Risk factors associated with mental health issues in adolescents: a integrative review

Prevalence of child maltreatment in a nationwide sample of 18 to 31 year-olds in Germany

BACKGROUND

Child maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults.

METHODS

The study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM.

RESULTS

Overall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM.

CONCLUSIONS

CM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM.

How to Link Assessment and Suitable Interventions for Adolescents: Relationships among Mental Health, Friendships, Demographic Indicators and Well-Being at School

BACKGROUND

Over the last 10 years, a noticeable deterioration in mental health has affected adolescents' lives.

METHODS

This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included students aged 12 to 17 years. The adolescents filled out a questionnaire about the need for outside help, friendships, and well-being at school and the Strengths and Difficulties Questionnaire. The goal of our study was to analyze the risk factors that influence adolescents' psycho-emotional state.

RESULTS

A total of 4124 students were involved in this study, with a mean age of 14.48 ± 1.15 years. The sample consisted of 50.9% males and 49.1% females. The boys showed a statistically significantly lower total difficulty score on the Strength and Difficulties Questionnaire (SDQ TDS) and internalizing score (IS) than the girls (12.45 ± 5.39 vs. 14.93 ± 5.76; 5.39 ± 3.30 vs. 7.49 ± 3.64, p < 0.001). Also, the SDQ TDS, IS, and externalizing score (ES) were statistically significantly lower in the group of adolescents who lived with both parents (13.50 ± 5.69 vs. 14.76 ± 5.72; 6.32 ± 3.61 vs. 6.98 ± 3.65; 7.18 ± 3.23 vs. 7.78 ± 3.35, p < 0.001). Linear regression analysis of the SDQ TDS (R2 = 0.406) indicated a significant impact on the feeling of safety at schools (β = -0.173, p < 0.001) and loneliness (β = 0.314, p < 0.001). Linear regression of the SDQ IS (R2 = 0.469) showed that there was a significant predictor effect of bullying (β = 0.170, p < 0.001) and loneliness (β = 0.345, p < 0.001). However, the linear regression of the SDQ ES (R2 = 0.256) showed that there was a significant predictor effect of the feeling of teacher care (β = -0.163, p < 0.001) and loneliness (β = 0.166, p < 0.001). We determined that gender (OR = 2.30) and loneliness (OR = 1.77) were the most significant factors associated with adolescents seeking help.

CONCLUSIONS

It is crucial to determine specific risk factors and particular groups of teenagers who need psycho-emotional support the most. The findings of this study may offer valuable insights for advancing additional prevention or support programs aimed at adolescents within higher-risk groups.

Exploring Mental Health Services for Youth Experiencing Homelessness in East Asian Pacific Regions: A Systematic Scoping Review

BACKGROUND

Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs.

OBJECTIVE

The objective of this study is to explore and systematically search the types of mental health services and interventions available for YEH in EAP and their impact on overall quality of life and wellbeing.

METHODS

Electronic databases (e.g., Medline, PsycINFO, PubMed, Scopus) were systematically searched (publication dates between 1 January 1990 and 13 May 2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies.

RESULTS

Eight studies with different interventions were identified in Indonesia (n = 2), Malaysia (n = 1), South Korea (n = 3), and the Philippines (n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening, and government interventions/services.

CONCLUSIONS

This review highlights effective mental health interventions' positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures.

Prevalence and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa

INTRODUCTION

Between 10 and 20% of children and adolescents globally experience common mental health conditions such as depression or anxiety. Given the dearth of mental health services in low- and middle-income countries, most mental health conditions among adolescents remain undiagnosed and untreated. In South Africa, few studies have explored the prevalence of depression and anxiety among young adolescents aged 10-14 years. This study examined the prevalence of, and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa.

METHODS

A cross-sectional study was conducted in 10 schools in the Western Cape Province from February to July 2022. Data were collected using a tablet-based survey and included sociodemographic items, the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire for Adolescents (PHQ-A) and other psychosocial measures. The prevalence of depression and anxiety was estimated based on cut-off scores for the GAD-7 and PHQ-A. Multivariable logistic regression models were used to investigate the associations between sociodemographic and psychosocial factors, and depression and anxiety.

RESULTS

Of the 621 adolescents, 33.5% (n = 208) reported experiencing symptoms of depression and 20.9% (n = 130) symptoms of anxiety potentially indicative of a diagnosis. The results of the multivariable logistic regression model indicate that being in a higher grade in school (AOR = 1.65, CI:1.43-1.92), any lifetime alcohol use (AOR = 1.62, CI:1.04-2.64), other drug use (AOR = 2.07, CI:1.06-4.04), and witnessing violence among adults at home (AOR = 2.12, CI:1.07-1.41) were significantly associated with experiencing depressive symptoms. Being in a higher grade in school (AOR = 1.69, CI: 1.42-2.01), poor emotional regulation skills (AOR = 1.03, CI: 1.00-1.07), and the use of cannabis (AOR = 1.03, CI: 1.00-1.07) were significantly associated with experiencing anxiety symptoms.

CONCLUSION

These findings add to our understanding of school-going adolescents' pressing mental health needs and suggest that mental health adolescent and caregiver interventions may be required to address mental health symptoms and associated risk factors.

Prevalence of Physical Violence Against Brazilian Women: Systematic Review and Meta-Analysis

Violence against women is a major problem in Brazil, but data on its prevalence are scarce. We aimed to estimate the prevalence of physical violence against women in Brazil. We conducted a systematic review and meta-analysis of the prevalence of physical violence against women. Population-based researches that assessed physical violence in Brazilian women were searched on MEDLINE, Embase, Scopus, and VHL/BIREME. The last search update was carried out in March 2020. Two researchers selected the studies, extracted the data, and assessed the quality of the eligible studies. Summary of prevalence and 95% confidence interval (CI) was calculated using Freeman-Tukey double arccosine transformation, weighted by the official local population size. Heterogeneity was estimated by I ² and investigated by meta-regression analyses. Of 3,408 reports, 13 studies carried out from 1999 to 2016 (n = 25,781 women) were included. Most studies had limitations on sample size (5/13) and response rate (7/13). The prevalence of physical violence was 22.4% in lifetime (95% CI [21.6, 23.2%]; I ² = 99.0%), and 11.5% in previous year (95% CI [11.1, 11.9%]; I ² = 99.5%). Assuring privacy during interview significantly increased the prevalence (p = .028; residual I ² = 80.0%). Higher prevalence was also observed in studies with adequate sample source, validated questionnaire, and privacy (in both recall periods), potentially due to lower risk of nonresponse bias. Over two in 10 Brazilian women suffered physical violence during their lives, and over one tenth, in the previous year. Measurement of outcome affected the prevalence; privacy should be assured for the interviewee for future reliable estimates in the country.

Factors associated with children and young people's mental health in the English-speaking Caribbean region: Systematic review and narrative synthesis

BACKGROUND

Studies conducted in regions consisting of low and middle income and developing countries often report high prevalence of mental health problems among children and young people (CYP). To identify some of the contributing factors we examined the available evidence from research in one such setting.

METHODS

Multiple academic databases and grey literature sources were searched until January 2022. We then identified primary research focusing on CYP's mental health in the English-speaking Caribbean region. Data was extracted and summarized to form a narrative synthesis of the factors associated with CYP's mental health. The synthesis was then organised according to the social-ecological model. The Joanna Briggs Institute's critical appraisal tools were used to examine the quality of the reviewed evidence. The study protocol was registered with PROSPERO, CRD42021283161.

RESULTS

From 9684 records, 83 publications representing CYP ages 3 to 24 years from 13 countries met our inclusion criteria. The evidence was varied in quality, quantity and consistency for 21 factors associated with CYP's mental health. Adverse events and negative peer to peer and sibling relationships were consistently associated with mental health problems, while helpful coping strategies were associated with better mental health. There were mixed findings for age, sex/gender, race/ethnicity, academic level, comorbidity, positive affect, health risks behaviours, religion/prayer, parent history, parent to parent and parent to child relationships, school/employment, geography and social status. There was also some limited evidence for associations between sexuality, screen time and policies/procedures and CYP's mental health. At least 40% of the evidence contributing to each of the factors was judged as high quality.

CONCLUSION

Individual, relationship, community and societal factors may influence CYP's mental health outcomes in the English-speaking Caribbean. Knowledge of these factors is useful to inform early identification and early interventions. More research is needed to explore inconsistent findings and understudied areas.

School-Based meditation in adolescents: an integrative literature review

OBJECTIVES

Utility of cognitive-behavioral practice interventions in school settings have been discussed by the scientific community regarding their possibility of insertion in the educational field. In this way, this review article analyzes the scientific production on the practice of meditation offered at school in adolescents, since the appropriation of studies that point to reflections and perspectives of meditative practice can favor the development of new pedagogical trajectories in the school environment.

CONTENT

The electronic databases VHL, PubMed, and CAPES were consulted, using the combination of the terms related to meditation, adolescents, and school. This analysis resulted in eight articles, including field research and reviews, published between 2010 and 2021.

SUMMARY

The articles showed improvement in emotional coping skills, social relationships, self-regulation, control of mood levels, stress, depression, and anger, and significant gains in self-reflection and academic attention. They pointed out that elementary and high school students present more significant responses, and these factors, such as duration, frequency, and systematization of the session, can interfere with these responses.

OUTLOOK

These results indicate that meditation practice in adolescents can be a valuable strategy for health promotion and educational training in the school environment.

Community violence and internalizing mental health symptoms in adolescents: A systematic review

PURPOSES

Mental disorders are responsible for 16% of the global burden of disease in adolescents. This review focuses on one contextual factor called community violence that can contribute to the development of mental disorders OBJECTIVE: To evaluate the impact of community violence on internalizing mental health symptoms in adolescents, to investigate whether different proximity to community violence (witness or victim) is associated with different risks and to identify whether gender, age, and race moderate this association.

METHODS

systematic review of observational studies. The population includes adolescents (10-24 years), exposition involves individuals exposed to community violence and outcomes consist of internalizing mental health symptoms. Selection, extraction and quality assessment were performed independently by two researchers.

RESULTS

A total of 2987 works were identified; after selection and extraction, 42 works remained. Higher exposure to community violence was positively associated with internalizing mental health symptoms. Being a witnessing is less harmful for mental health than being a victim. Age and race did not appear in the results as modifiers, but male gender and family support appear to be protective factors in some studies.

CONCLUSION

This review confirms the positive relationship between community violence and internalizing mental health symptoms in adolescents and provides relevant information that can direct public efforts to build policies in the prevention of both problems.

Exploring the Decisional Drivers of Deviance: A Qualitative Study of Institutionalized Adolescents in Malaysia

Adolescents who break the law or deviate from social norms are often criminalized as their behavior is perceived as resulting from conscious choices. However, it is likely that such choices result from their circumstances, namely the failure of their proximal environment to safeguard their wellbeing. The purpose of this study was to gain an in-depth understanding of the background variables and choices that led these institutionalized adolescents down the road of deviance. We conducted a qualitative study using semi-structured in-depth interviews, conducted between March and May 2018, with 18 participants aged between 15 to 19 years. Participants were purposefully sampled from various welfare institutions in the states of Kuala Lumpur and Selangor, Malaysia. Audio recordings of interviews were transcribed verbatim and analyzed thematically. We found three core themes, (i) Sources of Distress, (ii) Drivers of Deviance, and (iii) Adjustment Strategies for Coping with Distress, which appeared to have influenced participants’ life trajectories and eventual institutionalization. The findings showed that participants were disadvantaged by backgrounds of risk and vulnerability, characterized by a lack of social support and opportunities for personal development, negative schooling experiences, and negative peer interactions. Substance abuse, which provided a coping strategy for the participants, may have further contributed to their delinquency. Drawing upon the socio ecological model (SEM), we systematically identify interventional opportunities at the individual, community, and policy levels to safeguard the wellbeing of at-risk adolescents. We make recommendations aimed at improving the family dynamics, promoting a healthy schooling experience, and transforming neighborhoods into a safe and nurturing environment.

Depression and Anxiety in Youth and Young Adults Living with HIV: Frequency and Associated Factors in Thai Setting

Integrative mental health care in HIV patients is an important contributor to successful therapy. This is a cross-sectional study in youth and young adults who attend routine HIV clinic at a tertiary care centre in Bangkok. We recruited 100 youth and 130 young adults living with HIV to evaluate the frequency of depression and anxiety and associated sociodemographic including sexual orientation and health-related behaviours. Overall, about a fifth of the participants had significant depression or anxiety. Interestingly, we found different factors associated with depression in youth and young adults living with HIV. Loss of their father, loss of close relatives or friends, and being unemployed or school exclusion were the factors associate with depression in youth; while dangerous alcohol use, feeling discriminated against and having lipodystrophy were factors in young adults. The understanding of the frequency and different associated factors can inform more effective prevention and treatment strategies.

Early life mental health and problematic drinking in mid-adulthood: evidence from two British birth cohorts

PURPOSE

Accumulating evidence suggests that externalising problems are consistently associated with alcohol use behaviours, but findings are inconsistent regarding the role of internalising problems. We investigate whether externalising and internalising problems are associated with problematic drinking in mid-adulthood, and whether potential associations are modified by age, sex and cohort.

METHODS

The National Child Development Study (NCDS58, n = 17,633) and 1970 British Cohort Study (BCS70, n = 17,568) recruited new-borns in Great Britain in a single week in 1958 and 1970. Mental health was assessed with the Rutter Behaviour Questionnaire at ages 7, 11, and 16 in NCDS58 and ages 5, 10 and 16 in BCS70. Problematic drinking was measured with the CAGE questionnaire at age 33 in NCDS58 and age 34 in BCS70, and the AUDIT scale at age 44/45 in NCDS58 and age 46 in BCS70. Latent scores of externalising and internalising problems were added chronologically into lagged logistic regression models.

RESULTS

Externalising and internalising problems were associated in opposite directions with problematic drinking in mid-adulthood. Externalising was a risk factor (OR [95% CI] ranging from 1.06 [1.03, 1.10] to 1.11 [1.07, 1.15] for different ages), and internalising was a protective factor (OR [95% CI] ranging from 0.95 [0.92, 0.99] to 0.90 [0.86, 0.94] for different ages). Associations between early life mental health and mid-adulthood problematic drinking did not differ by developmental timing but were stronger in males.

CONCLUSION

Our study provides new insights on links of externalising and internalising difficulties with alcohol use and has implications for public policy in the UK.

Mood Symptoms, Suicide, and Associated Factors Among Jimma Community. A Cross-Sectional Study

Background: The global burden of mental health problems is high and is predicted to rise. At present, mood symptoms are the foremost common psychological problems worldwide, yet little is known regarding their magnitude and associated factors in developing countries. Therefore, this study aimed to assess the magnitude and associated factors of anxiety, depressive, manic symptoms, and suicidal behavior among the rural Jimma community, Ethiopia. Methods: A community-based quantitative cross-sectional survey was employed on 423 households selected through systematic random sampling. An adapted version of the Mini International Neuropsychiatric Interview tool was used for the structured face-to-face interview. The collected data were checked for completeness, coded, and inserted into Epi Data version 3.1 and exported to SPSS version 23 for analysis. Variables with P < g0.05 and odds ratio (OR) [95% confidence interval (CI)] on multivariate logistic regression analysis were considered as factors associated with the outcome variable. Results: Overall, 185 (44.0%), 55 (13.1%), 44 (10.5%), and 23 (5.5%) of the respondents had anxiety, depressive, manic symptom, and suicide behavior, respectively. The odds of having anxiety symptoms were nearly 5 times higher among those who had perceived discrimination and racism experience compared to their counterpart [adjusted OR (AOR), 5.02; 95% CI, 1.90-13.26]. Likewise, recently bereaved participants had 4-fold higher odds of reporting depressive symptoms (AOR, 3.9; 95% CI, 1.4-10.4) than the non-bereaved ones. Furthermore, respondents who had depressive symptoms were almost four and a half times more likely to have manic symptoms compared to those who did not (AOR, 4.3; 95% CI, 1.71-11.02). Conclusion: Anxiety, depressive, manic symptoms, and suicidal behavior were prevalent in the community and positively associated with multiple psychosocial factors. Implementing accessible and affordable community-based mental health services is recommended to mitigate the problems.

Factors Associated with Lifestyle Habits and Mental Health Problems in Korean Adolescents: The Korea National Health and Nutrition Examination Survey 2017-2018

To identify factors associated with Korean adolescents' lifestyle habits and mental health problems (stress perception, depressive mood, and suicidal thoughts), data from 842 adolescents' (13-18 years) responses to the Korea National Health and Nutrition Examination Survey (VII-2 and 3; 2017-2018) were analyzed. After controlling for sociodemographic and health status characteristics, results of multinomial logistic regression revealed drinking alcohol (stress perception: odds ratio (OR) = 1.61, 95% confidence interval (CI) = 1.19-2.19; depressive mood: OR = 2.59, 95% CI = 1.67-4.02; suicidal thoughts: OR = 2.28, 95% CI = 1.18-4.42), increased sedentary time (stress perception: OR = 1.88, 95% CI = 1.36-2.58), ≤6 h weekday sleep (stress perception: OR = 1.28, 95% CI = 1.00-1.66; suicidal thoughts: OR = 1.98, 95% CI = 1.05-3.75), and 8 h ≤ weekend sleep (stress perception: OR = 0.74, 95% CI = 0.56-0.98; depressive mood: OR = 0.63, 95% CI = 0.41-0.98; suicidal thoughts: OR = 0.41, 95% CI = 0.21-0.79) were significantly associated with mental health problems. Reducing Korean adolescents' mental health issues may require alcohol education, timed breaks/reduced sedentary time, and campaigns encouraging adequate sleep for teenagers.

Development of a Family-Based Mental Health Program for Runaway Adolescents Using an Intervention Mapping Protocol

The mental health and related quality of life of runaway adolescents are global public health issues. As few intervention studies have considered the family contexts of runaway adolescents, we aimed to develop an intervention tailored specifically to the needs of this population using an Intervention Mapping protocol. First, a literature review and interviews with runaway adolescents and youth shelter workers were conducted to create a logic model of the problem. Second, the behavioral and environmental outcomes were set to adapt to stressful situations and enable families to become more resourceful in dealing with family adversity, based on the results of needs assessment. Performance objectives and changeable determinants were also created by reviewing the pertinent theories and studies. Third, theory- and evidence-based methods to influence changes in the determinants were identified. Fourth, we designed an eight-session family-based mental health program incorporating individual and family approaches for runaway adolescents. Fifth, we determined that mental health nurses at community mental health centers linked to youth shelters would serve as the program implementers. Finally, we planned a randomized controlled trial to evaluate the effects of our program on improving runaway adolescents’ mental health status and perceived family functioning.

Child maltreatment is mediating long-term consequences of household dysfunction in a population representative sample

Background:

Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs.

Methods:

A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey.

Results:

The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95–5.55), just as household substance abuse (ORs 5.32–6.98), violence against the mother (ORs 4.43–10.26), incarceration of a household member (ORs 6.11–14.93) and parental separation (OR 3.37–4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood.

Conclusions:

ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.

Predictors of emotional and behavioral problems among Indian adolescents: A clinic-based study

BACKGROUND

Emotional and behavioral problems place a heavy burden on the adolescents and their families. Many factors are known to influence adolescent mental health. The current study was designed to determine the predictors of emotional and behavioral problems among Indian adolescents.

METHODS

The parents of adolescents in the age group of 10 to 18 (N = 81) were recruited from the National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Alabama Parenting Questionnaire (Parent version), Strength and Difficulty Questionnaire (Parent version) and, the Parent Interview Schedule (PIS) were used to assess the parental practices, emotional and behavioral problems and abnormal psychosocial environment of the adolescents. The data were analyzed with stepwise multiple linear and Quantile regression to find out significant predictors of emotional and behavioral problems among adolescents.

RESULTS

Adolescent's age, parental involvement, and paternal age are the significant predictors of emotional problems. Parental mental disorder or deviance, gender, and inconsistent discipline are the significant predictors for conduct problems. Poor monitoring and supervision, paternal and maternal age are statistically significant predictors of prosocial skills among the adolescents. Inadequate or distorted intrafamilial communication and parental mental disorder are the significant predictors of total difficulties among the adolescents.

CONCLUSION

The study validates the role of abnormal psychosocial environments and negative parenting practices as risk factors for emotional and behavioral problems among the adolescents. A comprehensive analysis which covers all possible variables related to adolescent mental health is mandatory for the health professionals before planning the intervention.

Body image dissatisfaction in patients with inflammatory bowel disease: a systematic review protocol

BACKGROUND

Inflammatory bowel disease (IBD) is a debilitating chronic disease characterised by inflammation and ulceration of the gastrointestinal tract. It is associated with a range of debilitating symptoms and reduced quality of life. People living with IBD may also be at risk of body image dissatisfaction (BID). BID is a distorted and negative view of the physical self, which in turn can adversely affect mental health and quality of life. To date, there have been no systematic reviews of the evidence on BID in IBD patients. Therefore, the aim of this systematic review is to clarify the evidence base on BID in *IBD patients including (i) the tools used to measure BID, (ii) the prevalence and severity of BID, (iii) the risk factors associated with BID and (iv) the relationship between BID and quality of life.

METHODS

Bibliographic databases (EMBASE, MEDLINE, PsycINFO, Cochrane CENTRAL) will be searched using a sensitive search strategy aiming to identify any quantitative study reporting on body image in the context of IBD. This will be supplemented by searches of ongoing trials registers and checking of reference lists. Studies will be assessed for eligibility using predetermined selection criteria for each question. Data will be extracted using a predefined data extraction form, and risk of bias (quality) of included studies will be assessed based on checklists appropriate to the study designs identified. Key methodological steps will be undertaken in duplicate to minimise bias and error. Synthesis will be undertaken separately for the different systematic review sub-questions. Given the anticipated heterogeneity of evidence on each question, it is likely that synthesis will be mostly narrative.

DISCUSSION

To the best of our knowledge, this will be the first systematic review to collate the existing evidence on BID in IBD patients. Understanding the impact of BID, its relationship with quality of life, and which patients may be at greater risk, may ultimately lead to the development of interventions to prevent or treat BID and to better patient care. Any gaps in the identified evidence will help to inform the research agenda in this area.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO: (CRD42018060999).

Mental health as a dimension for the care of teenagers

OBJECTIVE

To analyze the demands in the field of mental health from the perspective of teenagers.

METHOD

A descriptive study with a qualitative approach, having comprehensiveness as an analytical category. It was carried out with 21 teenagers of both genders, students of two public schools of a municipality of the countryside of Bahia state. The empirical material was produced through reflection workshops and analyzed through the technique of Discourse Analysis.

RESULTS

Teenagers value the indissociability between body and mind, recognize lack of attention to the psychological dimension in the health network, and point to mental disorders as resulting from contexts of life and lack of Health Care.

CONCLUSION

Health services need to be structured to attract teenagers, to recognize singularities through professionals trained in welcoming, listening and accountability. It is urgent to fulfill what is defined in public policies and in specific programs, and that comprehensiveness has a centrality as a perspective to be realized.

A retrospective cohort study describing the characteristics of patients under 18 years old in one section 136 suite

Section 136 of the Mental Health Act 1983 is an authority allowing police officers to remove a person 'who appears to him to be suffering from mental disorder' from a public area. There has been much media coverage regarding the inappropriate detention of minors under section 136 and the suggestion that many were taken to police cells, as there were no suitable places of safety. Although previous studies describe characteristics of a typical individual detained under section 136, few distinguish the differences between adults and adolescents. Profiling these adolescents can help to identify adolescents at risk, allowing for earlier intervention and prevent the inappropriate detention of individuals. Data were collected retrospectively for all patients under 18 years of age who were brought to a section 136 suite in south-west London over a five-year period. The typical profile of an adolescent presenting to this suite was a 16-year-old female of white ethnicity who was sectioned in a public area due to attempted suicide or deliberate self-harm. The individual is more likely to have mental or behavioural difficulties, a history of abuse, be under the care of local authorities and have had previous convictions compared to adolescents in the general population.

Exposure to violence: associations with psychiatric disorders in Brazilian youth

OBJECTIVE

The effects of exposure to violent events in adolescence have not been sufficiently studied in middle-income countries such as Brazil. The aims of this study are to investigate the prevalence of psychiatric disorders among 12-year-olds in two neighborhoods with different socioeconomic status (SES) levels in São Paulo and to examine the influence of previous violent events and SES on the prevalence of psychiatric disorders.

METHODS

Students from nine public schools in two neighborhoods of São Paulo were recruited. Students and parents answered questions about demographic characteristics, SES, urbanicity and violent experiences. All participants completed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to obtain DSM-IV diagnoses. The data were analyzed using weighted logistic regression with neighborhood stratification after adjusting for neighborhood characteristics, gender, SES and previous traumatic events.

RESULTS

The sample included 180 individuals, of whom 61.3% were from low SES and 39.3% had experienced a traumatic event. The weighted prevalence of psychiatric disorders was 21.7%. Having experienced a traumatic event and having low SES were associated with having an internalizing (adjusted OR = 5.46; 2.17-13.74) or externalizing disorder (adjusted OR = 4.33; 1.85-10.15).

CONCLUSIONS

Investment in reducing SES inequalities and preventing violent events during childhood may improve the mental health of youths from low SES backgrounds.