Pub Date : 2024-09-01Epub Date: 2024-06-15DOI: 10.1007/s00787-024-02492-w
Panos Vostanis
{"title":"Mental health provision for children affected by war and armed conflicts.","authors":"Panos Vostanis","doi":"10.1007/s00787-024-02492-w","DOIUrl":"10.1007/s00787-024-02492-w","url":null,"abstract":"","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"3293-3299"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1-11.8%, I2: 98.0%)), followed by ADHD (2.9% (95% CI 1.2-6.9%, I2 = 94.3%)), ODD (1.9% (95% CI 1.0-3.7%, I2 = 98.4%)), depressive disorder (1.7% (95% CI 1.0-2.9%, I2 = 97.7%)), CD (1.5% (95% CI 0.6-3.8%, I2 = 98.8%)) and ASD (1.4% (95% CI 0.4-5.4%, I2 = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.
大多数精神障碍在 14 岁之前就已出现,但在大多数情况下,直到成年后仍未得到诊断和治疗。一项范围界定审查显示,目前缺乏针对欧洲儿童和青少年精神障碍患病率的系统性审查,这些审查基于 2015 年至 2020 年间开展的社区研究。为了估算焦虑症、抑郁症、注意力缺陷多动障碍 (ADHD)、行为障碍 (CD)、对立违抗障碍 (ODD)、自闭症谱系障碍、进食障碍、药物使用障碍 (SUD) 在欧洲儿童和青少年中的最新汇总患病率,我们使用 MEDLINE、Embase 和 Psych Info 进行了检索,并从参考文献列表和灰色文献中找到了相关研究。对符合条件的研究进行了可靠性、有效性和偏差评估。对每种精神障碍的患病率趋势进行了计算。在欧洲,几乎每五个年轻人中就有一人患有精神障碍,综合患病率为 15.5%。焦虑症的综合患病率最高(7.9% (95% CI 5.1-11.8%, I2: 98.0%)),其次是多动症(2.9% (95% CI 1.2-6.9%, I2 = 94.3%))、定向障碍(1.9% (95% CI 1.0-3.7%,I2 = 98.4%)、抑郁障碍(1.7%(95% CI 1.0-2.9%,I2 = 97.7%))、CD(1.5%(95% CI 0.6-3.8%,I2 = 98.8%))和 ASD(1.4%(95% CI 0.4-5.4%,I2 = 99.7%)。没有发现有关 SUD 的研究。通过引入常规筛查、提高诊断敏感性、提高对精神障碍的认识、尽量减少污名化和社会经济不平等,以及发展早期干预服务,可以改善儿童和青少年的心理健康。需要优先考虑这些促进良好心理健康的因素,尤其是在心理健康不良的风险因素前所未有的时候。
{"title":"A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe.","authors":"Rosemarie Sacco, Nigel Camilleri, Judith Eberhardt, Katja Umla-Runge, Dorothy Newbury-Birch","doi":"10.1007/s00787-022-02131-2","DOIUrl":"10.1007/s00787-022-02131-2","url":null,"abstract":"<p><p>Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1-11.8%, I<sup>2</sup>: 98.0%)), followed by ADHD (2.9% (95% CI 1.2-6.9%, I<sup>2</sup> = 94.3%)), ODD (1.9% (95% CI 1.0-3.7%, I<sup>2</sup> = 98.4%)), depressive disorder (1.7% (95% CI 1.0-2.9%, I<sup>2</sup> = 97.7%)), CD (1.5% (95% CI 0.6-3.8%, I<sup>2</sup> = 98.8%)) and ASD (1.4% (95% CI 0.4-5.4%, I<sup>2</sup> = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2877-2894"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-02-14DOI: 10.1007/s00787-024-02385-y
Katie Finning, Amy Haeffner, Sohum Patel, Bryony Longdon, Rachel Hayes, Obioha C Ukoumunne, Tamsin Ford
As both socioeconomic deprivation and the prevalence of childhood mental health difficulties continue to increase, exploring the relationship between them is important to guide policy. We aimed to replicate the finding of a mental health gap that widened with age between those living in the most and least deprived areas among primary school pupils. We used data from 2075 children aged 4-9 years in the South West of England recruited to the STARS (Supporting Teachers and childRen in Schools) trial, which collected teacher- and parent-reported Strength and Difficulties Questionnaire (SDQ) at baseline, 18-month and 30-month follow-up. We fitted multilevel regression models to explore the relationship between Index of Multiple Deprivation (IMD) quintile and SDQ total difficulties score and an algorithm-generated "probable disorder" variable that combined SDQ data from teachers and parents. Teacher- and parent-reported SDQ total difficulties scores indicated worse mental health in children living in more deprived neighbourhoods, which was attenuated by controlling for special educational needs and disabilities but remained significant by parent report, and there was no interaction year group status (age) at baseline. We did not detect an association between probable disorder and IMD although an interaction with time was evident (p = 0.003). Analysis by study wave revealed associations at baseline (odds ratio 1.94, 95% confidence interval 0.97-3.89) and 18 months (1.96, 1.07-3.59) but not 30 months (0.94, 0.54-1.57). These findings augment the existing, highly compelling evidence demonstrating worse mental health in children exposed to socioeconomic deprivation.
{"title":"Is neighbourhood deprivation in primary school-aged children associated with their mental health and does this association change over 30 months?","authors":"Katie Finning, Amy Haeffner, Sohum Patel, Bryony Longdon, Rachel Hayes, Obioha C Ukoumunne, Tamsin Ford","doi":"10.1007/s00787-024-02385-y","DOIUrl":"10.1007/s00787-024-02385-y","url":null,"abstract":"<p><p>As both socioeconomic deprivation and the prevalence of childhood mental health difficulties continue to increase, exploring the relationship between them is important to guide policy. We aimed to replicate the finding of a mental health gap that widened with age between those living in the most and least deprived areas among primary school pupils. We used data from 2075 children aged 4-9 years in the South West of England recruited to the STARS (Supporting Teachers and childRen in Schools) trial, which collected teacher- and parent-reported Strength and Difficulties Questionnaire (SDQ) at baseline, 18-month and 30-month follow-up. We fitted multilevel regression models to explore the relationship between Index of Multiple Deprivation (IMD) quintile and SDQ total difficulties score and an algorithm-generated \"probable disorder\" variable that combined SDQ data from teachers and parents. Teacher- and parent-reported SDQ total difficulties scores indicated worse mental health in children living in more deprived neighbourhoods, which was attenuated by controlling for special educational needs and disabilities but remained significant by parent report, and there was no interaction year group status (age) at baseline. We did not detect an association between probable disorder and IMD although an interaction with time was evident (p = 0.003). Analysis by study wave revealed associations at baseline (odds ratio 1.94, 95% confidence interval 0.97-3.89) and 18 months (1.96, 1.07-3.59) but not 30 months (0.94, 0.54-1.57). These findings augment the existing, highly compelling evidence demonstrating worse mental health in children exposed to socioeconomic deprivation.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"3111-3121"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.
{"title":"Do maternal anxiety and depressive symptoms predict anxiety in children with and without ADHD at 8 years?","authors":"Christine Baalsrud Ingeborgrud, Beate Oerbeck, Svein Friis, Are Hugo Pripp, Pål Zeiner, Heidi Aase, Guido Biele, Søren Dalsgaard, Kristin Romvig Overgaard","doi":"10.1007/s00787-024-02374-1","DOIUrl":"10.1007/s00787-024-02374-1","url":null,"abstract":"<p><p>Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"3169-3178"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-02-08DOI: 10.1007/s00787-023-02368-5
Pascal-M Aggensteiner, Boris Böttinger, Sarah Baumeister, Sarah Hohmann, Stefan Heintz, Anna Kaiser, Alexander Häge, Julia Werhahn, Christoph Hofstetter, Susanne Walitza, Barbara Franke, Jan Buitelaar, Tobias Banaschewski, Daniel Brandeis, Nathalie E Holz
Disruptive behavior disorders [including conduct disorder (CD) and oppositional defiant disorder (ODD)] are common childhood and adolescent psychiatric conditions often linked to altered arousal. The recommended first-line treatment is multi-modal therapy and includes psychosocial and behavioral interventions. Their modest effect sizes along with clinically and biologically heterogeneous phenotypes emphasize the need for innovative personalized treatment targeting impaired functions such as arousal dysregulation. A total of 37 children aged 8-14 years diagnosed with ODD/CD were randomized to 20 sessions of individualized arousal biofeedback using skin conductance levels (SCL-BF) or active treatment as usual (TAU) including psychoeducation and cognitive-behavioral elements. The primary outcome was the change in parents´ ratings of aggressive behavior measured by the Modified Overt Aggression Scale. Secondary outcome measures were subscales from the Child Behavior Checklist, the Inventory of Callous-Unemotional traits, and the Reactive-Proactive Aggression Questionnaire. The SCL-BF treatment was neither superior nor inferior to the active TAU. Both groups showed reduced aggression after treatment with small effects for the primary outcome and large effects for some secondary outcomes. Importantly, successful learning of SCL self-regulation was related to reduced aggression at post-assessment. Individualized SCL-BF was not inferior to active TAU for any treatment outcome with improvements in aggression. Further, participants were on average able to self-regulate their SCL, and those who best learned self-regulation showed the highest clinical improvement, pointing to specificity of SCL-BF regulation for improving aggression. Further studies with larger samples and improved methods, for example by developing BF for mobile use in ecologically more valid settings are warranted.
{"title":"Randomized controlled trial of individualized arousal-biofeedback for children and adolescents with disruptive behavior disorders (DBD).","authors":"Pascal-M Aggensteiner, Boris Böttinger, Sarah Baumeister, Sarah Hohmann, Stefan Heintz, Anna Kaiser, Alexander Häge, Julia Werhahn, Christoph Hofstetter, Susanne Walitza, Barbara Franke, Jan Buitelaar, Tobias Banaschewski, Daniel Brandeis, Nathalie E Holz","doi":"10.1007/s00787-023-02368-5","DOIUrl":"10.1007/s00787-023-02368-5","url":null,"abstract":"<p><p>Disruptive behavior disorders [including conduct disorder (CD) and oppositional defiant disorder (ODD)] are common childhood and adolescent psychiatric conditions often linked to altered arousal. The recommended first-line treatment is multi-modal therapy and includes psychosocial and behavioral interventions. Their modest effect sizes along with clinically and biologically heterogeneous phenotypes emphasize the need for innovative personalized treatment targeting impaired functions such as arousal dysregulation. A total of 37 children aged 8-14 years diagnosed with ODD/CD were randomized to 20 sessions of individualized arousal biofeedback using skin conductance levels (SCL-BF) or active treatment as usual (TAU) including psychoeducation and cognitive-behavioral elements. The primary outcome was the change in parents´ ratings of aggressive behavior measured by the Modified Overt Aggression Scale. Secondary outcome measures were subscales from the Child Behavior Checklist, the Inventory of Callous-Unemotional traits, and the Reactive-Proactive Aggression Questionnaire. The SCL-BF treatment was neither superior nor inferior to the active TAU. Both groups showed reduced aggression after treatment with small effects for the primary outcome and large effects for some secondary outcomes. Importantly, successful learning of SCL self-regulation was related to reduced aggression at post-assessment. Individualized SCL-BF was not inferior to active TAU for any treatment outcome with improvements in aggression. Further, participants were on average able to self-regulate their SCL, and those who best learned self-regulation showed the highest clinical improvement, pointing to specificity of SCL-BF regulation for improving aggression. Further studies with larger samples and improved methods, for example by developing BF for mobile use in ecologically more valid settings are warranted.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"3055-3066"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1007/s00787-024-02566-9
Helena Ludwig-Walz, Martin Bujard, Jonas Fegert, Jörg M Fegert
{"title":"Integrating European contexts and needs into WHO guiding principles on online mental health content for young people: five recommendations.","authors":"Helena Ludwig-Walz, Martin Bujard, Jonas Fegert, Jörg M Fegert","doi":"10.1007/s00787-024-02566-9","DOIUrl":"https://doi.org/10.1007/s00787-024-02566-9","url":null,"abstract":"","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1007/s00787-024-02553-0
Lisa Serravalle, Florencia Trespalacios, Mark A Ellenbogen
Because the offspring of parents with an affective disorder (OAD) are at high risk for developing mental disorders, and persons with an affective disorder (AD) show dysfunctional hypothalamic-pituitary-adrenal (HPA) axis activity, changes in HPA functioning in OAD might be an etiological risk factor that precedes the development of ADs. The primary aim of the meta-analysis was to quantitatively summarize the existing data on different indices of diurnal cortisol in the OAD. The secondary aim was to explore potential moderators of this relation. Following PRISMA guidelines, we included 26 studies (3052 offspring) on diurnal cortisol in our meta-analysis after an initial screening of 3408 articles. Intercept-only and meta-regression models were computed using the robust variance estimation method. Analyses examining mean cortisol levels at discrete timepoints, total cortisol output, and the cortisol rise in response to awakening (CAR) were conducted separately. The results demonstrated that the OAD had higher mean levels of cortisol at different timepoints throughout the day compared to controls (Hedge's g = 0.21). There was evidence of publication bias in studies examining CAR, such that effect sizes were positively biased. The present findings are consistent with a meta-analysis showing elevated cortisol in youth having an AD. Notable limitations across studies include the method of cortisol measurement and assessment of ADs. Altogether, these results highlight the fact that increased cortisol levels may act as a potential neuroendocrine antecedent and/or risk factor for the development of ADs among high risk youth.
{"title":"Hypothalamic-pituitary-adrenal axis functioning in offspring of parents with a major affective disorder: a meta-analytic review.","authors":"Lisa Serravalle, Florencia Trespalacios, Mark A Ellenbogen","doi":"10.1007/s00787-024-02553-0","DOIUrl":"https://doi.org/10.1007/s00787-024-02553-0","url":null,"abstract":"<p><p>Because the offspring of parents with an affective disorder (OAD) are at high risk for developing mental disorders, and persons with an affective disorder (AD) show dysfunctional hypothalamic-pituitary-adrenal (HPA) axis activity, changes in HPA functioning in OAD might be an etiological risk factor that precedes the development of ADs. The primary aim of the meta-analysis was to quantitatively summarize the existing data on different indices of diurnal cortisol in the OAD. The secondary aim was to explore potential moderators of this relation. Following PRISMA guidelines, we included 26 studies (3052 offspring) on diurnal cortisol in our meta-analysis after an initial screening of 3408 articles. Intercept-only and meta-regression models were computed using the robust variance estimation method. Analyses examining mean cortisol levels at discrete timepoints, total cortisol output, and the cortisol rise in response to awakening (CAR) were conducted separately. The results demonstrated that the OAD had higher mean levels of cortisol at different timepoints throughout the day compared to controls (Hedge's g = 0.21). There was evidence of publication bias in studies examining CAR, such that effect sizes were positively biased. The present findings are consistent with a meta-analysis showing elevated cortisol in youth having an AD. Notable limitations across studies include the method of cortisol measurement and assessment of ADs. Altogether, these results highlight the fact that increased cortisol levels may act as a potential neuroendocrine antecedent and/or risk factor for the development of ADs among high risk youth.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-29DOI: 10.1007/s00787-024-02563-y
Gennaro Catone, Vincenzo Paolo Senese, Antonio Pascotto, Simone Pisano, Matthew R Broome
Paranoia is the erroneous idea that people are targeting you for harm, and the cognitive model suggests that symptoms increase with emotional and relational distress. A factor potentially associated with paranoia is mistrust, a milder form of suspiciousness. This study investigated the longitudinal course of non-clinical paranoia in a sample of 739 students (age range 10-12 at baseline assessment, 12-14 at second assessment) using data from the Social Mistrust Scale (SMS) and the paranoia subscale of the Specific Psychotic Experiences Questionnaire (SPEQ). Prevalence of mistrustful and high paranoia children was 14.6 and 15% respectively. Independently, baseline internalizing symptoms (b = 0.241, p < 0.001) and mistrust (b = 0.240, p < 0.001) longitudinally predict paranoia after controlling for confounders. The interaction of mistrust and internalizing symptoms at T1 increases the possibility of the onset of paranoia at T2. Therefore, the effect of mistrust on paranoia is more marked when internalizing symptoms are higher. Our results confirm the role of mistrust as a factor involved in the developmental trajectory of paranoia in adolescence, enhanced by the presence of internalizing symptoms. The implications of these results are both theoretical and clinical, as they add developmental information to the cognitive model of paranoia and suggests the assessment and clinical management of mistrust and internalizing symptoms in youth may be useful with the aim of reducing the risk of psychotic experiences.
{"title":"The developmental course of adolescent paranoia: a longitudinal analysis of the interacting role of mistrust and general psychopathology.","authors":"Gennaro Catone, Vincenzo Paolo Senese, Antonio Pascotto, Simone Pisano, Matthew R Broome","doi":"10.1007/s00787-024-02563-y","DOIUrl":"https://doi.org/10.1007/s00787-024-02563-y","url":null,"abstract":"<p><p>Paranoia is the erroneous idea that people are targeting you for harm, and the cognitive model suggests that symptoms increase with emotional and relational distress. A factor potentially associated with paranoia is mistrust, a milder form of suspiciousness. This study investigated the longitudinal course of non-clinical paranoia in a sample of 739 students (age range 10-12 at baseline assessment, 12-14 at second assessment) using data from the Social Mistrust Scale (SMS) and the paranoia subscale of the Specific Psychotic Experiences Questionnaire (SPEQ). Prevalence of mistrustful and high paranoia children was 14.6 and 15% respectively. Independently, baseline internalizing symptoms (b = 0.241, p < 0.001) and mistrust (b = 0.240, p < 0.001) longitudinally predict paranoia after controlling for confounders. The interaction of mistrust and internalizing symptoms at T1 increases the possibility of the onset of paranoia at T2. Therefore, the effect of mistrust on paranoia is more marked when internalizing symptoms are higher. Our results confirm the role of mistrust as a factor involved in the developmental trajectory of paranoia in adolescence, enhanced by the presence of internalizing symptoms. The implications of these results are both theoretical and clinical, as they add developmental information to the cognitive model of paranoia and suggests the assessment and clinical management of mistrust and internalizing symptoms in youth may be useful with the aim of reducing the risk of psychotic experiences.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1007/s00787-024-02570-z
Samuele Cortese, David Coghill, Joerg M Fegert, Gregory W Mattingly, Luis A Rohde, Ian C K Wong, Stephen V Faraone
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Pub Date : 2024-08-28DOI: 10.1007/s00787-024-02548-x
Yinzhi Kang, Qingfeng Li, Wenjing Liu, Yang Hu, Zhen Liu, Shuqi Xie, Changminghao Ma, Lei Zhang, Xiaochen Zhang, Zhishan Hu, Yue Ding, Wenhong Cheng, Zhi Yang
Social anxiety disorder (SAD) is one of the most common psychiatric disorders in adolescents. The heterogeneity of both symptoms and etiology is an essential source of difficulties in the treatment and prevention of SAD. The study aimed to identify subtypes of adolescent SAD based on etiology-related phenotype dimensions and examine symptom and brain associations of the subtypes. We used a deeply phenotyped sample (47 phenotype subscales from 13 measures) of adolescents with SAD (n = 196) and healthy controls (n = 109) to extract etiology-relevant risk factors, based on which we identified subtypes of SAD. We compared the subtypes on clinical characteristics and brain morphometrics and functional connectivity, and examined subtype-specific links between risk factors, brain aberrance, and clinical characteristics. We identified six etiology-relevant risk factors and two subtypes of adolescent SAD. One subtype showed mainly elevated negative emotionality trait and coping style and diminished positive emotionality trait and coping style, while the other additionally had significantly high environmental risk factors, more severe impairments in social functioning, and significant abnormalities in brain structure and function. There were subtype-specific links between the risk factor profiles, brain aberrance, and clinical characteristics. The finding suggests two etiology-based subtypes of adolescent SAD, providing novel insights to the diversity of pathological pathways and precise intervention strategies.
社交焦虑症(SAD)是青少年最常见的精神疾病之一。症状和病因的异质性是导致 SAD 治疗和预防困难的重要原因。本研究旨在根据病因相关的表型维度确定青少年 SAD 的亚型,并研究亚型的症状和大脑关联。我们对患有 SAD 的青少年(196 人)和健康对照组(109 人)进行了深度表型抽样(13 项测量中的 47 个表型子量表),提取了与病因相关的风险因素,并在此基础上确定了 SAD 的亚型。我们比较了这些亚型的临床特征、大脑形态计量学和功能连接,并研究了风险因素、大脑畸变和临床特征之间的亚型特异性联系。我们发现了六种与病因相关的风险因素和两种青少年 SAD 亚型。其中一种亚型主要表现为消极情绪特质和应对方式的升高,以及积极情绪特质和应对方式的降低,而另一种亚型则具有明显的高环境风险因素、更严重的社会功能障碍以及大脑结构和功能的显著异常。风险因素特征、大脑异常和临床特征之间存在亚型特异性联系。研究结果表明,青少年 SAD 有两种基于病因的亚型,为病理途径的多样性和精确干预策略提供了新的见解。
{"title":"Risk factor patterns define social anxiety subtypes in adolescents with brain and clinical feature differences.","authors":"Yinzhi Kang, Qingfeng Li, Wenjing Liu, Yang Hu, Zhen Liu, Shuqi Xie, Changminghao Ma, Lei Zhang, Xiaochen Zhang, Zhishan Hu, Yue Ding, Wenhong Cheng, Zhi Yang","doi":"10.1007/s00787-024-02548-x","DOIUrl":"https://doi.org/10.1007/s00787-024-02548-x","url":null,"abstract":"<p><p>Social anxiety disorder (SAD) is one of the most common psychiatric disorders in adolescents. The heterogeneity of both symptoms and etiology is an essential source of difficulties in the treatment and prevention of SAD. The study aimed to identify subtypes of adolescent SAD based on etiology-related phenotype dimensions and examine symptom and brain associations of the subtypes. We used a deeply phenotyped sample (47 phenotype subscales from 13 measures) of adolescents with SAD (n = 196) and healthy controls (n = 109) to extract etiology-relevant risk factors, based on which we identified subtypes of SAD. We compared the subtypes on clinical characteristics and brain morphometrics and functional connectivity, and examined subtype-specific links between risk factors, brain aberrance, and clinical characteristics. We identified six etiology-relevant risk factors and two subtypes of adolescent SAD. One subtype showed mainly elevated negative emotionality trait and coping style and diminished positive emotionality trait and coping style, while the other additionally had significantly high environmental risk factors, more severe impairments in social functioning, and significant abnormalities in brain structure and function. There were subtype-specific links between the risk factor profiles, brain aberrance, and clinical characteristics. The finding suggests two etiology-based subtypes of adolescent SAD, providing novel insights to the diversity of pathological pathways and precise intervention strategies.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}