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Liang W, Cao S, Suo Y, Zhang L, Yang L, Wang P, Wang H, Wang H, Bai G, Li Q, Zheng J, Jin X. Long-term distress throughout one's life: health-related quality of life, economic and caregiver burden of patients with neurofibromatosis type 1 in China. Front Public Health 2024; 12:1398803. [PMID: 39234078 PMCID: PMC11371622 DOI: 10.3389/fpubh.2024.1398803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 08/07/2024] [Indexed: 09/06/2024] Open
Abstract
Introduction Neurofibromatosis type 1 (NF1) is a rare genetic disorder, with lack of evidence of disease burden in China. We aimed to describe the economic burden, health-related quality of life (HRQL), and caregiver burden of NF1 patients in China. Methods We conducted an online cross-sectional survey employing the China Cloud Platform for Rare Diseases, with 223 caregivers of NF1 pediatric patients (patients under 18), and 226 adult patients. Economic burden was estimated using direct and indirect costs related to NF1 in 2021, and the Work Productivity and Activity Impairment Questionnaire: General Health V2.0 (WPAI-GH). HRQL measures included EQ-5D-Y proxy version and PedsQL™ 4.0 Generic Core Scales (PedsQL GCS) proxy version for pediatric patients, and EQ-5D-5L and PedsQL™ 3.0 Neurofibromatosis Module (PedsQL NFM) for adult patients. Caregiver burden was estimated by Zarit Burden Interview (ZBI). Results For pediatric patients, the average direct cost in 2021 was CNY 33,614 (USD 4,879), and employed caregivers' annual productivity loss was 81 days. EQ-5D-Y utility was 0.880 ± 0.13 and VAS score was 75.38 ± 20.67, with 52.6% patients reporting having problems in "pain/discomfort" and 42.9% in "anxiety/depression." PedsQL GCS total score was 68.47 ± 19.42. ZBI score demonstrated that 39.5% of caregivers had moderate-to-severe or severe burden. For adult patients, average direct cost in 2021 was CNY 24,531 (USD 3,560). Patients in employment reported an absenteeism of 8.5% and presenteeism of 21.6% according to the results of WPAI-GH. EQ-5D-5L utility was 0.843 ± 0.17 and VAS score was 72.32 ± 23.49, with more than half of patients reporting having problems in "pain/discomfort" and "anxiety/depression" dimensions. PedsQL NFM total score was 68.40 ± 15.57. Conclusion Both pediatric and adult NF1 patients in China had a wide-ranging economic burden and low HRQL, especially in the psychological dimension. Caregivers for NF1 pediatric patients experienced considerable caregiver burden. More attention and support from policymakers and stakeholders are required to relieve NF1 patients' and caregivers' distress.
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Affiliation(s)
- Wanxian Liang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shihuan Cao
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yusi Suo
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lining Zhang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lujia Yang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ping Wang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hanfei Wang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Han Wang
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Guannan Bai
- Children's Hospital, Zhejiang University School of Medicine, National Children's Regional Medical Center, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, China
| | - Qingnan Li
- China Alliance for Rare Diseases, Beijing, China
- Beijing Society of Rare Disease Clinical Care and Accessibility, Beijing, China
| | - Jiayin Zheng
- China Alliance for Rare Diseases, Beijing, China
- Beijing Society of Rare Disease Clinical Care and Accessibility, Beijing, China
| | - Xuejing Jin
- Centre for Evidence-Based Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- International Institute of Evidence-Based Traditional Chinese Medicine, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Forster F, Milek A, Breitenstein C, Senn M, Bradbury TN, Bodenmann G. Coping equally: Equity of dyadic coping and depressive symptoms among adolescent couples. J Adolesc 2024. [PMID: 39075641 DOI: 10.1002/jad.12377] [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: 02/02/2024] [Revised: 07/04/2024] [Accepted: 07/04/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION Many adolescents are in their first romantic relationship; at the same time, depressive symptoms generally increase during this developmental stage. In adults, equity of support in romantic relationships is associated with less depressive symptoms-especially in female partners, who are generally on "the losing side" of support transactions with male partners. This study examines whether equity of dyadic coping is associated with depressive symptoms in adolescent mixed-gender couples. We disentangle equity of positive and negative dyadic coping, as differential effects might arise. METHODS Self-report data on dyadic coping and depressive symptoms were gathered from 124 mixed-gender couples aged between 16 and 21 years living in Switzerland between 2011 and 2013. Equity of dyadic coping was quantified by calculating the difference between received dyadic coping and provided dyadic coping for each partner separately. These difference scores and the overall level of dyadic coping were used to predict depressive symptoms in both partners using an Actor-Partner-Interdependence Model. RESULTS For female adolescents, we found the expected curvilinear association between equity of negative dyadic coping behaviors and depressive symptoms (actor effect). Additionally, the female perception of equity of positive dyadic coping was correlated with less depressive symptoms in male partners (partner effect). For male adolescents, receiving more positive dyadic coping than they provided was associated with more depressive symptoms (actor effect). DISCUSSION In female partners, results resembled those in adult mixed-gender couples. In male partners, results changed depending on the direction of inequity-possibly due to gender role development.
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Affiliation(s)
- Fabienne Forster
- Competence Center for Gynecopsychiatry, Outpatient Clinic Wil, Psychiatry St. Gallen, St. Gallen, Switzerland
| | - Anne Milek
- Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
| | | | - Mirjam Senn
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Thomas N Bradbury
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Zurich, Switzerland
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Münker L, Rimvall MK, Frostholm L, Ørnbøl E, Wellnitz KB, Jeppesen P, Maria Rosmalen JG, Rask CU. Exploring the course of functional somatic symptoms (FSS) from pre- to late adolescence and associated internalizing psychopathology - an observational cohort-study. BMC Psychiatry 2024; 24:495. [PMID: 38977964 PMCID: PMC11232134 DOI: 10.1186/s12888-024-05937-3] [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: 09/01/2023] [Accepted: 06/26/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Functional somatic symptoms (FSS), which commonly cannot be attributed to well-defined organic pathology, often co-occur with internalizing psychopathology and fluctuate throughout different life stages. We examined FSS courses throughout adolescence, and the association between preadolescent FSS, FSS severity and internalizing psychopathology at late adolescence. METHODS Data from the Copenhagen Child Cohort (CCC2000) were utilized from assessments at ages 11-12 years (preadolescence; T0) and 16-17 years (late adolescence; T1). Self-report questionnaire and interview data on FSS, internalizing psychopathology, chronic medical conditions, and sociodemographic data from Danish national registers were available for 1285 youths. FSS courses were categorized into persistent (high FSS at T0 & T1), remission (high FSS only at T0), incident (high FSS only at T1) or no FSS (no FSS at T0 & T1). Multiple linear and multinomial logistic regressions were conducted to investigate the FSS/psychopathology association. RESULTS 1.8% of adolescents fell into the persistent FSS course group throughout adolescence. Higher preadolescent FSS predicted FSS (b = 0.07, p < .001), anxiety (b = 0.05, p < .001) and depression (b = 0.06, p < .001) at age 16/17, even after controlling for sex, parental education, a chronic medical condition and internalizing psychopathology in preadolescence. Persistent, incident, and remittent FSS courses were associated with significantly higher mean levels of anxiety and depression compared to the reference group (no FSS). CONCLUSIONS FSS during pre- and late adolescence might increase and co-occur with anxiety and depression throughout adolescence, potentially due to shared underlying risk factors and processes.
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Affiliation(s)
- Lina Münker
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Psychiatry, Aarhus, Denmark.
- Department of Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Lisbeth Frostholm
- Department of Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Eva Ørnbøl
- Department of Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kaare Bro Wellnitz
- Department of Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Judith Gerarda Maria Rosmalen
- Departments of Psychiatry and Internal medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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King N, Davison CM, Pickett W. Development of a novel continuous measure of adolescent mental health inspired by the dual-factor model. Front Psychol 2022; 13:918894. [PMID: 36033094 PMCID: PMC9416863 DOI: 10.3389/fpsyg.2022.918894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background According to the Dual-factor Model, mental health is comprised of two related constructs: subjective well-being and psychopathology. Combining these constructs can provide a more accurate and comprehensive assessment of adolescent mental health than considering either on its own. The model suggests the need to group mental health into four distinct categories, which does not recognize its potential continuum and adds statistical complexity. In this study, we developed a continuous measure inspired by, and as a complement to, the Dual-factor Model. Our goal was to demonstrate a novel approach to developing a valid measure for use in public health research that captures varying mental health states more accurately than traditional approaches and has advantages over the categorical version. Methods Self-report data are from the 2014 Canadian Health Behavior in School-aged Children study (n = 21,993). Subjective well-being was measured by combining indicators of life satisfaction, positive affect, and negative affect. Internalized and externalized symptoms scales were combined to measure psychopathology. The continuous dual-factor measure was created by subtracting standardized psychopathology scores from standardized subjective well-being scores. Construct validity was assessed using multivariable linear regression by examining associations between factors known to be associated with adolescent mental health status (demographic characteristics, social and academic functioning, and specific indicators of mental health) and average mental health scores. Results The average age was 14.0 (SD = 1.41) years. The continuous mental health score ranged from 5 to 67 [Mean (SD): 50.1 (9.8)], with higher scores indicating better overall mental health. The nature and direction of the associations examined supported construct validity. Being from a more affluent family, and having more supportive relationships with family, peers, teachers, and classmates was associated with greater mental health (Cohen’s d: 0.65 to 1.63). Higher average marks were also associated with better mental health. Average mental health scores were much lower if students reported feeling hopeless or rated their health as fair or poor. Conclusion A continuous measure of mental health based on the Dual-factor Model appears to be a comprehensive and valid measure with applications for research aimed at increasing our understanding of adolescent mental health.
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Affiliation(s)
- Nathan King
- Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada
- *Correspondence: Nathan King,
| | - Colleen M. Davison
- Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Kingston, ON, Canada
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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Wunram HL, Hamacher S, Oberste M, Neufang S, Belke L, Jänicke F, Graf C, Schönau E, Bender S, Fricke O. Influence of motivational placebo-related factors on the effects of exercise treatment in depressive adolescents. Eur Child Adolesc Psychiatry 2022; 31:1-14. [PMID: 33709258 PMCID: PMC9343287 DOI: 10.1007/s00787-021-01742-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/08/2021] [Indexed: 11/26/2022]
Abstract
Recent meta-analyses reveal a moderate effect of physical activity (PA) in the treatment of adolescent depression. However, not only the underlying neurobiological mechanisms, also the influences of placebo-related motivational factors (beliefs and expectancies in sporting, enjoyment and prior sports experiences), are still unclear. Based on the data of our prior study "Mood Vibes", we hypothesized that placebo-inherent factors like positive prior sports experiences and motivational factors, (positive beliefs, expectancies, and enjoyment related to PA), would increase the effects of an add-on exercise-therapy in juvenile depression. From 64 included depressed adolescents, 41 underwent an intensive add-on PA-therapy. Motivational factors were assessed using sport-specific scales. The changes in depression scores under treatment were rated by self-rating scale (German "Childhood Depression Inventory", (DIKJ)). A mixed model for repeated measures (MMRM) was used to analyze the effects of the different motivational variates on DIKJ. While prior sports experiences had no impact, motivational factors showed a significant effect on PA-induced changes in DIKJ scores (p = 0.002). The demotivated participants improved less, whereas it was sufficient to be neutral towards sporting to benefit significantly more. Motivational placebo-related factors (beliefs, expectancies and enjoyment regarding PA) affected the outcomes of an exercise treatment in depressed adolescents. Yet, a neutral mindset was sufficient to profit more from PA. Prior sporting in the sense of positive conditioning and as a protective factor did not play a role. Knowledge about these influences could in a second step help to develop tailored therapies.
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Affiliation(s)
- Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Stefanie Hamacher
- Department of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany
| | - Max Oberste
- Department of Medical Statistics, Informatics and Epidemiology (IMSIE), University of Cologne, Cologne, Germany
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty Heinrich-Heine University, Düsseldorf, Germany
| | - Luisa Belke
- Children’s Hospital Amsterdam Street, Cologne, Germany
| | | | - Christine Graf
- Institute of Movement and Neuroscience, German Sport University Cologne, Cologne, Germany
| | - Eckhard Schönau
- Children’s Hospital, University Hospital of Cologne and UniReha®, University Hospital of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, Cologne, Germany
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke and Chairs of Child and Adolescent Psychiatry, Witten/Herdecke University, Witten, Germany
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Mancinelli E, Sharka O, Lai T, Sgaravatti E, Salcuni S. Self-injury and Smartphone Addiction: Age and gender differences in a community sample of adolescents presenting self-injurious behavior. Health Psychol Open 2021; 8:20551029211038811. [PMID: 34659789 PMCID: PMC8512283 DOI: 10.1177/20551029211038811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify the variables (i.e., internalizing, and externalizing problems, self-control, emotion dysregulation, and alexithymia) relevant for Smartphone Addiction and non-suicidal self-injury (NSSI), conceptualized as emotion-regulation strategies, also assessing age and gender differences. Based on power analysis, N = 78 Italian adolescents (11-19 years; Mage = 14.24; SD = 1.56; 73.1% females) were considered. Step-wise multivariate linear regressions evidence a mutual association between NSSI and Smartphone Addiction, particularly relevant in pre-adolescence. Low self-control is significantly associated with the Smartphone Addiction, while emotion dysregulation and alexithymia with NSSI. This study supports NSSI and Smartphone Addiction conceptualization as emotion-regulation strategies and the importance of prevention interventions.
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Affiliation(s)
- Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Ona Sharka
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Eleonora Sgaravatti
- The Net-ONLUS, Padua, Italy.,Complex Psychology Unit - Infancy, Adolescence and Family, USSL3, Via Piazzetta Unità d'Italia, Padua, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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King N, Davison CM, Pickett W. Development of a dual-factor measure of adolescent mental health: an analysis of cross-sectional data from the 2014 Canadian Health Behaviour in School-aged Children (HBSC) study. BMJ Open 2021; 11:e041489. [PMID: 34593480 PMCID: PMC8487193 DOI: 10.1136/bmjopen-2020-041489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Studies of adolescent mental health require valid measures that are supported by evidence-based theories. An established theory is the dual-factor model, which argues that mental health status is only fully understood by incorporating information on both subjective well-being and psychopathology. OBJECTIVES To develop a novel measure of adolescent mental health based on the dual-factor model and test its construct validity. DESIGN Cross-sectional analysis of national health survey data. SETTING AND PARTICIPANTS Nationally weighted sample of 21 993 grade 6-10 students; average age: 14.0 (SD 1.4) years from the 2014 Canadian Health Behaviour in School-aged Children study. MEASURES Self-report indicators of subjective well-being (life satisfaction, positive and negative affect), and psychopathology (psychological symptoms and overt risk-taking behaviour) were incorporated into the dual-factor measure. Characteristics of adolescents families, specific mental health indicators and measures of academic and social functioning were used in the assessment of construct validity. RESULTS Proportions of students categorised to the four mental health groups indicated by the dual-factor measure were 67.6% 'mentally healthy', 17.5% 'symptomatic yet content', 5.5% 'asymptomatic yet discontent' and 9.4% 'mentally unhealthy'. Being mentally healthy was associated with the highest functioning (greater social support and academic functioning) and being mentally unhealthy was associated with the worst. A one-unit increase (ranges=0-10) in peer support (OR 1.19; 95% CI 1.15 to 1.22), family support (OR 1.32; 95% CI 1.28 to 1.36), student support (OR 1.20; 95% CI 1.17 to 1.24) and average school marks (OR 1.18; 95% CI 1.10 to 1.27) increased the odds of being symptomatic yet content versus mentally unhealthy. Mentally healthy youth were the most likely to live with both parents (77% vs ≤65%) and report their family as well-off (62% vs ≤53%). CONCLUSIONS We developed a novel, construct valid dual-factor measure of adolescent mental health. This potentially provides a nuanced and comprehensive approach to the assessment of adolescent mental health that is direly needed.
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Affiliation(s)
- Nathan King
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Colleen M Davison
- Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - William Pickett
- Health Sciences, Brock University, Saint Catharines, Ontario, Canada
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[Treatment of disorders of emotion regulation in the Adolescents Center at the Central Intitute of Mental Health]. DER NERVENARZT 2021; 92:670-678. [PMID: 34137903 DOI: 10.1007/s00115-021-01152-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
Severe disorders of emotion regulation, e.g. in the context of mental illnesses, such as borderline disorders, attention deficit hyperactivity disorder (ADHD) and complex posttraumatic stress disorder (PTSD), often begin in childhood and adolescence and influence the psychosocial development of those affected, often into adulthood. Professional treatment therefore often requires longer term planning, if possible from a single source. The sectorized structure of the current psychiatric healthcare system, however, makes this process more difficult or is even a hindrance and promotes high hospitalization rates and chronification. The concept of the Adolescents Center for Disorders of Emotion Regulation at the Central Institute of Mental Health functions as a model concept for long-term, cross-sectoral treatment structures. A constant treatment team from child, adolescent and adult psychiatry and psychotherapy provides evidence-based psychotherapy according to the guidelines of dialectical behavior therapy (DBT) for those affected between the ages of 16 and 24 years. Conceptually, inpatient, day care and staged outpatient treatment modules complement each other in order to not only provide psychotherapy to the young patients in this important phase of life but also to accompany and support them in completing school and training, in partnership and independent living.
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Wunram HL, Oberste M, Hamacher S, Neufang S, Grote N, Krischer MK, Bloch W, Schönau E, Bender S, Fricke O. Immunological Effects of an Add-On Physical Exercise Therapy in Depressed Adolescents and Its Interplay with Depression Severity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6527. [PMID: 34204400 PMCID: PMC8296386 DOI: 10.3390/ijerph18126527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pro-inflammatory cytokines (PICs) have gained attention in the pathophysiology and treatment of depressive disorders. At the same time, the therapeutic effect of physical activity seems to work via immunomodulatory pathways. The interventional study "Mood Vibes" analyzed the influence of exercise on depression severity (primary endpoint) in depressive adolescents; the influence of PICs on the clinical outcome was analyzed as a secondary endpoint. METHODS Clinically diagnosed depressed adolescents (N = 64; 28.1% male; mean age = 15.9; mean BMI = 24.6) were included and participated either in Whole Body Vibration (WBV) (n = 21) or bicycle ergometer training (n = 20) in addition to treatment-as-usual (TAU). Patients in the control treatment group received TAU only (n = 23). The PICs (interleukin-6-IL-6 and tumor necrosis factor-α-TNF-α) were analyzed before intervention, after 6 weeks of training (t1), and 8 weeks post-intervention (t2). The effects of the treatment on depression severity were rated by self-rating "Depression Inventory for Children and Adolescents" (DIKJ). RESULTS Basal IL-6 decreased in all groups from t0 to t1, but it increased again in WBV and controls at t2. TNF-α diminished in ergometer and controls from baseline to t1. PIC levels showed no correlation with depression severity at baseline. The influence on DIKJ scores over time was significant for IL-6 in the WBV group (p = 0.008). Sex had an impact on TNF-α (p < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points (p < 0.001). CONCLUSIONS The positive effects of an intensive add-on exercise therapy on adolescent depression seem to be partly influenced by immunomodulation. A small sample size and non-randomized controls are limitations of this study.
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Affiliation(s)
- Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Max Oberste
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, 50937 Cologne, Germany; (M.O.); (S.H.)
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, 50933 Cologne, Germany
| | - Stefanie Hamacher
- Institute of Medical Statistics and Computational Biology (IMSB), University of Cologne, 50937 Cologne, Germany; (M.O.); (S.H.)
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty Heinrich-Heine University, 40225 Düsseldorf, Germany;
| | - Nils Grote
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Maya Kristina Krischer
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Wilhelm Bloch
- Institute of Movement and Neuroscience, German Sport University Cologne, 50933 Cologne, Germany;
| | - Eckhard Schönau
- Children’s Hospital, University Hospital of Cologne & UniReha, University Hospital of Cologne, 50933 Cologne, Germany;
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry Psychosomatic and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (N.G.); (M.K.K.); (S.B.)
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke & Chair of Child and Adolescent Psychiatry, Witten/Herdecke University, 58313 Witten/Herdecke, Germany;
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Jystad I, Bjerkeset O, Haugan T, Sund ER, Vaag J. Sociodemographic Correlates and Mental Health Comorbidities in Adolescents With Social Anxiety: The Young-HUNT3 Study, Norway. Front Psychol 2021; 12:663161. [PMID: 33935922 PMCID: PMC8085386 DOI: 10.3389/fpsyg.2021.663161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/23/2021] [Indexed: 01/29/2023] Open
Abstract
Social anxiety is highly prevalent in adolescents and is often associated with great individual suffering and functional impairment. Psychiatric comorbidity is common and further adds to this burden. The purposes of this study were: (1) to describe the occurrence of diagnosed and self-reported social anxiety among 8,199 Norwegian adolescents aged 13–19 years who participated in the population-based Young-HUNT3 study (2006–2008); (2) to examine associations between sociodemographic characteristics and different subgroups of social anxiety; and (3) to describe the psychiatric health comorbidities among adolescents diagnosed with social anxiety disorder (SAD). In total, 388 (5.9%) of the adolescents screened positive for SAD and were invited into a diagnostic interview, performed by professional nurses, using Anxiety Disorders Interview Schedule for DSM IV: child version (ADIS-C) (response rate = 54.6%). A SAD diagnosis was indicated in 106 individuals (50% of the interview subjects), and more than two-thirds of the adolescents diagnosed with SAD had one or more comorbid psychiatric disorders. Higher mean scores of self-reported social anxiety symptoms, poor self-rated health, sleep problems, poor family economic situation, low physical activity, and having sought professional help within the last year were associated with higher odds of being in the screening positive subgroup. Screening positive subjects who did not meet for a diagnostic interview did not differ notably from the rest of the screening positive group in terms of these sociodemographic characteristics. Based on our results and the fact that individuals with social anxiety often fear interview situations, the use of ADIS-C, screening questions and self-reports seem to be sufficient when aiming to identify epidemiologically representative cohorts of adolescents at risk of social anxiety.
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Affiliation(s)
- Ingunn Jystad
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tommy Haugan
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway
| | - Erik R Sund
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jonas Vaag
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway.,Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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11
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Christensen J, Beveridge JK, Wang M, Orr SL, Noel M, Mychasiuk R. A Pilot Study Investigating the Role of Gender in the Intergenerational Relationships between Gene Expression, Chronic Pain, and Adverse Childhood Experiences in a Clinical Sample of Youth with Chronic Pain. EPIGENOMES 2021; 5:epigenomes5020009. [PMID: 34968296 PMCID: PMC8594698 DOI: 10.3390/epigenomes5020009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/24/2021] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Chronic pain is a highly prevalent and costly issue that often emerges during childhood or adolescence and persists into adulthood. Adverse childhood experiences (ACEs) increase risk for several adverse health conditions, including chronic pain. Recent evidence suggests that parental trauma (ACEs, post-traumatic stress disorder (PTSD) symptoms) confers risk of poor health outcomes in their children. Intergenerational relationships between parental trauma and child chronic pain may be mediated by epigenetic mechanisms. A clinical sample of youth with chronic pain and their parents completed psychometrically sound questionnaires assessing ACEs, PTSD symptoms, and chronic pain, and provided a saliva sample. These were used to investigate the intergenerational relationships between four epigenetic biomarkers (COMT, DRD2, GR, and SERT), trauma, and chronic pain. The results indicated that the significant biomarkers were dependent upon the gender of the child, wherein parental ACEs significantly correlated with changes in DRD2 expression in female children and altered COMT expression in the parents of male children. Additionally, the nature of the ACE (maltreatment vs. household dysfunction) was associated with the specific epigenetic changes. There may be different pathways through which parental ACEs confer risk for poor outcomes for males and females, highlighting the importance of child gender in future investigations.
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Affiliation(s)
- Jennaya Christensen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
| | - Jaimie K. Beveridge
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
| | - Melinda Wang
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Serena L. Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3004, Australia;
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4, Canada; (J.K.B.); (M.N.)
- Hotchkiss Brain Institute, Calgary, AB T2N 4N1, Canada;
- Alberta Children’s Hospital Research Institute, Calgary, AB T2N 4N1, Canada
- Correspondence:
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12
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Grootendorst-van Mil NH, Bouter DC, Hoogendijk WJG, van Jaarsveld SFLM, Tiemeier H, Mulder CL, Roza SJ. The iBerry study: a longitudinal cohort study of adolescents at high risk of psychopathology. Eur J Epidemiol 2021; 36:453-464. [PMID: 33796978 PMCID: PMC8076148 DOI: 10.1007/s10654-021-00740-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/13/2021] [Indexed: 11/26/2022]
Abstract
The iBerry study is a population-based cohort study designed to investigate the transition from subclinical symptoms to a psychiatric disorder. Adolescents were selected based on their self-reported emotional and/or behavioral problems assessed by completing the strengths and difficulties questionnaire-youth (SDQ-Y) in their first year of high school. A total of 16,736 SDQ-Y questionnaires completed in the academic years 2014-2015 and 2015-2016 by students in the greater Rotterdam area in the Netherlands were screened. A high-risk group of adolescents was then selected based on the 15% highest-scoring adolescents, and a low-risk group was randomly selected from the 85% lowest-scoring adolescents, with a 2.5:1 ratio between the number of high-risk and low-risk adolescents. These adolescents were invited to come with one parent for a baseline visit consisting of interviews, questionnaires, neuropsychological tests, and biological measurements to assess determinants of psychopathology. A total of 1022 high-risk and low-risk adolescents (mean age at the first visit: 15.0 years) enrolled in the study. The goal of the iBerry study is to follow these adolescents for a 10-year period in order to monitor any changes in their symptoms. Here, we present the study design, response rate, inclusion criteria, and the characteristics of the cohort; in addition, we discuss possible selection effects. We report that the oversampling procedure was successful at selecting a cohort of adolescents with a high rate of psychiatric problems based on comprehensive multi-informant measurements. The future results obtained from the iBerry Study will provide new insights into the way in which the mental health of high-risk adolescents changes as they transition to adulthood. These findings will therefore facilitate the development of strategies designed to optimize mental healthcare and prevent psychopathology.
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Affiliation(s)
- Nina H Grootendorst-van Mil
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Diandra C Bouter
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Cornelis L Mulder
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sabine J Roza
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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13
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Dziedzic B, Sarwa P, Kobos E, Sienkiewicz Z, Idzik A, Wysokiński M, Fidecki W. Loneliness and Depression among Polish High-School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041706. [PMID: 33578868 PMCID: PMC7916597 DOI: 10.3390/ijerph18041706] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
Introduction: Having impaired relations and limited interpersonal contact is associated with a sense of loneliness, and can result in a number of mental disorders, including the development of depression. Approximately one in five adolescents in the world suffers from depression, and first episodes of such are occurring at increasingly young ages. Due to a lack of appropriate support from parents, teachers and the healthcare system, the young person feels alone when dealing with their problem. Aims: The aims of this study are to determine the prevalence of anxiety, depression, aggression and sense of loneliness among high school students, and to analyze a correlation between loneliness and depression. Materials and methods: The study was conducted on 300 high school students in Poland. The study material was collected using the Hospital Anxiety and Depression Scale (HADS-M) and De Jong Gierveld Loneliness Scale (DJGLS). Results: A feeling of loneliness correlated significantly with depressive disorders (p < 0.005), with the strongest effect between the total HADS-M score and the total loneliness scale score (r = 0.61). The overall presence of disorders as per HADS-M was found to be 23%, and borderline conditions were found in 19.3%. In 24% of the students, disorders were revealed on the anxiety subscale and in 46.3% on the aggression subscale. On DJGLS, a very severe sense of loneliness was observed in 6.67% of the subjects, and in 42.3% of them, a moderate feeling of loneliness was indicated. On the social loneliness subscale, a severe sense of loneliness was found in 22.7%, while on the emotional loneliness subscale, it was found in 16.7% of the subjects. Conclusions: In this study, a quarter of the student participants experienced anxiety and depression disorders. Students showing higher levels of anxiety, depression, and aggression also showed enhanced loneliness. Girls showed higher levels of anxiety, depression and aggression, as well as emotional loneliness.
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Affiliation(s)
- Beata Dziedzic
- Department of Nursing Development, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland; (E.K.); (Z.S.); (A.I.)
- Correspondence:
| | - Paulina Sarwa
- Central Teaching Hospital of the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warszawa, Poland;
| | - Ewa Kobos
- Department of Nursing Development, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland; (E.K.); (Z.S.); (A.I.)
| | - Zofia Sienkiewicz
- Department of Nursing Development, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland; (E.K.); (Z.S.); (A.I.)
| | - Anna Idzik
- Department of Nursing Development, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland; (E.K.); (Z.S.); (A.I.)
| | - Mariusz Wysokiński
- Department of Basic Nursing and Medical Teaching, Chair of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (M.W.); (W.F.)
| | - Wiesław Fidecki
- Department of Basic Nursing and Medical Teaching, Chair of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (M.W.); (W.F.)
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14
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Durbeej N, Sörman K, Norén Selinus E, Lundström S, Lichtenstein P, Hellner C, Halldner L. Trends in childhood and adolescent internalizing symptoms: results from Swedish population based twin cohorts. BMC Psychol 2019; 7:50. [PMID: 31375136 PMCID: PMC6679471 DOI: 10.1186/s40359-019-0326-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 07/18/2019] [Indexed: 02/07/2023] Open
Abstract
Background Previous research has noted trends of increasing internalizing problems (e.g., symptoms of depression and anxiety), particularly amongst adolescent girls. Cross-cohort comparisons using identical assessments of both anxiety and depression in youth are lacking, however. Methods In this large twin study, we examined trends in internalizing symptoms in samples of 9 year old children and 15 year old adolescents, gathered from successive birth cohorts from 1998 to 2008 (age 9) and 1994–2001 (age 15). Assessments at age 9 were parent-rated, and at age 15 self- and parent-rated. We examined (i) the relation between birth cohorts and internalizing symptoms using linear regressions, and (ii) whether percentages of participants exceeding scale cut-off scores changed over time, using Cochrane Armitage Trend Tests. Results Among 9 year old children, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off on anxiety symptoms, but not on depressive symptoms. At age 15, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off particularly on self-reported internalizing symptoms. On parent-reported internalizing symptoms, only girls demonstrated a corresponding trend. Conclusion In line with previous studies, we found small changes over sequential birth cohorts in frequencies of depression and anxiety symptoms in children. Further, these changes were not exclusive to girls.
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Affiliation(s)
- Natalie Durbeej
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Karolina Sörman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Eva Norén Selinus
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research, County of Västmanland, Uppsala University, Uppsala, Sweden
| | - Sebastian Lundström
- Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Centre of Ethics Law and Mental Health, Gothenburg University, Gothenburg, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Clara Hellner
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Linda Halldner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. .,Child and Adolescent Psychiatry Research center, BUP Klinisk forskningsenhet, Stockholm, Sweden. .,Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, SE-901 87 Umeå, Sweden.
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15
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Whole body vibration added to treatment as usual is effective in adolescents with depression: a partly randomized, three-armed clinical trial in inpatients. Eur Child Adolesc Psychiatry 2018; 27:645-662. [PMID: 29119301 DOI: 10.1007/s00787-017-1071-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 10/19/2017] [Indexed: 12/22/2022]
Abstract
There is growing evidence for the effectiveness of exercise in the treatment of adult major depression. With regard to adolescents, clinical trials are scarce. Due to the inherent symptoms of depression (lack of energy, low motivation to exercise), endurance training forms could be too demanding especially in the first weeks of treatment. We hypothesized that an easy-to-perform passive muscular training on a whole body vibration (WBV) device has equal anti-depressive effects compared to a cardiovascular training, both administered as add-ons to treatment as usual (TAU). Secondly, we presumed that both exercise interventions would be superior in their response, compared to TAU. In 2 years 64 medication-naïve depressed inpatients aged 13-18, were included. Both exercise groups fulfilled a supervised vigorous training for 6 weeks. Depressive symptoms were assessed by self-report ("Depressions Inventar für Kinder und Jugendliche"-DIKJ) before intervention and after weeks 6, 14 and 26. Compared to TAU, both groups responded earlier and more strongly measured by DIKJ scores, showing a trend for the WBV group after week 6 (p = 0.082). The decrease became statistically significant for both intervention groups after week 26 (p = 0.037 for ergometer and p = 0.042 for WBV). Remission rates amounted to 39.7% after week 6 and 66% after week 26, compared to 25% after week 26 in TAU. These results provide qualified support for the effectiveness of exercise as add-on treatment for medication-naïve depressed adolescents. The present results are limited by the not randomized control group.
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16
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Otto C, Haller AC, Klasen F, Hölling H, Bullinger M, Ravens-Sieberer U. Risk and protective factors of health-related quality of life in children and adolescents: Results of the longitudinal BELLA study. PLoS One 2017; 12:e0190363. [PMID: 29284054 PMCID: PMC5746247 DOI: 10.1371/journal.pone.0190363] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/12/2017] [Indexed: 11/19/2022] Open
Abstract
AIMS Cross-sectional studies demonstrated associations of several sociodemographic and psychosocial factors with generic health-related quality of life (HRQoL) in children and adolescents. However, little is known about factors affecting the change in child and adolescent HRQoL over time. This study investigates potential psychosocial risk and protective factors of child and adolescent HRQoL based on longitudinal data of a German population-based study. METHODS Data from the BELLA study gathered at three measurement points (baseline, 1-year and 2-year follow-ups) were investigated in n = 1,554 children and adolescents aged 11 to 17 years at baseline. Self-reported HRQoL was assessed by the KIDSCREEN-10 Index. We examined effects of sociodemographic factors, mental health problems, parental mental health problems, as well as potential personal, familial, and social protective factors on child and adolescent HRQoL at baseline as well as over time using longitudinal growth modeling. RESULTS At baseline, girls reported lower HRQoL than boys, especially in older participants; low socioeconomic status and migration background were both associated with low HRQoL. Mental health problems as well as parental mental health problems were negatively, self-efficacy, family climate, and social support were positively associated with initial HRQoL. Longitudinal analyses revealed less increase of HRQoL in girls than boys, especially in younger participants. Changes in mental health problems were negatively, changes in self-efficacy and social support were positively associated with the change in HRQoL over time. No effects were found for changes in parental mental health problems or in family climate on changes in HRQoL. Moderating effects for self-efficacy, family climate or social support on the relationships between the investigated risk factors and HRQoL were not found. CONCLUSION The risk factor mental health problems negatively and the resource factors self-efficacy and social support positively affect the development of HRQoL in young people, and should be considered in prevention programs.
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Affiliation(s)
- Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne-Catherine Haller
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heike Hölling
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Monika Bullinger
- Institute and Outpatients Clinic Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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17
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Rozenblat V, Ryan J, Wertheim EH, King R, Olsson CA, Krug I. Investigating Direct Links between Depression, Emotional Control, and Physical Punishment with Adolescent Drive for Thinness and Bulimic Behaviors, Including Possible Moderation by the Serotonin Transporter 5-HTTLPR Polymorphism. Front Psychol 2017; 8:1361. [PMID: 28848475 PMCID: PMC5552700 DOI: 10.3389/fpsyg.2017.01361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/26/2017] [Indexed: 11/13/2022] Open
Abstract
Objectives: To examine the relationship between psychological and social factors (depression, emotional control, sexual abuse, and parental physical punishment) and adolescent drive for Thinness and Bulimic behaviors in a large community sample, and to investigate possible genetic moderation. Method: Data were drawn from the Australian Temperament Project (ATP), a population-based cohort study that has followed a representative sample of 2443 participants from infancy to adulthood across 16 waves since 1983. A subsample of 650 participants (50.2% female) of Caucasian descent who provided DNA were genotyped for a serotonin transporter promoter polymorphism (5-HTTLPR). Adolescent disordered eating attitudes and behaviors were assessed using the Bulimia and Drive for Thinness scales of the Eating Disorder Inventory-2 (15–16 years). Depression and emotional control were examined at the same age using the Short Mood and Feelings Questionnaire, and an ATP-devised measure of emotional control. History of sexual abuse and physical punishment were assessed retrospectively (23–24 years) in a subsample of 467 of those providing DNA. Results: EDI-2 scores were associated with depression, emotional control, and retrospectively reported parental physical punishment. Although there was statistically significant moderation of the relationship between parental physical punishment and bulimic behaviors by 5-HTTLPR (p = 0.0048), genotypes in this subsample were not in Hardy–Weinberg Equilibrium. No other G×E interactions were significant. Conclusion: Findings from this study affirm the central importance of psychosocial processes in disordered eating patterns in adolescence. Evidence of moderation by 5-HTTLPR was not conclusive; however, genetic moderation observed in a subsample not in Hardy–Weinberg Equilibrium warrants further investigation.
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Affiliation(s)
- Vanja Rozenblat
- School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, ParkvilleVIC, Australia
| | - Joanne Ryan
- Murdoch Childrens Research Institute, Royal Children's Hospital Melbourne, ParkvilleVIC, Australia
| | - Eleanor H Wertheim
- School of Psychology and Public Health, Faculty of Health, La Trobe University, MelbourneVIC, Australia
| | - Ross King
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development, Deakin University, GeelongVIC, Australia
| | - Craig A Olsson
- Murdoch Childrens Research Institute, Royal Children's Hospital Melbourne, ParkvilleVIC, Australia.,School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development, Deakin University, GeelongVIC, Australia.,Department of Paediatrics, The Royal Children's Hospital Melbourne, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, ParkvilleVIC, Australia
| | - Isabel Krug
- School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, ParkvilleVIC, Australia
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18
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Remschmidt H. How Can We Prevent School Avoidance and Behavior Problems in Preschool Children? DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 112:645-646. [PMID: 26479483 PMCID: PMC4627208 DOI: 10.3238/arztebl.2015.0645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Helmut Remschmidt
- Department of Child and Adolescent Psychiatry, Philipps University, Marburg
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Michal M, Duven E, Giralt S, Dreier M, Müller KW, Adler J, Beutel ME, Wölfling K. Prevalence and correlates of depersonalization in students aged 12-18 years in Germany. Soc Psychiatry Psychiatr Epidemiol 2015; 50:995-1003. [PMID: 25201182 DOI: 10.1007/s00127-014-0957-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 08/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depersonalization (DP) involves unpleasant experiences of detachment from one's sense of self or unreality in the environment. DP may occur in a broad range of conditions, among healthy persons due to sleep loss, drug induced, secondary to anxiety disorders or primary in depersonalization disorder. Although DP has an early age of onset, little is known about the prevalence and correlates of DP among adolescents. METHODS Between January and June 2011, we conducted a questionnaire-based representative survey of pupils aged 12-18 years in the federal state Rhineland-Palatinate of Germany. The final sample comprised 3,809 pupils. We analyzed the prevalence of depersonalization and its correlates regarding sociodemographic characteristics, substance abuse, global mental distress and resilience factors. RESULTS One-third of the sample showed severe global mental distress, and 11.9 % were in the range of clinically significant depersonalization. Depersonalized students were less often living with both parents (67.3 vs. 75.7 %), came more often from an disadvantaged socioeconomic background, had a very severe level of global mental distress (comparable to psychiatric inpatients), were more often smoking and abusing cannabis and they suffered from specific impairments regarding social insecurity, global self-efficacy and active coping abilities. CONCLUSIONS Experiences of depersonalization were very common among adolescents and may indicate an increased risk for poor academic achievement and mental health in the long term. Prospective studies are needed to investigate the course and clinical relevance of depersonalization for the development of the adolescents.
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Affiliation(s)
- Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany,
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20
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Huang Y, Zhong XN, Li QY, Xu D, Zhang XL, Feng C, Yang GX, Bo YY, Deng B. Health-related quality of life of the rural-China left-behind children or adolescents and influential factors: a cross-sectional study. Health Qual Life Outcomes 2015; 13:29. [PMID: 25888732 PMCID: PMC4349722 DOI: 10.1186/s12955-015-0220-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 02/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to sustained export of labor service, the left-behind children/ adolescents in rural areas of China have become a group that can no longer be neglected. However, even up to this day, little is known about the health-related quality of life (HRQoL) of the left-behind children/adolescents, particularly in Midwest China. This study aims at investigating their living condition and analyzing the influential factors of their HRQoL. METHODS A cross-sectional study based on households was conducted and 1363 children or adolescents from rural areas of 6 provinces in China, among whom 608 were left-behind and 755 were non-left-behind, were enrolled in a multistage sampling. HRQoL was revealed using the Pediatric Quality of Life Inventory (PedsQL). Differences in scores were analyzed using rank sum tests, and multivariate analyses were conducted with multiple linear regression. RESULTS There was a total of 608 (44.61%) left-behind children or adolescents, and they scored significantly lower in terms of the HRQoL synthesis scores (F = 6.14, P < 0.05), Physical Functioning (H = 33.18, P < 0.05), Emotional Functioning (H = 24.99, P < 0.05) and Social Functioning (H = 12.24, P < 0.05), compared with the non-left-behind. Multiple linear regressions indicated that age and mother's final academic qualification were in positive correlation with the HRQoL of the left-behind children, while mother's longer migrant working time and less frequent visits, and being reared by uncle/aunt etc., were potential risk factors for the left-behind children. CONCLUSIONS The HRQoL scores of left-behind children or adolescents were significantly lower than those of their counterparts both in the physical and the psychological domains. Influential factors should be considered when relevant policies are being made and intervening practices are being undertaken in the future, so as to improve the HRQoL of the left-behind children or adolescents.
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Affiliation(s)
- Yun Huang
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Xiao-Ni Zhong
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Qing-Ying Li
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Dan Xu
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Xuan-Lin Zhang
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Chao Feng
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Guo-Xiu Yang
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Yun-Yun Bo
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Bing Deng
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
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Remschmidt H. Mental health and psychological illness in adolescence. DEUTSCHES ARZTEBLATT INTERNATIONAL 2013; 110:423-4. [PMID: 23840286 PMCID: PMC3705202 DOI: 10.3238/arztebl.2013.0423] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Helmut Remschmidt
- Department of Child and Adolescent Psychiatry, Philipps University, Marburg
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