European Child & Adolescent Psychiatry最新文献

Individuals with orofacial clefts (OFCs) may be at an increased risk of developing autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This systematic review provides a summary of the most recent data regarding the prevalence of ASD and ADHD in the OFC population and compares this to the general paediatric population. Multiple databases were searched including PubMed/Medline and Embase in July 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42024565219). 1025 papers were identified for screening, of which nine were included in the report. Percentage prevalence was calculated and compared to global prevalence or control populations where available. Overall, ASD prevalence among children with a cleft ranged from 0 to 50% (Mean = 2.87%; SD = 5.40) compared to ~ 1% globally (WHO) and ADHD prevalence ranged from 2.34 to 31.71% (Mean = 3.63%; SD = 4.30) compared to ~ 5% globally (NICE). Matched control populations showed larger differences. Isolated cleft palate was associated with higher rates than isolated cleft lip or combined cleft lip and palate. Prevalence in individuals with syndromic clefts appeared greater still (Mean = 14.80%; SD = 16.58) although populations were small. Children with OFCs demonstrate increased prevalence of ASD compared to the average paediatric population. Evidence for increased prevalence of ADHD is less clear, with varying rates across studies. Children with isolated cleft palate or cleft associated with genetic syndromes appear most at risk, although further research is needed.

Online social interactions increase into adolescence. Although cross-sectional studies have positively associated online social activity (OSA) time and attention-deficit/hyperactivity disorder (ADHD) problems, the directionality remains unclear. Therefore, we examined longitudinal associations between OSA time and ADHD problems using data from the Adolescent Brain Cognitive Development (ABCD) study. Four waves of ABCD data from 11,819 youth participants (52.1% boys; Baseline: M_age = 9.92 years, SD_age = 0.62) were utilized. Random-intercepts cross-lagged panel models (RI-CLPMs) adjusting for potential confounds were employed to estimate longitudinal bidirectional associations. Multiple-group RI-CLPM analyses examined potential moderation effects of OSA content type and child's sex. The results revealed that greater OSA time was associated with more ADHD problems in early adolescence, while more ADHD problems did not predict greater OSA time. In moderation analyses, the cross-lagged effects of OSA time on ADHD problems were only significant for girls, and boys showed an inverse relation between ADHD problems and subsequent OSA time. No moderation effect of OSA content type was observed. These findings highlight the potential detrimental effect of OSA time on the development of attentional processes, especially for girls, thereby offering insights that could guide the development and targeting of interventions to mitigate future risks for ADHD problems during adolescence.

Tourette syndrome and other tic disorders are prevalent neurodevelopmental disorders typically treated with behavioral techniques or pharmacological interventions, primarily antipsychotics. However, many patients do not achieve sufficient response to conventional treatments, underscoring the need for further research in this area. To provide a comprehensive overview of ongoing research activities, we systematically searched the clinical registries of the World Health Organization (WHO) and of the United States National Institutes of Health (NIH) for currently planned or ongoing registered clinical studies. Our search identified 21 registered studies, of which seven focus specifically on pharmacological interventions. Potential candidates include the dopamine D1 antagonist ecopipam, the phosphodiesterase inhibitor gemlapodect, and cannabis-based therapies. Additionally, several studies are exploring behavioral interventions including Comprehensive Behavioral Interventions for Tics (CBIT) and mindfulness training, neurostimulation including MRI-navigated transcranial stimulation, theta burst stimulation, and deep brain stimulation, traditional Chinese medicine, and other approaches such as microbiota transplantation. Despite the range of research activities underway, the overall landscape remains limited. In this report we will discuss the findings, current developments, and relevant aspects concerning future research including clinical, scientific, and patient perspectives.

Tobacco use often starts during adolescence, with many adults beginning before 21. This study investigated the patterns and factors associated with tobacco and e-cigarette use among school-aged adolescents in Albania. Data were analyzed from two Albania Global Youth Tobacco Surveys (GYTS) conducted in 2015 and 2020. Participants included 7th-10th grade students (ages 12-16) who completed the survey (n = 9985). Descriptive statistics depicted demographic characteristics, tobacco, and e-cigarette use across survey years. Logistic regression assessed temporal changes and the odds of use across independent variables, adjusting for age and sex. From 2015 to 2020, tobacco and e-cigarette use among students aged 13-15 increased from 12.86 to 14.49% and from 6.8 to 8.8%, respectively. Cigarette smoking declined from 8.4 to 4.3%, but the use of other tobacco products nearly doubled, from 6.4 to 12.3%. Higher odds of use were found among males, older students, and those with more pocket money. Environmental factors like family, peer, and media exposure to smoking increased the likelihood of use. Anti-tobacco messages had no significant impact, while advertising strongly influenced usage. Knowledge of tobacco harms and anti-smoking attitudes correlated with lower odds of use. Increased availability of cigarettes near schools was linked to higher odds of tobacco use. The study highlights gaps in anti-tobacco messaging and the strong influence of advertising, underscoring the need for targeted and effective tobacco control strategies in Albania.

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by dysplasia in early life. Psychoradiology studies have suggested that mental and behavioral deficits in individuals with PWS are linked to abnormalities in brain structural and functional networks. However, little is known about changes in network-based structural-functional coupling and structural/functional topological properties and their correlations with developmental scales in children with PWS. Here, we acquired diffusion tensor imaging and resting-state functional magnetic resonance imaging data from 25 children with PWS and 28 age- and sex-matched healthy controls, constructed structural and functional networks, examined intergroup differences in structural-functional coupling and structural/functional topological properties (both global and nodal), and tested their partial correlations with developmental scales. We found that children with PWS exhibited (1) decreased structural-functional coupling, (2) a higher characteristic path length and lower global efficiency in the structural network in terms of global properties, (3) alterations in classical cortical and subcortical networks in terms of nodal properties, with the structural network dominated by decreases and the functional network dominated by increases, and (4) partial correlation with developmental scales, especially for functional networks. These findings suggest that structural-functional decoupling and abundant structural/functional network topological properties may reveal the mechanism of early neurodevelopmental delays in PWS from a neuroimaging perspective and might serve as potential markers to assess early neurodevelopmental backwardness in PWS.

Excessive screen time was associated with mental health problems, yet whether the associations differ by screen content types remain unknown. Here, we conducted a cross-sectional study of adolescents from 156 junior and high school to investigate the association of types of on-screen content with mental health problems in China. The exposure variable was screen exposure, measured by the self-reported questionnaire. Symptoms of depression and anxiety were assessed by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7), respectively. Suicide-related behavior was adapted from the Centers for Disease Control's Youth Risk Behavior Surveillance. Generalized linear models and network analysis were performed. Of the 15,194 adolescents included in the final analysis, 8,019 were males and mean (SD) age was 14.50 (1.68) years. 34.6% of adolescents had an average screen time of ≥ 4 h/day on weekends. The most frequently used screen contents (≥ 4 h/d) were electronic games (9.1%), followed by short video (6.6%). Learning online had strong associations with depression (OR = 2.03, 95%CI: 1.29-3.11, P = 0.002) and anxiety (OR = 2.05, 95%CI: 1.24-3.27, P = 0.004) symptoms. The associations between on-screen content and mental health varied. The strongest edges linked to screen content types were edge between "Electronic games" and "Anhedonia" in the network model. "Control worry" was the most central nodes, followed by "Irritable" and "Worry A Lot". Findings suggested that both screen time and different types of screen content were associated with mental health problems among adolescents. Limiting screen exposure and developing effective interventions to improve mental health should be a priority.

Integration of child mental health services in general practice may improve early detection and treatment and reduce strain on specialized services. In this study we investigated whether outpatient mental health care utilization and associated costs in children and adolescents were affected by the introduction of youth mental health practice nurses (YMHPNs) in general practice. We linked healthcare data of the Rijnmond Primary Care Database to municipal registry data on child outpatient mental health care expenditures between 2019 and 2022. Using mixed models, we assessed if the presence of a YMHPN in practices was associated with outpatient mental health care utilization. Our cohort consisted of 33,971 children aged 0-17 years registered in 38 general practices in Rotterdam, the Netherlands. 5.5% of these children attended outpatient mental health services between 2019 and 2022. The proportion of children utilizing outpatient mental health care and associated costs increased over time. After correction for practice demographics and trends over time, the presence of a YMHPN in a practice was associated with small non-significant reductions in the number of children receiving outpatient care (Rate Ratio = 0.99, 95%CI 0.92 to 1.06) and associated costs (-395.80 euros 95%CI -1431.27 to 639.67) compared with practices without YMHPN. Considering the study limitations, we cautiously concluded that the introduction of YMHPNs in general practice was not associated with significant changes in outpatient mental health care utilization one to four years after implementation. Future studies should elucidate the long-term impact and underlying changes in pathways to care due to the introduction of the YMHPN.