. For ERI commitment, only problem-solving coping with ethnic/racial discrimination mediated the links to health outcomes, an observation possibly explained by the benefits of holding a strong sense of commitment to ERI.
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Affiliation(s)
- Mingjun Xie
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China.
| | - Zhenqiang Zhao
- Department of Psychology, Fordham University, Bronx, New York
| | - Jinjin Yan
- Department of Psychology, Fordham University, Bronx, New York
| | - Heining Cham
- Department of Psychology, Fordham University, Bronx, New York
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, New York
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Sreedharan S, Benzouak T, Rao S, Islam FN, Parvathareddy N, Sachdev A, Shah S. Mental Health of Frontline Nurses in India During COVID-19: A Multisite Study. Cureus 2024; 16:e55181. [PMID: 38558590 PMCID: PMC10980785 DOI: 10.7759/cureus.55181] [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: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Background The COVID-19 pandemic has been difficult for all healthcare providers. Nurses in Indian hospitals are at risk for mental health consequences of COVID-19-related stress. The study aimed to evaluate the mental health responses of Indian nurses working during the COVID-19 pandemic. Method The study was carried out during the COVID-19 pandemic from November 2020 to February 2021. Frontline nurses (n=387) working in both government and private sectors were recruited from four hospital centers across Mangalore, India. Nurses were selected based on specific inclusion criteria, including active duty within wards and intensive care units designated for COVID-19 care or suspected cases of SARS-CoV-2 infection. Recruitment and data collection were facilitated by medical residents using a mix of physical and electronic survey methods. Results Nurses within the private sector with low personal protective equipment (PPE) security experienced heightened anxiety. Somatic symptoms were incrementally related to mental health depending on the workplace setting; private sector staff reported greater depression symptoms compared to those in government-run hospitals. Self-efficacy buffered against depression outcomes only in nurses within the private sector working within non-COVID units. Conclusions This study's findings showed differential responses to the stress of COVID-19 based on the setting. Future studies should further explore the factors associated with such differences. Somatic symptoms can be indicators of mental health adversity. Early detection and supportive interventions need to be taken into account.
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Affiliation(s)
- Suja Sreedharan
- Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Mangalore, IND
| | - Tarek Benzouak
- Faculty of Medicine, McGill University, Montreal, CAN
- Department of Psychiatry, University of Ottawa, Ottawa, CAN
- Department of Psychology, Carleton University, Ottawa, CAN
| | - Sanjay Rao
- Department of Psychiatry, University of Ottawa, Ottawa, CAN
| | - Farnaz N Islam
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Manipal, Mangalore, IND
| | - Navya Parvathareddy
- Department of Otorhinolaryngology and Head & Neck Surgery, Kasturba Medical College, Manipal, Mangalore, IND
| | | | - Swar Shah
- Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
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Alkan F, Sapmaz SY, Kardelen C, Bircan O, Bilac O, Kandemir H, Coskun S. Should pediatric cardiologists refer all patients with unexplained chest pain to a psychiatrist? Cardiol Young 2023:1-7. [PMID: 38149344 DOI: 10.1017/s1047951123004195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The present study aimed to investigate the relationship between unexplained chest pain in children with parents' mental problems, parental attitudes, family functionality, and the child's mental problems. MATERIAL AND METHOD A total of 433 children (between 11 and 18 years of age) applied to the Pediatric Cardiology Outpatient Clinic due to chest pain in the last year. A clinical interview was conducted by a child psychiatrist with 43 patients and 33 controls included in the study due to unexplained chest pain. RESULTS Family history of physical illness was significantly higher in the chest pain group. When evaluated in terms of psychosocial risk factors, life events causing difficulties, derangement in the family, loss of a close person, and exposure to violence were statistically significantly higher in the group with chest pain. Mental disorders were observed in 67.4% of the children in the chest pain group as a result of the clinical interview. The total score of the DSM-5 somatic symptoms scale, which evaluates other somatic complaints in the chest pain group, was also significantly higher. When the family functions of both groups were evaluated, communication, emotional response, behaviour control, and general functions sub-dimensions were statistically significantly higher in families in the chest pain group. CONCLUSION We recommend that psychiatric evaluation be included in diagnostic research to prevent unnecessary medical diagnostic procedures in children describing unexplained chest pain, as well as to prevent the potential for diagnosing mental disorders in both children and adults.
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Affiliation(s)
- Fatos Alkan
- Division of Pediatrics Cardiology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Sermin Yalın Sapmaz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Cansın Kardelen
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Onur Bircan
- Division of Pediatrics Cardiology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Oznur Bilac
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Senol Coskun
- Division of Pediatrics Cardiology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
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Grigorian K, Östberg V, Raninen J, Åhlén J, Brolin Låftman S. Prospective associations between psychosomatic complaints in adolescence and depression and anxiety symptoms in young adulthood: A Swedish national cohort study. SSM Popul Health 2023; 24:101509. [PMID: 37720821 PMCID: PMC10500464 DOI: 10.1016/j.ssmph.2023.101509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/16/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023] Open
Abstract
Background Psychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood. Methods A Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779). Results The frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls. Conclusions Psychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.
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Affiliation(s)
- Karina Grigorian
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Viveca Östberg
- Department of Public Health Sciences, Stockholm University, Sweden
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Johan Åhlén
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Sweden
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Ziaei S, Hammarström A. The relationship between interpersonal violence in adulthood and mental health: a longitudinal study based on the Northern Swedish Cohort. BMC Public Health 2023; 23:637. [PMID: 37013550 PMCID: PMC10071752 DOI: 10.1186/s12889-023-15525-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 03/25/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Longitudinal studies evaluating the negative effects of exposure to interpersonal violence in the adulthood on the mental health of both women and men are scarce. Using longitudinal data, we evaluated the relationship between the last year experience of violence and functional somatic and depressive symptoms at the ages of 30 and 43 among participants (n = 1006; 483 women and 523 men) in the Northern Swedish Cohort. Further, the relationship between cumulative exposure to violence over a decade and mental health symptoms among participants was evaluated. METHODS Participants' experience of interpersonal violence and symptoms of functional somatic and depressive symptoms were evaluated with standard questionnaires at the ages of 30 and 43. General linear models were used to evaluate the relationship between the experience of interpersonal violence and mental health symptoms among the participants. The interactions between gender and violence on functional somatic and depressive symptoms were evaluated separately, and models in which the interaction was significant, were split by gender. RESULTS We found that the last year experience of violence at the age of 30 was related to current functional somatic symptoms among all participants and depressive symptoms only among men, (β Adj for the experience of any violence among men: 0.21; CI: 0.12-0.29; Vs. among women: 0.06; CI: -0.04-0.16, p for interaction = 0.02). At the age of 43, last year experience of violence was related to both functional somatic and depressive symptoms in both genders. Finally, a cumulative relationship between the experience of violence over time and mental health symptoms was observed in all participants. CONCLUSIONS Our findings revealed that while the relationship between the experience of interpersonal violence and mental health symptoms may differ among men and women and with age, the experience of violence can be negatively related to the mental health in both genders.
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Affiliation(s)
- Shirin Ziaei
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65 Stockholm, Stockholm, Sweden.
| | - Anne Hammarström
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65 Stockholm, Stockholm, Sweden
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
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Parents' drinking, childhood hangover? Parental alcohol use, subjective health complaints and perceived stress among Swedish adolescents aged 10-18 years. BMC Public Health 2023; 23:162. [PMID: 36694162 PMCID: PMC9872733 DOI: 10.1186/s12889-023-15097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/05/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Alcohol abuse is not only harmful to the consumer but may also negatively impact individuals in the drinker's social environment. Alcohol's harm to others is vital to consider when calculating the true societal cost of alcohol use. Children of parents who have alcohol use disorder tend to have an elevated risk of negative outcomes regarding, e.g., health, education, and social relationships. Research on the general youth population has established a link between parental drinking and offspring alcohol use. However, there is a lack of knowledge regarding other outcomes, such as health. The current study aimed to investigate the associations between parental drinking and children's psychological and somatic complaints, and perceived stress. METHODS Data were derived from a nationally representative sample, obtained from the 2010 Swedish Level-of-Living survey (LNU). Parents and adolescents (ages 10-18) living in the same households were interviewed independently. The final study sample included 909 adolescents from 629 households. The three outcomes, psychological and somatic complaints and perceived stress, were derived from adolescents' self-reports. Parents' self-reports of alcohol use, both frequency and quantity, were used to categorise adolescents as having abstaining, low-consuming, moderate-drinking, or heavy-drinking parents. Control variables included adolescents' gender, age, family structure, and household socioeconomic status. Linear and binary logistic regression analyses were performed. RESULTS Parental heavy drinking was more common among adolescents living in more socioeconomically advantaged households and among adolescents living with two custodial parents or in reconstituted families. Adolescents with heavy-drinking parents reported higher levels of psychological and somatic complaints and had an increased likelihood of reporting stress, compared with those having moderate-drinking parents. These associations remained statistically significant when adjusting for all control variables. CONCLUSION The current study's results show that parental alcohol consumption is associated with poorer offspring adolescent health. Public health policies that aim to reduce parental drinking or provide support to these adolescents may be beneficial. Further studies investigating the health-related outcomes among young people living with heavy-drinking parents in the general population are needed to gain more knowledge about these individuals and to implement adequate public health measures.
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Lawrence TI, Hong JS, Sopchak KS, Voisin DR. The association between exposure to community violence and somatic symptoms through bullying victimization among African American adolescents in Chicago: A developmental trauma approach. J Clin Psychol 2023; 79:1280-1292. [PMID: 36649603 DOI: 10.1002/jclp.23475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/08/2022] [Accepted: 12/17/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The developmental trauma theory suggests that traumatic events impede the ability of individuals to form interpersonal relationships, impair cognition, affect, and increase the vulnerability of adolescents to develop psychopathology. However, few studies have examined the applicability of this theory among African American adolescents who were exposed to community violence and adverse outcomes, including bullying victimization and somatic symptoms. AIMS Therefore, the purpose of the present study is to first test the association between exposure to community violence and somatic symptoms. Then, we explored whether bullying victimization mediated the relationship between exposure to community violence and somatic symptoms while controlling for gender differences and substance use (n = 622). RESULTS Results suggest that exposure to community violence is positively associated with somatic symptoms. Moreover, the association between exposure to community violence and somatic symptoms was mediated by bullying victimization. DISCUSSION AND CONCLUSION These results were consistent with the developmental trauma theory, such that trauma could increase the vulnerability for future victimization, thus, leading to somatic symptoms. Implications for research and practice are discussed.
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Affiliation(s)
- Timothy I Lawrence
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Texas A&M University, Bryan, Texas, USA
| | - Jun S Hong
- School of Social Work, Wayne State University, Detroit, Michigan, USA.,Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Kelly S Sopchak
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Texas A&M University, Bryan, Texas, USA
| | - Dexter R Voisin
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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11
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Among the swedish generation of adolescents who experience an increased trend of psychosomatic symptoms. Do they develop depression and/or anxiety disorders as they grow older? BMC Psychiatry 2022; 22:779. [PMID: 36503425 PMCID: PMC9743552 DOI: 10.1186/s12888-022-04432-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
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Ssegonja R, Alaie I, Holmgren A, Bohman H, Päären A, von Knorring L, von Knorring AL, Jonsson U. Association of adolescent depression with subsequent prescriptions of anti-infectives and anti-inflammatories in adulthood: A longitudinal cohort study. Psychiatry Res 2022; 317:114813. [PMID: 36058038 DOI: 10.1016/j.psychres.2022.114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
New insights into how depression is linked to physical health throughout the lifespan could potentially inform clinical decision making. The aim of this study was to explore the association of adolescent depression with subsequent prescriptions of anti-infectives and anti-inflammatories in adulthood. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study initiated in 1991. Depressed (n = 321) and non-depressed (n = 218) adolescents were followed prospectively using patient registries. The associations of adolescent depression (age 16-17 years) with subsequent prescription of anti-infectives and anti-inflammatories (age 30-40 years), were analysed using generalized linear models. Sub-analyses explored the impact of diagnostic characteristics in adolescence and reception of anti-depressants prescriptions in adulthood. The results suggest that females with persistent depressive disorder in adolescence have a higher rate of future prescriptions than non-depressed peers, with adjusted incidence rate ratio of 1.42 (1.06 to 1.92) for anti-infectives and 1.72 (1.10 to 2.70) for anti-inflammatories. These associations were mainly driven by those who were also prescribed antidepressants during the same period. Associations were less robust for females with episodic or subsyndromal depression in adolescence and for males. These findings emphasize the importance of integrated mental health services at the primary healthcare level.
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Affiliation(s)
- Richard Ssegonja
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden; Department of Medical Sciences, Respiratory, Allergy- and Sleep Medicine Research Unit, Uppsala University, Uppsala, Sweden.
| | - Iman Alaie
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Amanda Holmgren
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Hannes Bohman
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Aivar Päären
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Lars von Knorring
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anne-Liis von Knorring
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Ulf Jonsson
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden; Centre of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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13
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Grishkevich NY, Evert LS, Bakhshieva SA, Kostyuchenko YR. Gender Differences In Functional Somatic Disorders Of Indigenous Adolescents In Khakassia. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rationale — The goal of the study was to investigate gender characteristics of functional somatic disorders in adolescents of the indigenous population of Khakassia (using the case study of the Abakan city). Material and methods — The object of the study was 215 (46.8%) boys and 244 (53.2%) girls of four secondary schools in Abakan. Their average age was 14.5±1.3 years. Data collection was conducted by means of an original screening questionnaire developed by Professor S.Yu. Tereshchenko. Results — The incidence of recurrent pain in the total sample of the surveyed youths was 184 (40.1%) for cephalalgia, 225 (49.0%) for abdominal pain, and 269 (58.7%) for back pain. The prevalence and structure of functional somatic disorders in Khakas adolescents depended on their gender. Asthenic syndrome was more common among girls – 42 (17.2%) vs. 14 (6.5%) in boys. In girls, the percentage of frequent headaches was higher than in boys: 22 (9.0%) vs. 8 (3.7%), respectively. Similar trend was observed in case of rare headaches: 100 (41.0%) vs. 54 (25.1%). Also, girls, compared with boys, were characterized by a higher incidence of both frequent and rare abdominal pains: 38 (15.6%) vs. 9 (4.2%) and 106 (43.4%) vs. 72 (33.5%), correspondingly. Conclusion — The case study of surveyed ethnic sample of Abakan school students revealed a high prevalence of recurrent pain syndromes in the indigenous youths of Khakassia. We have also established that incidence, structure and severity of recurrent pain, as well as its negative impact on well-being and daily activities, were associated with gender.
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Affiliation(s)
| | - Lidia S. Evert
- Krasnoyarsk Scientific Center, Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk, Russia
| | | | - Yuliya R. Kostyuchenko
- Krasnoyarsk Scientific Center, Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk, Russia
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14
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The educational burden of disease: a cohort study. THE LANCET PUBLIC HEALTH 2022; 7:e549-e556. [DOI: 10.1016/s2468-2667(22)00059-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 01/05/2023] Open
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15
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Kocsel N, Horváth Z, Reinhardt M, Szabó E, Kökönyei G. Nonproductive thoughts, somatic symptoms and well-being in adolescence: testing the moderator role of age and gender in a representative study. Heliyon 2022; 8:e09688. [PMID: 35734556 PMCID: PMC9207659 DOI: 10.1016/j.heliyon.2022.e09688] [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: 10/27/2021] [Revised: 01/28/2022] [Accepted: 06/01/2022] [Indexed: 10/26/2022] Open
Abstract
Background Previous findings suggest a female preponderance in nonproductive thoughts -rumination and worry-, but studies on gender differences in the strength of the relationship between nonproductive thoughts, somatic symptoms and subjective well-being are scarce. Our aim was to test whether gender and age would moderate these associations. Methods 1572 adolescents were involved in this representative cross-sectional study (770 boys; mean age = 15.39; SD = 2.26 years). Nonproductive thoughts were measured by Nonproductive Thoughts Questionnaire for Children (NPTQ-C), somatic symptoms were assessed by Somatic Complaint List (SCL), while Mental Health Continuum-Short Form (MHC-SF) was used to measure subjective well-being. To assess the moderation effects of age and gender on the relationship between nonproductive thoughts, somatic symptoms and well-being, four multiple indicator multiple causes (MIMIC) models were defined. Results Our results suggested that higher rates of nonproductive thoughts predicted a higher level of somatic symptoms and a lower level of subjective well-being. The analyses revealed that although nonproductive thoughts were strongly and equally associated with somatic symptoms among boys and girls, age was a significant moderator. Gender also moderated the relationship between nonproductive thoughts and subjective well-being. Conclusions Our results support the importance of nonproductive thoughts in somatic symptoms and highlight that the strength of the relationship is similar across both genders but could be dependent upon age. The findings also shed light on the decreased well-being of girls, especially with elevated level of nonproductive thoughts.
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Affiliation(s)
- Natália Kocsel
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Horváth
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Melinda Reinhardt
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,XIV. District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary
| | - Edina Szabó
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Center for Pain and the Brain, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, United States
| | - Gyöngyi Kökönyei
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary.,Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
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16
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Rokoff LB, Shoaff JR, Coull BA, Enlow MB, Bellinger DC, Korrick SA. Prenatal exposure to a mixture of organochlorines and metals and internalizing symptoms in childhood and adolescence. ENVIRONMENTAL RESEARCH 2022; 208:112701. [PMID: 35016863 PMCID: PMC8917058 DOI: 10.1016/j.envres.2022.112701] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/23/2021] [Accepted: 01/05/2022] [Indexed: 05/17/2023]
Abstract
BACKGROUND Although prenatal chemical exposures influence neurobehavior, joint exposures are not well explored as risk factors for internalizing disorders through adolescence. OBJECTIVE To evaluate associations of prenatal organochlorine and metal exposures, considered individually and as a mixture, with mid-childhood and adolescent internalizing symptoms. METHODS Participants were 468 children from a prospective cohort recruited at birth (1993-1998) in New Bedford, Massachusetts. Organochlorines (hexachlorobenzene, p,p'-dichlorodiphenyl dichloroethylene, polychlorinated biphenyls) and metals (lead, manganese) were analyzed in cord blood. Internalizing symptoms (anxiety, depressive, somatic) were assessed via multiple informants on the Conners' Rating Scale (CRS) at 8-years and Behavior Assessment System for Children, Second Edition (BASC-2) at 15-years; higher T-scores indicate greater symptoms. Overall and sex-specific covariate-adjusted associations were evaluated using Bayesian Kernel Machine Regression (BKMR) and five-chemical linear regression models. RESULTS The cohort was socioeconomically diverse (35% household income <$20,000; 55% maternal ≤ high school education at birth). Most chemical concentrations were consistent with background levels [e.g., median (range) cord blood lead: 1.1 (0-9.4) μg/dL]. BKMR suggested linear associations and no interactions between chemicals. The overall mixture was positively associated with Conners' Parent Rating Scale (CPRS) and BASC-2 Self Report of Personality (SRP) anxiety and depressive symptoms, and negatively with somatic symptoms. Prenatal lead was positively associated with adolescent anxiety symptoms [1.56 (95% CI: 0.50, 2.61) BASC-2 SRP Anxiety score increase per doubling lead]. For CRPS and BASC-2 SRP, a doubling of cord blood manganese was positively associated with internalizing symptoms for girls [e.g., 3.26 (95% CI: 0.27, 6.25) BASC-2 SRP Depression score increase], but not boys. Organochlorine exposures were not adversely associated with internalizing symptoms. DISCUSSION Low-level prenatal lead exposure was positively associated with adolescent anxiety symptoms, and prenatal manganese exposure was positively associated with internalizing symptoms for girls from mid-childhood through adolescence. In utero neurotoxicant metal exposures may contribute to the emergence of anxiety and depression.
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Affiliation(s)
- Lisa B Rokoff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Population Health Sciences Program, Harvard University, Cambridge, MA, USA.
| | - Jessica R Shoaff
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - David C Bellinger
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan A Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Klastrup LK, Rosendal M, Rask MT, Christensen KS, Rask CU. Functional somatic symptoms in youths in general practice: A cross-sectional study on prevalence, clinical management and perceived burden. J Psychosom Res 2022; 156:110765. [PMID: 35276589 DOI: 10.1016/j.jpsychores.2022.110765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Functional somatic symptoms (FSS) may progress into a functional disorder if poorly managed, which may have serious implications. This cross-sectional study describes the management of youths compared to adults in general practice and estimates the prevalence of FSS in youths in this setting by comparing consultation-related aspects between youths with FSS and 1) youths with a specific diagnosis and 2) adults with FSS. METHODS We used data from a Danish survey (2008-2009), including 3295 face-to-face consultations between GPs and patients aged 15-64 years. Patients were divided into youths (15-24 years) and adults (25-64 years) and then into subgroups according to the GPs' classifications: 1) specific diagnosis, 2) resolving symptom and 3) FSS. Logistic regression analysis was used for all comparisons, and estimates were adjusted for gender, concomitant chronic disorder and GP cluster. RESULTS The GPs more frequently ensured continuity of care in adults (AOR:0.75, 95%CI:0.61-0.92, p < 0.01) and perceived youths as less time consuming (AOR:0.58, 95%CI: 0.43-0.77, p < 0.01) and less burdensome (AOR:0.60; 95%CI: 0.45-0.81, p < 0.01) compared to adults. FSS prevalence was 4.4% in youths and 9.0% in adults. However, GPs perceived youths with FSS as more burdensome (AOR:7.77, 95%CI:2.93-20.04, p < 0.01) and more time consuming (AOR:3.98, 95%CI:1.42-11.12, p < 0.01) than youths with a specific diagnosis. No significant differences were found between youths and adults with FSS, respectively, in regards to perceived burden and consultation time. CONCLUSION The results indicate age-related variations in the prevalence and clinical management of FSS in general practice. The GPs perceived both youths and adults with FSS time consuming, which underlines a need for supportive management strategies.
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Affiliation(s)
- L K Klastrup
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark.
| | - M Rosendal
- Research Clinic for Functional Disorders, Aarhus University Hospital, Denmark; Research Unit for General Practice, Aarhus, Denmark.
| | - M T Rask
- Research Clinic for Functional Disorders, Aarhus University Hospital, Denmark.
| | - K S Christensen
- Research Unit for General Practice, Aarhus, Denmark; Department of Public Health, Aarhus University, Denmark.
| | - C U Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
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18
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Raemen L, Claes L, Verschueren M, Van Oudenhove L, Vandekerkhof S, Triangle I, Luyckx K. Personal identity, somatic symptoms, and symptom-related thoughts, feelings, and behaviors: Exploring associations and mechanisms in adolescents and emerging adults. SELF AND IDENTITY 2022. [DOI: 10.1080/15298868.2022.2063371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Leni Raemen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | | | - Lukas Van Oudenhove
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Cognitive and Affective Neuroscience Lab, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Sarah Vandekerkhof
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Resilient People, Ucll Research and Expertise, Diepenbeek, Belgium
| | - Ine Triangle
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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19
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Liu R, Chen X, Qi H, Feng Y, Su Z, Cheung T, Jackson T, Lei H, Zhang L, Xiang YT. Network analysis of depressive and anxiety symptoms in adolescents during and after the COVID-19 outbreak peak. J Affect Disord 2022; 301:463-471. [PMID: 34995705 PMCID: PMC8730647 DOI: 10.1016/j.jad.2021.12.137] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/18/2021] [Accepted: 12/31/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study examined the extent to which the network structure of anxiety and depression among adolescents identified during the peak of the COVID-19 pandemic could be cross-validated in a sample of adolescents assessed after the COVID-19 peak. METHODS Two cross-sectional surveys were conducted between February 20 and 27, 2020 and between April 11 and 19, 2020, respectively. Depressive and anxiety symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression and 7-item Generalized Anxiety Disorder, respectively. Anxiety-depression networks of the first and second assessments were estimated separately using a sparse Graphical Gaussian Model combined with the graphical least absolute shrinkage and selection operator method. A Network Comparison Test was conducted to assess differences between the two networks. RESULTS The most central symptoms in the first and second survey networks were Depressed affect and Nervousness. Compared with connections in the first survey network, connections in the second survey network analysis between Relax-Nervousness-Depressed affect-Interpersonal problems (diff, contrast: second survey-first survey. diff=-0.04, P = 0.04; diff=-0.03, P = 0.03; diff=-0.03, P = 0.04), and Irritability-Somatic complaints (diff=-0.04, P = 0.02) were weaker while connections of Somatic complaints-Nervousness (diff=0.05, P<0.001), Somatic complaints-Depressed affect (diff=0.03, P = 0.009), and Irritability-Control worry-Restlessness (diff=0.02, P = 0.03; diff=0.05, P = 0.02) were stronger. CONCLUSIONS Depressed affect emerged as a robust central symptom and bridge symptom across Anxiety-Depression networks. Considering the negative impact of depression and anxiety on daily life, timely interventions targeting depressed affect should be implemented to reduce the co-occurrence of anxious and depressive symptoms among adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China,Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Han Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States of America
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Hui Lei
- College of Education, Hunan Agricultural University, Changsha, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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20
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Balderas-Vazquez CL, Bernal-Morales B, Garcia-Montalvo EA, Vega L, Herrera-Huerta EV, Rodríguez-Landa JF, Velázquez-Hernández JF, Xotlanihua-Gervacio MDC, Valenzuela OL. Association Between Socio-Affective Symptoms and Glutathione and CD4 and CD8 Lymphocytes in College Students. Front Psychol 2022; 12:666347. [PMID: 35069302 PMCID: PMC8766728 DOI: 10.3389/fpsyg.2021.666347] [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] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 12/02/2021] [Indexed: 12/18/2022] Open
Abstract
Background: The prevalence of anxiety and depression in young students is associated with biosocial factors and scholastic stress. However, few studies have evaluated emotional-affective symptoms that are related to the immune system and antioxidant parameters in young individuals without diagnoses of affective disorders. Aim: This study aims to assess the relationship between emotional-affective symptoms and glutathione concentrations and CD4 and CD8 lymphocyte counts in college students. Methods: College students (n = 177) completed standardized psychometric instruments, including the Perceived Stress Scale, Hamilton Anxiety Scale, Beck Depression Inventory, Familiar Social and Friends Support Scale, and Rosenberg Scale. Blood samples were biochemically analyzed. Analyses of variance were conducted between four groups according to symptom severity. Results: A considerable prevalence of stress, anxiety, and depression symptoms was observed and negatively correlated with self-esteem and socio-familiar support. Perceived stress was sexually dimorphic. Although biochemical parameters were within reference ranges, glutathione, CD4, and CD8 tended to be lower in participants with anxiety and depression symptoms, which may be of predictive value. Conclusion: The relationship between antioxidant/immune parameters and socio-affective scores is latent in undiagnosed college students who might develop affective disorders. The findings suggest that during the initial development of affective disorders, stress management strategies should be implemented to help college students cope with the academic load and monitor negative changes in their physiological state.
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Affiliation(s)
| | - Blandina Bernal-Morales
- Laboratorio de Neurofarmacología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Mexico
| | | | - Libia Vega
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Ciudad de México, Mexico
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21
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Zolotareva A. Measurement of Somatic Symptoms in the General Population: Standardization of the Russian PHQ-15. CULTURAL-HISTORICAL PSYCHOLOGY 2022. [DOI: 10.17759/chp.2022180404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
<p>The Patient Health Questionnaire (PHQ-15) is a self-report measure assessing presence and severity of somatic symptoms [15]. The aim of this study was to standardize the Russian version of PHQ-15. The study included 1157 respondents from the general population aged 18 to 71. In addition to the PHQ-15, the participants completed the Russian Depression, Anxiety, and Stress Scales-21 (DASS-21), evaluating the psychological distress symptoms. The results showed that 91% of the respondents reported at least one symptom bothering them in the past four weeks. Regarding gender and age specifics of somatization, the most predisposed to the psychosomatic burden were females and persons aged 35-49 years. Moreover, 28.2% of the respondents demonstrated a high level of somatization, as well as increased scores of depression, anxiety, and stress compared to the participants with low and moderate psychosomatic burden. In conclusion, the Russian version of PHQ-15 has been successfully standardized and can be recommended for screening and monitoring of medically unexplained symptoms.</p>
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22
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Areskoug Sandberg E, Duberg A, Lorenzon Fagerberg U, Mörelius E, Särnblad S. Saliva Cortisol in Girls With Functional Abdominal Pain Disorders: A Randomized Controlled Dance and Yoga Intervention. Front Pediatr 2022; 10:836406. [PMID: 35633978 PMCID: PMC9133484 DOI: 10.3389/fped.2022.836406] [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: 12/15/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Functional abdominal pain disorders (FAPDs) are common among girls and has been associated with stress. Cortisol is one of the major stress hormones. Dance and yoga have been shown to reduce abdominal pain among girls with FAPDs. AIM To investigate the effect of an 8-month intervention with dance and yoga on cortisol levels in saliva among girls with FAPDs. METHODS A total of 121 girls aged 9-13 years with irritable bowel syndrome (IBS) or functional abdominal pain were included in the study. Participants were randomized into an intervention group and a control group. The intervention group attended a combined dance and yoga session twice a week for 8 months. Saliva samples were collected during 1 day, in the morning and evening, at baseline, and at 4 and 8 months. Subjective pain and stress were assessed as well. RESULTS No significant effects on saliva cortisol levels between groups were observed after completion of the intervention at 8 months. However, evening cortisol and evening/morning quotient were significantly reduced at 4 months in the intervention group compared to the control group (p = 0.01, p = 0.004). There was no association between cortisol quota and pain or stress. CONCLUSION Improvements in cortisol levels were seen in the intervention group at 4 months but did not persist until the end of the study. This indicates that dance and yoga could have a stress-reducing effect during the ongoing intervention.
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Affiliation(s)
- Elin Areskoug Sandberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ulrika Lorenzon Fagerberg
- Centre for Clinical Research, Department of Paediatrics, Västmanland Hospital, Region Västmanland, Uppsala University, Västerås, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.,Perth Children's Hospital, Nedlands, WA, Australia
| | - Stefan Särnblad
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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23
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Wahlström J, Modin B, Svensson J, Löfstedt P, Brolin Låftman S. Sense of Unity and Self-Reported Health Among 15-year-Olds: Findings From the Swedish 2017/18 Health Behavior in School-Aged Children Study. Int J Public Health 2021; 66:621964. [PMID: 34744583 PMCID: PMC8565282 DOI: 10.3389/ijph.2021.621964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Sense of unity refers to the positive feeling of being part of a larger social structure. This study aimed to investigate to what extent adolescents report sense of unity and if this differs across groups, and to assess the associations between sense of unity and self-reported health while taking into account sociodemographic characteristics and tangible social relationships. Methods: Data were obtained from the 2017/18 Swedish Health Behavior in School-aged Children study, using information collected among 15-year-old students (n = 1,392). Linear and binary logistic regression analyses were performed. Results: The participants reported overall high levels of sense of unity. Sense of unity did not differ by gender, but adolescents without an immigrant background and those with higher family affluence reported higher levels. Sense of unity was inversely associated with psychological complaints, somatic complaints, and less than good self-rated health, even when adjusting for sociodemographic characteristics and family, classmate, and teacher relationships. Conclusion: This study suggests that sense of unity may be an important social determinant for adolescent health. More research is needed on the origins and implications of sense of unity.
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Affiliation(s)
- Joakim Wahlström
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Bitte Modin
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Johan Svensson
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden
| | - Petra Löfstedt
- Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Brolin Låftman
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
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Ludot M, Merlo M, Ibrahim N, Piot MA, Lefèvre H, Carles ME, Harf A, Moro MR. ["Somatic symptom disorders" in adolescence. A systematic review of the recent literature]. Encephale 2021; 47:596-604. [PMID: 34538623 DOI: 10.1016/j.encep.2021.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 04/02/2021] [Accepted: 04/18/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Body expression of mental disorders is common in adolescence. Only two literature reviews over the last five years have been identified about somatoform disorders in children., The present article provides a systematic review of articles in English, which concern "Somatic Symptom and Related Disorders" according to the DSM-5 (Diagnostic and Statistical Manual - 5th Edition) among adolescents. METHODS The article search was made on Medline, Psychinfo, Google Scholar, BiomedCentral, Central and tripdatabase (for grey literature) according to PRISMA criteria and with the items "somatoform disorders" or "somatic symptom disorders". An age filter was applied for "adolescents", and a selection was done from the last five years. All articles concerning adolescents (often associated with children) were initially included, except for articles concerning eating disorders, dysmorphic disorders or adult population. Comments, editorials, opinion or descriptive articles were also excluded. The authors then carried out an analysis of the main topics, themes and questions covered in the selected publications and presented a descriptive synthesis. RESULTS A total of seventy-seven publications were included in the analysis, from three hundred and seventy-two publications. First, the terms used to refer to these "somatic symptom disorders" were varied, such as "somatization", "somatic complaints/symptoms", "functional disorder", "unexplained symptoms" and "somatoform disorders". Then, studies related just to adolescents were limited: most of studies included children and adolescents in their methodologies; and some of them questioned somatic symptoms from a developmental perspective. Case reports were the most represented articles among all medical specialties, with clinical descriptions about "functional neurological symptom disorder", "factitious disorder" and "somatic symptom disorder" with a medical disease, among children and adolescents. We sometimes observed a controversial borderline between psychological and somatic disorders. Various explanatory models appeared, especially the trauma path; familial and social environment was also pointed out, with a possible peer group effect; neurocognitive theories were finally described. The literature highlights the effectiveness of psychosocial therapies (especially the cognitive-behavioral therapy) and the importance of multidisciplinary management. Finally, a few studies with a qualitative methodology are represented. CONCLUSIONS Only nine articles included "somatic symptom disorder" in their titles, despite a terminology valued by many authors (compared to "somatoform disorders" from the DSM-IV). The heterogeneity of terminologies, case reports and explanatory models witness a lack of connexions between medical specialties. This could explain in part the wandering of adolescents and their families in the health care system. It could also contribute to the delay before diagnosis, especially when neurological symptoms exist, and a late referral for psychiatric consultation. Further studies are needed to understand difficulties to use a clinical pathway among medical specialties, when the benefit of amultidisciplinary approach seems to be unanimous.
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Affiliation(s)
- M Ludot
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France.
| | - M Merlo
- Maison de Solenn, hôpital Cochin, 75014 Paris, France
| | - N Ibrahim
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France; Groupe français de recherche en médecine et santé de l'adolescent, maison de Solenn, hôpital Cochin, 75014 Paris, France
| | - M-A Piot
- Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France; Faculté de santé, UFR de médecine, université de Paris, 75006 Paris, France; Service de psychiatrie de l'enfant, de l'adolescent et du jeune adulte, institut mutualiste Montsouris, 75014 Paris, France
| | - H Lefèvre
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France; Groupe français de recherche en médecine et santé de l'adolescent, maison de Solenn, hôpital Cochin, 75014 Paris, France
| | - M-E Carles
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France
| | - A Harf
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France
| | - M R Moro
- Maison de Solenn, hôpital Cochin, 75014 Paris, France; PCPP, université de Paris, 92100 Boulogne-Billancourt, France; Inserm, CESP, Team DevPsy, UVSQ, université Paris-Saclay, 94807 Villejuif, France
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Högström S, Philipson A, Ekstav L, Eriksson M, Fagerberg UL, Falk E, Möller M, Sandberg E, Särnblad S, Duberg A. Dance and yoga reduced functional abdominal pain in young girls: A randomized controlled trial. Eur J Pain 2021; 26:336-348. [PMID: 34529293 DOI: 10.1002/ejp.1862] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/25/2021] [Accepted: 09/13/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Functional abdominal pain disorders (FAPDs) affect children, especially girls, all over the world. The evidence for existing treatments is mixed, and effective accessible treatments are needed. Dance, a rhythmic cardio-respiratory activity, combined with yoga, which enhances relaxation and focus, may provide physiological and psychological benefits that could help to ease pain. OBJECTIVES The aim of this study was to evaluate the effect of a dance and yoga intervention on maximum abdominal pain in 9- to 13-year- old girls with FAPDs. METHODS This study was a prospective randomized controlled trial with 121 participants recruited from outpatient clinics as well as the general public. The intervention group participated in dance and yoga twice weekly for 8 months; controls received standard care. Abdominal pain, as scored on the Faces Pain Scale-Revised, was recorded in a pain diary. A linear mixed model was used to estimate the outcomes and effect sizes. RESULTS Dance and yoga were superior to standard health care alone, with a medium to high between-group effect size and significantly greater pain reduction (b = -1.29, p = 0.002) at the end of the intervention. CONCLUSIONS An intervention using dance and yoga is likely a feasible and beneficial complementary treatment to standard health care for 9- to 13-year-old girls with FAPDs. SIGNIFICANCE FAPDs affect children, especially girls, all over the world. The negative consequences such as absence from school, high consumption of medical care and depression pose a considerable burden on children and their families and effective treatments are needed. This is the first study examining a combined dance/yoga intervention for young girls with FAPDs and the result showed a reduction of abdominal pain. These findings contribute with new evidence in the field of managing FAPDs in a vulnerable target group.
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Affiliation(s)
- Sofie Högström
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anna Philipson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Lars Ekstav
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ulrika L Fagerberg
- Department of Pediatrics, Center for Clinical Research, Västmanland Hospital, Västerås, Uppsala University Uppsala, Västerås, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Elin Falk
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Child and Adolescent Psychiatry, Uppsala University hospital, Uppsala, Sweden
| | - Margareta Möller
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elin Sandberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Clinical Sciences, Center for primary Health Care Research, Lund University, Malmö, Sweden
| | - Stefan Särnblad
- Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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26
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Dahlstrand J, Friberg P, Fridolfsson J, Börjesson M, Arvidsson D, Ekblom Ö, Chen Y. The use of coping strategies "shift-persist" mediates associations between physical activity and mental health problems in adolescents: a cross-sectional study. BMC Public Health 2021; 21:1104. [PMID: 34107916 PMCID: PMC8191033 DOI: 10.1186/s12889-021-11158-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background Self-perceived mental health problems among adolescents has had an upward trend. Concurrently, adolescents’ physical activity (PA) has been falling whilst sedentary time (SED) has increased. There is a lack of research using accelerometer measured PA and SED to study their relationships to perceived stress and psychosomatic symptoms, both frequently observed mental health problems among adolescents. Whether coping strategies is one of the mechanisms underlying such relationship is less clear. Methods A total of 2283 13-year olds were enrolled in the baseline examination of the STARS (STudy of Adolescence Resilience and Stress) study in Western Sweden. Light-, moderate-, vigorous-intensity PA (LPA, MPA and VPA) and SED were measured using hip-worn ActiGraph GT3X+ accelerometer. A total of 1284 adolescents provided valid accelerometer data (at least 4 days with ≥10 h per day). PA and SED during school-time and leisure-time were analysed separately. Surveys were utilized to monitor perceived stress, psychosomatic symptoms and the use of coping strategies “shift-persist”. Logistic regression and mediation analyses were performed adjusting for gender, ethnicity, socioeconomic status and puberty development. Results We observed that more time spent in PA was associated with less stress in adolescents. The associations were observed for LPA (Odds ratio for LPA per 60 min: 0.557 (95% CI 0.399–0.776), VPA (Odds ratio for VPA per 15 min: 0.688 (95% CI 0.588–0.806) and MVPA (Odds ratio for MVPA per 15 min: 0.795 (95%CI 0.718–0.879) during leisure time, but not during school time. Similar associations were observed between leisure time PA and psychosomatic symptoms. The associations remained statistically significant even after adjusting for the confounders. Further, our data showed that adolescents who engaged more time in PA during leisure time were more likely to adopt the coping strategies of “shift-persist”. Mediation analysis showed that the use of “shift-persist” mediated the associations between leisure time PA and stress/psychosomatic symptoms. Conclusions Leisure time physical activity, irrespective of intensity, may facilitate successful coping with stress and stress-related mental health problems in adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11158-0.
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Affiliation(s)
- Johan Dahlstrand
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Peter Friberg
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden
| | - Jonatan Fridolfsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of MGA, Sahlgrenska University Hopsital, Region Västra Götaland, Gothenburg, Sweden
| | - Daniel Arvidsson
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Yun Chen
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Morabito G, Barbi E, Ghirardo S, Bramuzzo M, Conversano E, Ventura A, Cozzi G. Mental health problems in children admitted with physical symptoms. Eur J Pediatr 2021; 180:1611-1615. [PMID: 33464368 DOI: 10.1007/s00431-021-03938-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/07/2020] [Accepted: 01/11/2021] [Indexed: 11/29/2022]
Abstract
The aim of the study was to investigate the burden of mental health problems in children and adolescents admitted to a pediatric ward with physical complaints. We conducted a retrospective study, considering all patients admitted to the pediatric ward of the IRCCS Burlo Garofolo, Trieste, Italy, between January 2015 and September 2016. We selected all patients, from 5 to 17 years old, who were admitted with physical complaints and were discharged with a diagnosis suggestive of a mental health problem: somatic symptom disorder, anxiety disorder, depressive disorder, factious disorders. For every patient, we collected demographic features, medical characteristics, health care services utilization, length of hospital stay, and after discharge referral. We selected 1456 patients; of these, 101 (6.9%) revealed a mental health problem. The median duration of symptoms was 5 months (IQR 1.5-12), and pain was the main reported symptom (69%). Of the 101 patients, 23 (23%) were affected by a previously documented chronic organic disease. Somatic symptom disorder was the most common diagnosis. In 69/78 patients (88%), a loss of social contacts emerged; 49/95 patients frequenting school (51%) had chronic school absenteeism in the previous school year.Conclusion: A considerable proportion of patients admitted to a pediatric ward with physical complaints have mental health problems. What is Known: • It has been suggested that mental health problems in children and adolescents are increasing and frequently burden on pediatric healthcare services, but how they impact on a general pediatric ward is not clear. What is New: • Among 1456 patients admitted to a general pediatric ward with physical symptoms, 101 patients (6.9%) had a mental health problem. Among them, pain was the most commonly reported symptom and somatic symptom disorder was the commonly reported diagnosis.
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Affiliation(s)
- Giuliana Morabito
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Egidio Barbi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.,University of Trieste, Trieste, Italy
| | | | - Matteo Bramuzzo
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Ester Conversano
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy
| | | | - Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy
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28
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Khushboo, Kumar A, Sharma B. Biomedical Implications of Plant-Based Principles as Antidepressants: Prospects for Novel Drug Development. Mini Rev Med Chem 2021; 22:904-926. [PMID: 33858313 DOI: 10.2174/1389557521666210415112601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Depression is a most common mental disorder. The symptoms of depression include loss of energy, changes in appetite, more or less sleep, anxiety, low concentration, uncertainty, restlessness, feelings of worthlessness, guilt, or despair, and thoughts of self-harm or suicide. In order to provide safe, efficient and cost-effective medication, the plants based principles in isolation or in combination with traditional antidepressants are attracting increasing attention for depression therapy. METHOD The information regarding the present review and its contents such as collected from published literature materials in different international journals. We have used different search engines such as PubMed, Medline, ResearchGate Google Semantic Scholar and ScienceDirect. For this purpose, the data obtained were properly organized and suitably analyzed to include in this article. RESULTS Most of the phytomolecules isolated from the medicinal plants display antidepressant effect through the synaptic regulation of levels of neurotransmitters such as dopamine, serotonin, and noradrenaline in different parts of the brain. The mechanism of action of phytomolecules also involves negative regulation of the activities of monoamine oxidase (MAO) and acetylcholinesterase (AChE) and prevention of hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis. In addition, the strong antioxidative and antiinflamatory potential of these phytochemicals offer synergy to their antidepressant as well as antipsychosomatic functions. CONCLUSION The application of phytochemicals has proved it to be a safe, cost effective and efficient therapeutic agent to treat the patients suffering from mild to severe state of depression and other psychiatric disorders. The potential phytochemicals may be further optimized using in silico tools to develop better antidepressants and antisychotic agents in future.
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Affiliation(s)
- Khushboo
- Department of Biochemistry, University of Allahabad. India
| | - Abhishek Kumar
- Department of Biochemistry, University of Allahabad. India
| | - Bechan Sharma
- Department of Biochemistry, University of Allahabad. India
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29
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Garnow T, Einberg EL, Edberg AK, Garmy P. Sadness and Other Health Complaints among Swedish Adolescents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3999. [PMID: 33920254 PMCID: PMC8069189 DOI: 10.3390/ijerph18083999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/25/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
Health complaints are increasing among adolescents and are recognized as a global public health issue. Health complaints are an indicator for subjective ill-being, but little is known about the relationship between sadness and other health complaints. The aim of this study was to investigate sadness and other health complaints among Swedish adolescents. A survey with a cross-sectional design was completed by adolescents (n = 1489, 15-17 years old) in the south of Sweden. A logistic regression analysis was used to analyze the relationship between sadness and other health complaints. The result show that sadness and other health complaints were common among adolescents, and sadness was related to health complaints (headache (OR: 1.58), sleeping difficulties (OR: 2.00), reduced appetite (OR: 1.43), tension (OR: 2.44), and concentration difficulties (OR: 2.75)). When adolescents express sadness or other health complaints it is important to reflect on what these complaints are an expression of, and take into account the body as physical and psychological intertwined. This might entail person-centered support that hopefully leads to an improvement in adolescents' well-being. Future research that profoundly highlights adolescents' existential health is needed.
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Affiliation(s)
- Tide Garnow
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden; (E.-L.E.); (A.-K.E.); (P.G.)
| | - Eva-Lena Einberg
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden; (E.-L.E.); (A.-K.E.); (P.G.)
| | - Anna-Karin Edberg
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden; (E.-L.E.); (A.-K.E.); (P.G.)
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden; (E.-L.E.); (A.-K.E.); (P.G.)
- WHO-CC (World Health Organization Collaborative Centre), Clinical Health Promotion Centre, Lund University, SE-205 02 Malmö, Sweden
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30
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Purborini N, Lee MB, Devi HM, Chang HJ. Associated factors of depression among young adults in Indonesia: A population-based longitudinal study. J Formos Med Assoc 2021; 120:1434-1443. [PMID: 33558103 DOI: 10.1016/j.jfma.2021.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/PURPOSE Depression is highly prevalent among young adults in Indonesia; despite this, information pertaining to the associated factors of depression remains scarce. In this study, we aimed to identify these associated factors among young adults in Indonesia by using a longitudinal study design. METHODS We undertook secondary data analyses of the Indonesia Family Life Survey. Questionnaires related to smoking behavior, acute morbidities, perceived health, experience of natural disasters, and sociodemographic records from 2007 were used as independent variables and depression in 2014 was used as the outcome variable. The generalized estimating equation (GEE) approach was used to investigate the associated factors of depression. RESULTS The prevalence of depression among 1960 young adults was 27.86%. Based on the GEE results, perceived health was significantly negatively correlated with depression in 2014 (p < .001), whereas smoking behavior, smoking cessation, and acute morbidities in 2007 were significantly positively correlated with depression in 2014 (p < .001). CONCLUSION We report that the early identification of depression in this population is pivotal and relevant associated factors should be considered when developing preventive programs to avoid depression in the community.
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Affiliation(s)
- Nurul Purborini
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan; Department of Nursing, Faculty of Health Sciences, Muhammadiyah University of Magelang, Central Java, Indonesia
| | - Ming-Been Lee
- Department of Psychiatry, National Taiwan University College of Medicine, Taiwan; Taiwan Suicide Prevention Center, Taiwan; Shin Kong Wu Ho-Su Memorial Hospital, Taiwan; Taiwanese Society of Suicidology, Taiwan; Taiwan Association Against Depression, Taiwan
| | - Hilda Mazarina Devi
- Department of Nursing, Faculty of Health Science, University of Tribhuwana Tunggadewi, Malang, East Java, Indonesia
| | - Hsiu-Ju Chang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
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31
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Philipson A, Särnblad S, Ekstav L, Eriksson M, Fagerberg UL, Möller M, Mörelius E, Duberg A. An Intervention With Dance and Yoga for Girls With Functional Abdominal Pain Disorders (Just in TIME): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e19748. [PMID: 33320103 PMCID: PMC7772067 DOI: 10.2196/19748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/02/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Functional abdominal pain disorders (FAPDs) affect many children worldwide, predominantly girls, and cause considerable long-term negative consequences for individuals and society. Evidence-based and cost-effective treatments are therefore strongly needed. Physical activity has shown promising effects in the practical management of FAPDs. Dance and yoga are both popular activities that have been shown to provide significant psychological and pain-related benefits with minimal risk. The activities complement each other, in that dance involves dynamic, rhythmic physical activity, while yoga enhances relaxation and focus. OBJECTIVE This study aims to evaluate the effects of a dance and yoga intervention among girls aged 9 to 13 years with FAPDs. METHODS The study is a prospective randomized controlled trial among girls aged 9 to 13 years with functional abdominal pain, irritable bowel syndrome, or both. The target sample size was 150 girls randomized into 2 arms: an intervention arm that receives dance and yoga sessions twice weekly for 8 months and a control arm that receives standard care. Outcomes will be measured at baseline and after 4, 8, 12, and 24 months, and long-term follow-up will be conducted 5 years from baseline. Questionnaires, interviews, and biomarker measures, such as cortisol in saliva and fecal microbiota, will be used. The primary outcome is the proportion of girls in each group with reduced pain, as measured by the faces pain scale-revised in a pain diary, immediately after the intervention. Secondary outcomes are gastrointestinal symptoms, general health, mental health, stress, and physical activity. The study also includes qualitative evaluations and health economic analyses. This study was approved by the Regional Ethical Review Board in Uppsala (No. 2016/082 1-2). RESULTS Data collection began in October 2016. The intervention has been performed in 3 periods from 2016 through 2019. The final 5-year follow-up is anticipated to be completed by fall 2023. CONCLUSIONS Cost-effective and easily accessible interventions are warranted to reduce the negative consequences arising from FAPDs in young girls. Physical activity is an effective strategy, but intervention studies are needed to better understand what types of activities facilitate regular participation in this target group. The Just in TIME (Try, Identify, Move, and Enjoy) study will provide insights regarding the effectiveness of dance and yoga and is anticipated to contribute to the challenging work of reducing the burden of FAPDs for young girls. TRIAL REGISTRATION ClinicalTrials.gov (NCT02920268); https://clinicaltrials.gov/ct2/show/NCT02920268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19748.
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Affiliation(s)
- Anna Philipson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Stefan Särnblad
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Lars Ekstav
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Mats Eriksson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ulrika L Fagerberg
- Centre for Clinical Research, Västmanland Hospital Västerås, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Möller
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Evalotte Mörelius
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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32
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Duberg A, Jutengren G, Hagberg L, Möller M. The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls: A randomized controlled trial. J Int Med Res 2020; 48:300060520902610. [PMID: 32019389 PMCID: PMC7111017 DOI: 10.1177/0300060520902610] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective To investigate whether a dance intervention for adolescent girls reduces stress-related symptoms. Methods This was a randomized controlled trial of an after-school intervention. Participants were 112 girls aged 13 to 18 years with stress-related somatic symptoms and emotional distress. The intervention comprised twice-weekly dance sessions for 8 months with a focus on enjoyment and socialization. A questionnaire was administered at baseline and after 8, 12 and 20 months. Participants rated the frequency with which they had experienced somatic symptoms and emotional distress during the previous 3 months. Results After the intervention, there was a significantly greater reduction in somatic symptoms and emotional distress in the dance intervention group than in the control group. The difference in the mean score change on a 5-point scale was 0.26 (95% confidence interval [CI]: 0.04 to 0.47) for somatic symptoms and 0.30 (95% CI: 0.04 to 0.58) for emotional distress. Conclusion Dance interventions may reduce somatic symptoms and emotional distress in adolescent girls, and may constitute a nonpharmacological complement to school health services. However, continued participation is needed for long-term sustainable results. Additional randomized studies are required to further evaluate the effect of this type of intervention in different settings. This study was registered with ClinicalTrials.gov. Study name: ‘Influencing Adolescent Girls With Creative Dance Twice Weekly’. URL: http: //clinicaltrials.gov/ct2/show/study/NCT01523561. Trial registration number: NCT01523561.
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Affiliation(s)
- Anna Duberg
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Göran Jutengren
- School of Health Sciences, University of Borås, Borås, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Margareta Möller
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Medically unexplained symptoms in children and adolescents: Illness-related self-concept and parental symptom evaluations. J Behav Ther Exp Psychiatry 2020; 68:101565. [PMID: 32171996 DOI: 10.1016/j.jbtep.2020.101565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/15/2020] [Accepted: 02/29/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND OBJECTIVES According to cognitive-behavioral models, illness-related symptom evaluations and self-concepts play a pivotal role in the development and maintenance of medically unexplained somatic symptoms (MUS). However, illness-related cognitions related to MUS have rarely been studied in children/adolescents and their parents. METHODS Seventy-eight children and adolescents (M = 14.2 years; 59% female) performed two versions of the Implicit Association Test (IAT) to measure the implicit illness-related and the implicit anxiety-related self-concept. Illness-related evaluations of unspecific symptoms were assessed via the Health Norms Sorting Task (HNST), and MUS as well as characteristics of somatic symptom disorder (SSD) via questionnaires. RESULTS MUS were significantly positively associated with the explicit (r = 0.30, p < .01) and implicit illness-related self-concept (r = 0.24, p = .04), but not with the anxiety-related self-concept (r = 0.15, p = .18). The implicit illness-related self-concept explained incremental variance in MUS (ΔR2 = 0.05, p = .04) beyond the explicit illness-related self-concept. Regarding health anxiety, parental illness-related symptom evaluations moderated the relationship between child-reported severity of MUS and health anxiety (B = 0.12, p < .01). LIMITATIONS Some measures have been adapted for childhood and adolescence, but validations on larger samples are still pending. CONCLUSIONS A disorder-specific self-concept of being ill, as well as parental symptom evaluations, seem to play an essential role in MUS and health anxiety in childhood and adolescence. Due to the importance of the top-down processes found here, the findings are in line with current predictive coding models of somatic symptom perception.
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BUTEAN I, MONE I, VISU-PETRA L, OPRE A. Predictors of Individual Differences in Lie Acceptability in Adolescence: Exploring the Influence of Social Desirability, Callous Unemotional Traits and Somatization. JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2020. [DOI: 10.24193/jebp.2020.2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Lie acceptability is defined as an attitude toward lying that can vary along a continuum, from considering that lying is completely unacceptable, to a most lenient view upon deception. The present research focused on identifying factors associated with individual differences in lie acceptability in a sample of Romanian adolescents (N =167, 14-19 years). We investigated associations between variables with a preliminary documented theoretical and/or empirical association with lie acceptability (callous-unemotional traits or social desirability), along with exploratory age-specific measures of somatization. Our results revealed that male adolescents who displayed high callousness, uncaring, or somatization tended to view lying as more acceptable. Social desirability did not predict lie acceptability above and beyond these individual predictors. The implications of these findings for attempts to reduce problematic deceptive behavior in adolescence are discussed."
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Affiliation(s)
- Iulia BUTEAN
- "Department of Psychology, Babeș-Bolyai University, Republicii Str. 37, 400015, Cluj-Napoca, Romania. Regional Centre for Resources and Educational Assistance, Cluj-Napoca"
| | - Ionuț MONE
- Department of Psychology, Babeș-Bolyai University, Republicii Str. 37, 400015, Cluj-Napoca,
| | - Laura VISU-PETRA
- "Research in Individual Differences and Legal Psychology (RIDDLE) Lab, Department of Psychology, Babeș-Bolyai University, Republicii Str. 37, 400015, Cluj-Napoca, Romania"
| | - Adrian OPRE
- Department of Psychology, Babeș-Bolyai University, Republicii Str. 37, 400015, Cluj-Napoca, Romania
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Saunders NR, Gandhi S, Chen S, Vigod S, Fung K, De Souza C, Saab H, Kurdyak P. Health Care Use and Costs of Children, Adolescents, and Young Adults With Somatic Symptom and Related Disorders. JAMA Netw Open 2020; 3:e2011295. [PMID: 32701161 PMCID: PMC7378752 DOI: 10.1001/jamanetworkopen.2020.11295] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Somatic symptom and related disorders are highly prevalent mental health disorders among young people. Presentation can be varied, and patients often face long delays and see multiple practitioners to receive a diagnosis. OBJECTIVE To evaluate the health care use and costs in a population-based sample of children and young people with somatic symptom and related disorders in Ontario, Canada. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used linked health and administrative databases in Ontario, Canada, where health services are funded through a universal single-payer health insurance plan. Participants included children aged 4 to 12 years, adolescents aged 13 to 17 years, and young adults aged 18 to 24 years residing in Ontario, Canada, during the period of April 1, 2008, to March 31, 2015. Included participants had a first health record diagnosis of somatic symptom and related disorders and were grouped based on the setting of their index somatic symptom and related disorders contact: outpatient, emergency department, or inpatient. Data were analyzed from August 1, 2017, to February 1, 2018. EXPOSURES One year before and 1 year after diagnosis of somatic symptom and related disorders. MAIN OUTCOMES AND MEASURES Outcome measures included overall and mental health-specific ambulatory and acute care visits and overall health system costs and sector-specific costs. RESULTS A total of 33 272 patients (median [interquartile range {IQR}] age, 20 [16-22] years; 17 387 female [52.3%]) were included in the analysis. Among these patients, 3875 (11.6%) were aged 4 to 12 years, 7273 (21.9%) were aged 13 to 17 years, and 22 124 (66.5%) were aged 18 to 24 years. A total of 17 893 (53.8%) had their index visit as outpatients, whereas 13 310 (40.0%) and 2069 (6.2%) were diagnosed in the emergency department and inpatient settings, respectively. Ambulatory physician visits were frequent and persisted 1 year after diagnosis within each setting (before vs after 1 year, median [IQR] visits, inpatient setting: 7 [3-13] vs 7 [3-13]; emergency department setting: 4 [2-8] vs 4 [2-9]; outpatient setting: 3 [1-7] vs 4 [2-7]; P < .001). After diagnosis, many did not receive physician-delivered mental health care (35.3% [730 of 2069] in an inpatient setting, 59.1% [7866 of 13 310] in an emergency department setting, 58.5% [10 467 of 17 893] in an outpatient setting; P < .001). Acute care use was frequent and remained so after diagnosis across settings. Of those hospitalized as inpatients at diagnosis, 37.7% (779 of 2069) were readmitted within 1 year. Mean (SD) 2-year patient costs were CAD$9845 ($39 725) (median [IQR], $2401 [$960-$7019]). Hospitalized patients had a 2-year mean (SD) cost of $51 424 ($100 416) (median [IQR], $21 997 [$12 510-$45 841]) per-patient expenditure. CONCLUSION AND RELEVANCE This study found that children and young people with somatic symptom and related disorders frequently used the health system with substantial health system costs before and after diagnosis. Many of these patients did not receive physician-delivered mental health care. These findings suggest that this population may be under-recognized, and initiatives for early recognition and engagement with mental health support may be warranted.
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Affiliation(s)
- Natasha Ruth Saunders
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada
| | | | | | - Simone Vigod
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Claire De Souza
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Hana Saab
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Paul Kurdyak
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, The University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Hou Y, Liu Y, Liu C, Yan Z, Ma Q, Chen J, Zhang M, Yan Q, Li X, Chen J. Xiaoyaosan regulates depression‐related behaviors with physical symptoms by modulating Orexin A/OxR1 in the hypothalamus. Anat Rec (Hoboken) 2020; 303:2144-2153. [DOI: 10.1002/ar.24386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/18/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Yajing Hou
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Yueyun Liu
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Chenyue Liu
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Zhiyi Yan
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Qingyu Ma
- Formula‐pattern Research Center, School of Traditional Chinese Medicine Jinan University Guangzhou Guangdong China
| | - Jianbei Chen
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Man Zhang
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Qiuying Yan
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
| | - Xiaojuan Li
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
- Formula‐pattern Research Center, School of Traditional Chinese Medicine Jinan University Guangzhou Guangdong China
| | - Jiaxu Chen
- School of Traditional Chinese Medicine Beijing University of Chinese Medicine Beijing China
- Formula‐pattern Research Center, School of Traditional Chinese Medicine Jinan University Guangzhou Guangdong China
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Nilsson S, Wallbing U, Alfvén G, Dalenius K, Fors A, Golsäter M, Rosvall PÅ, Wigert H, Lundberg M. Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain-A Feasibility Study. CHILDREN-BASEL 2019; 6:children6090095. [PMID: 31450645 PMCID: PMC6770885 DOI: 10.3390/children6090095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022]
Abstract
Chronic pain and its consequences are major global health challenges, and the prevalence is increasing worldwide among adolescents. Adolescents spend most of their waking hours in school; however, there is limited research available on how school nurses can address chronic pain among adolescents in the Swedish school context. Therefore, we designed a person-centred intervention, known as Help Overcoming Pain Early (HOPE), to enable school nurses to offer adolescents strategies to manage their stress and pain. We used the Medical Research Council (MRC) framework for developing and designing this new complex intervention. For this study, we describe two of the four phases: (a) development and (b) feasibility and piloting. The final version of the HOPE programme consists of (i) an educational package for school nurses in the areas person-centred care, stress and pain education/management and gender perspective; and (ii) an intervention package for adolescents with chronic pain. The programme consists of four sessions during which adolescents with chronic pain have person-centred dialogues with a school nurse. The HOPE programme is based on the existing evidence of managing chronic pain and on the assumption that school nurses can support adolescents with chronic pain by using person-centred care.
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Affiliation(s)
- Stefan Nilsson
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Ulrika Wallbing
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Neurobiology, Care and Sciences and Society, Division of Physiotherapy, Karolinska Institute, 141 52 Huddinge, Sweden
| | - Gösta Alfvén
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Clintec, Karolinska Institute, 141 52 Huddinge, Sweden
| | | | - Andreas Fors
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Närhälsan Research and Development Primary Health Care, Region Västra Götaland, SE 411 18 Gothenburg, Sweden
| | - Marie Golsäter
- Child Health Care and Futurum, Region Jönköping County, Barnhälsovården, Regionens hus, 551 85 Jönköping, Sweden
- CHILD Research Group, School of Health and Welfare, Jönköping University, 551 11 Jönköping, Sweden
| | - Per-Åke Rosvall
- Department of Applied Educational Sciences, Umeå University, 901 87 Umeå, Sweden
| | - Helena Wigert
- Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Mari Lundberg
- Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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Alaie I, Philipson A, Ssegonja R, Hagberg L, Feldman I, Sampaio F, Möller M, Arinell H, Ramklint M, Päären A, von Knorring L, Olsson G, von Knorring AL, Bohman H, Jonsson U. Uppsala Longitudinal Adolescent Depression Study (ULADS). BMJ Open 2019; 9:e024939. [PMID: 30826765 PMCID: PMC6429885 DOI: 10.1136/bmjopen-2018-024939] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To present the Uppsala Longitudinal Adolescent Depression Study, initiated in Uppsala, Sweden, in the early 1990s. The initial aim of this epidemiological investigation was to study the prevalence, characteristics and correlates of adolescent depression, and has subsequently expanded to include a broad range of social, economic and health-related long-term outcomes and cost-of-illness analyses. PARTICIPANTS The source population was first-year students (aged 16-17) in upper-secondary schools in Uppsala during 1991-1992, of which 2300 (93%) were screened for depression. Adolescents with positive screening and sex/age-matched peers were invited to a comprehensive assessment. A total of 631 adolescents (78% females) completed this assessment, and 409 subsequently completed a 15-year follow-up assessment. At both occasions, extensive information was collected on mental disorders, personality and psychosocial situation. Detailed social, economic and health-related data from 1993 onwards have recently been obtained from the Swedish national registries for 576 of the original participants and an age-matched reference population (N≥200 000). FINDINGS TO DATE The adolescent lifetime prevalence of a major depressive episode was estimated to be 11.4%. Recurrence in young adulthood was reported by the majority, with a particularly poor prognosis for those with a persistent depressive disorder or multiple somatic symptoms. Adolescent depression was also associated with an increased risk of other adversities in adulthood, including additional mental health conditions, low educational attainment and problems related to intimate relationships. FUTURE PLANS Longitudinal studies of adolescent depression are rare and must be responsibly managed and utilised. We therefore intend to follow the cohort continuously by means of registries. Currently, the participants are approaching mid-adulthood. At this stage, we are focusing on the overall long-term burden of adolescent depression. For this purpose, the research group has incorporated expertise in health economics. We would also welcome extended collaboration with researchers managing similar datasets.
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Affiliation(s)
- Iman Alaie
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna Philipson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden
| | - Lars Hagberg
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden
| | - Filipa Sampaio
- Department of Public Health and Caring Sciences, Child Health and Parenting (CHAP), Uppsala University, Uppsala, Sweden
| | - Margareta Möller
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Hans Arinell
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Aivar Päären
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Lars von Knorring
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Gunilla Olsson
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anne-Liis von Knorring
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Ulf Jonsson
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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Health complaints among adolescents in Norway: A twenty-year perspective on trends. PLoS One 2019; 14:e0210509. [PMID: 30625222 PMCID: PMC6326500 DOI: 10.1371/journal.pone.0210509] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 12/23/2018] [Indexed: 01/17/2023] Open
Abstract
Purpose Examine time trends in health complaints among adolescents in Norway between 1994 and 2014 and among population subgroups, e.g., age and gender, as well as their interactions. Methods Norwegian data on 11-16-year-olds were drawn from the Health Behaviour in School-aged Children survey (HBSC) and analyzed for 1994 (n = 4,952), 1998 (n = 5,026), 2002 (n = 5,023), 2006 (n = 4,711), 2010 (n = 4,342) and 2014 (n = 3,422). Design adjusted linear regression that accounts for clustering effects was used to examine mean scores of two subscales of the HBSC-symptom checklist: psychological and somatic health complaints. Results Psychological and somatic health complaints among adolescents in Norway followed somewhat different trajectories, but the mean scores of both types of health complaints appeared to increase during the 20-year period. For psychological health complaints, there was a three-way interaction between age, gender and time, indicating that increasing trends in health complaints depended on both age and gender, in which older adolescent girls had a greater increase over time relative to younger adolescents and boys. Conclusions Findings from this study, together with earlier findings, suggest that there has been an increasing trend in health complaints among adolescents in Norway from 1994 to 2014, especially among older adolescent girls. Future research should examine if trends in health complaints also depend on gender and age in other contexts. This will help the planning and implementation of tailored and effective interventions.
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