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miRNAs as biomarkers of autism spectrum disorder: a systematic review and meta-analysis. 作为自闭症谱系障碍生物标志物的 miRNAs:系统综述与荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2023-02-03 DOI: 10.1007/s00787-023-02138-3
Nathalia Garrido-Torres, Karem Guzmán-Torres, Susana García-Cerro, Gladys Pinilla Bermúdez, Claudia Cruz-Baquero, Hansel Ochoa, Diego García-González, Manuel Canal-Rivero, Benedicto Crespo-Facorro, Miguel Ruiz-Veguilla

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with complex clinical manifestations that arise between 18 and 36 months of age. Social interaction deficiencies, a restricted range of interests, and repetitive stereotyped behaviors are characteristics which are sometimes difficult to detect early. Several studies show that microRNAs (miRs/miRNAs) are strongly implicated in the development of the disorder and affect the expression of genes related to different neurological pathways involved in ASD. The present systematic review and meta-analysis addresses the current status of miRNA studies in different body fluids and the most frequently dysregulated miRNAs in patients with ASD. We used a combined approach to summarize miRNA fold changes in different studies using the mean values. In addition, we summarized p values for differential miRNA expression using the Fisher method. Our literature search yielded a total of 133 relevant articles, 27 of which were selected for qualitative analysis based on the inclusion and exclusion criteria, and 16 studies evaluating miRNAs whose data were completely reported were ultimately included in the meta-analysis. The most frequently dysregulated miRNAs across the analyzed studies were miR-451a, miR-144-3p, miR-23b, miR-106b, miR150-5p, miR320a, miR92a-2-5p, and miR486-3p. Among the most dysregulated miRNAs in individuals with ASD, miR-451a is the most relevant to clinical practice and is associated with impaired social interaction. Other miRNAs, including miR19a-3p, miR-494, miR-142-3p, miR-3687, and miR-27a-3p, are differentially expressed in various tissues and body fluids of patients with ASD. Therefore, all these miRNAs can be considered candidates for ASD biomarkers. Saliva may be the optimal biological fluid for miRNA measurements, because it is easy to collect from children compared to other biological fluids.

自闭症谱系障碍(ASD)是一种神经发育障碍,临床表现复杂,发病年龄在 18 到 36 个月之间。自闭症谱系障碍(ASD)是一种神经发育障碍,临床表现复杂,多发生在 18 到 36 个月大的儿童身上。自闭症谱系障碍的特征包括社交互动障碍、兴趣狭窄和重复刻板行为,这些特征有时很难在早期发现。多项研究表明,微小核糖核酸(miRs/miRNAs)与该疾病的发展密切相关,并影响与 ASD 所涉及的不同神经通路相关的基因的表达。本系统综述和荟萃分析探讨了不同体液中 miRNA 的研究现状,以及 ASD 患者中最常见的失调 miRNA。我们采用了一种综合方法,利用平均值总结了不同研究中 miRNA 的折叠变化。此外,我们还采用费雪法总结了不同 miRNA 表达的 p 值。通过文献检索,我们共获得了 133 篇相关文章,根据纳入和排除标准,我们选择了其中的 27 篇文章进行定性分析,最终有 16 项评估 miRNA 的研究被纳入了荟萃分析,这些研究的数据均已完整报告。在所分析的研究中,最常见的失调 miRNA 是 miR-451a、miR-144-3p、miR-23b、miR-106b、miR150-5p、miR320a、miR92a-2-5p 和 miR486-3p。在 ASD 患者体内失调最严重的 miRNAs 中,miR-451a 与临床实践最为相关,它与社会交往能力受损有关。其他 miRNA,包括 miR19a-3p、miR-494、miR-142-3p、miR-3687 和 miR-27a-3p,在 ASD 患者的不同组织和体液中都有不同程度的表达。因此,所有这些 miRNA 都可被视为 ASD 生物标志物的候选者。唾液可能是测量 miRNA 的最佳生物液体,因为与其他生物液体相比,唾液易于从儿童身上收集。
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引用次数: 0
Traditional bullying and cyberbullying in the digital age and its associated mental health problems in children and adolescents: a meta-analysis. 数字时代的传统欺凌和网络欺凌以及与之相关的儿童和青少年心理健康问题:荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2022-12-31 DOI: 10.1007/s00787-022-02128-x
Chao Li, Ping Wang, Marina Martin-Moratinos, Marcos Bella-Fernández, Hilario Blasco-Fontecilla

Bullying is a risk factor for the physical and mental health of adolescents. The advent of new technologies has resulted in a brand-new type of bullying, cyberbullying (CB). The co-occurring effects of cyberbullying and traditional bullying(TB) forms of bullying on adolescent mental health are unclear. We performed a meta-analysis to explore the unique and combined effects of CB and TB on adverse psychological outcomes in victims by conducting a joint study of both types of bullying. By doing so, we provide the basis for a comprehensive community bullying prevention program. The database PubMed, PsyclNFO, and Web of Science were searched for studies from 2010 to 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed for data abstraction, and the NIH tool was used to evaluate study-level risk of bias. 42 studies with 266,888 participants were identified. Random-Effect models were used for our study. The moderator analysis was used to explore the moderator of prevalence. Studies with three groups of victims (TB only, CB only, and Both) and two groups of victims (TB and CB) were compared in subgroup analysis. The mean victimization rate was 24.32% (95% CI 20.32-28.83%) for TB and 11.10% (95% CI 9.12-13.44%) for CB. Roughly one-third of TB victims were also victimized by CB. Conversely, only about one-third of CB victims were free from TB. The estimated ORs for depression, suicidal ideation, suicide attempts, and self-harm in the three-group (TB only, CB only and Both) analysis were: depression [TB only: 3.33 (2.22-5.00); CB only: 3.38 (2.57-4.46); Both: 5.30 (2.43-11.56)]; suicidal ideations [TB only: 3.08 (2.12-4.46); CB only: 3.52 (2.38-5.20); Both: 6.64 (4.14-10.64)]; self-harm [TB only: 2.70 (1.86-3.91); CB only: 3.57 (3.20-3.98); Both: 5.57 (2.11-16.00)]; and suicide attempts: [TB only: 2.61 (1.50-4.55); CB only: 3.52 (2.50-4.98); Both: 7.82 (3.83-15.93)]. TB and CB victimization among youth are a matter of public health concern. Victimization appears to be a marker of greater psychopathological severity, particularly suicide-related issues.

欺凌是影响青少年身心健康的一个危险因素。新技术的出现产生了一种全新的欺凌形式--网络欺凌(CB)。目前还不清楚网络欺凌和传统欺凌(TB)对青少年心理健康的共同影响。我们进行了一项荟萃分析,通过对两种欺凌形式进行联合研究,探讨了网络欺凌和传统欺凌对受害者不良心理后果的独特和综合影响。通过这样做,我们为全面的社区欺凌预防计划奠定了基础。我们在数据库PubMed、PsyclNFO和Web of Science中搜索了2010年至2021年的研究。数据摘录遵循《系统综述和元分析首选报告项目》(PRISMA)报告指南,并使用 NIH 工具评估研究的偏倚风险。共确定了 42 项研究,266,888 名参与者。我们的研究采用了随机效应模型。调节因子分析用于探索流行率的调节因子。在分组分析中,我们比较了三组受害者(仅肺结核、仅肺结核和肺结核)和两组受害者(肺结核和肺结核)的研究。肺结核的平均受害率为 24.32%(95% CI 20.32-28.83%),肺结核的平均受害率为 11.10%(95% CI 9.12-13.44%)。大约三分之一的肺结核病人同时也是社区传播疾病的受害者。相反,只有约三分之一的 CB 受害者没有结核病。在三组(仅肺结核、仅 CB 和两者)分析中,抑郁、自杀意念、自杀未遂和自残的估计 OR 值为:抑郁[仅肺结核:3.33(2.22-5.00);仅 CB:3.38(2.57-4.46);两者:5.30(2.43-11.56)];自杀意念[仅肺结核:3.08(2.12-4.46);仅 CB:3.52(2.38-5.20);两者:6.64(4.14-10.64)];自残[仅肺结核:2.70(1.86-3.91);仅 CB:3.57(3.20-3.98);两者:5.57(2.11-16.00)];自杀未遂:[仅肺结核:2.61 (1.50-4.55);仅 CB:3.52 (2.50-4.98);两者:7.82 (3.83-15.93)]。青少年中的肺结核和CB受害情况是一个值得关注的公共卫生问题。受害似乎是精神病理学严重程度的标志,尤其是与自杀有关的问题。
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引用次数: 0
Prevalence of mental disorders among family members of individuals on the autism spectrum: systematic review and meta-analysis. 自闭症谱系患者家庭成员中精神障碍的患病率:系统回顾和荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 DOI: 10.1007/s00787-024-02575-8
Daniel H Lins-Silva, Igor D Bandeira, Daniela Faria-Guimarães, Ingrid Dorea-Bandeira, Arthur Tolentino, Ângela Miranda-Scippa, Daniel F Hermens, Rita Lucena

Parenting a child on the autism spectrum presents particular challenges that can lead to increased stress, anxiety, and depression among family members. Therefore, we aimed to investigate the prevalence of mental disorders in first-degree relatives of individuals on the autism spectrum. This article adheres to the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines, including studies indexed in PubMed/Medline, Embase, PsycINFO, Biblioteca Virtual em Saúde (BVS), and SciELO. Nineteen articles met eligibility criteria for the systematic review. Using a random-effects model (N = 93,876), we found a pooled prevalence of affective disorders of 13% in mothers of people on the autism spectrum (95% CI 7-21%; I2 = 99%, p < 0.01). Additionally, another random-effects model pointed out that first-degree relatives of people on the autism spectrum (N = 93,263) were more likely to present affective disorders than relatives of people with neurotypical development (N = 152,455) (pooled OR: 2.17; 95% CI 1.81-2.61). Careful assessment for mental disorders in parents and siblings of individuals on the autism spectrum is crucial to ensure appropriate treatment for these family members. This approach can also contribute to optimizing care for the individuals on the autism spectrum.

养育自闭症谱系儿童是一项特殊的挑战,可能导致家庭成员的压力、焦虑和抑郁增加。因此,我们旨在调查自闭症谱系儿童一级亲属中精神障碍的患病率。本文遵循《系统综述和荟萃分析首选报告项目》(PRISMA-P)指南,包括在 PubMed/Medline、Embase、PsycINFO、Biblioteca Virtual em Saúde (BVS) 和 SciELO 中索引的研究。19篇文章符合系统综述的资格标准。使用随机效应模型(N = 93,876),我们发现自闭症谱系患者母亲中情感障碍的合计患病率为 13%(95% CI 7-21%;I2 = 99%,p<0.05)。
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引用次数: 0
Resilience strengthening in youth with a chronic medical condition: a randomized controlled feasibility trial of a combined app and coaching program. 增强患有慢性疾病的青少年的抗逆力:应用程序与辅导计划相结合的随机对照可行性试验。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-03-02 DOI: 10.1007/s00787-024-02395-w
Anne Christine Bischops, L Sieper, J Dukart, N K Schaal, C Reinauer, P T Oommen, C Tomoiaga, O David, E Mayatepek, T Meissner

Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth's mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive behavioral group coaching. Fifty-one youths with CMC treated at a German university children's hospital aged 12-16 years were recruited. They were randomly assigned to a combined app game and coaching intervention or sole app gameplay. At pre-, post-intervention, and at a 2-month follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of 70%, an 85% adherence rate for the REThink game, and 70% participation in both coaching sessions. Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink game app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. The findings support a combination of a gamification app approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language, and age-adapted updates of the REThink game app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts.

患有慢性疾病(CMC)的青少年通常会合并精神障碍。加强抗逆力的干预措施可以保护青少年的心理健康,但以证据为基础的项目仍然很少。为了解决这一问题,本研究旨在评估将基于应用程序的抗逆力训练与认知行为小组辅导相结合的双重方法的可行性。研究招募了 51 名在德国一所大学儿童医院接受治疗的 12-16 岁 CMC 青少年。他们被随机分配到综合应用游戏和辅导干预或单独的应用游戏中。在干预前、干预后和两个月的随访中,对复原力、自动消极想法以及应用程序和辅导评估进行了评估。可行性的定义是招募率达到 70%,REThink 游戏的坚持率达到 85%,两个辅导课程的参与率均达到 70%。辅导参与率达到了可行性标准,但招募率和应用坚持率没有达到。虽然 REThink 游戏应用程序和辅导干预在患有 CMC 的青少年中的接受率都很高,但接受额外辅导课程的参与者的满意度和坚持率都更高。与面谈相比,参与者更喜欢远程面谈。研究结果支持将游戏化应用程序方法与在线小组辅导相结合。小组辅导可以提高坚持率,而在线选项则增加了可及性。未来的研究应侧重于在不同的参与者样本、语言和适应年龄的 REThink 游戏应用程序更新中进行测试。这些研究结果为今后在青少年社区多媒体中心队列中开展干预研究时提高依从性提供了指导。
{"title":"Resilience strengthening in youth with a chronic medical condition: a randomized controlled feasibility trial of a combined app and coaching program.","authors":"Anne Christine Bischops, L Sieper, J Dukart, N K Schaal, C Reinauer, P T Oommen, C Tomoiaga, O David, E Mayatepek, T Meissner","doi":"10.1007/s00787-024-02395-w","DOIUrl":"10.1007/s00787-024-02395-w","url":null,"abstract":"<p><p>Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth's mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive behavioral group coaching. Fifty-one youths with CMC treated at a German university children's hospital aged 12-16 years were recruited. They were randomly assigned to a combined app game and coaching intervention or sole app gameplay. At pre-, post-intervention, and at a 2-month follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of 70%, an 85% adherence rate for the REThink game, and 70% participation in both coaching sessions. Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink game app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. The findings support a combination of a gamification app approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language, and age-adapted updates of the REThink game app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021236","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}
引用次数: 0
Vitamin D3 improves iminodipropionitrile-induced tic-like behavior in rats through regulation of GDNF/c-Ret signaling activity. 维生素 D3 通过调节 GDNF/c-Ret 信号活动改善亚氨基二丙腈诱发的大鼠抽搐样行为
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-23 DOI: 10.1007/s00787-024-02376-z
Hong-Hua Li, Xi-Fei Wang, Bing Wang, Fei-Yong Jia

Children with chronic tic disorders (CTD), including Tourette syndrome (TS), have significantly reduced serum 25-hydroxyvitamin D [25(OH)D]. While vitamin D3 supplementation (VDS) may reduce tic symptoms in these children, its mechanism is unclear. The study aim was to investigate the effects and mechanisms of vitamin D deficiency (VDD) and VDS on TS model behavior. Forty 5-week-old male Sprague-Dawley rats were randomly divided into (n = 10 each): control, TS model, TS model with VDD (TS + VDD), or TS model with VDS (TS + VDS; two intramuscular injections of 20,000 IU/200 g) groups. The VDD model was diet-induced (0 IU vitamin D/kg); the TS model was iminodipropionitrile (IDPN)-induced. All groups were tested for behavior, serum and striatal 25(OH)D and dopamine (DA), mRNA expressions of vitamin D receptor (VDR), glial cell line-derived neurotrophic factor (GDNF), protooncogene tyrosine-protein kinase receptor Ret (c-Ret), and DA D1 (DRD1) and D2 (DRD2) receptor genes in the striatum. TS + VDD had higher behavior activity scores throughout, and higher total behavior score at day 21 compared with TS model. In contrast, day 21 TS + VDS stereotyped behavior scores and total scores were lower than TS model. The serum 25(OH)D in TS + VDD was < 20 ng/mL, and lower than control. Striatal DA of TS was lower than control. Compared with TS model, striatal DA of TS + VDD was lower, while in TS + VDS it was higher than TS model. Furthermore, mRNA expression of VDR, GDNF, and c-Ret genes decreased in TS model, and GDNF expression decreased more in TS + VDD, while TS + VDS had higher GDNF and c-Ret expressions. VDD aggravates, and VDS ameliorates tic-like behavior in an IDPN-induced model. VDS may upregulate GDNF/c-Ret signaling activity through VDR, reversing the striatal DA decrease and alleviating tic-like behavior.

患有慢性抽搐症(CTD)(包括妥瑞症(TS))的儿童血清中 25- 羟维生素 D [25(OH)D]明显减少。虽然维生素 D3 补充剂(VDS)可减轻这些儿童的抽搐症状,但其作用机制尚不清楚。本研究旨在探讨维生素 D 缺乏(VDD)和 VDS 对 TS 模型行为的影响和机制。研究人员将 40 只 5 周大的雄性 Sprague-Dawley 大鼠随机分为(每组 10 只):对照组、TS 模型组、维生素 D 缺乏的 TS 模型组(TS + VDD)或维生素 D 缺乏的 TS 模型组(TS + VDS;肌肉注射两次,每次 20,000 IU/200 g)。VDD模型由饮食诱导(0 IU维生素D/kg);TS模型由亚胺二丙腈(IDPN)诱导。对所有组的行为、血清和纹状体中的25(OH)D和多巴胺(DA)、维生素D受体(VDR)、胶质细胞系源性神经营养因子(GDNF)、原癌基因酪氨酸蛋白激酶受体Ret(c-Ret)以及纹状体中的DA D1(DRD1)和D2(DRD2)受体基因的mRNA表达进行了检测。与 TS 模型相比,TS + VDD 在整个过程中的行为活动评分更高,第 21 天的行为总评分更高。相比之下,第21天TS + VDS的刻板行为得分和总分均低于TS模型。TS + VDD 的血清 25(OH)D 为
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引用次数: 0
The correlation between brain structure characteristics and emotion regulation ability in children at high risk of autism spectrum disorder. 自闭症谱系障碍高危儿童的大脑结构特征与情绪调节能力之间的相关性。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-24 DOI: 10.1007/s00787-024-02369-y
Ning Ding, Linyan Fu, Lu Qian, Bei Sun, Chunyan Li, Huiyun Gao, Tianyu Lei, Xiaoyan Ke

As indicated by longitudinal observation, autism has difficulty controlling emotions to a certain extent in early childhood, and most children's emotional and behavioral problems are further aggravated with the growth of age. This study aimed at exploring the correlation between white matter and white matter fiber bundle connectivity characteristics and their emotional regulation ability in children with autism using machine learning methods, which can lay an empirical basis for early clinical intervention of autism. Fifty-five high risk of autism spectrum disorder (HR-ASD) children and 52 typical development (TD) children were selected to complete the skull 3D-T1 structure and diffusion tensor imaging (DTI). The emotional regulation ability of the two groups was compared using the still-face paradigm (SFP). The classification and regression models of white matter characteristics and white matter fiber bundle connections of emotion regulation ability in the HR-ASD group were built based on the machine learning method. The volume of the right amygdala (R2 = 0.245) and the volume of the right hippocampus (R2 = 0.197) affected constructive emotion regulation strategies. FA (R2 = 0.32) and MD (R2 = 0.34) had the predictive effect on self-stimulating behaviour. White matter fiber bundle connection predicted constructive regulation strategies (positive edging R2 = 0.333, negative edging R2 = 0.334) and mother-seeking behaviors (positive edging R2 = 0.667, negative edging R2 = 0.363). The emotional regulation ability of HR-ASD children is significantly correlated with the connections of multiple white matter fiber bundles, which is a potential neuro-biomarker of emotional regulation ability.

纵向观察表明,自闭症儿童在婴幼儿时期就存在一定程度的情绪控制困难,随着年龄的增长,多数儿童的情绪和行为问题会进一步加重。本研究旨在利用机器学习方法探讨自闭症儿童白质和白质纤维束连通性特征与其情绪调节能力的相关性,为自闭症的早期临床干预奠定实证基础。研究选取55名自闭症谱系障碍高危儿童和52名典型发育(TD)儿童,完成头颅3D-T1结构和弥散张量成像(DTI)。采用静止面部范式(SFP)比较了两组儿童的情绪调节能力。基于机器学习方法,建立了HR-ASD组情绪调节能力的白质特征和白质纤维束连接的分类和回归模型。右侧杏仁核体积(R2 = 0.245)和右侧海马体积(R2 = 0.197)对建设性情绪调节策略有影响。FA(R2 = 0.32)和MD(R2 = 0.34)对自我刺激行为有预测作用。白质纤维束连接对建设性调节策略(正向边缘 R2 = 0.333,负向边缘 R2 = 0.334)和寻求母亲行为(正向边缘 R2 = 0.667,负向边缘 R2 = 0.363)有预测作用。HR-ASD儿童的情绪调节能力与多个白质纤维束的连接显著相关,这是情绪调节能力的潜在神经生物标记。
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引用次数: 0
Protective factors for suicidal ideation: a prospective study from adolescence to adulthood. 自杀意念的保护因素:一项从青春期到成年期的前瞻性研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-14 DOI: 10.1007/s00787-024-02379-w
Victoria Bakken, Stian Lydersen, Norbert Skokauskas, Anne Mari Sund, Jannike Kaasbøll

Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected-especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini-Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females.

青少年自杀与成年后的不良后果有关。传统上,预防自杀的重点是识别风险因素,但自杀率却一直保持稳定。由于自杀倾向(尤其是自杀意念)常常不被发现,因此需要进一步了解保护因素。本研究的主要目的是调查从青春期到成年期自杀意念的潜在保护因素。研究采用了 "青少年与心理健康研究 "的纵向人口调查数据,包括两个时间点(平均年龄 14.9 岁,SD = 0.6 和 27.2 岁,SD = 0.6)的自我报告(n = 2423 和 n = 1198)。保护因素(个人、社会和环境层面)是根据先验知识选定的。量表的内部一致性采用麦氏欧米茄进行分析。我们使用了线性混合模型,自杀意念为因变量,时间点、保护因素变量及其交互作用为协变量,参与者个人为随机效应。我们对性别进行了调整,并对男性和女性进行了单独分析。本杰明-霍奇伯格程序用于调整多重假设的 p 值。所调查的保护因素与自杀意念的时间变化相关(显著的交互作用)。就男女而言,较少的情绪导向应对、较高的自我认知分数、较多的体育活动和较高的学校福利/联系是自杀意念的保护因素。安全依恋和较高的家庭功能仅对女性具有保护作用。青春期的影响在成年后大多得以保持。在这项研究中,自杀意念的几个保护因素一直持续到成年期,男性和女性之间存在明显差异。
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引用次数: 0
Developmental origins of psycho-cardiometabolic multimorbidity in adolescence and their underlying pathways through methylation markers: a two-cohort study. 青春期心理-心脏-代谢多病性的发展起源及其通过甲基化标记的潜在途径:一项双队列研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-17 DOI: 10.1007/s00787-024-02390-1
Priyanka Choudhary, Justiina Ronkainen, Jennie Carson, Ville Karhunen, Ashleigh Lin, Phillip E Melton, Marjo-Riitta Jarvelin, Jouko Miettunen, Rae-Chi Huang, Sylvain Sebert

Understanding the biological mechanisms behind multimorbidity patterns in adolescence is important as they may act as intermediary risk factor for long-term health. We aimed to explore relationship between prenatal exposures and adolescent's psycho-cardiometabolic intermediary traits mediated through epigenetic biomarkers, using structural equation modeling (SEM). We used data from mother-child dyads from pregnancy and adolescents at 16-17 years from two prospective cohorts: Northern Finland Birth Cohort 1986 (NFBC1986) and Raine Study from Australia. Factor analysis was applied to generate two different latent factor structures: (a) prenatal exposures and (b) adolescence psycho-cardiometabolic intermediary traits. Furthermore, three types of epigenetic biomarkers were included: (1) DNA methylation score for maternal smoking during pregnancy (DNAmMSS), (2) DNAm age estimate PhenoAge and (3) DNAm estimate for telomere length (DNAmTL). Similar factor structure was observed between both cohorts yielding three prenatal factors, namely BMI (Body Mass Index), SOP (Socio-Obstetric-Profile), and Lifestyle, and four adolescent factors: Anthropometric, Insulin-Triglycerides, Blood Pressure, and Mental health. In the SEM pathways, stronger direct effects of F1prenatal-BMI (NFBC1986 = β: 0.27; Raine = β: 0.39) and F2prenatal-SOP (β: -0.11) factors were observed on adolescent psycho-cardiometabolic multimorbidity. We observed an indirect effect of prenatal latent factors through epigenetic markers on a psycho-cardiometabolic multimorbidity factor in Raine study (P < 0.05). The present study exemplifies an evidence-based approach in two different birth cohorts to demonstrate similar composite structure of prenatal exposures and psycho-cardiometabolic traits (despite cultural, social, and genetic differences) and a common plausible pathway between them through underlying epigenetic markers.

了解青少年多病模式背后的生物机制非常重要,因为它们可能是影响长期健康的中间风险因素。我们的目的是利用结构方程模型(SEM)探讨产前暴露与青少年心理-心血管代谢中间特质之间的关系。我们使用了来自两个前瞻性队列的孕期母子二人组和 16-17 岁青少年的数据:这两个前瞻性队列分别是:1986 年北芬兰出生队列(NFBC1986)和澳大利亚雷恩研究(Raine Study)。应用因子分析生成了两种不同的潜在因子结构:(a) 产前暴露和 (b) 青春期心理-心血管代谢中间特征。此外,研究还纳入了三种表观遗传生物标志物:(1)孕期母体吸烟的 DNA 甲基化评分(DNAmMSS);(2)DNAm 年龄估计值 PhenoAge;(3)DNAm 端粒长度估计值(DNAmTL)。两个组群的因子结构相似,都有三个产前因子,即 BMI(体重指数)、SOP(社会产科概况)和生活方式,以及四个青少年因子:人体测量、胰岛素-甘油三酯、血压和心理健康。在 SEM 途径中,观察到 F1 产前-体重指数(NFBC1986 = β:0.27;Raine = β:0.39)和 F2 产前-SOP(β:-0.11)因素对青少年心理-心血管代谢多病性的直接效应更强。在 Raine 研究中,我们观察到产前潜伏因素通过表观遗传标记对心理-心血管代谢多病因子的间接影响(P
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引用次数: 0
Position Paper: fragmented youth healthcare services in the Netherlands endanger treatment of teenage boys with psychiatric disorders. 立场文件:荷兰分散的青少年医疗保健服务危及对患有精神疾病的青少年男孩的治疗。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-16 DOI: 10.1007/s00787-024-02378-x
Rinske IJsselhof, Amy Hintjens, Anne Pelzer, Edward Nieuwenhuis

For children who show strongly deviant behaviour in the Netherlands, a distinction is made between behavioural problems and psychiatric problems. As a result, two different domains have emerged over time, each with its own legal frameworks and inclusion and exclusion criteria. Consequently, there is no well-organized, coherent system for youth mental health care in the Netherlands. This strong dichotomy raises the question whether patients are being admitted to facilities where they are receiving appropriate care. In addition, referral bias can arise, because the type of complaint with which a young person presents is often dependent on the type of coping of the individual and thus, in turn, the gender of the patient. In this Position Paper, we examined the gender distribution at a youth psychiatric high and intensive care (HIC-Y) and other streams of youth care in the Netherlands to explore possible inequities in access to psychiatric care among children and adolescents. Results show that girls are significantly more likely than boys to be admitted to the HIC-Y for suicidal thoughts, self-harm and emotional dysregulation. In fact, girls account for 80% of all admissions, while boys account for only 20%. In contrast, regional and national reports from youth services and probation show a majority of boys being admitted (56-89%). The way care is organized (lack of cross-domain collaboration and the interplay between gender-dependent coping and exclusion criteria) seems to play a role in the underrepresentation of boys in acute psychiatry and their overrepresentation in secure youth care. Based on our research results, the concern is raised whether boys have a greater chance of undertreatment for psychiatric problems. Further research is needed to better understand the underlying factors that contribute to gender bias in psychiatric admissions, and to develop interventions that promote gender equality in healthcare.

在荷兰,对于表现出强烈异常行为的儿童,行为问题和精神问题是有区别的。因此,随着时间的推移,出现了两个不同的领域,每个领域都有自己的法律框架以及纳入和排除标准。因此,荷兰没有一个组织完善、协调一致的青少年心理健康护理系统。这种强烈的二分法提出了一个问题,即患者是否被收治到了能够接受适当治疗的机构。此外,还可能出现转诊偏差,因为青少年的主诉类型往往取决于个人的应对类型,进而取 决于患者的性别。在这份立场文件中,我们研究了荷兰一家青少年精神病重症监护中心(HIC-Y)和其他青少年护理机构的性别分布情况,以探讨儿童和青少年在获得精神病护理方面可能存在的不平等现象。结果显示,因有自杀念头、自残和情绪失调而被送入 HIC-Y 的女孩明显多于男孩。事实上,女孩占所有入院者的 80%,而男孩仅占 20%。相比之下,地区和国家青年服务机构和缓刑机构的报告显示,入院的大多数是男孩(56%-89%)。护理工作的组织方式(缺乏跨领域合作,以及依赖性别的应对和排斥标准之间的相互作用)似乎是造成男孩在急性精神病治疗中比例偏低,而在安全青少年护理中比例偏高的原因之一。根据我们的研究结果,我们担心男孩是否有更大的机会因精神问题而得不到治疗。我们需要开展进一步的研究,以便更好地了解造成精神病入院性别偏见的潜在因素,并制定干预措施,促进医疗保健中的性别平等。
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引用次数: 0
Whole-family programmes for families living with parental mental illness: a systematic review and meta-analysis. 针对父母患有精神疾病的家庭的全家庭计划:系统回顾和荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-01 Epub Date: 2024-02-23 DOI: 10.1007/s00787-024-02380-3
B Moltrecht, Aurelie M C Lange, H Merrick, J Radley

Several interventions have been developed to support families living with parental mental illness (PMI). Recent evidence suggests that programmes with whole-family components may have greater positive effects for families, thereby also reducing costs to health and social care systems. This review aimed to identify whole-family interventions, their common characteristics, effectiveness and acceptability. A systematic review was conducted according to PRISMA 2020 guidelines. A literature search was conducted in ASSIA, CINAHL, Embase, Medline, and PsycINFO in January 2021 and updated in August 2022. We double screened 3914 abstracts and 212 papers according to pre-set inclusion and exclusion criteria. The Mixed Methods Appraisal Tool was used for quality assessment. Quantitative and qualitative data were extracted and synthesised. Randomised-control trial data on child and parent mental health outcomes were analysed separately in random-effects meta-analyses. The protocol, extracted data, and meta-data are accessible via the Open Science Framework ( https://osf.io/9uxgp/ ). Data from 66 reports-based on 41 independent studies and referring to 30 different interventions-were included. Findings indicated small intervention effects for all outcomes including children's and parents' mental health (dc = -0.017, -027; dp = -0.14, -0.16) and family outcomes. Qualitative evidence suggested that most families experienced whole-family interventions as positive, highlighting specific components as helpful, including whole-family components, speaking about mental illness, and the benefits of group settings. Our findings highlight the lack of high-quality studies. The present review fills an important gap in the literature by summarising the evidence for whole-family interventions. There is a lack of robust evidence coupled with a great need in families affected by PMI which could be addressed by whole-family interventions. We recommend the involvement of families in the further development of these interventions and their evaluation.

为支持患有父母精神疾病(PMI)的家庭,已经制定了多项干预措施。最近的证据表明,包含全家庭内容的计划可能会对家庭产生更大的积极影响,从而也会降低医疗和社会护理系统的成本。本综述旨在确定全家庭干预措施、其共同特点、有效性和可接受性。根据 PRISMA 2020 指南进行了系统性综述。我们于 2021 年 1 月在 ASSIA、CINAHL、Embase、Medline 和 PsycINFO 中进行了文献检索,并于 2022 年 8 月进行了更新。根据预先设定的纳入和排除标准,我们对 3914 篇摘要和 212 篇论文进行了双重筛选。采用混合方法评估工具进行质量评估。我们提取并综合了定量和定性数据。在随机效应荟萃分析中分别分析了有关儿童和家长心理健康结果的随机对照试验数据。研究方案、提取的数据和元数据可通过开放科学框架(https://osf.io/9uxgp/ )获取。共纳入了 66 份报告的数据,这些报告基于 41 项独立研究,涉及 30 种不同的干预措施。研究结果表明,干预对包括儿童和父母的心理健康(dc = -0.017, -027; dp = -0.14, -0.16)和家庭结果在内的所有结果都产生了微小的影响。定性证据表明,大多数家庭对整个家庭干预的体验是积极的,并强调了特定的干预内容是有帮助的,包括整个家庭干预、谈论精神疾病以及小组环境的益处。我们的研究结果凸显了高质量研究的缺乏。本综述通过总结有关全家庭干预的证据,填补了文献中的一个重要空白。在缺乏有力证据的同时,受 PMI 影响的家庭存在着巨大的需求,可以通过全家庭干预来解决。我们建议让家庭参与这些干预措施的进一步发展及其评估。
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引用次数: 0
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