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Jiang X, Zhang K. Family Environmental Risk and Perceived Stress in Adolescent Depressive Symptoms: A Network Analysis. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01719-w. [PMID: 38782807 DOI: 10.1007/s10578-024-01719-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
This study, grounded in the Process-Person-Context-Time framework, investigates the complex interplay of family environmental factors and their influence on adolescent depressive symptoms, focusing on the role of 'perceived stress'. Using network analysis, we examined data from 735 junior high students (52.1% female adolescents) from three provinces in China (Jiangsu, Shandong, and Henan), with an average age of 13.81 ± 0.92 years, ranging from 12 to 16 years, exploring the relationships between depressive symptoms, perceived stress, and seven family risk factors. The analysis identified three distinct communities. The incorporation of perceived stress led to its integration into a community that included depressive symptoms, parental restrictive monitoring, and family economic strain. Perceived stress emerged as the strongest predictor of depressive symptoms, surpassing parental restrictive monitoring. Furthermore, it overtook depressive symptoms as the node with the strongest bridging connection within its community. These findings underscore the importance of interventions targeting both family conditions and the internal processing of these stressors by adolescents, especially in challenging family environments, to mitigate the risk of depression and promote resilience.
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Affiliation(s)
- Xiaoliu Jiang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China
| | - Kuo Zhang
- Department of Social Psychology, School of Sociology, Nankai University, No. 38 Tongyan Road, Haihe Education Park, Tianjin, China.
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Petruzzelli MG, Marzulli L, Colacicco G, Tarantino F, Furente F, Gabellone A, Margari L, Matera E. Adolescent Mental Health: A Focus on Psychiatric Counseling from the Emergency Room of an Italian University Hospital in the Five Years from 2019 to 2023. Eur J Investig Health Psychol Educ 2024; 14:1248-1259. [PMID: 38785580 PMCID: PMC11119817 DOI: 10.3390/ejihpe14050082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/25/2024] Open
Abstract
Recent studies have revealed increasingly worse and more complex mental health conditions in young people, which is reflected in a growing trend in emergency room (ER) visits for acute psychopathological symptoms (APSs). This phenomenon has become exacerbated in recent decades, with a peak in the post-pandemic period. To better characterize the phenomenon, we investigated the change in the rate and type of ER counseling requests provided at the Child Neuropsychiatry Unit of the University Hospital of Bari, Italy over the period between 2019 and 2023 for subjects younger than 18 years old. For this purpose, we retrospectively analyzed a total number of 1073 urgent consultation reports retrieved through the reporting computerized operating system of our hospital. The distribution of the counseling requests provided for APSs and, among these, the distribution of the numbers of APSs and of the male: female ratio were significantly different over the years, with an increasing linear trend identified for APSs (p = 3.095 × 10-7), the average number of APSs (p = 3.598 × 10-7), and female gender prevalence (p = 0.03908), as well as for the patients with a history of psychotropic drug assumption (p = 0.0006319). A significant change in the number of urgent counseling requests received for eating disorders (p = 0.0007408), depression (p = 7.92 × 10-8), somatization (p = 4.03 × 10-6), self-harm (SA) (p = 1.358 × 10-6), and non-suicidal self-injury (NSSI) (p = 8.965 × 10-6) was found, with a significant increasing trend for anxiety (p = 0.0444), depression (p = 8.06 × 10-6), somatization (p = 0.004616), SA (p = 3.998 × 10-8), and NSSI (p = 5.074 × 10-7). The findings of our study support the hypothesis of an alarming progressive worsening of the mental health of children and adolescents, with an overlapping effect of the pandemic exacerbating the process.
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Affiliation(s)
- Maria Giuseppina Petruzzelli
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Lucia Marzulli
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Giuseppe Colacicco
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Fabio Tarantino
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Flora Furente
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Alessandra Gabellone
- Department of Translational Biomedicine and Neuroscience (DIBRAIN), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (M.G.P.); (G.C.); (F.T.)
| | - Lucia Margari
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (L.M.); (E.M.)
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Studies of Bari “Aldo Moro”, 70124 Bari, Italy; (L.M.); (E.M.)
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Busa F, Csima MP, Márton JA, Rozmann N, Pandur AA, Ferkai LA, Deutsch K, Kovács Á, Sipos D. Sleep Quality and Perceived Stress among Health Science Students during Online Education-A Single Institution Study. Healthcare (Basel) 2023; 12:75. [PMID: 38200981 PMCID: PMC10778774 DOI: 10.3390/healthcare12010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/14/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Recently, online education has been gaining prominence in university life. Our survey aimed to examine sleep quality and perceived stress levels among students at the University of Pécs Faculty of Health Sciences. A cross-sectional, quantitative, descriptive survey was conducted between February and March 2023. The online survey included the Hungarian versions of the internationally validated Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS). Statistical analysis involved descriptive statistics, independent t-tests, analysis of variance (ANOVA), and Mann-Whitney and Kruskal-Wallis tests (p < 0.05). We analyzed 304 responses, and females dominated (n = 270; 88.8%). Students in a relationship had significantly higher AIS scores (t = -2.470; p = 0.014). Medium average (2.50-3.49) students and those who rarely/never exercise showed significantly higher AIS and PSS (p ≤ 0.05). Students on the phone/watching a series during online education, daily laptop/TV use for more than 2 h, and pre-sleep use of smart devices for more than 60 min also negatively affected AIS and PSS scores (p ≤ 0.05). Nursing, physiotherapy, and radiography students were the most affected regarding insomnia and perceived stress (p ≤ 0.05). Our survey shows that excessive smart device use and lack of exercise are associated with higher stress levels and poorer sleep quality.
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Affiliation(s)
- Flóra Busa
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
| | - Melinda Petőné Csima
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Institute of Education, Hungarian University of Agriculture and Life Sciences, Guba Sándor Street 40, 7400 Kaposvár, Hungary
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
| | - Johanna Andrea Márton
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
| | - Nóra Rozmann
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
| | - Attila András Pandur
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Luca Anna Ferkai
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Krisztina Deutsch
- Faculty of Health Sciences, Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pécs, Hungary; (L.A.F.); (K.D.)
- Department of Oxyology, Faculty of Health Sciences, Emergency Care, University of Pécs, 7621 Pécs, Hungary;
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Nagyerdei 98, 4032 Debrecen, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (F.B.); (M.P.C.); (Á.K.)
- Faculty of Health Science, Doctoral School of Health Sciences, University of Pẻcs, Vörösmarty Street 4, 7621 Pẻcs, Hungary; (J.A.M.); (N.R.)
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Ranjani H, Jagannathan N, Rawal T, Vinothkumar R, Tandon N, Vidyulatha J, Mohan V, Gupta Y, Anjana RM. The impact of yoga on stress, metabolic parameters, and cognition of Indian adolescents: Cluster randomized controlled trial. Integr Med Res 2023; 12:100979. [PMID: 37601421 PMCID: PMC10432694 DOI: 10.1016/j.imr.2023.100979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Background This project aimed to assess the impact of yoga on stress, metabolic parameters and cognition (attention & concentration) in adolescents, aged 13-15 years from public and private schools in two cities (Chennai and New Delhi) in India. Methods The study recruited 2000 adolescents from 24 schools in a cluster randomized controlled trial design. The yoga group participants underwent 17 yoga sessions, which included: pranayama, basic asanas, meditation and relaxation exercises. Yoga sessions, were held in the school premises once a week. A total of five awareness talks on healthy lifestyle were delivered once a month to the education group. ADOlescence Stress Scale (ADOSS), salivary cortisol, metabolic and clinical parameters and Letter Cancellation Test (LCT) score were measured at baseline and post-intervention (5-6 months). Results The yoga group showed statistically significant differences in the mean ADOSS score, metabolic parameters, salivary cortisol, and LCT scores compared to the education group. In the intention- to- treat analysis, a significant reduction [5.11, 95% CI (4.78, 5.36), p = 0.001] in ADOSS score was seen in the yoga group compared to education. Conclusion Implementation of a 17-week standardized yoga program at the school level significantly decreased stress, improved attention and concentration, metabolic and clinical parameters in Indian adolescents. Trial registration Clinical Trials Registry, India (CTRI/2017/08/009203).
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Affiliation(s)
- Harish Ranjani
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
| | | | - Tina Rawal
- Health Related Information Dissemination Amongst Youth (India), Delhi, India
| | | | - Nikhil Tandon
- All India Institute of Medical Sciences, New Delhi, India
| | - Jayaram Vidyulatha
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
| | - Viswanathan Mohan
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
| | - Yashdeep Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Ranjit Mohan Anjana
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, India
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Has Anything Changed in the Frequency of Emergency Department Visits and the Profile of the Adolescent Seeking Emergency Mental Care during the COVID-19 Pandemic? CHILDREN 2023; 10:children10030578. [PMID: 36980136 PMCID: PMC10047842 DOI: 10.3390/children10030578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/22/2023]
Abstract
We described changes caused by the COVID-19 pandemic in the frequency of Emergency Department (ED) visits for mental health disorders (MHDs) in adolescents on a wider temporal range—that is, not just “the waves” of the pandemic—and characterized the profile of the adolescent seeking emergency psychiatric care. We conducted a retrospective longitudinal study by analyzing ED visits for MHDs from 10 March 2019 to 10 March 2021. A total of 1407 ED visits for MHDs were registered: 702 in the pre-COVID-19 and 707 in the COVID-19 period. The cumulative incidence of ED visits for MHDs was 1.22% in the pre-COVID-19 period and 1.77% in the COVID-19 period, with a statistically significant difference (p < 0.001). The principal characteristics of the adolescent with MHDs during the pandemic period: the odds of comorbidities decreased by 26% (p = 0.02), and the odds of transfer from other hospitals decreased by 71% (p < 0.001), while the odds of the ED presentation as first psychiatric episode were twice greater (p < 0.001). The risk of hospitalization increased by 54% (p = 0.001). Regarding psychopathology, the likelihood of attempted suicide increased by 74% during the pandemic (p = 0.02). The rate of mood and eating disorders grew significantly during the COVID-19 pandemic period (p = 0.005 and p = 0.031, respectively). Monitoring ED visits for MHDs and understanding changes in the profile of adolescents presenting to ED helps to reinforce the role of ED in identifying special clinical needs for these vulnerable patients in case of a future public health crisis.
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Zelviene P, Kairyte A, Dumarkaite A, Nomeikaite A, Kazlauskas E. Internet-based stress recovery intervention for adolescents: study protocol for a randomized controlled trial. Trials 2023; 24:174. [PMID: 36890560 PMCID: PMC9996863 DOI: 10.1186/s13063-023-07188-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Research reveals a high prevalence of stressors in adolescence. Mental health in adolescence is highly related to life-stressors exposure and difficulties in adjusting to stressors. Therefore, interventions for recovery from stress are in high demand. The study aims to evaluate the efficacy of the Internet-based stress recovery intervention for adolescents. METHODS A two-arm randomized controlled trial (RCT) on the efficacy of the FOREST-A-an Internet-based stress recovery intervention for adolescents-will be conducted. The FOREST-A is an adapted version of stress recovery intervention initially developed for healthcare workers. FOREST-A is a third-wave cognitive behavioral therapy and mindfulness-based Internet-delivered 4-week psychosocial intervention, which comprises six modules: Introduction, Relaxation, Psychological detachment, Mastery, Control, and Summary. The intervention will be evaluated using the two-arm RCT with intervention and care as usual (CAU) condition at pre-test, post-test, and 3-month follow-up. The measured outcomes will be stress recovery, adjustment disorder, generalized anxiety and depression symptoms, psychological well-being, and perceived positive social support. DISCUSSION The study will contribute to the development of Internet interventions-easily and broadly accessible tools-for the enhancement of adolescents' stress recovery skills. Based on the study's findings, further development of the FOREST-A, including upscaling and implementation, is foreseen. TRIAL REGISTRATION ClinicalTrials.gov NCT05688254. Registered on January 6, 2023.
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Affiliation(s)
- Paulina Zelviene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania.
| | - Agniete Kairyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| | - Austeja Dumarkaite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| | - Augustė Nomeikaite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, M. K. Ciurlionio str. 29, Vilnius, Lithuania
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Persistence of Anxiety/Depression Symptoms in Early Adolescence: A Prospective Study of Daily Life Stress, Rumination, and Daytime Sleepiness in a Genetically Informative Cohort. Twin Res Hum Genet 2022; 25:115-128. [PMID: 35856184 DOI: 10.1017/thg.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this prospective study of mental health, we examine the influence of three interrelated traits - perceived stress, rumination, and daytime sleepiness - and their association with symptoms of anxiety and depression in early adolescence. Given the known associations between these traits, an important objective is to determine the extent to which they may independently predict anxiety/depression symptoms. Twin pairs from the Queensland Twin Adolescent Brain (QTAB) project were assessed on two occasions (N = 211 pairs aged 9-14 years at baseline and 152 pairs aged 10-16 years at follow-up). Linear regression models and quantitative genetic modeling were used to analyze the data. Prospectively, perceived stress, rumination, and daytime sleepiness accounted for 8-11% of the variation in later anxiety/depression; familial influences contributed strongly to these associations. However, only perceived stress significantly predicted change in anxiety/depression, accounting for 3% of variance at follow-up after adjusting for anxiety/depression at baseline, although it did not do so independently of rumination and daytime sleepiness. Bidirectional effects were found between all traits over time. These findings suggest an underlying architecture that is shared, to some degree, by all traits, while the literature points to hypothalamic-pituitary-adrenal (HPA) axis and/or circadian systems as potential sources of overlapping influence and possible avenues for intervention.
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