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Transmission of depressive symptoms in the nuclear family: a cross-sectional and cross-lagged network perspective. 核心家庭中抑郁症状的传播:横截面和跨滞后网络视角。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-16 DOI: 10.1007/s00787-024-02377-y
Wenrui Zhang, Ting He, Qinglu Wu, Peilian Chi, Xiuyun Lin

Children are more likely to develop depressive symptoms in families where parents have depressive symptoms. By conceptualizing the individual depressive symptom network of each family member as a whole, this study proposes a family symptom network model, and explored the mechanisms of transmission of depression within nuclear families at the symptom level. This study used four waves (2012, 2016, 2018, 2020) of data from the China Family Panel Studies (CFPS), which in wave one contained a representative sample of 1963 children (1038 boys; age = 12.60), 4763 mothers and 4614 fathers from China. Children with their parents completed the Center for Epidemiology Studies Depression Scale at each wave. Individual depressive symptom networks among children, fathers, and mothers were highly similar and stable across time. When considering depressive symptoms of all family members as a whole, there was a wide range of associations between child, father, and mother depressive symptom networks. The results of the cross-lagged network model suggest the bidirectional relationships between couples and parent-child depression. The current study provides preliminary validation of the family symptom network model. The model represents a further integration and extension of network theory of mental disorders and family systems theory, and points out the limitations of studying the intergenerational transmission of depression from a latent variable perspective. Thus, the family symptom network model proposed in this study could provide valuable new insights into understanding the intergenerational transmission of depression.

在父母有抑郁症状的家庭中,子女更容易出现抑郁症状。本研究通过将每个家庭成员的个体抑郁症状网络概念化为一个整体,提出了家庭症状网络模型,并从症状层面探讨了抑郁症在核心家庭中的传播机制。本研究使用了中国家庭面板研究(CFPS)的四波数据(2012、2016、2018、2020),其中第一波包含了来自中国的1963名儿童(1038名男孩;年龄=12.60)、4763名母亲和4614名父亲的代表性样本。儿童和他们的父母在每个波次都填写了流行病学研究中心抑郁量表。儿童、父亲和母亲的个体抑郁症状网络在不同时期高度相似且稳定。从整体上考虑所有家庭成员的抑郁症状时,儿童、父亲和母亲的抑郁症状网络之间存在广泛的关联。交叉滞后网络模型的结果表明,夫妻抑郁与亲子抑郁之间存在双向关系。目前的研究初步验证了家庭症状网络模型。该模型是精神障碍网络理论和家庭系统理论的进一步整合和延伸,指出了从潜变量角度研究抑郁代际传递的局限性。因此,本研究提出的家庭症状网络模型可为理解抑郁症的代际传播提供有价值的新见解。
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引用次数: 0
Increased risk of attention-deficit/hyperactivity disorder in adolescents with high salivary levels of copper, manganese, and zinc. 唾液中铜、锰和锌含量高的青少年患注意力缺陷/多动症的风险增加。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-14 DOI: 10.1007/s00787-024-02381-2
D'Artagnan M Robinson, Karen L Edwards, Michael T Willoughby, Katrina R Hamilton, Clancy B Blair, Douglas A Granger, Elizabeth A Thomas

Exposure to toxic heavy metals has been associated with the development of attention-deficit/hyperactivity disorder (ADHD). However, fewer studies have examined the associations between abnormal levels of essential trace metals and ADHD, and none have done so using saliva. We investigated whether salivary metals were associated with ADHD in adolescents aged 12 from the Family Life Project (FLP) using a nested case-control study design that included 110 adolescents who met diagnostic criteria for inattentive (ADHD-I), hyperactive-impulsive (ADHD-H), or combined type ADHD (ADHD-C) (cases) and 173 children who did not (controls). We used inductively coupled plasma optical emission spectrophotometry to measure chromium, copper, manganese, and zinc in saliva samples. We employed logistic regression models to examine associations between quartile levels of individual metals and ADHD outcomes by subtype. Salivary copper levels were significantly associated with increased odds of any ADHD diagnosis (OR = 3.31, 95% CI: 1.08-10.12; p = 0.04) and with increased odds of ADHD-C diagnosis (OR = 8.44, 95% CI: 1.58-45.12; p = 0.01). Salivary zinc levels were significantly associated with increased odds of ADHD-C diagnosis (OR = 4.06, 95% CI: 1.21-13.69; p = 0.02). Salivary manganese levels were also significantly associated with increased odds of ADHD-C diagnosis (OR = 5.43, 95% CI: 1.08-27.27, p = 0.04). This is the first study using saliva to assess metal exposure and provide a potential link between salivary levels of copper, manganese, and zinc and ADHD diagnoses in adolescents. Public health interventions focused on metal exposures might reduce ADHD incidence in low-income, minority communities.

接触有毒重金属与注意力缺陷/多动症(ADHD)的发生有关。然而,研究必需微量金属异常水平与多动症之间关系的研究较少,而且没有一项研究使用唾液进行研究。我们采用巢式病例对照研究设计,调查了家庭生活项目(FLP)中 12 岁青少年唾液中的金属是否与多动症有关,研究对象包括 110 名符合注意力不集中型多动症(ADHD-I)、多动冲动型多动症(ADHD-H)或综合型多动症(ADHD-C)诊断标准的青少年(病例)和 173 名不符合诊断标准的儿童(对照)。我们使用电感耦合等离子体光发射分光光度法测量唾液样本中的铬、铜、锰和锌。我们采用逻辑回归模型,按亚型研究了各种金属的四分位水平与多动症结果之间的关系。唾液中铜的水平与诊断为任何多动症的几率增加(OR = 3.31,95% CI:1.08-10.12;p = 0.04)和诊断为ADHD-C的几率增加(OR = 8.44,95% CI:1.58-45.12;p = 0.01)明显相关。唾液锌水平与诊断为ADHD-C的几率增加明显相关(OR = 4.06,95% CI:1.21-13.69;p = 0.02)。唾液中的锰水平也与ADHD-C诊断几率的增加明显相关(OR = 5.43,95% CI:1.08-27.27,p = 0.04)。这是第一项利用唾液评估金属暴露的研究,它提供了唾液中铜、锰和锌水平与青少年多动症诊断之间的潜在联系。针对金属暴露的公共卫生干预措施可能会降低低收入少数民族社区的多动症发病率。
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引用次数: 0
The impact of universal, school based, interventions on help seeking in children and young people: a systematic literature review. 基于学校的普遍干预措施对儿童和青少年求助的影响:系统性文献综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-01-13 DOI: 10.1007/s00787-022-02135-y
Daniel Hayes, Rosie Mansfield, Carla Mason, Joao Santos, Anna Moore, Jan Boehnke, Emma Ashworth, Bettina Moltrecht, Neil Humphrey, Paul Stallard, Praveetha Patalay, Jessica Deighton

Reviews into universal interventions to improve help seeking in young people focus on specific concepts, such as behaviour, do not differentiate between interpersonal and intrapersonal help seeking, and often report on statistical significance, rather than effect size. The aim of this review was to address the gaps highlighted above, to investigate the impact of universal, school-based interventions on help-seeking in children and young people, as well as to explore longer term impact. Four databases were searched. Data were extracted on country of origin, design, participant, school, and intervention characteristics, the help-seeking concept measured (e.g. knowledge, attitude/intention, behaviour), the duration between baseline and each follow-up (if applicable) and effect sizes at each follow-up. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Overall, 14 different interventions met inclusion criteria. The majority of the studies were rated low in the quality assessment. Three constructs were most frequently reported a) intrapersonal attitudes towards help-seeking, b) interpersonal attitudes towards help-seeking and c) intrapersonal intended help-seeking. Findings around intervention effect were mixed. There was tentative evidence that interventions impacting interpersonal attitudes produced small effect sizes when measured between 3 and 6 months post intervention and that when effect sizes were initially observed intrapersonal attitudes, this remained at 3-6 month follow-up. Further work should pay attention to implementation factors, understanding the core ingredients needed to deliver effective interventions and whether embedding mental health education could help sustain or top up effect sizes from help-seeking interventions.

有关改善青少年求助情况的普遍干预措施的综述主要集中在行为等特定概念上,没有区分人际求助和人内求助,而且通常只报告统计意义而非效果大小。本综述旨在弥补上述不足,调查以学校为基础的普遍干预措施对儿童和青少年寻求帮助的影响,并探讨其长期影响。我们检索了四个数据库。提取的数据包括来源国、设计、参与者、学校和干预措施的特点、所测量的求助概念(如知识、态度/意向、行为)、基线与每次随访之间的持续时间(如适用)以及每次随访的效果大小。研究质量评估采用有效公共卫生实践项目(EPHPP)质量评估工具进行。共有 14 项不同的干预措施符合纳入标准。大多数研究在质量评估中被评为低级。报告最多的有三个方面:a) 个人内部对寻求帮助的态度;b) 人际间对寻求帮助的态度;c) 个人内部打算寻求帮助的态度。关于干预效果的研究结果不一。有初步证据表明,对人际态度产生影响的干预措施在干预后 3 至 6 个月的测量中产生了较小的效应大小,而当最初观察到人际态度的效应大小时,这种效应大小在 3 至 6 个月的随访中依然存在。进一步的工作应关注实施因素,了解实施有效干预所需的核心要素,以及嵌入心理健康教育是否有助于维持或提高求助干预的效果。
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引用次数: 0
Prevalence and quality of life of 11-15-year-old adolescent young carers in France: a school-based study. 法国 11-15 岁青少年照顾者的普遍性和生活质量:一项以学校为基础的研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-14 DOI: 10.1007/s00787-024-02383-0
Jade Pilato, Géraldine Dorard, Aurélie Untas

Our study aimed to establish the prevalence of adolescent young carers (AYCs) among 11-15-year-old French adolescents and explore the impacts of caring on these youths through a comprehensive evaluation of their quality of life. A total of 1983 middle school pupils (mean age = 12.89; 56.23% females) completed self-reported questionnaires evaluating their sociodemographic characteristics, illness/disability in their family, caring activities (MACA-YC18), quality of life (KIDSCREEN-52), perceived health, and academic performance. Descriptive analyses, Chi-square tests of independence, Student's t-tests, and analysis of variance and of covariance were conducted. The results showed that 12.25% of middle school pupils were AYCs. They were mostly females, coming from disadvantaged economic backgrounds. The ill/disabled relative was typically a parent, and 23.87% of respondents reported having more than one ill/disabled relative. The AYCs more often declared an illness or a disability and reported lower quality of life scores than their peers in several dimensions: Physical Well-Being, Psychological Well-Being, Moods and Emotions, Self-Perception, Autonomy, Relations with Parents and Home Life, Financial Resources, School Environment, Social Acceptance. No differences were identified in the Social Support and Peers dimension. Given the high prevalence of AYCs in middle schools and the impact of the situation on their lives, special support should be provided for AYCs, and professionals at school should be trained to better identify and assist AYCs.

我们的研究旨在确定 11-15 岁法国青少年中青少年照护者(AYCs)的普遍程度,并通过对这些青少年生活质量的综合评估,探讨照护对他们的影响。共有 1983 名中学生(平均年龄 = 12.89 岁;56.23% 为女性)填写了自我报告问卷,评估了他们的社会人口特征、家庭中的疾病/残疾情况、照顾活动(MACA-YC18)、生活质量(KIDSCREEN-52)、健康感知和学习成绩。研究进行了描述性分析、独立性卡方检验、学生 t 检验、方差分析和协方差分析。结果表明,12.25% 的初中生是青少年学生。他们大多为女性,来自弱势经济背景。患病/残疾的亲属通常是父母,23.87%的受访者表示有一个以上患病/残疾的亲属。与同龄人相比,亚青会成员更常宣称自己患病或残疾,并在多个方面的生活质量得分较低:身体健康、心理健康、情绪和情感、自我认知、自主性、与父母的关系和家庭生活、经济资源、学校环境、社会接纳度。在社会支持和同伴维度上没有发现差异。鉴于青少年自闭症儿童在中学中的高发率以及这种情况对他们生活的影响,应为青少年自闭症儿童提供特别支持,并培训学校专业人员更好地识别和帮助青少年自闭症儿童。
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引用次数: 0
Impact of poverty and adversity on perceived family support in adolescence: findings from the UK Millennium Cohort Study. 贫困和逆境对青少年时期家庭支持感的影响:英国千年队列研究的发现。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-14 DOI: 10.1007/s00787-024-02389-8
Nicholas Kofi Adjei, Kenisha Russell Jonsson, Viviane S Straatmann, Gabriella Melis, Ruth McGovern, Eileen Kaner, Ingrid Wolfe, David C Taylor-Robinson

Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people's relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months-14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent-adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education-degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent-adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7-2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health.

家庭成员的情感支持可能会对青少年的健康结果产生重要影响,并已被确定为政策目标,以防止贫困和其他早期生活逆境的影响。然而,很少有研究对贫困和逆境本身对父母为青少年提供情感支持的影响程度进行评估。因此,我们旨在调查收入贫困和家庭逆境(包括父母精神疾病、酗酒和家庭暴力)在儿童成长阶段的轨迹对青少年与家人的关系以及感知到的情感支持的影响。我们分析了具有全国代表性的英国千年队列研究中 10,976 名儿童的纵向数据。我们使用基于群体的多轨迹模型(9 个月至 14 岁)描述了贫困和家庭逆境的暴露轨迹。研究结果是通过三项目短式社会供给量表(SPS-3)测量的感知到的情感支持和家庭关系质量,以及 14 岁时测量的父母与青少年的亲密程度和冲突程度。采用多变量逻辑回归模型估算 ORs 和 95% CIs,并对潜在的混杂因素进行调整。14 岁时,感知到的情感支持较低的总体患病率为 13%(95% CI:12-14)。社会经济地位(SES)较低的母亲的子女更有可能报告情感支持度低,社会梯度明显(有学历:10.3% 对无学历:15.4%)。与处于低水平贫困和逆境中的儿童相比,处于持续逆境轨迹组的儿童出现情感支持低和父母与青少年关系低质量的几率更高;那些同时处于持续贫困和父母精神健康状况差的儿童出现家庭关系差和感知情感支持低的风险尤其高(调整后的几率比为 2-2;95% CI 为 1-7-2-9)。在社会弱势儿童和青少年以及经历社会逆境的儿童和青少年中,青少年时期感知到的情感支持低和家庭关系差的情况更为普遍。改善英国青少年家庭支持水平的政策应侧重于改善可改变的决定因素,如儿童贫困和家庭心理健康。
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引用次数: 0
Self-management, self-care, and self-help in adolescents with emotional problems: a scoping review. 有情绪问题的青少年的自我管理、自我护理和自助:范围界定综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-01-15 DOI: 10.1007/s00787-022-02134-z
Rosa Town, Daniel Hayes, Anna March, Peter Fonagy, Emily Stapley

This study aimed to review the existing published and grey literature describing the concepts of self-management, self-care, and self-help, and to capture strategies or techniques related to these concepts, for adolescents with emotional problems. Emotional problems are rising amongst adolescents, yet timely access to specialist mental health treatment is limited to those with greater severity of mental health difficulties. Self-management, self-care, and self-help strategies may be used by adolescents with emotional problems both in terms of those waiting for treatment and to prevent relapse. Given the overlap in existing definitions and the lack of clarity around these concepts in an adolescent mental health context, a scoping review of the literature is warranted to provide clarity. Eligible studies were those involving adolescents aged 10 to 19 years with symptoms of emotional problems. Studies referenced self-management, self-care, or self-help, not involving a professional, in this population. Quantitative, qualitative, economic, and mixed methods studies, as well as systematic, scoping, and literature reviews, from 2000 onwards and in the English language, were eligible for inclusion. A systematic search was conducted of both published and grey literature. Databases searched included PsycINFO, Medline, Embase, Web of Science, and CINAHL Plus. Mednar was also searched for unpublished studies and grey literature. Tables  of themes, terms, and associated strategies are presented alongside a thematic analysis of the results. 62 articles were included. These were 20 quantitative studies, 14 systematic reviews, 10 qualitative studies, five review papers, four book chapters, four mixed methods studies, two dissertations, two meta-analyses and one scoping review and systematic review. Most of the included articles referenced self-help (n = 51), followed by self-management (n = 17) and self-care (n = 6). A total of 12 themes were identified from a reflexive thematic analysis of descriptions (and associated strategies) of self-management, self-help, or self-care in included texts. This scoping review provides clarity on the similarities and differences between how these concepts are discussed, and the strategies which are associated with each of these concepts in the relevant literature. Implications for policy and intervention development for adolescents' self-management, self-help, and self-care of their mental health are discussed. There is considerable overlap in both the ways in which these concepts are described, and the strategies or approaches proposed in relation to them, supporting previous research suggesting these strategies should be grouped under a single term, such as "self or community approaches." More research is needed for self-management, self-help, and self-care amongst marginalized groups as these adolescents may have the highest unmet need for mental health support.

本研究旨在回顾现有的公开出版文献和灰色文献,这些文献描述了有情绪问题的青少年的自我管理、自我照顾和自助等概念,并总结了与这些概念相关的策略或技巧。青少年的情绪问题日益增多,但及时获得专业心理健康治疗的机会却仅限于那些有较严重心理健康问题的青少年。有情绪问题的青少年可能会采用自我管理、自我护理和自助的策略来等待治疗和防止复发。鉴于现有的定义存在重叠,而且这些概念在青少年心理健康方面还不够明确,因此有必要对相关文献进行一次范围界定审查,以澄清这些概念。符合条件的研究是那些涉及有情绪问题症状的 10 至 19 岁青少年的研究。研究内容涉及该人群的自我管理、自我护理或自助,不涉及专业人士。2000年以后的定量、定性、经济和混合方法研究,以及系统、范围界定和文献综述,均符合纳入条件。我们对已发表的文献和灰色文献进行了系统性检索。检索的数据库包括 PsycINFO、Medline、Embase、Web of Science 和 CINAHL Plus。此外,还检索了 Mednar 中未发表的研究报告和灰色文献。在对结果进行主题分析的同时,还列出了主题、术语和相关策略表。共纳入 62 篇文章。其中包括 20 篇定量研究、14 篇系统综述、10 篇定性研究、5 篇综述论文、4 篇书籍章节、4 篇混合方法研究、2 篇学位论文、2 篇荟萃分析以及 1 篇范围界定综述和系统综述。大部分收录的文章都提到了自助(51 篇),其次是自我管理(17 篇)和自我护理(6 篇)。通过对收录文章中关于自我管理、自助或自我护理的描述(及相关策略)进行反思性专题分析,共确定了 12 个主题。本范围界定综述阐明了相关文献中讨论这些概念的方式以及与每个概念相关的策略之间的异同。此外,还讨论了制定青少年心理健康自我管理、自助和自我保健政策和干预措施的意义。无论是对这些概念的描述方式,还是针对这些概念提出的策略或方法,都有相当多的重叠之处,这也支持了之前的研究提出的建议,即这些策略应归为一个单一的术语,如 "自我或社区方法"。需要对边缘化群体的自我管理、自助和自我保健进行更多的研究,因为这些青少年对心理健康支持的需求可能是最得不到满足的。
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引用次数: 0
Association between maternal employment and the child´s mental health: a systematic review with meta-analysis. 母亲就业与儿童心理健康之间的关系:系统回顾与荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-02-13 DOI: 10.1007/s00787-023-02164-1
Marie Kopp, Marina Lindauer, Susan Garthus-Niegel

The recent rise in maternal workforce participation has led to more research regarding the role of maternal employment for (early) childhood mental health. This systematic review with meta-analysis covers new evidence on the association of both variables. A systematic literature search was conducted. Studies had to compare children 0-7 years of age on the basis of their mothers' employment status, working amount, employment duration, i.e., how long the mother had been back at work after birth, or timing of return to work. Child mental health was operationalized as behavior problems and prosocial behavior. Narrative and meta-analytic syntheses of evidence were conducted. Maternal employment was associated with more conduct problems but less internalizing behavior problems and anxious/depressed behavior in children; full-time employment was linked to more externalizing behavior problems and more hyperactivity/inattention. Longer employment duration was related to less (internalizing) behavior problems and more prosocial behavior but also more externalizing behavior problems. Narrative syntheses indicated early maternal return to work to be associated with more child externalizing behavior problems and less prosocial behavior. Whether maternal employment is associated with child mental health strongly depends on both variables' operationalization. Especially part-time employment, longer employment duration, and return to work only after the first year postpartum may be beneficial for child mental health. Practical implications pertain to an expanded offer of family leave and the endorsement of maternal employment after the first year postpartum. Here, factors that may buffer the negative associations with full-time employment warrant consideration.

近来,孕产妇劳动力参与率的上升促使人们对孕产妇就业对(早期)儿童心理健康的作用进行了更多的研究。本系统综述和荟萃分析涵盖了有关这两个变量之间关联的新证据。我们进行了系统的文献检索。研究必须根据母亲的就业状况、工作数量、就业持续时间(即母亲产后重返工作岗位的时间)或重返工作岗位的时间对 0-7 岁的儿童进行比较。儿童心理健康的具体表现为行为问题和亲社会行为。对证据进行了叙述和元分析综合。母亲就业与儿童较多的行为问题有关,但与较少的内化行为问题和焦虑/抑郁行为有关;全职就业与较多的外化行为问题和较多的多动/注意力有关。较长的就业时间与较少的(内化)行为问题和较多的亲社会行为有关,但也与较多的外化行为问题有关。叙述性综合研究表明,母亲过早重返工作岗位与儿童外部化行为问题较多、亲社会行为较少有关。母亲就业与儿童心理健康是否相关,在很大程度上取决于这两个变量的操作方法。尤其是非全职就业、就业时间较长以及产后一年后才重返工作岗位可能对儿童心理健康有益。这对扩大提供探亲假和支持产妇在产后第一年后就业具有实际意义。在此,需要考虑可能缓冲全职就业负面影响的因素。
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引用次数: 0
Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review. 经颅直流电刺激对患有精神障碍的儿童和青少年的影响:系统性综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-02-11 DOI: 10.1007/s00787-023-02157-0
Lucy Gallop, Samuel J Westwood, Yael Lewis, Iain C Campbell, Ulrike Schmidt

Transcranial direct current stimulation (tDCS) has demonstrated benefits in adults with various psychiatric disorders, but its clinical utility in children and young people (CYP) remains unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of tDCS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to December 2022. Eligible studies involved multiple session (i.e., treatment) tDCS in CYP (≤ 25 years old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Of 33 eligible studies (participant N = 517), the majority (n = 27) reported an improvement in at least one outcome measure of disorder-specific symptoms. Few studies (n = 13) examined tDCS effects on mood and/or neurocognition, but findings were mainly positive. Overall, tDCS was well tolerated with minimal side effects. Of 11 eligible ongoing studies, many are sham-controlled RCTs (n = 9) with better blinding techniques and a larger estimated participant enrolment (M = 79.7; range 15-172) than published studies. Although encouraging, the evidence to date is insufficient to firmly conclude that tDCS can improve clinical symptoms, mood, or cognition in CYP with psychiatric disorders. Ongoing studies appear of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of tDCS and develop dosage guidance (i.e., treatment regimens).

经颅直流电刺激(tDCS)已被证明对患有各种精神障碍的成年人有益,但其对儿童和青少年(CYP)的临床效用仍不明确。本 PRISMA 系统性综述利用已发表和正在进行的研究来考察 tDCS 对患有精神障碍的儿童和青少年的特定障碍症状、情绪和神经认知的影响。我们检索了截至 2022 年 12 月的 Medline(通过 PubMed)、Embase、PsychINFO(通过 OVID)和 Clinicaltrials.gov。符合条件的研究涉及对患有精神障碍的 CYP(≤ 25 岁)进行多次治疗(即治疗)的 tDCS。两名独立评分员对研究的资格进行评估,并使用定制的表格提取数据。在 33 项符合条件的研究中(参与者人数 = 517),大多数研究(n = 27)报告了至少一种失调症特异性症状的改善情况。很少有研究(n = 13)探讨了 tDCS 对情绪和/或神经认知的影响,但研究结果主要是正面的。总体而言,tDCS 的耐受性良好,副作用极小。在 11 项符合条件的正在进行的研究中,许多都是假对照 RCT(n = 9),与已发表的研究相比,这些研究采用了更好的盲法和更多的估计参与人数(M = 79.7;范围 15-172)。尽管令人鼓舞,但迄今为止的证据还不足以坚定地断定 tDCS 可以改善患有精神障碍的 CYP 的临床症状、情绪或认知。正在进行的研究在方法学质量上似乎有所提高;不过,未来的研究应扩大结果测量的范围,以更全面地评估 tDCS 的效果,并制定剂量指导(即治疗方案)。
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引用次数: 0
Risk and protective factors of suicidal tendencies among freshmen in China revealed by a hierarchical regression model. 分层回归模型揭示中国大一新生自杀倾向的风险和保护因素。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-07 DOI: 10.1007/s00787-024-02370-5
Zhongrui Wang, Xiyu Li, Haiyu Xu, Tao Zhang

This study aimed to identify risk and protective factors for suicidal tendencies among college students by exploring current mental health, personal experiences, family environment, and school adaptation. A total of 11,504 freshmen in China were recruited. Suicidal tendencies were assessed using the Adolescents Suicidal Tendencies Scale (ASTS), while explored risk and protective factors included mental health assessed by the Symptom Checklist-90 (SCL-90), campus adaptation using the College Student School Adaptation Scale, and Personal Situation Survey. Single-factor Logistic regression analysis, correlation analysis, and hierarchical regression analysis were used to analyze the risk and protective factors affecting suicidal tendencies. The results showed that in terms of personal experience, self-injury behavior (OR = 3.522, 95% CI [3.256, 3.811]), sexual assault experience (OR = 2.603, 95% CI [2.374, 2.855]) and lack of friendship relationship (OR = 2.249, 95% CI [2.076, 2.436]) were the most significant risk factors. Regarding family environment, parenting style (OR = 2.455, 95% CI [2.272, 2.652]), parent-child relationship (OR = 2.255, 95% CI [2.092, 2.429]) and violent conflict (OR = 2.164, 95% CI [2.015, 2.324]) were the most prominent risk factors. For protective factors, life satisfaction (OR = 0.330, 95% CI [0.304, 0.359]) and rest quality (OR = 0.415, 95% CI [0.386, 0.447]) were the most significant protective factors. In addition, Symptom Checklist-90 was positively correlated with suicidal tendencies (r = 0.541, 95% CI [0.522, 0.560], p < 0.001), while school adaptation was negatively correlated with suicidal tendencies (r = - 0.590, 95% CI [- 0.579, - 0.601], p < 0.001). After considering demographic variables, psychological symptoms, school adaptation and other risk and protective factors, the hierarchical regression model could explain 48.9% of the variance of suicidal tendencies. The study emphasizes a range of multidimensional risk and protective factors for suicidal tendencies. This enhanced understanding is crucial in aiding the design of future intervention studies targeted at improving the mental health of college students.

本研究旨在通过探究大学生当前的心理健康状况、个人经历、家庭环境和学校适应情况,找出大学生自杀倾向的危险因素和保护因素。研究共招募了 11504 名中国大一新生。自杀倾向采用青少年自杀倾向量表(ASTS)进行评估,风险和保护因素包括症状检查表-90(SCL-90)评估的心理健康状况、大学生校园适应量表和个人情况调查。研究采用单因素逻辑回归分析、相关分析和层次回归分析来分析影响自杀倾向的风险和保护因素。结果显示,在个人经历方面,自伤行为(OR = 3.522,95% CI [3.256,3.811])、性侵犯经历(OR = 2.603,95% CI [2.374,2.855])和缺乏友谊关系(OR = 2.249,95% CI [2.076,2.436])是最显著的风险因素。在家庭环境方面,父母教养方式(OR = 2.455,95% CI [2.272,2.652])、亲子关系(OR = 2.255,95% CI [2.092,2.429])和暴力冲突(OR = 2.164,95% CI [2.015,2.324])是最主要的风险因素。在保护因素方面,生活满意度(OR = 0.330,95% CI [0.304,0.359])和休息质量(OR = 0.415,95% CI [0.386,0.447])是最重要的保护因素。此外,症状检查表-90 与自杀倾向呈正相关(r = 0.541,95% CI [0.522,0.560],p
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引用次数: 0
Physical activity and psychopathology: are long-term developmental trajectories of physical activity in children and adolescents associated with trajectories of general mental health problems and of attention-deficit hyperactivity (ADHD) symptoms? 体育锻炼与心理病理学:儿童和青少年体育锻炼的长期发展轨迹与一般心理健康问题和注意力缺陷多动症(ADHD)症状的发展轨迹是否相关?
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-12 DOI: 10.1007/s00787-023-02352-z
Parisa Ganjeh, York Hagmayer, Thomas Meyer, Ronny Kuhnert, Ulrike Ravens-Sieberer, Nicole von Steinbuechel, Aribert Rothenberger, Andreas Becker

A medium-to-high level of physical activity (PA) may have at least a short-term positive effect on psychopathology in children and adolescents. Hence, the objective of this study was to investigate the long-term effects of PA in non-adult age groups on their general mental health problems and/or ADHD symptoms, using trajectories of concurrent development over a period of 10 years. This study employed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected at three time points (baseline, Wave 1, Wave 2, over 10 years) from 17,640 children and adolescents. Using parent-reported data from the Strengths and Difficulties Questionnaire (SDQ), different developmental trajectories of general mental health problems (SDQ-total) and ADHD symptoms (SDQ-H/I) were identified with latent class mixed models (LCMM) statistics. This was also applied to parent- and self-reported data of three levels of PA. The latter was assessed according to WHO recommendations. The joint probability of class membership for SDQ-total as well as ADHD symptoms with PA was calculated to generate the concurrent developmental trajectories between variables. Results showed a 4-class trajectory model for both SDQ-total and ADHD symptoms among boys and girls. The majority of children and adolescents showed "low general difficulties" and "low ADHD symptoms" over the period of 10 years. Three distinct trajectories in boys and four distinct trajectories in girls were found for PA. Most of the participants showed an "increasing-decreasing activity" trajectory. No statistically significant correlations were found between the different SDQ-total or ADHD symptom trajectories and the trajectories of PA in the two genders. Taken together, our findings did not indicate any significant relationship between waxing and waning PA course over 10 years and various classes of mental health problems for children and adolescents. In contrast to our cross-sectional findings, no steady long-term medium/high-level of PA was present, which could (at least partly) explain the non-significant findings.

中高水平的体育锻炼(PA)至少会对儿童和青少年的精神病理学产生短期的积极影响。因此,本研究的目的是利用 10 年的并发发展轨迹,调查 PA 对非成人年龄组的一般心理健康问题和/或多动症状的长期影响。本研究采用了德国儿童和青少年健康访谈和检查调查(KiGGS)在三个时间点(基线、第 1 波、第 2 波,历时 10 年)收集的数据,这些数据来自 17,640 名儿童和青少年。利用家长报告的优势与困难问卷(SDQ)数据,通过潜类混合模型(LCMM)统计确定了一般心理健康问题(SDQ-总计)和多动症状(SDQ-H/I)的不同发展轨迹。这也适用于家长和自我报告的三个水平的 PA 数据。后者是根据世界卫生组织的建议进行评估的。我们计算了SDQ-总分以及ADHD症状与PA的共同概率,以生成变量之间的并发发展轨迹。结果表明,男孩和女孩的 SDQ 总分和 ADHD 症状均为 4 级轨迹模型。大多数儿童和青少年在 10 年间表现出 "低一般困难 "和 "低多动症状"。在 PA 方面,男孩和女孩分别发现了三种不同的轨迹。大多数参与者表现出 "活动量增加-减少 "的轨迹。不同的 SDQ 总量或多动症症状轨迹与两性的活动量轨迹之间没有统计学意义上的相关性。综上所述,我们的研究结果表明,儿童和青少年 10 年间活动量的增减与各类心理健康问题之间并无明显关系。与我们的横断面研究结果不同的是,并不存在长期稳定的中/高水平的 PA,这可以(至少部分地)解释为什么研究结果不显著。
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引用次数: 0
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European Child & Adolescent Psychiatry
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