Pub Date : 2024-09-18DOI: 10.1007/s00787-024-02577-6
Nicolas Ayala-Aldana, Ariadna Pinar-Martí, Marina Ruiz-Rivera, Sílvia Fernández-Barrés, Dora Romaguera, Jordi Casanova-Mollà, Nuria Solà-Valls, Jordi Julvez
A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city. We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education. Six dietary patterns were identified in PCA analyses. “low consumption of calorie-dense foods” dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and “Nuts” dietary pattern showed a negative (protective) association with impulsivity index (:{(beta:}_{1})= −24.60, 95% CI = −36.80, −12.41, p value < 0.001). Overall, our main results suggest that healthy dietary patterns, including higher intakes of “nuts” and a preference of “low consumption of calorie-dense foods” dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.
{"title":"Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort","authors":"Nicolas Ayala-Aldana, Ariadna Pinar-Martí, Marina Ruiz-Rivera, Sílvia Fernández-Barrés, Dora Romaguera, Jordi Casanova-Mollà, Nuria Solà-Valls, Jordi Julvez","doi":"10.1007/s00787-024-02577-6","DOIUrl":"https://doi.org/10.1007/s00787-024-02577-6","url":null,"abstract":"<p>A balanced diet is relevant for neuropsychological functioning. We aimed to analyze the association between dietary patterns and neuropsychological outcomes in a sample of healthy adolescents of the Walnuts Smart Snack (WSS) cohort from Barcelona city. We performed principal components analysis (PCA) to determine dietary patterns in the adolescent sample using a food frequency questionnaire (60 items). Multiple linear regression models were performed to analyze the association between PCA dietary patterns with neuropsychological outcomes: Strengths and Difficulties (SDQ) externalizing and internalizing scores, Attention Network Test (ANT) Impulsivity Index and Emotional Recognition Task (ERT) scores. We additionally adjusted the models for child sex, age, body mass index (BMI), physical activity and maternal education. Six dietary patterns were identified in PCA analyses. “low consumption of calorie-dense foods” dietary pattern had a negative association (protective) with the both SDQ outcomes (p value < 0.001) and “Nuts” dietary pattern showed a negative (protective) association with impulsivity index <span>(:{(beta:}_{1})</span>= −24.60, 95% CI = −36.80, −12.41, p value < 0.001). Overall, our main results suggest that healthy dietary patterns, including higher intakes of “nuts” and a preference of “low consumption of calorie-dense foods” dietary patterns, could provide a beneficial association with neuropsychological functions during the adolescence period. The associations may include improvements of externalizing and internalizing problem symptoms, and impulsivity.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264024","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 : 2024-09-17DOI: 10.1007/s00787-024-02579-4
Shuran Yang, Jingjing Han, Zhihan Ye, Huizhi Zhou, Yangye Yan, Dong Han, Shi Chen, Lu Wang, Qiang Feng, Xudong Zhao, Chuanyuan Kang
Accumulating evidence suggests a role for the tryptophan-kynurenine pathway (TKP) in the psychopathology of major depressive disorder (MDD). Abnormal inflammatory profile and production of TKP neurotoxic metabolites appear more pronounced in MDD with suicidality. Progress in understanding the neurobiology of MDD in adolescents lags significantly behind that in adults due to limited empirical evidence. Aims of this study was to investigate the association between inflammation, TKP, and suicidality in adolescent depression. Seventy-three adolescents with MDD were assessed for serum levels of interleukin (IL)-1β, IL-6, IL-18, IL-10, tumor necrosis factor-α (TNF-α), tryptophan (TRP), kynurenine (KYN), 3-hydroxykynurenine (3-HK), and kynurenine acid (KA). Correlations between cytokines and TKP measures were examined. Patients were divided into high- (n = 42) and non-high-suicide-risk groups (n = 31), and serum levels of cytokines and TKP metabolites were compared. Significant negative correlations were found between TRP and IL-8 (r = – 0.27, P < 0.05) and IL-10 (r = – 0.23, P < 0.05), while a significant positive correlation was observed between 3-HK and IL-8 (r = 0.39, P < 0.01) in depressed adolescents. The KYN/TPR (index of indoleamine 2,3-dioxygenase, IDO) was positively correlated with IL-1β (r = 0.34), IL-6 (r = 0.32), IL-10 (r = 0.38) and TNF-α (r = 0.35) levels (P < 0.01); and 3-HK/KYN (index of kynurenine3-monooxidase, KMO) was positively correlated with IL-8 level (r = 0.31, P < 0.01). Depressed adolescents at high suicide risk exhibited significantly higher levels of IL-1β (Z = 2.726, P < 0.05), IL-10 (Z = 2.444, P < 0.05), and TNF-α (Z = 2.167, P < 0.05) and lower levels of 3-HK (Z = 2.126, P < 0.05) compared to their non-high suicide risk counterparts. Our findings indicated that serum inflammatory cytokines were robustly associated with IDO and KMO activity, along with significantly decreased serum level of TRP, increased level of 3-HK, and higher suicide risk in adolescent depression.
越来越多的证据表明,色氨酸-犬尿氨酸通路(TKP)在重度抑郁障碍(MDD)的精神病理学中发挥作用。在伴有自杀倾向的重度抑郁症患者中,异常炎症特征和 TKP 神经毒性代谢产物的产生似乎更为明显。由于经验证据有限,对青少年重度抑郁症神经生物学的研究进展明显落后于成人。本研究旨在调查青少年抑郁症患者的炎症、TKP 和自杀倾向之间的关系。研究人员对73名患有抑郁症的青少年进行了血清白细胞介素(IL)-1β、IL-6、IL-18、IL-10、肿瘤坏死因子-α(TNF-α)、色氨酸(TRP)、犬尿氨酸(KYN)、3-羟基犬尿氨酸(3-HK)和犬尿氨酸(KA)水平的评估。研究了细胞因子与 TKP 测量值之间的相关性。患者被分为高自杀风险组(42 人)和非高自杀风险组(31 人),并比较了血清中细胞因子和 TKP 代谢物的水平。研究发现,在抑郁青少年中,TRP 与 IL-8 (r = - 0.27,P < 0.05)和 IL-10 (r = - 0.23,P < 0.05)呈显著负相关,而 3-HK 与 IL-8 (r = 0.39,P < 0.01)呈显著正相关。KYN/TPR(吲哚胺-2,3-二氧化酶指数,IDO)与IL-1β(r = 0.34)、IL-6(r = 0.32)、IL-10(r = 0.38)和TNF-α(r = 0.35)水平呈正相关(P <0.01);3-HK/KYN(犬尿氨酸-3-单氧化酶指数,KMO)与IL-8水平呈正相关(r = 0.31,P <0.01)。与非高自杀风险青少年相比,高自杀风险抑郁青少年的 IL-1β (Z = 2.726, P < 0.05)、IL-10 (Z = 2.444, P < 0.05)和 TNF-α (Z = 2.167, P < 0.05)水平明显较高,而 3-HK (Z = 2.126, P < 0.05)水平较低。我们的研究结果表明,在青少年抑郁症患者中,血清炎症细胞因子与IDO和KMO活性密切相关,血清TRP水平显著降低,3-HK水平显著升高,自杀风险较高。
{"title":"The correlation of inflammation, tryptophan-kynurenine pathway, and suicide risk in adolescent depression","authors":"Shuran Yang, Jingjing Han, Zhihan Ye, Huizhi Zhou, Yangye Yan, Dong Han, Shi Chen, Lu Wang, Qiang Feng, Xudong Zhao, Chuanyuan Kang","doi":"10.1007/s00787-024-02579-4","DOIUrl":"https://doi.org/10.1007/s00787-024-02579-4","url":null,"abstract":"<p>Accumulating evidence suggests a role for the tryptophan-kynurenine pathway (TKP) in the psychopathology of major depressive disorder (MDD). Abnormal inflammatory profile and production of TKP neurotoxic metabolites appear more pronounced in MDD with suicidality. Progress in understanding the neurobiology of MDD in adolescents lags significantly behind that in adults due to limited empirical evidence. Aims of this study was to investigate the association between inflammation, TKP, and suicidality in adolescent depression. Seventy-three adolescents with MDD were assessed for serum levels of interleukin (IL)-1β, IL-6, IL-18, IL-10, tumor necrosis factor-α (TNF-α), tryptophan (TRP), kynurenine (KYN), 3-hydroxykynurenine (3-HK), and kynurenine acid (KA). Correlations between cytokines and TKP measures were examined. Patients were divided into high- (n = 42) and non-high-suicide-risk groups (n = 31), and serum levels of cytokines and TKP metabolites were compared. Significant negative correlations were found between TRP and IL-8 (r = – 0.27, P < 0.05) and IL-10 (r = – 0.23, P < 0.05), while a significant positive correlation was observed between 3-HK and IL-8 (r = 0.39, P < 0.01) in depressed adolescents. The KYN/TPR (index of indoleamine 2,3-dioxygenase, IDO) was positively correlated with IL-1β (r = 0.34), IL-6 (r = 0.32), IL-10 (r = 0.38) and TNF-α (r = 0.35) levels (P < 0.01); and 3-HK/KYN (index of kynurenine3-monooxidase, KMO) was positively correlated with IL-8 level (r = 0.31, P < 0.01). Depressed adolescents at high suicide risk exhibited significantly higher levels of IL-1β (Z = 2.726, P < 0.05), IL-10 (Z = 2.444, P < 0.05), and TNF-α (Z = 2.167, P < 0.05) and lower levels of 3-HK (Z = 2.126, P < 0.05) compared to their non-high suicide risk counterparts. Our findings indicated that serum inflammatory cytokines were robustly associated with IDO and KMO activity, along with significantly decreased serum level of TRP, increased level of 3-HK, and higher suicide risk in adolescent depression.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264025","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 : 2024-09-14DOI: 10.1007/s00787-024-02582-9
Peter J. Castagna, Dara E. Babinski, Daniel A. Waschbusch
The presence of callous-unemotional (CU) traits may not be unique to conduct disorder (CD) but also extend to oppositional defiant disorder (ODD). While a distinct neurocognitive profile characterizes CU traits, it remains unclear whether this CU-related neurocognitive profile differs between youth with CD and ODD. This study investigated whether CU traits moderate the relationship between inhibitory control and CD or ODD symptoms. We leveraged computational modeling to decompose task-based inhibitory control in a sample of 200 children (59.5% boys, 86.5% Caucasian), aged 8 to 15 years (M = 10.10, SD = 1.88), referred to an outpatient child diagnostic clinic focused on externalizing problems. Analyses examined whether CU traits moderated the relationship between inhibitory control and CD or ODD symptoms while controlling for ADHD symptoms and child demographics. The results indicated that the strength of the relationship between inhibitory control and CD and ODD symptoms varies as a function of CU traits. Specifically, CD was linked to a more cautious decision-making style when elevated CU traits were present, whereas ODD was associated with more efficient decision making. These findings suggest distinct neurocognitive profiles based on CU traits, which vary between CD and ODD. Clinically, this underscores the importance of tailoring interventions for CD-CU and ODD-CU, focusing on decision making processes rather than merely addressing impulsivity. This research contributes to a more nuanced understanding of the interaction between neurocognitive processes and disruptive behavior, with significant implications for both theoretical models and treatment approaches.
冷酷无情(CU)特质的存在可能并不是行为障碍(CD)所独有的,它也可能延伸至对立违抗障碍(ODD)。虽然CU特质具有独特的神经认知特征,但这种与CU相关的神经认知特征在CD和ODD青少年之间是否存在差异仍不清楚。本研究调查了CU特质是否会缓和抑制控制与CD或ODD症状之间的关系。我们利用计算模型分解了200名儿童(59.5%为男孩,86.5%为白种人)的任务型抑制控制,这些儿童的年龄在8至15岁之间(中=10.10,标差=1.88),他们被转介到一家专注于外化问题的儿童诊断门诊。在控制多动症症状和儿童人口统计学特征的情况下,研究分析了 CU 特征是否调节了抑制控制与 CD 或 ODD 症状之间的关系。结果表明,抑制控制与 CD 和 ODD 症状之间的关系强度随 CU 特质的变化而变化。具体地说,当CU特质升高时,CD与更谨慎的决策风格有关,而ODD则与更高效的决策有关。这些研究结果表明,基于CU特质的不同神经认知特征在CD和ODD之间存在差异。在临床上,这强调了针对 CD-CU 和 ODD-CU 定制干预措施的重要性,干预措施应侧重于决策过程,而不仅仅是解决冲动问题。这项研究有助于人们更细致地了解神经认知过程与破坏性行为之间的相互作用,对理论模型和治疗方法都具有重要意义。
{"title":"Callous-unemotional traits moderate the association between inhibitory control and disruptive behavior problems","authors":"Peter J. Castagna, Dara E. Babinski, Daniel A. Waschbusch","doi":"10.1007/s00787-024-02582-9","DOIUrl":"https://doi.org/10.1007/s00787-024-02582-9","url":null,"abstract":"<p>The presence of callous-unemotional (CU) traits may not be unique to conduct disorder (CD) but also extend to oppositional defiant disorder (ODD). While a distinct neurocognitive profile characterizes CU traits, it remains unclear whether this CU-related neurocognitive profile differs between youth with CD and ODD. This study investigated whether CU traits moderate the relationship between inhibitory control and CD or ODD symptoms. We leveraged computational modeling to decompose task-based inhibitory control in a sample of 200 children (59.5% boys, 86.5% Caucasian), aged 8 to 15 years (<i>M</i> = 10.10, <i>SD</i> = 1.88), referred to an outpatient child diagnostic clinic focused on externalizing problems. Analyses examined whether CU traits moderated the relationship between inhibitory control and CD or ODD symptoms while controlling for ADHD symptoms and child demographics. The results indicated that the strength of the relationship between inhibitory control and CD and ODD symptoms varies as a function of CU traits. Specifically, CD was linked to a more cautious decision-making style when elevated CU traits were present, whereas ODD was associated with more efficient decision making. These findings suggest distinct neurocognitive profiles based on CU traits, which vary between CD and ODD. Clinically, this underscores the importance of tailoring interventions for CD-CU and ODD-CU, focusing on decision making processes rather than merely addressing impulsivity. This research contributes to a more nuanced understanding of the interaction between neurocognitive processes and disruptive behavior, with significant implications for both theoretical models and treatment approaches.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142264026","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 : 2024-09-12DOI: 10.1007/s00787-024-02565-w
Johanne Pereira Ribeiro,Christian Gluud,Maja Rosenberg Overby Storm,Ole Jakob Storebø
{"title":"Should methylphenidate be included in the WHO model lists of essential medicines?","authors":"Johanne Pereira Ribeiro,Christian Gluud,Maja Rosenberg Overby Storm,Ole Jakob Storebø","doi":"10.1007/s00787-024-02565-w","DOIUrl":"https://doi.org/10.1007/s00787-024-02565-w","url":null,"abstract":"","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201413","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 : 2024-09-12DOI: 10.1007/s00787-024-02578-5
Gali Chelouche-Dwek, Peter Fonagy
Mentalization-based interventions (MBIs) have been increasingly applied in school settings to support the social-emotional development and mental health of children and adolescents. This systematic review aimed to synthesize the evidence on the effectiveness of MBIs implemented in educational contexts for students aged 6–18 years. A comprehensive search was conducted in PsychInfo, MEDLINE, EMBASE, Web of Science, and ERIC databases from inception to October 2023. The search strategy combined terms related to mentalization, school-based interventions, and the target age group. The review protocol was registered with PROSPERO (CRD42022302757). Inclusion criteria included peer-reviewed publications in English, studies published between 1980 and 2023, interventions based on mentalization principles, and a primary focus on children aged 6 to 18 years. Exclusion criteria involved non-mentalization based interventions and research outside the 6–18 age range. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health (NIH). Data were synthesized narratively due to the heterogeneity of study designs and outcomes. Of the 5,250 articles screened, 21 studies met the inclusion criteria, comprising over 7,500 participants. The reviewed interventions targeted various aspects of mentalizing, such as emotion-understanding, empathy, perspective-taking, and Theory of Mind. Significant improvements were found in social-cognitive abilities, emotion regulation, and mental health outcomes, including reductions in disruptive behaviours. Interventions that combined mentalizing training for both students and teachers showed promising results. However, the long-term sustainability of these benefits remains unclear. Limitations of the reviewed studies include the lack of control groups, small sample sizes, and variations in outcome measures. The findings highlight the potential of MBIs as a promising approach to fostering socio-emotional competence, positive behaviour, and well-being in school-aged children. Future research should aim to establish the active components and optimal delivery of these interventions through well-designed randomized controlled trials with larger, more diverse samples and extended follow-up periods. The integration of MBIs within educational systems holds promise for promoting resilience and positive mental health outcomes in young people. Embedding MBIs within school curriculums and evaluating cost-effectiveness are important next steps to guide widespread implementation.
{"title":"Mentalization-based interventions in schools for enhancing socio-emotional competencies and positive behaviour: a systematic review","authors":"Gali Chelouche-Dwek, Peter Fonagy","doi":"10.1007/s00787-024-02578-5","DOIUrl":"https://doi.org/10.1007/s00787-024-02578-5","url":null,"abstract":"<p>Mentalization-based interventions (MBIs) have been increasingly applied in school settings to support the social-emotional development and mental health of children and adolescents. This systematic review aimed to synthesize the evidence on the effectiveness of MBIs implemented in educational contexts for students aged 6–18 years. A comprehensive search was conducted in PsychInfo, MEDLINE, EMBASE, Web of Science, and ERIC databases from inception to October 2023. The search strategy combined terms related to mentalization, school-based interventions, and the target age group. The review protocol was registered with PROSPERO (CRD42022302757). Inclusion criteria included peer-reviewed publications in English, studies published between 1980 and 2023, interventions based on mentalization principles, and a primary focus on children aged 6 to 18 years. Exclusion criteria involved non-mentalization based interventions and research outside the 6–18 age range. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health (NIH). Data were synthesized narratively due to the heterogeneity of study designs and outcomes. Of the 5,250 articles screened, 21 studies met the inclusion criteria, comprising over 7,500 participants. The reviewed interventions targeted various aspects of mentalizing, such as emotion-understanding, empathy, perspective-taking, and Theory of Mind. Significant improvements were found in social-cognitive abilities, emotion regulation, and mental health outcomes, including reductions in disruptive behaviours. Interventions that combined mentalizing training for both students and teachers showed promising results. However, the long-term sustainability of these benefits remains unclear. Limitations of the reviewed studies include the lack of control groups, small sample sizes, and variations in outcome measures. The findings highlight the potential of MBIs as a promising approach to fostering socio-emotional competence, positive behaviour, and well-being in school-aged children. Future research should aim to establish the active components and optimal delivery of these interventions through well-designed randomized controlled trials with larger, more diverse samples and extended follow-up periods. The integration of MBIs within educational systems holds promise for promoting resilience and positive mental health outcomes in young people. Embedding MBIs within school curriculums and evaluating cost-effectiveness are important next steps to guide widespread implementation.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201412","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 : 2024-09-11DOI: 10.1007/s00787-024-02573-w
Katherine N. Thompson, Olakunle Oginni, Jasmin Wertz, Andrea Danese, Malaika Okundi, Louise Arseneault, Timothy Matthews
We assessed genetic and environmental influences on social isolation across childhood and the overlap between social isolation and mental health symptoms including depression symptoms, conduct problems, and psychotic-like experiences from adolescence to young adulthood. Participants included 2,232 children from the Environmental Risk Longitudinal Twin Study. Social isolation was measured at ages 5, 7, 10, 12, and 18. A Cholesky decomposition was specified to estimate the genetic and environmental influences on social isolation across ages 5, 7, 10, and 12. An independent pathway model was used to assess additive genetic (A), shared environmental (C), and non-shared environmental (E) influences on the overlap between social isolation and mental health problems from age 12 to 18. Genetic and non-shared environmental influences accounted for half of the variance in childhood social isolation. Genetic influences contributed to the continuity of social isolation across childhood, while non-shared environmental influences were age-specific. The longitudinal overlap between social isolation and mental health symptoms was largely explained by genetic influences for depression symptoms (r = 0.15–0.24: 82–84% A, 11–12% C, and 5–6% E) and psychotic-like experiences (r = 0.13–0.15: 81–91% A, 0–8% C, and 9–11% E) but not conduct problems (r = 0.13–0.16; 0–42% A, 42–81% C, 16–24% E). Our findings emphasise that rather than a risk factor or an outcome, social isolation is aetiologically intertwined with the experience of poor mental health. An integrative assessment of social isolation could be a helpful indicator of underlying mental health symptoms in young people.
我们评估了遗传和环境对儿童期社会隔离的影响,以及社会隔离与心理健康症状(包括抑郁症状、品行问题和青春期至青年期的精神病样经历)之间的重叠。研究对象包括环境风险纵向双胞胎研究中的 2,232 名儿童。社会隔离度在 5、7、10、12 和 18 岁时进行测量。采用 Cholesky 分解法估算了 5、7、10 和 12 岁时遗传和环境对社会隔离的影响。独立路径模型用于评估遗传(A)、共享环境(C)和非共享环境(E)对 12 至 18 岁期间社会隔离与心理健康问题重叠的影响。遗传和非共享环境影响占童年社会隔离差异的一半。遗传因素使儿童时期的社会隔离具有连续性,而非共同环境因素则具有年龄特异性。社会隔离与心理健康症状之间的纵向重叠在很大程度上是由抑郁症状(r = 0.15-0.24: 82-84% A, 11-12% C, and 5-6% E)和精神病样经历(r = 0.13-0.15: 81-91% A, 0-8% C, and 9-11% E)的遗传影响所解释的,但行为问题(r = 0.13-0.16; 0-42% A, 42-81% C, 16-24% E)则不是。我们的研究结果强调,社会隔离与其说是一种风险因素或结果,不如说是与心理健康状况不佳交织在一起的病因。对社会隔离的综合评估可以作为青少年潜在心理健康症状的一个有用指标。
{"title":"Social isolation and poor mental health in young people: testing genetic and environmental influences in a longitudinal cohort study","authors":"Katherine N. Thompson, Olakunle Oginni, Jasmin Wertz, Andrea Danese, Malaika Okundi, Louise Arseneault, Timothy Matthews","doi":"10.1007/s00787-024-02573-w","DOIUrl":"https://doi.org/10.1007/s00787-024-02573-w","url":null,"abstract":"<p>We assessed genetic and environmental influences on social isolation across childhood and the overlap between social isolation and mental health symptoms including depression symptoms, conduct problems, and psychotic-like experiences from adolescence to young adulthood. Participants included 2,232 children from the Environmental Risk Longitudinal Twin Study. Social isolation was measured at ages 5, 7, 10, 12, and 18. A Cholesky decomposition was specified to estimate the genetic and environmental influences on social isolation across ages 5, 7, 10, and 12. An independent pathway model was used to assess additive genetic (A), shared environmental (C), and non-shared environmental (E) influences on the overlap between social isolation and mental health problems from age 12 to 18. Genetic and non-shared environmental influences accounted for half of the variance in childhood social isolation. Genetic influences contributed to the continuity of social isolation across childhood, while non-shared environmental influences were age-specific. The longitudinal overlap between social isolation and mental health symptoms was largely explained by genetic influences for depression symptoms (<i>r =</i> 0.15–0.24: 82–84% A, 11–12% C, and 5–6% E) and psychotic-like experiences (<i>r =</i> 0.13–0.15: 81–91% A, 0–8% C, and 9–11% E) but not conduct problems (<i>r =</i> 0.13–0.16; 0–42% A, 42–81% C, 16–24% E). Our findings emphasise that rather than a risk factor or an outcome, social isolation is aetiologically intertwined with the experience of poor mental health. An integrative assessment of social isolation could be a helpful indicator of underlying mental health symptoms in young people.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201414","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 : 2024-09-06DOI: 10.1007/s00787-024-02576-7
Michael O'Brien, Rachael Quirke, Roisin Gowan, Fiona McNicholas
Thiamine is an essential vitamin that plays a crucial role in many biochemical processes in the body. Anorexia nervosa (AN) is one potential cause of a state of deficiency which can result in grave medical sequelae. There is limited available evidence of the prevalence of thiamine deficiency in patients who suffer from AN. The current study aimed to systematically review all available evidence on the prevalence of thiamine deficiency in cohorts with AN. Studies were included where thiamine status in a group of participants with AN was measured, either through self-reporting or objective measurement. Eight databases (Scopus, CINAHL complete, Medline complete, EMBASE, WEB OF SCIENCE, PROSPERO, COCHRANE DATABASE OF SYSTEMATIC REVIEWS and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. PRISMA guidelines were followed. The study was registered on PROSPERO. A minimum of two researchers conducted each part of the review. The search identified 42 articles whose full texts were screened for eligibility, with 17 retained for qualitative synthesis. The prevalence rates of thiamine deficiency in AN varied from 5.9% to 100% when based on self-report dietary intake. When objective measurements were taken, rates ranged from 0% to 56.7%. The review suggested that age, body mass index (BMI), duration of illness and subtype of AN were not associated with thiamine status. The limited available evidence suggested that the use of supplements, prior treatment and higher energy intakes were associated with a reduced risk of developing a thiamine deficiency among individuals with AN. Poor study methodology including small sample size, inconsistent deficiency definition and study heterogeneity limits the conclusions that can be drawn. Ultimately, there is insufficient strength of evidence to draw definitive clinical recommendations. This review highlights the need for further studies with more robust methodology to help further inform clinical practice.
硫胺素是一种人体必需的维生素,在体内许多生化过程中发挥着至关重要的作用。神经性厌食症(AN)是导致硫胺素缺乏的一个潜在原因,而硫胺素缺乏可能导致严重的医疗后遗症。关于神经性厌食症患者中硫胺素缺乏症发病率的现有证据十分有限。目前的研究旨在系统性地回顾所有关于AN患者群体中硫胺素缺乏症发生率的现有证据。研究纳入了通过自我报告或客观测量对一组AN患者的硫胺素状态进行测量的研究。共检索了八个数据库(Scopus、CINAHL complete、Medline complete、EMBASE、WEB OF SCIENCE、PROSPERO、COCHRANE DATABASE OF SYSTEMATIC REVIEWS 和 Cochrane Central Register of Controlled Trials (CENTRAL))。研究遵循 PRISMA 指南。研究已在 PROSPERO 上注册。每部分的综述至少由两名研究人员进行。此次检索共发现 42 篇文章,对其全文进行了资格筛选,并保留了 17 篇文章进行定性综合。根据自我报告的膳食摄入量,苯丙胺缺乏症的发病率从5.9%到100%不等。在进行客观测量时,发病率从0%到56.7%不等。综述表明,年龄、体重指数(BMI)、病程和AN亚型与硫胺素状态无关。有限的现有证据表明,使用补充剂、接受过治疗和摄入较多能量与降低AN患者发生硫胺素缺乏症的风险有关。研究方法不当,包括样本量小、缺乏症定义不一致以及研究的异质性,都限制了可以得出的结论。最终,由于证据不足,无法得出明确的临床建议。本综述强调了进一步研究的必要性,这些研究应采用更可靠的方法,以帮助进一步指导临床实践。
{"title":"Prevalence of thiamine deficiency in anorexia nervosa: a systematic review and narrative synthesis.","authors":"Michael O'Brien, Rachael Quirke, Roisin Gowan, Fiona McNicholas","doi":"10.1007/s00787-024-02576-7","DOIUrl":"https://doi.org/10.1007/s00787-024-02576-7","url":null,"abstract":"<p><p>Thiamine is an essential vitamin that plays a crucial role in many biochemical processes in the body. Anorexia nervosa (AN) is one potential cause of a state of deficiency which can result in grave medical sequelae. There is limited available evidence of the prevalence of thiamine deficiency in patients who suffer from AN. The current study aimed to systematically review all available evidence on the prevalence of thiamine deficiency in cohorts with AN. Studies were included where thiamine status in a group of participants with AN was measured, either through self-reporting or objective measurement. Eight databases (Scopus, CINAHL complete, Medline complete, EMBASE, WEB OF SCIENCE, PROSPERO, COCHRANE DATABASE OF SYSTEMATIC REVIEWS and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. PRISMA guidelines were followed. The study was registered on PROSPERO. A minimum of two researchers conducted each part of the review. The search identified 42 articles whose full texts were screened for eligibility, with 17 retained for qualitative synthesis. The prevalence rates of thiamine deficiency in AN varied from 5.9% to 100% when based on self-report dietary intake. When objective measurements were taken, rates ranged from 0% to 56.7%. The review suggested that age, body mass index (BMI), duration of illness and subtype of AN were not associated with thiamine status. The limited available evidence suggested that the use of supplements, prior treatment and higher energy intakes were associated with a reduced risk of developing a thiamine deficiency among individuals with AN. Poor study methodology including small sample size, inconsistent deficiency definition and study heterogeneity limits the conclusions that can be drawn. Ultimately, there is insufficient strength of evidence to draw definitive clinical recommendations. This review highlights the need for further studies with more robust methodology to help further inform clinical practice.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139623","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 : 2024-09-06DOI: 10.1007/s00787-024-02560-1
Melissa P DelBello, Robert L Findling, Michael Huss, Oscar Necking, Maria L Petersen, Simon N Schmidt, Monika Rosen
Children and adolescents with severe or relapsing major depressive disorder (MDD) may require long-term antidepressant use, but safety and tolerability data on long-term treatment are limited. In a randomized, placebo-controlled trial in children and another in adolescents, vortioxetine and placebo groups showed improvement in MDD symptoms without statistically significant differences between groups. To gain insights on long-term safety and tolerability of vortioxetine in pediatric patients, participants from these two studies were enrolled in two long-term extension studies: 6 months (NCT02871297) followed by another 18 months (NCT03108625). Key safety measures included adverse events (AEs) and Columbia-Suicide Severity Rating Scale (C-SSRS); effectiveness measures included depression symptom severity, cognitive function, and overall functioning. Among the 662 patients in the 6-month extension, 61% experienced a treatment-emergent AE (TEAE), with the most common being nausea (20.8%); 2.1% had a serious AE (SAE), and 6% withdrew because of TEAEs. In the following 18-month extension (n = 94), 51% of patients experienced a TEAE, with the most common being headache (13.8%); no SAEs were reported. Based on the C-SSRS, 94% and 96% of patients reported no suicidal ideation or behavior in the 6- and 18-month studies, respectively. During the extension studies, patients continued to show improvement in depressive symptoms and cognitive and overall functioning, with > 50% of patients in remission at the end of each study, regardless of study treatment in the lead-in trial. Overall, vortioxetine remained well tolerated in pediatric patients with MDD who continued in the long-term extension studies with no observed increased risk in suicidal ideation.
{"title":"Vortioxetine in children and adolescents with major depressive disorder: 6-month and 18-month open-label, flexible-dose, long-term extension studies.","authors":"Melissa P DelBello, Robert L Findling, Michael Huss, Oscar Necking, Maria L Petersen, Simon N Schmidt, Monika Rosen","doi":"10.1007/s00787-024-02560-1","DOIUrl":"https://doi.org/10.1007/s00787-024-02560-1","url":null,"abstract":"<p><p>Children and adolescents with severe or relapsing major depressive disorder (MDD) may require long-term antidepressant use, but safety and tolerability data on long-term treatment are limited. In a randomized, placebo-controlled trial in children and another in adolescents, vortioxetine and placebo groups showed improvement in MDD symptoms without statistically significant differences between groups. To gain insights on long-term safety and tolerability of vortioxetine in pediatric patients, participants from these two studies were enrolled in two long-term extension studies: 6 months (NCT02871297) followed by another 18 months (NCT03108625). Key safety measures included adverse events (AEs) and Columbia-Suicide Severity Rating Scale (C-SSRS); effectiveness measures included depression symptom severity, cognitive function, and overall functioning. Among the 662 patients in the 6-month extension, 61% experienced a treatment-emergent AE (TEAE), with the most common being nausea (20.8%); 2.1% had a serious AE (SAE), and 6% withdrew because of TEAEs. In the following 18-month extension (n = 94), 51% of patients experienced a TEAE, with the most common being headache (13.8%); no SAEs were reported. Based on the C-SSRS, 94% and 96% of patients reported no suicidal ideation or behavior in the 6- and 18-month studies, respectively. During the extension studies, patients continued to show improvement in depressive symptoms and cognitive and overall functioning, with > 50% of patients in remission at the end of each study, regardless of study treatment in the lead-in trial. Overall, vortioxetine remained well tolerated in pediatric patients with MDD who continued in the long-term extension studies with no observed increased risk in suicidal ideation.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139624","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 : 2024-09-05DOI: 10.1007/s00787-024-02574-9
Shaogen Zhong, Xindi Lin, Mengxing Wang, Yi Mao, Jiayao Shen, Xiaoxia Du, Lichi Zhang, Jun Ma
Existing literature strongly supports the idea that children with primary nocturnal enuresis (PNE) have brainstem abnormalities. However, the connection between pre-micturition arousal responses and brain functional connectivities is still not clearly defined. Our study investigated the correlation between the gradations of micturition desire-awakening (MDA) functionality and the functional connectivity of the midbrain periaqueductal gray (PAG), a pivotal brainstem hub implicated in the neural regulation of micturition in humans. Neuroimaging and behavioral data from 133 patients with PNE and 40 healthy children were acquired from functional magnetic resonance imaging (fMRI) and precise clinical observations, respectively. The whole-brain correlation analyses were undertaken to elucidate the complex connectivity patterns between the subregions of PAG and the cerebral cortex, with a focus on their correlation to the spectrum of MDA functionality. A positive correlation was identified between MDA dysfunction and the resting-state functional connectivity (RSFC) between the left ventrolateral periaqueductal gray (vlPAG) and the right temporal pole of the superior temporal gyrus. Conversely, a negative correlation was observed between MDA dysfunction and the RSFC of the right vlPAG with the right superior parietal lobule. Additionally, MDA dysfunction exhibited a negative association with the RSFC between the dorsomedial PAG (dmPAG) and the right inferior parietal lobule. These findings may indicate that the specific signal from a distended bladder is blocked in the PAG and its functional connectivity with the executive function, attention, and default mode networks, ultimately leading to impaired arousal and bladder control. This revelation underscores potential neural targets for future therapeutic interventions.
{"title":"Periaqueductal gray subregions connectivity and its association with micturition desire-awakening function.","authors":"Shaogen Zhong, Xindi Lin, Mengxing Wang, Yi Mao, Jiayao Shen, Xiaoxia Du, Lichi Zhang, Jun Ma","doi":"10.1007/s00787-024-02574-9","DOIUrl":"https://doi.org/10.1007/s00787-024-02574-9","url":null,"abstract":"<p><p>Existing literature strongly supports the idea that children with primary nocturnal enuresis (PNE) have brainstem abnormalities. However, the connection between pre-micturition arousal responses and brain functional connectivities is still not clearly defined. Our study investigated the correlation between the gradations of micturition desire-awakening (MDA) functionality and the functional connectivity of the midbrain periaqueductal gray (PAG), a pivotal brainstem hub implicated in the neural regulation of micturition in humans. Neuroimaging and behavioral data from 133 patients with PNE and 40 healthy children were acquired from functional magnetic resonance imaging (fMRI) and precise clinical observations, respectively. The whole-brain correlation analyses were undertaken to elucidate the complex connectivity patterns between the subregions of PAG and the cerebral cortex, with a focus on their correlation to the spectrum of MDA functionality. A positive correlation was identified between MDA dysfunction and the resting-state functional connectivity (RSFC) between the left ventrolateral periaqueductal gray (vlPAG) and the right temporal pole of the superior temporal gyrus. Conversely, a negative correlation was observed between MDA dysfunction and the RSFC of the right vlPAG with the right superior parietal lobule. Additionally, MDA dysfunction exhibited a negative association with the RSFC between the dorsomedial PAG (dmPAG) and the right inferior parietal lobule. These findings may indicate that the specific signal from a distended bladder is blocked in the PAG and its functional connectivity with the executive function, attention, and default mode networks, ultimately leading to impaired arousal and bladder control. This revelation underscores potential neural targets for future therapeutic interventions.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132185","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 : 2024-09-05DOI: 10.1007/s00787-024-02556-x
Keely E Thornton, Kelsey K Wiggs, Jeffery N Epstein, Leanne Tamm, Stephen P Becker
The current study examined attention-deficit/hyperactivity disorder (ADHD) dimensions and cognitive disengagement syndrome (CDS) symptoms in relation to self-injurious thoughts and behaviors (SITBs) in an early adolescent sample. Participants were 341 adolescents ages 10-12 years (52.2% female; 37.8% people of color) recruited from the community. Caregivers reported on CDS and ADHD symptoms. Adolescents completed a rating scale and were administered an interview assessing SITBs. We estimated associations using logistic regression in a stepped fashion: (1) no adjustment, (2) adjustment for sex, race, family income, and psychotropic medication use, and (3) further adjustment for depressive symptoms. In this early adolescent community sample, 22.9% reported a history of suicidal ideation, 8.2% reported a history of a suicide plan, 6.2% reported a history of non-suicidal self-injury (NSSI), and 16.4% met a clinical cutoff for current suicide risk. Across most analyses using rating scale or interview methods, higher mean CDS scores were related to endorsement of suicidal ideation and planning. ADHD inattentive (IN) and hyperactive-impulsive (HI) symptoms were associated with endorsement of NSSI, and ADHD-IN symptoms were associated with thoughts of suicide and/or plan measured via questionnaire, though effects were less robust and not significant, potentially due to low base rates impacting statistical power. This study adds to a growing body of research highlighting the importance of screening for CDS symptoms among individuals with and without ADHD. More research, especially longitudinal work, is needed that examines possible differential pathways to SITBs by ADHD and CDS symptoms to advance SITB prevention, early detection, and intervention.
{"title":"ADHD and cognitive disengagement syndrome symptoms related to self-injurious thoughts and behaviors in early adolescents.","authors":"Keely E Thornton, Kelsey K Wiggs, Jeffery N Epstein, Leanne Tamm, Stephen P Becker","doi":"10.1007/s00787-024-02556-x","DOIUrl":"https://doi.org/10.1007/s00787-024-02556-x","url":null,"abstract":"<p><p>The current study examined attention-deficit/hyperactivity disorder (ADHD) dimensions and cognitive disengagement syndrome (CDS) symptoms in relation to self-injurious thoughts and behaviors (SITBs) in an early adolescent sample. Participants were 341 adolescents ages 10-12 years (52.2% female; 37.8% people of color) recruited from the community. Caregivers reported on CDS and ADHD symptoms. Adolescents completed a rating scale and were administered an interview assessing SITBs. We estimated associations using logistic regression in a stepped fashion: (1) no adjustment, (2) adjustment for sex, race, family income, and psychotropic medication use, and (3) further adjustment for depressive symptoms. In this early adolescent community sample, 22.9% reported a history of suicidal ideation, 8.2% reported a history of a suicide plan, 6.2% reported a history of non-suicidal self-injury (NSSI), and 16.4% met a clinical cutoff for current suicide risk. Across most analyses using rating scale or interview methods, higher mean CDS scores were related to endorsement of suicidal ideation and planning. ADHD inattentive (IN) and hyperactive-impulsive (HI) symptoms were associated with endorsement of NSSI, and ADHD-IN symptoms were associated with thoughts of suicide and/or plan measured via questionnaire, though effects were less robust and not significant, potentially due to low base rates impacting statistical power. This study adds to a growing body of research highlighting the importance of screening for CDS symptoms among individuals with and without ADHD. More research, especially longitudinal work, is needed that examines possible differential pathways to SITBs by ADHD and CDS symptoms to advance SITB prevention, early detection, and intervention.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132184","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}