European Child & Adolescent Psychiatry最新文献

The COVID-19 pandemic has raised concerns about adverse effects on youth mental health, including suicidal behavior. While suicide mortality remained stable in many countries, less is known about temporal changes in suicide attempts presenting to clinical services. This study examined trends in psychiatric emergency presentations following suicide attempts among children and adolescents across COVID-19 pandemic phases and their association with the intensity of governmental containment measures. A retrospective analysis was conducted at a tertiary care center in Vienna, Austria, between January 2019 and December 2023, distinguishing pre-pandemic, pandemic, and post-pandemic periods. COVID-19 containment stringency was quantified using the Oxford COVID-19 Government Response Tracker Stringency Index. Temporal changes in monthly suicide attempt presentations were analyzed using Poisson regression models, adjusting for linear time trends. A total of 6,319 psychiatric emergency presentations were recorded, including 722 presentations following suicide attempts (11.4%). Compared with the pre-pandemic period, suicide attempt-related presentations increased significantly during the pandemic (RR = 1.80, p < .001), while the post-pandemic period did not differ significantly from pre-pandemic levels. Higher monthly suicide attempt presentation rates were associated with greater containment stringency (RR per point = 1.007, p < .001). An independent upward temporal trend in suicide attempt presentations was observed across the study period. Associations with policy stringency and persistent temporal trends suggest that suicide attempts may serve as an indicator of psychosocial burden not captured by mortality data alone. Continuous monitoring of emergency presentations and access to low-threshold mental health support are necessary beyond periods of acute crisis.

Climate change is increasingly recognised as a significant threat to mental health, particularly among younger populations. Despite growing research attention, systematic syntheses of this emerging field still remain limited. This scoping review examined the prevalence of these emotional responses and their associations with mental health outcomes and related factors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched APA PsycInfo, PubMed, and Web of Science for studies published before December 2025. Eligible studies reported quantitative data on climate anxiety, concern, distress, or worry in community samples of individuals under the age of 25. A total of 51 studies met inclusion criteria. Prevalence estimates for the four constructs varied widely, ranging from 18% to 90%, reflecting inconsistencies in definitions and measurement tools. The available evidence suggests that climate-related anxiety and worry may be positively associated with reduced mental wellbeing, as well as with symptoms of depression and generalised anxiety disorder. Age, gender, socioeconomic status, place of residence, education level, climate change knowledge and exposure, and participation in climate action emerged as potential influencing factors. Future research using standardised measures and longitudinal methods, particularly in younger children, is needed to clarify the direction of these relationships and distinguish between adaptive and maladaptive responses. As the climate crisis continues to unfold, addressing its psychological impacts, especially on vulnerable populations, must become a public health priority.

Childhood maltreatment commonly predicts adolescent non-suicidal self-injury (NSSI). However, evidence on how specific maltreatment subtypes influence NSSI trajectories (i.e., intercept and slope) and through which potential pathways remain limited. Moreover, gender differences in these associations are insufficiently understood. Using latent growth curve model (LGCM) and its extensions, this study examined the effects of distinct maltreatment subtypes on adolescent NSSI trajectories, tested the mediating roles of depressive symptoms and peer victimization, and assessed whether these indirect associations vary by gender. A total of 3,228 Chinese adolescents (Mage = 13.10 years, SD = 0.83; 58.1% boys) completed three-wave assessments. Results indicated: (1) higher levels of childhood emotional abuse, emotional neglect, and physical abuse predicted higher initial levels of NSSI (intercept), and greater emotional abuse further predicted a less steep increase in NSSI over time (slope); (2) childhood emotional abuse and emotional neglect indirectly affected the intercept of NSSI via the intercepts of depressive symptoms and peer victimization across the total, boys', and girls' samples, whereas only emotional abuse indirectly influenced the slope of NSSI via the slopes of these two mediators in the total and boys' samples; (3) childhood physical abuse influenced the intercept of NSSI through the same dual pathways in the total and boys' samples, whereas childhood physical neglect affected the slope of NSSI via the slope of peer victimization among boys. These findings underscore the need for personalized interventions tailored to specific maltreatment types and their potential pathways, with attention to gender differences.

The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) is often associated with disrupted continuity of care, where young people may experience a loss of support during transfer. This scoping review identifies the needs and challenges experienced by health and social care professionals navigating this boundary, a perspective often overlooked in transition research. A systematic search of major databases identified literature published between 2014 and 2025. Following Joanna Briggs Institute (JBI) methodology, 25 peer-reviewed publications were included after screening 4,040 records. Data were charted using a standardised extraction form and synthesised thematically within a socio-ecological framework across individual, interpersonal, service, and societal levels. Findings indicate multilevel barriers affecting transitions from CAMHS to AMHS. At the individual level, professionals often lack developmentally informed knowledge and disorder-specific expertise, alongside training to support autonomy as an ongoing process. Interpersonally, differences in care cultures -family-oriented in CAMHS versus more individualised in AMHS- complicate continuity, compounded by the absence of bridging roles and insufficient family involvement. At the service level, fragmentation is reinforced by inconsistent implementation of protocols, unclear responsibilities, and restrictive eligibility criteria, often resulting in a loss of continuity of care. At the societal level, rigid age boundaries and structural underfunding of coordination further perpetuate discontinuity. Despite well-documented challenges, progress in implementing sustainable solutions remains limited. Advancing transition care requires a shift towards action-oriented, multilevel implementation research. Integrated models, such as multidisciplinary youth mental health teams, are essential to ensure developmentally appropriate continuity of care.