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Brief Report: A population-based study of the impact of the COVID-19 pandemic on benzodiazepine use among children and young adults. 简要报告:关于 COVID-19 大流行对儿童和青少年使用苯并二氮杂卓的影响的人口研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-07 DOI: 10.1007/s00787-024-02531-6
Tony Antoniou, Kathleen Pajer, William Gardner, Melanie Penner, Yona Lunsky, Daniel McCormack, Mina Tadrous, Muhammad Mamdani, Peter Gozdyra, David N Juurlink, Tara Gomes

The COVID-19 pandemic was associated with increases in the prevalence of depression and anxiety among children and young adults. We studied whether the pandemic was associated with changes in prescription benzodiazepine use. We conducted a population-based study of benzodiazepine dispensing to children and young adults ≤ 24 years old between January 1, 2013, and June 30, 2022. We used structural break analyses to identify the pandemic month(s) when changes in prescription benzodiazepine dispensing occurred, and interrupted time series models to quantify changes in dispensing following the structural break and compare observed and expected benzodiazepine use. A structural break occurs where there is a sudden change in the trend of a time series. We observed an immediate decline in benzodiazepine dispensing of 23.6 per 100,000 (95% confidence interval [CI]: -33.6 to -21.2) associated with a structural break in April 2020, followed by a monthly decrease in the trend of 0.3 per 100,000 (95% CI: -0.74 to 0.14). Lower than expected benzodiazepine dispensing rates were observed each month of the pandemic from April 2020 onward, with relative percent differences ranging from - 7.4% (95% CI: -10.1% to - 4.7%) to -20.9% (95% CI: -23.2% to -18.6%). Results were generally similar in analyses stratified by sex, age, neighbourhood income quintile, and urban versus rural residence. Further research is required to understand the clinical implications of these findings and whether these trends were sustained with further follow-up.

COVID-19 大流行与儿童和年轻人抑郁和焦虑患病率的增加有关。我们研究了大流行是否与苯二氮卓处方药使用的变化有关。我们对 2013 年 1 月 1 日至 2022 年 6 月 30 日期间 24 岁以下儿童和年轻人的苯二氮卓配药情况进行了一项基于人群的研究。我们使用结构性中断分析来确定苯二氮卓处方配药量发生变化的流行月份,并使用间断时间序列模型来量化结构性中断后的配药量变化,并比较观察到的苯二氮卓药使用量和预期的苯二氮卓药使用量。当时间序列的趋势发生突然变化时,就会出现结构性中断。我们观察到,与 2020 年 4 月的结构性中断有关,苯二氮卓的配药量立即下降了 23.6/100,000(95% 置信区间 [CI]:-33.6 至 -21.2),随后趋势每月下降 0.3/100,000(95% 置信区间 [CI]:-0.74 至 0.14)。自 2020 年 4 月起,大流行期间每月观察到的苯并二氮杂卓配药率均低于预期,相对百分比差异从-7.4%(95% CI:-10.1% 至-4.7%)到-20.9%(95% CI:-23.2% 至-18.6%)不等。按性别、年龄、社区收入五分位数以及城市与农村居住地进行分层分析的结果基本相似。要了解这些研究结果的临床意义,以及这些趋势是否会随着进一步的随访而持续,还需要进一步的研究。
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引用次数: 0
Medication adherence and persistence in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and qualitative update. 注意缺陷多动障碍(ADHD)儿童和青少年的用药依从性和持久性:系统回顾和定性更新。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-06 DOI: 10.1007/s00787-024-02538-z
Maite Ferrin, Alexander Häge, James Swanson, Kirstie H T W Wong, Ralf W Dittmann, Tobias Banaschewski, David Coghill, Paramala J Santosh, Marcel Romanos, Emily Simonoff, Jan K Buitelaar

Low medication-adherence and persistence may reduce the effectiveness of ADHD-medication. This preregistered systematic review (PROSPERO CRD42020218654) on medication-adherence and persistence in children and adolescents with ADHD focuses on clinically relevant questions and extends previous reviews by including additional studies. We included a total of n = 66 studies. There was a lack of consistency in the measurement of adherence/persistence between studies. Pooling the medication possession ratios (MPR) and using the most common adherence definition (MPR ≥ 80%) indicated that only 22.9% of participants had good adherence at 12-month follow-up. Treatment persistence on medication measured by treatment duration during a 12-month follow-up averaged 170 days (5.6 months). Our findings indicate that medication-adherence and persistence among youth with ADHD are generally poor and have not changed in recent years. Clinicians need to be aware that various factors may contribute to poor adherence/persistence and that long-acting stimulants and psychoeducational programs may help to improve adherence/persistence. However, the evidence to whether better adherence/persistence contributes to better long-term outcomes is limited and requires further research.

用药依从性和持续性低可能会降低多动症药物治疗的效果。这篇预先注册的系统性综述(PROSPERO CRD42020218654)针对患有多动症的儿童和青少年的用药依从性和持续性问题,重点关注与临床相关的问题,并通过纳入更多研究对之前的综述进行了扩展。我们共纳入了 n = 66 项研究。不同研究对依从性/持续性的测量缺乏一致性。汇总药物持有率(MPR)并使用最常见的依从性定义(MPR ≥ 80%)表明,在 12 个月的随访中,仅有 22.9% 的参与者具有良好的依从性。在 12 个月的随访中,根据治疗持续时间衡量的药物治疗持续时间平均为 170 天(5.6 个月)。我们的研究结果表明,患有多动症的青少年的服药依从性和持续性普遍较差,且近年来没有改变。临床医生需要意识到,各种因素都可能导致服药依从性/持久性差,而长效兴奋剂和心理教育计划可能有助于提高服药依从性/持久性。但是,更好的依从性/持久性是否有助于获得更好的长期疗效,这方面的证据还很有限,需要进一步研究。
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引用次数: 0
Hospital admissions in adolescents with mental disorders in Spain over the last two decades: a mental health crisis? 过去二十年西班牙精神失常青少年的入院情况:精神健康危机?
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-04 DOI: 10.1007/s00787-024-02543-2
Vicente Soriano, José Manuel Ramos, María Inés López-Ibor, Carlos Chiclana-Actis, Manuel Faraco, Joaquín González-Cabrera, Eduardo González-Fraile, Gemma Mestre-Bach, Héctor Pinargote, Manuel Corpas, Lucía Gallego, Octavio Corral, Hilario Blasco-Fontecilla

Mental disorders account for a large and increasing health burden worldwide. Characterizing the spectrum of mental disorders and trends over time in adolescents should influence education policies and support preventative strategies at schools. Retrospective study of all hospitalizations in Spain in adolescents 11-18-years old, including mental disorders as diagnosis using the Spanish National Registry of Hospital Discharges. Information was retrieved from 2000 to 2021. During the 22-year study period there were 2,015,589 hospitalizations in adolescents in Spain, of which 118,609 (5.9%) had mental disorders. The rate of psychiatric diagnoses significantly increased from 3.9% in 2000 to 9.5% in 2021. Females accounted for 55.1% of admissions. Mean age at admission declined from 17 to 15 years-old from 2000 to 2021. Mean hospital stay was 10.6 days. Mean in-hospital mortality was 0.24%. By rate order, diagnoses were: substance use disorders (SUD) (40%) > eating disorders (15%) > anxiety/posttraumatic stress disorder (PTSD) (13%) > attention deficit hyperactivity disorder (ADHD) (9%) > major depression (8%) > schizophrenia/psychosis (6%) > autism spectrum disorder (ASD) (6%) > sleep disorder (3%) > suicidal behavior (2%) > sexual disorders (1%). A significant gender dichotomy was noticed, with female predominance for internalizing disorders (i.e., anxiety, depression, suicidal behavior and eating disorders) whereas externalizing disorders (i.e., SUD, ADHD, ASD, schizophrenia and other psychoses) predominated in males. Suicidal behavior and male sex were independent predictors of in-hospital death in multivariate analysis. After the first year of the COVID-19 pandemic, hospitalizations due to mental disorders in adolescents increased by 51% in 2021. There is a growing crisis of mental health among adolescents in Spain. Although the COVID-19 pandemic has unveiled the high rate and severity of psychiatric disorders among youth, a steadily increase has occurred since the beginning of the millennium. Primary preventative strategies should be adapted to distinct and more prevalent mental disorders in adolescents.

精神障碍给全世界造成了巨大的健康负担,而且这种负担还在不断加重。了解青少年精神障碍的范围和发展趋势,将对教育政策产生影响,并对学校的预防策略提供支持。这项回顾性研究利用西班牙全国出院登记系统,对西班牙所有 11-18 岁青少年的住院情况进行了调查,包括精神障碍诊断。信息检索时间为 2000 年至 2021 年。在 22 年的研究期间,西班牙共有 2,015,589 名青少年住院,其中 118,609 人(5.9%)患有精神障碍。精神病诊断率从 2000 年的 3.9% 大幅上升至 2021 年的 9.5%。女性占入院人数的 55.1%。入院时的平均年龄从 2000 年的 17 岁降至 2021 年的 15 岁。平均住院时间为 10.6 天。平均住院死亡率为 0.24%。按比例排序,诊断结果为:药物使用障碍(SUD)(40%)>进食障碍(15%)>焦虑/创伤后应激障碍(PTSD)(13%)>注意缺陷多动障碍(ADHD)(9%)>重度抑郁症(8%)>精神分裂症/精神病(6%)>自闭症谱系障碍(ASD)(6%)>睡眠障碍(3%)>自杀行为(2%)>性障碍(1%)。我们注意到一个明显的性别二分法,内化障碍(即焦虑、抑郁、自杀行为和进食障碍)以女性为主,而外化障碍(即自闭症、多动症、自闭症、精神分裂症和其他精神病)则以男性为主。在多变量分析中,自杀行为和男性性别是院内死亡的独立预测因素。在 COVID-19 大流行的第一年之后,2021 年青少年因精神障碍住院的人数增加了 51%。西班牙青少年的心理健康危机日益严重。尽管 COVID-19 大流行揭示了青少年精神疾病的高发率和严重性,但自本世纪初以来,青少年精神疾病的发病率持续上升。初级预防战略应针对青少年中更常见的不同精神疾病进行调整。
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引用次数: 0
Psychopathology of cognitive disengagement syndrome (CDS): a network analysis based on CBCL scales in 72,106 Chinese school students 认知脱离综合征(CDS)的精神病理学:基于 72 106 名中国中小学生 CBCL 量表的网络分析
IF 6.4 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-03 DOI: 10.1007/s00787-024-02540-5
Zhongliang Jiang, Hui Xu, Xianbin Wang, Wenyan Zhang, Anyi Zhang, Liping Yu, Shujin Hu, Kai Yang, Qinghao Yang, Yanlin Li, Yonghua Cui, Ying Li

Cognitive Disengagement Syndrome (CDS) is a cluster of behavioral problems that severely affect an individual's functioning. Currently, there is no consensus on the main clinical features of CDS, and further exploration in large samples is needed. Using a cluster-stratified random sampling method, 72,106 children and adolescents were recruited from five provinces in mainland China for this study. Using both the traditional two-factor scoring method and the CBCL DSM-oriented scales, we assessed individual behavioral problems from psychopathological and DSM-oriented perspectives. Network analysis was employed to explore the relationship between CDS and behavioral problems. The various networks were compared by gender and age subgroups. Among 72,106 participants (mean age, 11.49 years; minimum age, 5 years; maximum age, 16 years), there were 36,449 males (50.5%) and 35,657 females (49.5%). From a psychopathological perspective, the motor symptoms node was associated with the sad node and the withdrawn node, while the cognitive symptoms node was linked to the nervous node and the self-conscious node. In terms of gender, males had stronger associations of the motor symptoms node with the sad node and the withdrawn node than females (P = 0.043), and weaker associations of the cognitive symptoms node with the nervous node than females (P = 0.027). In terms of growth stage, the adolescent group had stronger associations of the cognitive symptoms node with the nervous node and the self-conscious node than the child group (P = 0.016, 0.001). From DSM perspective, motor symptoms node were associated with sad node, and cognitive symptoms node were related to can't concentrate node, nervous node, and worthless node. With increasing age, there was an upward trend in the strength of the cognitive and motor symptoms node. CDS is closely linked to psychological and behavioral issues, especially internalizing problems, with differences observed by gender and growth stage. The connection between CDS and the affective, anxiety, and ADH symptoms is particularly pronounced.

认知分离综合症(CDS)是严重影响个体功能的一组行为问题。目前,人们对 CDS 的主要临床特征尚未达成共识,需要在大样本中进行进一步探索。本研究采用集群分层随机抽样方法,从中国大陆五个省份招募了 72106 名儿童和青少年。我们使用传统的双因素计分法和CBCL DSM导向量表,从精神病理学和DSM导向的角度对个体行为问题进行了评估。我们采用网络分析法来探讨CDS与行为问题之间的关系。我们按性别和年龄分组对各种网络进行了比较。在 72 106 名参与者(平均年龄 11.49 岁;最小年龄 5 岁;最大年龄 16 岁)中,男性有 36 449 人(占 50.5%),女性有 35 657 人(占 49.5%)。从心理病理学角度来看,运动症状节点与悲伤节点和孤僻节点相关,而认知症状节点则与紧张节点和自我意识节点相关。在性别方面,男性运动症状节点与悲伤节点和孤僻节点的关联比女性强(P = 0.043),而认知症状节点与紧张节点的关联比女性弱(P = 0.027)。从成长阶段来看,青少年组认知症状节点与紧张节点和自我意识节点的关联强于儿童组(P = 0.016,0.001)。从 DSM 角度看,运动症状节点与悲伤节点相关,认知症状节点与无法集中精力节点、紧张节点和无价值节点相关。随着年龄的增长,认知症状和运动症状节点的强度呈上升趋势。CDS 与心理和行为问题,尤其是内化问题密切相关,不同性别和成长阶段的儿童在这方面存在差异。CDS 与情感、焦虑和 ADH 症状之间的联系尤为明显。
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引用次数: 0
Childhood obesity and adolescent follow-up depressive symptoms: exploring a moderated mediation model of body esteem and gender. 儿童肥胖症与青少年后续抑郁症状:探索身体自尊与性别的调节中介模型。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-02-07 DOI: 10.1007/s00787-023-02348-9
Lucia Beltrán-Garrayo, Junilla K Larsen, Rob Eisinga, Jacqueline M Vink, Miriam Blanco, Montserrat Graell, Ana Rosa Sepúlveda

Obesity is a well-recognized risk factor for adolescent depressive symptoms, but mediating mechanisms of this association have scarcely been studied. This study is unique in examining an indirect pathway of this link via body esteem (BE) prospectively from childhood (8-12 years) to adolescence (13-18 years). In addition, potential gender moderation was examined. This study utilized data from a case-control study comparing 100 children with and without obesity matched on important confounders (age, gender, and socioeconomic status). Our findings provide support for the mediating role of BE in the link between childhood weight status and adolescent depressive symptoms at a 5-year follow-up. This mediation effect did not differ between boys and girls. The findings suggest the relevance of specifically targeting children's BE in preventive intervention programs among children with obesity to prevent future mental health problems.

肥胖是导致青少年抑郁症状的一个公认的危险因素,但很少有人研究过这种关联的中介机制。本研究通过身体自尊(BE),前瞻性地研究了从童年(8-12 岁)到青春期(13-18 岁)这一关联的间接途径。此外,还研究了潜在的性别调节因素。这项研究利用了一项病例对照研究的数据,对 100 名患有和未患有肥胖症的儿童进行了比较,并对重要的混杂因素(年龄、性别和社会经济地位)进行了匹配。我们的研究结果证明,在为期 5 年的随访中,BE 在儿童体重状况与青少年抑郁症状之间起着中介作用。这种中介效应在男孩和女孩之间没有差异。研究结果表明,在肥胖儿童的预防干预计划中,专门针对儿童的BE来预防未来的心理健康问题是有意义的。
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引用次数: 0
Why we should focus more attention on uncertainty distress and intolerance of uncertainty in adolescents and emerging adults. 我们为什么要更多地关注青少年和新成人的不确定性困扰和对不确定性的不容忍?
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2023-12-06 DOI: 10.1007/s00787-023-02343-0
Gioia Bottesi

Sivertsen et al. (2023) showed that adolescents endorsing high levels of internalizing and externalizing symptoms are at risk of increased mental health problems during emerging adulthood and suggested the existence of both homotypic and heterotypic continuities of mental disorders over time. Since adolescence and emerging adulthood are transition periods highly intertwined with uncertainty, the present perspective contextualizes the findings by Sivertsen et al. (2023) in relation to the extant literature on intolerance of uncertainty and the recently developed Uncertainty Distress Model. Moreover, it claims for further research addressing the way adolescents and emerging adults process and deal with uncertainty. Indeed, focusing more attention on the implications of trans-situational and trans-diagnostic constructs such as uncertainty distress and intolerance of uncertainty in these life stages may hold great promise to design and implement effective mental health prevention programs.

Sivertsen 等人(2023 年)的研究表明,内化症状和外化症状水平较高的青少年在成年期有可能出现更多的心理健康问题,并提出心理障碍存在同型和异型的长期连续性。由于青春期和成年期是与不确定性高度交织的过渡时期,本视角将 Sivertsen 等人(2023 年)的研究结果与现有的不确定性不容忍文献和最近开发的不确定性压力模型联系起来。此外,它还要求进一步研究青少年和新成人处理和应对不确定性的方式。事实上,更多地关注不确定性困扰和对不确定性的不容忍等跨情境和跨诊断结构在这些人生阶段的影响,可能会为设计和实施有效的心理健康预防计划带来巨大的希望。
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引用次数: 0
Are the children alright? A systematic review of psychological adjustment of children conceived by assisted reproductive technologies. 孩子们还好吗?辅助生殖技术受孕儿童心理调适的系统回顾。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2022-12-29 DOI: 10.1007/s00787-022-02129-w
Francis Anne Teplitzky Carneiro, Valéria Leong, Sara Nóbrega, Fernando Salinas-Quiroz, Pedro Alexandre Costa, Isabel Leal

The present systematic review aims to assess the psychological adjustment of children born through assisted reproductive technologies (ARTs) and to screen for clinical problems when compared with normative data from the standardized indexes of mental health. Following PRISMA guidelines, the search was conducted from inception through September 2021 using APA PsycInfo, APA PsycArticles, Psychology and Behavioural Sciences Collection, Academic Search Complete, Pubmed, Scopus, Web of Science, Scielo, and RCAAP. Search terms related to ART and children's psychological adjustment were combined to Boolean operators to identify relevant published studies in English, French, Italian, Portuguese and Spanish. Peer-reviewed studies focused on the psychological adjustment of ART children aged between the 3 and 11 years were included. From a total of 337 results, 45 papers were eligible to be included in this review. Data extraction was performed independently by two authors and revised and confirmed by other two authors. All children scored below the clinical range for psychiatric symptoms when compared with normative data for the Strengths and Difficulties Questionnaire (SDQ) or the Achenbach System of Empirically Based Assessment (ASEBA), regardless of type of ART and different family configurations. Further, some evidence suggests that surrogacy children with gay fathers present the lowest levels of psychological problems when compared to normative data. These findings enable practitioners to develop an informed view of ART children mental health outcomes to help parents find more adaptive strategies to navigate their chosen pathways in healthier ways.

本系统综述旨在评估通过辅助生殖技术(ART)出生的儿童的心理适应情况,并与心理健康标准化指数的常模数据进行比较,筛查临床问题。根据 PRISMA 指南,我们使用 APA PsycInfo、APA PsycArticles、Psychology and Behavioural Sciences Collection、Academic Search Complete、Pubmed、Scopus、Web of Science、Scielo 和 RCAAP 进行了从开始到 2021 年 9 月的检索。与抗逆转录病毒疗法和儿童心理适应能力相关的搜索词与布尔运算符相结合,以确定以英语、法语、意大利语、葡萄牙语和西班牙语发表的相关研究。经同行评审的研究主要关注 3 至 11 岁 ART 儿童的心理适应问题。在总共 337 项结果中,有 45 篇论文符合纳入本综述的条件。数据提取由两位作者独立完成,并由另外两位作者进行修改和确认。与优势与困难问卷(SDQ)或阿亨巴赫实证评估系统(ASEBA)的常模数据相比,所有儿童的精神症状得分均低于临床范围,而与 ART 的类型和不同的家庭结构无关。此外,一些证据表明,与常模数据相比,父亲为同性恋者的代孕子女的心理问题水平最低。这些发现使从业人员能够对 ART 儿童心理健康结果形成一个明智的观点,以帮助父母找到更多的适应策略,以更健康的方式引导他们所选择的途径。
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引用次数: 0
Cool and hot executive function problems in young children: linking self-regulation processes to emerging clinical symptoms. 幼儿的冷热执行功能问题:将自我调节过程与新出现的临床症状联系起来。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-01-06 DOI: 10.1007/s00787-023-02344-z
Kate L Anning, Kate Langley, Christopher Hobson, Stephanie H M van Goozen

Self-regulation (SR) difficulties are implicated in a wide range of disorders which develop in childhood, including attention deficit hyperactivity disorder (ADHD), oppositional defiance disorder (ODD), anxiety and depression. However, the integration of the existing research evidence is challenging because of varying terminology and the wide range of tasks used, as well as the heterogeneity and comorbidity within and across diagnostic categories. The current study used the Research Domain Criteria (RDoC) framework to guide the examination of different SR processes in young children showing a wide range of symptomatology. Children (aged 4-8) referred by teachers for moderate-to-high conduct, hyperactivity and/or emotional problems at school (assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales; n = 212), and children in SDQ typical ranges (n = 30) completed computerised cognitive control and decision-making tasks. Parents completed questionnaires to assess ADHD, ODD, anxiety and depression symptoms (n = 191). Compared to children with no teacher-reported difficulties, those with moderate-to-high problems showed poorer visuomotor control and decision-making. A factor analysis revealed that task variables adhered to RDoC dimensions and predicted variance in specific disorders: difficulties in cognitive control predicted ADHD symptoms, low reward-seeking was associated with depression and high reward-seeking was associated with ODD. This study highlights how the assessment of cognitive processes positioned within the RDoC framework can inform our understanding of disorder-specific and transdiagnostic difficulties in SR which are associated with diverse clinical symptoms in children.

自我调节(SR)障碍与儿童期出现的多种疾病有关,包括注意力缺陷多动障碍(ADHD)、对立违抗障碍(ODD)、焦虑症和抑郁症。然而,由于术语不同、使用的任务范围广泛,以及诊断类别内部和之间的异质性和合并性,整合现有研究证据具有挑战性。本研究使用研究领域标准(RDoC)框架来指导对表现出各种症状的幼儿的不同 SR 过程进行检查。由教师转介的在学校有中度至高度行为、多动和/或情绪问题的儿童(4-8 岁)(使用优势与困难问卷(SDQ)分量表进行评估;n = 212)和 SDQ 典型范围内的儿童(n = 30)完成了计算机化的认知控制和决策任务。家长填写了评估多动症、注意力缺失症、焦虑症和抑郁症状的问卷(n = 191)。与没有教师报告困难的儿童相比,有中度至高度问题的儿童在视觉运动控制和决策方面表现较差。因子分析显示,任务变量与 RDoC 维度一致,并可预测特定障碍的差异:认知控制困难可预测多动症症状,低寻求奖赏与抑郁症相关,而高寻求奖赏与 ODD 相关。本研究强调了在 RDoC 框架内对认知过程进行评估,可以帮助我们了解 SR 中与特定障碍和跨诊断障碍相关的困难,这些困难与儿童的各种临床症状有关。
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引用次数: 0
Association between telomere length and neuropsychological function at 4-5 years in children from the INMA project: a cross-sectional study. INMA项目中儿童端粒长度与4-5岁时神经心理功能之间的关系:一项横断面研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2024-01-22 DOI: 10.1007/s00787-023-02361-y
Irene Campos-Sánchez, Eva María Navarrete-Muñoz, Miriam Hurtado-Pomares, Jordi Júlvez, Nerea Lertxundi, Dries S Martens, Ana Fernández-Somoano, Isolina Riaño-Galán, Mònica Guxens, Jesús María Ibarluzea, Tim Nawrot, Desirée Valera-Gran

Shortened telomere length (TL) has been associated with lower cognitive performance, different neurological diseases in adults, and certain neurodevelopmental disorders in children. However, the evidence about the association between TL and neuropsychological developmental outcomes in children from the general population is scarce. Therefore, this study aimed to explore the association between TL and neuropsychological function in children 4-5 years of age. We included 686 children from the INMA Project, a population-based birth cohort in Spain. Leucocyte TL was determined by quantitative PCR method, and neuropsychological outcomes were measured using the McCarthy Scales of Children's Abilities (MCSA). Multiple linear regression models were used to estimate associations adjusted for potential confounding variables. Main findings showed that a longer TL was associated with a higher mean working memory score (β = 4.55; 95% CI = 0.39, 8.71). In addition, longer TL was associated with a higher mean global quantitative score (β = 3.85; 95% CI = -0.19, 7.89), although the association was marginally significant. To our knowledge, this is the first study that shows a positive association between TL and better neuropsychological outcomes in children. Although further research is required to confirm these results, this study supports the hypothesis that TL is essential in protecting and maintaining a child's health, including cognitive functions such as working memory.

端粒长度(TL)缩短与认知能力下降、成人不同的神经系统疾病以及儿童某些神经发育障碍有关。然而,有关端粒长度与普通人群中儿童神经心理发育结果之间关系的证据却很少。因此,本研究旨在探讨 TL 与 4-5 岁儿童神经心理功能之间的关系。我们纳入了来自 INMA 项目的 686 名儿童,该项目是西班牙一个基于人口的出生队列。通过定量 PCR 方法测定了白细胞 TL,并使用麦卡锡儿童能力量表(MCSA)测量了神经心理学结果。采用多元线性回归模型来估计潜在混杂变量调整后的相关性。主要结果显示,TL越长,工作记忆平均得分越高(β = 4.55; 95% CI = 0.39, 8.71)。此外,较长的 TL 与较高的全局定量平均得分相关(β = 3.85;95% CI = -0.19,7.89),但相关性并不显著。据我们所知,这是第一项显示 TL 与儿童更好的神经心理学结果之间存在正相关关系的研究。尽管还需要进一步的研究来证实这些结果,但这项研究支持了这样一个假设,即 TL 对保护和维持儿童的健康(包括工作记忆等认知功能)至关重要。
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引用次数: 0
The impact of maternal childhood maltreatment on child externalizing behaviour and the mediating factors underlying this association: a three-level meta-analysis and systematic review. 母婴虐待对儿童外化行为的影响以及这种关联的中介因素:三级荟萃分析和系统回顾。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 Epub Date: 2022-12-04 DOI: 10.1007/s00787-022-02117-0
Lisa Loheide-Niesmann, Madelon M E Riem, Maaike Cima

Child maltreatment can negatively impact not only survivors but also survivors' children. However, research on the intergenerational effect of maternal childhood maltreatment on child externalizing behaviour has yielded contradictory results and has not yet been systematically synthesised. The current three-level meta-analysis and systematic review aimed to provide a quantitative estimate of the strength of the association between maternal childhood maltreatment and child externalizing behaviour and to summarise research on potential mediating factors of this association. PsycINFO, PubMed, and Embase were searched and 39 studies with 82 effects sizes were included in the meta-analysis. Results revealed a small significant association between maternal childhood maltreatment and child externalizing behaviour (r = 0.16; 95% CI 0.12-0.19; publication bias-adjusted effect size: r = 0.12, 95% CI 0.08-0.16). Maternal mental health, particularly depressive symptoms, maternal parenting and children's maltreatment exposure were the most frequently examined mediators of this association, with relatively robust mediating effects for children's maltreatment exposure and maternal depressive symptoms, but mixed evidence for the mediating role of maternal parenting. This meta-analysis provides evidence for a small but significant association between maternal childhood maltreatment and children's externalizing behaviour, emphasizing the need to develop effective preventive and intervention strategies to minimise the effects of childhood maltreatment on the next generation.

虐待儿童不仅会对幸存者造成负面影响,也会对幸存者的子女造成负面影响。然而,关于母婴虐待对儿童外化行为的代际影响的研究结果相互矛盾,尚未进行系统的综合。目前的三级荟萃分析和系统综述旨在对母婴虐待与儿童外化行为之间的关联强度进行量化评估,并总结有关这种关联的潜在中介因素的研究。荟萃分析检索了 PsycINFO、PubMed 和 Embase,共纳入了 39 项研究,效应大小为 82。结果显示,母亲童年虐待与儿童外化行为之间存在微小的显著关联(r = 0.16;95% CI 0.12-0.19;出版偏差调整效应大小:r = 0.12,95% CI 0.08-0.16)。母亲的心理健康(尤其是抑郁症状)、母亲养育子女的情况和儿童遭受虐待的情况是这种关联最常见的中介因素,其中儿童遭受虐待和母亲抑郁症状的中介效应相对较强,而母亲养育子女的中介作用则证据不一。这项荟萃分析提供的证据表明,母亲虐待儿童与儿童的外化行为之间存在微小但显著的关联,强调有必要制定有效的预防和干预策略,以尽量减少儿童虐待对下一代的影响。
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European Child & Adolescent Psychiatry
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