European Child & Adolescent Psychiatry最新文献

Predictors for the pharmacological effect of ADHD medication in children and adolescents are lacking. This study examined clinically relevant factors in a large (N = 638) prospective cohort reflecting real-world evidence. Children and adolescents aged 6-17 diagnosed with ADHD were evaluated at baseline and three months following ADHD medication initiation. The outcome was measured as a reduction in total SNAP-IV (Swanson Nolan and Pelham teacher and parent rating scale) score at three months compared to baseline. Outcome groups were defined as Responders (≥ 40% reduction), Intermediate Responders (≥ 20 to < 40% reduction), and Non-responders (< 20% reduction). Included independent variables were the Autism Spectrum Questionnaire (ASSQ), the Spence Children's Anxiety Scale (SCAS), the Pediatric Side Effect Checklist (P-SEC), anthropometrics measures, geographical region, relative age, Children´s Global Assessment Scale (CGAS), Intelligence quotient (IQ), pharmacological treatment initiation month, ADHD symptom severity, ADHD presentation, and psychotic-like experiences. Multinomial logistic regression suggested that ADHD symptom severity, region, relative age, and stating ADHD medication at three-month follow-up were associated with the response outcome group. However, when validating the data with Bootstrap Forest, none of the variables were significant. Thus, in our large naturalistic cohort, we could not identify any clinically relevant factors that reliably predict pharmacological treatment outcomes.Trial registration: NCT02136147.

Mixed results have been reported regarding the link between different types of maternal diabetes and attention deficit hyperactivity disorder (ADHD) in offspring. Hence, we conducted a systematic review and meta-analysis to explore these associations. Relevant studies on the subject were retrieved from six major databases, including PubMed, Medline, Embase, Scopus, CINAHL, and PsychINFO. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa Scale, and between-study heterogeneity was assessed using the I2 statistic. Subgroup, sensitivity, and meta-regression analyses were conducted to identify the sources of heterogeneity between studies. In total, seventeen observational studies (five case-control and twelve cohort studies) with 18,063,336 study participants were included in the final analysis. Our random-effects meta-analysis revealed that exposure to any form of maternal diabetes was associated with an increased risk of ADHD in children. Specifically, we observed a heightened risk of ADHD in children exposed to gestational diabetes mellitus, any pre-existing diabetes, pre-existing type 1 diabetes mellitus, and type 2 diabetes mellitus. Our study suggests that children exposed to diabetes during prenatal development are at a higher risk of developing ADHD. These findings underscore the critical importance of early screening and timely interventions for exposed offspring.

Objective: This study aimed to investigate the longitudinal bi-directional relationship between self-reported restrictive eating behaviours and sleep characteristics within a sample of UK adolescents from the Millennium Cohort Study (MCS).

Method: Using a Structural Equation Modelling approach, the present study investigated the prospective associations between individual sleep behaviours (e.g., sleep timing, sleep onset latency, social jetlag) at age 14 and restrictive eating behaviours at age 17. Moreover, the association between restrictive eating behaviours (age 14) and self-reported sleep quality (age 17) was tested. A mediation analysis was conducted to explore the role of depressive symptoms in these relationships. In total, N = 6,041 young people provided self-report data at both timepoints (sweep 6 & 7) and a subsample of N = 2,164 additionally provided diary data on their sleep behaviours over two separate 24 h periods.

Results: Sleep indicators at age 14 did not significantly predict changes in restrictive eating behaviours across time. However, engagement in restrictive eating behaviours at age 14 significantly predicted poorer self-perceived sleep quality three years later (β = 0.06, SE = 0.01, p <.01). Depressive symptoms fully mediated this relationship (indirect effect: β = 0.05, SE = 0.04, p <.001).

Discussion: The present study provides evidence for a prospective positive association between restrictive eating behaviours and subsequent poorer sleep quality in a large, general population sample. Findings of the mediation analysis suggest mood as a potential target for tertiary prevention when addressing restrictive eating behaviours as an eating disorder risk factor in adolescents.

Various interventions, including caregiver education, psychoeducation, teacher and clinician training and behavioral management embedded with education, are available to enhance awareness and knowledge among caregivers, teachers, and clinicians. This review synthesizes evidence on the effectiveness and cost-effectiveness of interventions to increase ADHD awareness and knowledge for caregivers, clinicians, and teachers. Peer-reviewed literature was identified through the systematic searches of six databases: MEDLINE Complete, APA PsycInfo, CINAHL Complete, ERIC, Global Health and EconLit. Two independent reviewers completed a two-stage screening process and quality assessment. Results are presented as a narrative synthesis. Economic evaluation study cost data were converted for comparability. Of the 5963 results, 28 studies were included. Most interventions were found to be effective in increasing the awareness and knowledge of ADHD among caregivers, clinicians, and teachers. Clinician knowledge and capacity to assess, diagnose and treat ADHD were improved. Of the economic evaluation studies, interventions were promising in parent education, and behavioral management and psychosocial therapy interventions were found to be cost-effective. The review provides important insights about effective and cost-effective interventions to increase ADHD awareness and knowledge. These insights are critical to effectively plan services/interventions for families and children with ADHD. Further research in economic evaluation of interventions is needed to assist policy-decision making.

We investigated whether there is an emotional processing deficit in ADHD and whether this only applies to specific emotional categories. In this PRISMA-compliant systematic review based on a pre-registered protocol ( https://osf.io/egp7d ), we searched MEDLINE, PsycINFO, ERIC, Scopus and Web of Science databases until 3rd December 2023, to identify empirical studies comparing emotional processing in individuals meeting DSM (version III to 5-TR) or ICD (version 9 or 10) criteria for Attention Deficit/Hyperactivity Disorder (ADHD) and in a non-psychiatric control group. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Eighty studies were included and meta-analysed (encompassing 6191 participants and 465 observations). Bayesian meta-analyses were conducted to compare individuals with ADHD and non-psychiatric controls on overall emotional processing measures (meta-analysis 1) and across emotional categories (meta-analysis 2). The type of stimulus employed, outcome measurement reported, age, sex, and medication status were analysed as moderators. We found poorer performance in both overall emotion processing (g =  - 0.65) and across emotional categories (anger g =  - 0.37; disgust g =  - 0.24; fear g =  - 0.37; sadness g =  - 0.34; surprise g =  - 0.26; happiness/positive g =  - 0.31; negative g =  - 0.20; neutral g =  - 0.25) for individuals with ADHD compared to non-psychiatric controls. Scales items and accuracy outcome being the most effective moderators in detecting such differences. No effects of age, sex, or medication status were found. Overall, these results show that impaired emotional processing is a relevant feature of ADHD and suggest that it should be systematically assessed in clinical practice.

Emerging evidence suggests aberrant functional connectivity (FC) of brain networks in children, adolescents, and adults with autism spectrum disorder (ASD). However, little is known about alterations of dynamic FC in toddlers with ASD. The aim of this study was to investigate the characteristics of brain network dynamics in ASD toddlers. We analyzed resting-state functional magnetic resonance imaging data of 41 ASD and 23 typically-developing (TD) toddlers aged 15-45 months using leading eigenvector dynamics analysis. The between-group differences in the temporal properties of state were evaluated, followed by correlation analysis of these differences with autistic factors in ASD. Compared with TD subjects, ASD toddlers had a lower occurrence rate and mean dwell time in the global state. The mean dwell time of this state was negatively correlated with the body and object use of the autism behavior checklist (ABC) score. The ASD group presented a higher occurrence probability in the state related to the visual network, and the dwell time of this state was positively correlated with the relationship building of the ABC score. Moreover, the occurrence probability of the state related to the dorsal attention network and default mode network was positively correlated with the body and object use of the ABC score. Our findings indicate that there are differences in the developmental patterns of large-scale brain functional networks in ASD toddlers, which may contribute to the early identification of ASD and provide meaningful insights into its potential neural mechanisms.

Suicide and self-harm are a leading cause of death globally, with females aged 15-24 years being a high-risk group requiring urgent intervention. Promoting mental health literacy is a well-established strategy for early intervention. No review has explored the available interventions promoting mental health literacy for female adolescents and their reach, effectiveness, adoption, implementation, and maintenance as a whole remains unknown. This study reviews existing interventions promoting mental health literacy in female adolescents. Searches included original peer-reviewed articles from inception to May 2024 across six databases, identifying twelve studies for review. Five independent meta-analyses were conducted, showing no significant effects immediately post-intervention for mental health literacy, knowledge, stigmatising attitudes, and help-provision. A significant reduction in stigmatising attitudes was found > 6 months post-intervention. Moderation analyses could not be performed due to insufficient data. None of the included studies reported on interventions specifically for female adolescents. This review also evaluated reporting of RE-AIM components, finding limited reporting on reach, adoption, and maintenance. These findings highlight a substantial gap in high-impact and tailored mental health prevention and promotion interventions for female adolescents. Therefore, there is a clear need to understand and target female adolescents' mental health literacy needs to develop and implement more effective interventions.