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Characteristics of single vs. multiple suicide attempters among adolescents: a systematic review and meta-analysis. 青少年中单一与多重自杀企图者的特征:系统回顾与荟萃分析。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-07-20 DOI: 10.1007/s00787-023-02260-2
Berta Ezquerra, Adrián Alacreu-Crespo, Inmaculada Peñuelas-Calvo, Sofía Abascal-Peiró, Laura Jiménez-Muñoz, Dasha Nicholls, Enrique Baca-García, Alejandro Porras-Segovia

There might be differential characteristics between those who have attempted suicide once in their lifetime (single attempters) and those who have attempted suicide two or more times (multiple attempters). We aimed to identify the factors that differentiate single and multiple attempters in child and adolescents. This study was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the review protocol was registered in PROSPERO. We conducted a systematic literature search in three databases to identify original studies exploring the characteristics of single attempters vs. multiple attempters among adolescents. We considered a wide range for the definition of adolescent, following most recent recommendations: 10-24 years. We carried out a meta-analysis. Fourteen studies were included in the systematic review and 13 in the meta-analysis with a total sample of with a total of 4286 participants. The factors statistically significantly associated with being a multiple attempter in the meta-analysis were: anxiety disorders, depression severity, alcohol abuse, substance abuse, aggressiveness, and hopelessness. Multiple attempters have a more severe clinical profile, with greater severity of symptoms. Knowledge of the risk factors associated with being a multiple attempter could help us to predict which patients are more likely to reattempt suicide and need further monitoring and a tailored treatment. Prevention programs tailored for the adolescent population, along with identification of early risk factors, could help to prevent suicidal behavior among this vulnerable population.

一生中自杀未遂过一次的人(单次自杀未遂者)和自杀未遂过两次或两次以上的人(多次自杀未遂者)可能有不同的特征。我们旨在找出儿童和青少年中区分单次自杀企图者和多次自杀企图者的因素。本研究遵照系统综述和元分析首选报告项目(PRISMA)指南进行,综述方案已在 PROSPERO 上注册。我们在三个数据库中进行了系统性文献检索,以确定探讨青少年中单次尝试者与多次尝试者特征的原创性研究。根据最新的建议,我们对青少年的定义范围进行了广泛的考虑:10-24 岁。我们进行了一项荟萃分析。14项研究被纳入系统综述,13项研究被纳入荟萃分析,样本总数为4286人。在荟萃分析中,与多重企图自杀者有明显统计学关联的因素包括:焦虑症、抑郁严重程度、酗酒、药物滥用、攻击性和绝望。多重企图自杀者的临床特征更为严重,症状更为严重。了解与多次企图自杀者相关的风险因素,有助于我们预测哪些患者更有可能再次企图自杀,并需要进一步的监测和有针对性的治疗。为青少年人群量身定制的预防计划,加上早期风险因素的识别,可以帮助预防这一弱势群体的自杀行为。
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引用次数: 0
Abnormal microstructure of corpus callosum in children with primary nocturnal enuresis: a DTI study. 原发性夜间遗尿症儿童胼胝体的异常微结构:一项 DTI 研究。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-21 DOI: 10.1007/s00787-024-02416-8
Jinqiu Li, Yang Zhang, Jing Chen, Xin Du, Yaqin Di, Qiaohui Liu, Chunxiang Wang, Quan Zhang

Primary nocturnal enuresis (PNE) is a common childhood disorder with abnormal sleep or arousal. The corpus callosum (CC) continues to develop into adulthood and plays an important role in sleep arousal. This study aimed to evaluate the microstructure of the CC in children with PNE. Diffusion tensor imaging (DTI) indices were extracted throughout the CC and its seven subregions were compared between the children with PNE and healthy children (HC). The correlation between abnormal DTI indices of the CC and cognitive condition was also tested. Compared to HC, decreased fiber number (NF) (F = 8.492, PFDR = 0.032) and fractional anisotropy (FA) value (F = 8.442, PFDR = 0.040) were found in the posterior midbody of the CC, increased RD was found in the posterior midbody (F = 6.888, PFDR = 0.040) and isthmus (F = 7.967, PFDR = 0.040) in children with PNE. The reduction of FA value was more obvious in boys than girls with PNE. In children with PNE, there was a significant positive correlation between the NF of the posterior midbody and full IQ (r = 0.322, P = 0.025) and between the FA value and the general knowledge memory (r = 0.293, P = 0.043). This study provides imaging evidence for abnormalities in the microstructure of the CC in children with PNE, especially in male PNE, which might affect the children's cognitive performance.

原发性夜间遗尿症(PNE)是一种常见的儿童疾病,会导致睡眠或觉醒异常。胼胝体(CC)一直发育到成年,在睡眠唤醒中扮演着重要角色。本研究旨在评估PNE患儿胼胝体的微观结构。研究人员提取了整个胼胝体及其七个亚区的弥散张量成像(DTI)指数,并比较了PNE患儿与健康儿童(HC)之间的差异。此外,还测试了CC的异常DTI指数与认知状况之间的相关性。与健康儿童相比,PNE患儿CC中后部的纤维数(NF)(F = 8.492,PFDR = 0.032)和分数各向异性(FA)值(F = 8.442,PFDR = 0.040)均有所减少,而RD则在中后部(F = 6.888,PFDR = 0.040)和峡部(F = 7.967,PFDR = 0.040)有所增加。与女孩相比,PNE 男孩的 FA 值下降更为明显。在 PNE 儿童中,后中体的 NF 值与全智商(r = 0.322,P = 0.025)以及 FA 值与常识记忆(r = 0.293,P = 0.043)之间存在显著的正相关。本研究提供了影像学证据,证明PNE患儿(尤其是男性PNE患儿)的CC微观结构存在异常,这可能会影响患儿的认知能力。
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引用次数: 0
Interaction effect of screen time and sugar-sweetened beverages with depressive symptoms in adolescents: evidence from a large sample-based survey in China. 屏幕时间和含糖饮料对青少年抑郁症状的交互影响:来自中国大样本调查的证据。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-21 DOI: 10.1007/s00787-024-02414-w
Zhengge Jin, Wan Xiao, Yi Zhang, Fan Rong, Weiqiang Yu, Ying Sun, Fangbiao Tao, Yuhui Wan

Excessive screen time and the consumption of sugar-sweetened beverages are found to be independent predictors of depressive symptoms. However, the potential interaction effect of screen time and sugar-sweetened beverages, that is, whether one exposure factor strengthens the association of another with depressive symptoms, remains unclear. A large-scale adolescent health surveillance survey was conducted in 27 schools in eight regions across China. A total of 22,868 students were recruited to complete an eligible questionnaire to provide details of their screen time and sugar-sweetened beverage consumption. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Multiplicative and additive interaction models were performed to estimate the interaction effects of screen time and sugar-sweetened beverages on depressive symptoms, and whether the relationship varied by age group was also examined. The multivariate logistic regression model showed that even if the confounding factors were controlled, screen time and sugar-sweetened beverages were still risk factors for depressive symptoms in adolescents. Interaction models indicated that screen time and sugar-sweetened beverages in combination were related to greater odds of depressive symptoms. Compared with late adolescents, early adolescents had a higher probability of depressive symptoms when exposed to the joint effects. Our study may hopefully deepen the understanding of the association between screen time and sugar-sweetened beverages and depressive symptoms. Future research should further explore how and why screen time and sugar-sweetened beverages affect individuals more profoundly in early adolescence than in late adolescence and how to mitigate this.

研究发现,过长的屏幕时间和饮用含糖饮料是抑郁症状的独立预测因素。然而,屏幕时间和含糖饮料的潜在交互效应,即一个暴露因素是否会加强另一个暴露因素与抑郁症状的关联,仍不清楚。我们在全国八个地区的27所学校开展了大规模的青少年健康监测调查。共招募了 22,868 名学生填写合格问卷,以了解他们的屏幕时间和含糖饮料消费详情。抑郁症状采用患者健康问卷(PHQ-9)进行评估。为了估计屏幕时间和含糖饮料对抑郁症状的交互影响,我们采用了乘法和加法交互模型,并研究了这一关系是否因年龄组而异。多变量逻辑回归模型显示,即使控制了混杂因素,屏幕时间和含糖饮料仍是青少年抑郁症状的风险因素。交互模型表明,屏幕时间和含糖饮料的组合与更高的抑郁症状几率有关。与晚期青少年相比,早期青少年在共同作用下出现抑郁症状的几率更高。我们的研究有望加深人们对屏幕时间和含糖饮料与抑郁症状之间关系的理解。未来的研究应进一步探讨屏幕时间和含糖饮料如何以及为何在青春期早期比青春期晚期对个体的影响更深,以及如何减轻这种影响。
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引用次数: 0
No evidence for a causal contribution of bioavailable testosterone to ADHD in sex-combined and sex-specific two-sample Mendelian randomization studies. 在性别组合和性别特异性双样本孟德尔随机研究中,没有证据表明生物可用睾酮与多动症有因果关系。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-27 DOI: 10.1007/s00787-024-02421-x
Lars Dinkelbach, Triinu Peters, Corinna Grasemann, Johannes Hebebrand, Anke Hinney, Raphael Hirtz

The higher prevalence of attention-deficit/hyperactivity disorder (ADHD) in males raises the question of whether testosterone is implicated in ADHD risk. However, cross-sectional studies did not identify an association between ADHD and testosterone levels. Mendelian randomization (MR) studies can overcome limitations inherent to association studies, especially of reverse causation and residual confounding. In the current study, sex-combined and sex-specific two-sample MR analyses were conducted to address whether testosterone has a causal influence on ADHD risk. Sex-combined as well as sex-specific target-genetic variants for bioavailable testosterone were derived from a large genome-wide association study (GWAS) on up to 382,988 adult white European UK Biobank study participants. In our sex-specific analyses for ADHD, including data from 14,154 males and 4,945 females with ADHD (17,948 and 16,246 controls respectively), no association between bioavailable testosterone and ADHD risk was found, neither in males (inverse-variance weighted (IVW): beta = 0.09, 95%-CI [-0.10, 0.27]) nor in females (IVW: beta=-0.01, 95%-CI [-0.20, 0.19]). However, in the sex-combined analysis, including 38,691 cases and 186,843 controls, genetically predicted bioavailable testosterone was associated with ADHD risk (IVW: beta = 0.24, 95%-CI [0.09, 0.39]). The inclusion of birth weight and/or SHBG as additional variables in multivariable MR analyses did not alter this result. However, when correcting for potential BMI-driven pleiotropy by a multivariable MR study, all effect estimates for testosterone showed non-significant results. Taken together, no robust evidence for a causal effect of bioavailable testosterone on the risk for ADHD was found.

男性注意力缺陷/多动障碍(ADHD)的发病率较高,这就提出了睾酮是否与 ADHD 风险有关的问题。然而,横断面研究并未发现多动症与睾酮水平之间存在关联。孟德尔随机化(MR)研究可以克服关联研究固有的局限性,尤其是反向因果关系和残余混杂因素。在本研究中,我们进行了性别组合和性别特异性双样本 MR 分析,以探讨睾酮是否对多动症风险有因果影响。生物可利用睾酮的性别组合和性别特异性目标基因变异来自于一项大型全基因组关联研究(GWAS),研究对象是多达 382,988 名成年欧洲白人英国生物库(UK Biobank)研究参与者。在我们针对多动症的性别特异性分析中,包括来自14154名男性多动症患者和4945名女性多动症患者的数据(对照组分别为17948人和16246人),无论是男性(逆方差加权(IVW):β=0.09,95%-CI [-0.10,0.27])还是女性(IVW:β=-0.01,95%-CI [-0.20,0.19]),都没有发现生物可用睾酮与多动症风险之间的关联。然而,在包括 38,691 例病例和 186,843 例对照的性别合并分析中,基因预测的生物可用睾酮与多动症风险相关(IVW:β=0.24,95%-CI [0.09,0.39])。将出生体重和/或 SHBG 作为额外变量纳入多变量 MR 分析并没有改变这一结果。然而,当通过多变量磁共振研究对潜在的体重指数驱动的多效应进行校正时,睾酮的所有效应估计值均显示出不显著的结果。综上所述,没有发现有力的证据表明生物可用睾酮对多动症风险有因果效应。
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引用次数: 0
Electroconvulsive therapy in children and adolescents in Europe-a systematic review of the literature complemented by expert information and guideline recommendations. 欧洲儿童和青少年的电休克疗法--以专家信息和指南建议为补充的系统性文献综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-07-17 DOI: 10.1007/s00787-023-02248-y
Christiane Licht, Steffen Weirich, Olaf Reis, Michael Kölch, Michael Grözinger

The first documented pediatric use of Electroconvulsive therapy (ECT) occurred in Europe in 1941. Since then, predominantly successful treatments and reasonable side effects have been reported in severely ill minors. Nevertheless, a shy reluctance determines the controversy about ECT in young patients. This study describes the use of ECT in children and adolescents in Europe. We systematically searched the literature concerning the practice of ECT in minors in all 53 European countries. In addition, we surveyed European experts about national practices and compared guidelines for ECT in minors. The search yielded 79 publications from 18 European countries, mainly from Western Europe, Israel, and Turkey. National data were available from eight countries. These showed an interestingly high relationship between the number of minors treated with ECT and the general use of ECT. No persistent deficits or deaths were reported. On the other hand, no randomized clinical trial was found, and many publications lacked relevant information. Accordingly, the appraisal of the evidence in the guidelines varies considerably. Experts from 13 European countries consistently reported infrequent and unsystematic use of ECT in minors. ECT has been used successfully in minors in Europe with reasonable complications and side effects. Adverse effects on the developing brain, as often suspected, have not been scientifically supported in eight decades. Nevertheless, the use of ECT in Europe is sparse and dependent on accidental circumstances. High-quality evidence is needed, as well as improved knowledge and training of child and adolescent psychiatrists.

1941 年,欧洲首次记录了儿科使用电休克疗法(ECT)的情况。从那时起,对重症未成年人的治疗就以成功为主,且副作用合理。然而,由于羞于启齿,人们对在年幼患者中使用电休克疗法存在争议。本研究描述了欧洲儿童和青少年使用电痉挛疗法的情况。我们系统地检索了欧洲所有 53 个国家在未成年人中使用电痉挛疗法的相关文献。此外,我们还对欧洲专家进行了有关各国实践的调查,并对未成年人电痉挛疗法的指南进行了比较。检索结果显示,共有来自18个欧洲国家的79篇文献,主要来自西欧、以色列和土耳其。八个国家提供了本国数据。这些数据显示,接受电痉挛疗法治疗的未成年人数量与电痉挛疗法的普遍使用之间存在着有趣的高度关系。没有关于持续障碍或死亡的报道。另一方面,没有发现随机临床试验,许多出版物缺乏相关信息。因此,指南中对证据的评估差异很大。来自 13 个欧洲国家的专家一致报告称,电痉挛疗法在未成年人中的使用并不频繁,也不系统。在欧洲,电痉挛疗法已成功用于未成年人,其并发症和副作用尚可接受。人们经常怀疑电痉挛疗法会对发育中的大脑造成不良影响,但八十年来,这种怀疑并未得到科学证实。然而,欧洲使用电痉挛疗法的情况并不多,而且取决于意外情况。我们需要高质量的证据,还需要提高儿童和青少年精神科医生的知识水平和培训。
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引用次数: 0
Positive psychotic symptoms as a marker of clinical severity in a transdiagnostic sample of help-seeking adolescents. 在求助青少年的跨诊断样本中,阳性精神病症状是临床严重程度的标志。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-30 DOI: 10.1007/s00787-024-02417-7
Janko M Kaeser, Stefan Lerch, Silvano Sele, Corinna Reichl, Julian Koenig, Ines Mürner-Lavanchy, Thomas Berger, Michael Kaess, Marialuisa Cavelti

The present study aimed to examine the association between the presence, number, and type of positive psychotic symptoms (PPS) and clinical severity in adolescent patients. Five hundred-six patients aged 11-17 years were assigned to either the noPPS (n = 341), the delusional beliefs only (del; n = 32), the hallucinations only (hall; n = 80), or the delusional beliefs and hallucinations (del&hall; n = 53) group. Generalized Structural Equation Modeling was applied to identify the best-fitting model representing clinical severity indicated by psychiatric diagnoses, depressivity, personality pathology, non-suicidal self-injury, suicide attempts, perceived stress, and psychosocial impairments, assessed by interviews and questionnaires. The groups were compared concerning the final model's factors. The final model consisted of three factors representing psychopathology and functional impairments, self-harming behavior, and perceived stress (BIC difference to reference model: 103.99). Participants with any PPS scored higher on all factors than the noPPS group (differences in SD: 0.49-1.48). Additionally, the del&hall group scored 1.31 SD higher on psychopathology and functional impairments than the hall group, and 1.16 SD higher on self-harming behavior compared to the del group. Finally, the hall group scored 0.84 SD higher on self-harming behavior than the del group, with no group differences in the other factors. In adolescent patients, the presence of PPS may represent a marker for a more severe form of mental disorder, with hallucinations being indicative of self-harming behavior. Early transdiagnostic assessment of PPS seems indicated as it may inform treatment in the context of clinical staging.

本研究旨在探讨青少年患者阳性精神病性症状(PPS)的存在、数量和类型与临床严重程度之间的关系。五百六十名 11-17 岁的患者被分配到无 PPS 组(341 人)、仅有妄想信念组(32 人)、仅有幻觉组(80 人)或妄想信念和幻觉组(53 人)。应用广义结构方程模型来确定最佳拟合模型,该模型通过访谈和问卷评估精神病学诊断、抑郁、人格病理学、非自杀性自伤、自杀未遂、感知压力和社会心理障碍来表示临床严重程度。各组就最终模型的因素进行了比较。最终模型由三个因子组成,分别代表精神病理学和功能障碍、自伤行为和感知压力(与参考模型的 BIC 差异:103.99)。有任何 PPS 的参与者在所有因子上的得分都高于无 PPS 组(SD 差异:0.49-1.48)。此外,del&hall 组在精神病理学和功能障碍方面的得分比 hall 组高 1.31 SD,在自我伤害行为方面的得分比 del 组高 1.16 SD。最后,霍尔组在自我伤害行为上的得分比谵妄组高 0.84 个标准差,而在其他因素上没有组间差异。在青少年患者中,PPS 的出现可能代表着一种更严重的精神障碍,而幻觉则是自残行为的标志。对 PPS 进行早期跨诊断评估似乎是明智之举,因为它可以为临床分期治疗提供依据。
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引用次数: 0
Continuity of mental disorders in children with chronic physical illness. 患有慢性躯体疾病的儿童精神障碍的持续性。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-23 DOI: 10.1007/s00787-024-02420-y
Mark A Ferro, Christy K Y Chan, Ellen L Lipman, Ryan J Van Lieshout, Lilly Shanahan, Jan Willem Gorter

Data on the chronicity of mental disorder in children with chronic physical illness (CPI) are limited. We examined the prevalence and predictors of homotypic and heterotypic continuity of mental disorder in children with CPI. A sample of 263 children aged 2-16 years with physician-diagnosed CPI were recruited from outpatient clinics (e.g., dermatology, respiratory) at a Canadian pediatric academic hospital and followed for 24 months. Parent and child-reported mental disorders (mood, anxiety, behavioral, attention-deficit hyperactivity disorder [ADHD]) were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents at baseline, 6, 12, and 24 months. Marginal regression models were computed to identify clinical, parent, and demographic factors associated with mental comorbidity over time. Mental disorder was observed in 24-27% of children with CPI based on child reports and 35-39% based on parent reports. Parent-reported models revealed significant homotypic continuity for all mental disorders (ORs = 4.2-9.5), and heterotypic continuity between mood and anxiety disorders (OR = 2.2), ADHD and behavioral disorders (OR = 5.1), and behavioral and each mental disorder (ORs = 6.7-8.4). Child-reported models revealed significant homotypic continuity for mood (OR = 8.8) and anxiety disorder (OR = 6.0), and heterotypic continuity between anxiety and mood disorders (OR = 12.4). Child disability (ORs = 1.3-1.5) and parent psychopathology (ORs = 1.2-1.8) were the most consistent predictors of both child- and parent-reported mental disorder over time. Mental comorbidity was prevalent and persistent in children with CPI with homotypic and heterotypic continuity common across informants. Child disability and parent psychopathology may be priority targets within integrated family-centered models of care to prevent mental comorbidity in children with CPI.

有关患有慢性躯体疾病(CPI)的儿童精神障碍长期存在的数据十分有限。我们研究了 CPI 儿童精神障碍同型和异型连续性的患病率和预测因素。我们从加拿大一家儿科学术医院的门诊诊所(如皮肤科、呼吸科)招募了 263 名年龄在 2-16 岁、经医生诊断患有 CPI 的儿童,对他们进行了为期 24 个月的跟踪调查。在基线、6 个月、12 个月和 24 个月时,使用儿童和青少年迷你国际神经精神访谈对家长和儿童报告的精神障碍(情绪、焦虑、行为、注意力缺陷多动障碍 [ADHD])进行评估。计算了边际回归模型,以确定随着时间的推移与精神合并症相关的临床、家长和人口学因素。根据儿童报告,24%-27% 的 CPI 儿童患有精神障碍,根据家长报告,35%-39% 的 CPI 儿童患有精神障碍。家长报告模型揭示了所有精神障碍的显著同型连续性(ORs = 4.2-9.5),以及情绪和焦虑障碍(ORs = 2.2)、多动症和行为障碍(ORs = 5.1)、行为障碍和各种精神障碍(ORs = 6.7-8.4)之间的异型连续性。儿童报告模型显示,情绪障碍(OR = 8.8)和焦虑障碍(OR = 6.0)具有明显的同型连续性,焦虑障碍和情绪障碍之间具有异型连续性(OR = 12.4)。儿童残疾(ORs = 1.3-1.5)和父母精神病理学(ORs = 1.2-1.8)是儿童和父母报告的精神障碍随时间变化的最一致的预测因素。患有 CPI 的儿童普遍且持续存在精神疾病合并症,不同信息提供者的同型和异型合并症也很常见。在以家庭为中心的综合护理模式中,儿童残疾和家长心理病理学可能是优先目标,以预防 CPI 儿童的精神合并症。
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引用次数: 0
Perinatal and neonatal factors and mental disorders in children and adolescents: looking for the contributions of the early environment to common and dissociable aspects of psychopathology. 围产期和新生儿因素与儿童和青少年的精神障碍:寻找早期环境对精神病理学的共性和差异性的影响。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-22 DOI: 10.1007/s00787-024-02402-0
Fabiane Leusin, Rodolfo Furlan Damiano, Lorenna Sena Teixeira Mendes, Maurício Scopel Hoffmann, Arthur Gus Manfro, Pedro Mario Pan, Ary Gadelha, Jair de Jesus Mari, Gisele Gus Manfro, Eurípedes Constantino Miguel, Luis Augusto Rohde, Rodrigo Affonseca Bressan, Giovanni Abrahão Salum

High rates of co-occurrence of mental disorders have been hypothesized to represent a result of common susceptibility to overall psychopathology. The purpose of this study is to test the hypothesis that commonalities among psychiatric disorders might be partially driven by sharable perinatal and neonatal environmental factors for mental disorders. Participants were 6-14 years of age children and their parents. Primary caregivers provided data on perinatal and neonatal information assessed retrospectively (n = 2231). Psychiatric disorders diagnoses were assessed using the Development and Well Being Behavior Assessment (DAWBA). We used bifactor models to disentangle common from dissociable aspects of psychopathology. These models allow modeling psychiatric disorders as the result of a common domain of psychopathology (p-factor) and three dissociable domains (fear, distress, and externalizing symptoms). Associations were tested using linear and tobit regression models. The p-factor was associated with male sex, low socioeconomic status, gestational smoking, gestational drinking, low levels of maternal education and presence of mental disorder in the mother. Associations with specific factors also emerged suggesting some risk factors might also have some role for fear, distress and externalizing factors. Our study supports the hypothesis that overall susceptibility to psychopathology might be partially driven by sharable perinatal and neonatal factors.

据推测,精神障碍的高并发率是整体精神病理学共同易感性的结果。本研究的目的就是要验证这样一个假设,即精神障碍的共同性可能部分是由精神障碍的围产期和新生儿期环境因素共同造成的。参与者为 6-14 岁的儿童及其父母。主要照顾者提供的围产期和新生儿期信息数据是通过回顾性评估得出的(n = 2231)。精神障碍诊断是通过发育与健康行为评估(DAWBA)进行评估的。我们使用双因素模型来区分精神病理学的共性和可分离性。这些模型可将精神障碍建模为一个共同的精神病理学领域(p 因子)和三个可分离的领域(恐惧、痛苦和外化症状)的结果。我们使用线性回归模型和托比特回归模型检验了两者之间的关联。p 因子与男性、社会经济地位低下、妊娠期吸烟、妊娠期饮酒、母亲受教育程度低和母亲存在精神障碍有关。与特定因素的关联也表明,一些风险因素也可能与恐惧、痛苦和外化因素有关。我们的研究支持这样的假设,即对精神病理学的总体易感性可能部分由可共享的围产期和新生儿因素驱动。
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引用次数: 0
Original article: adolescent dietary patterns derived using principal component analysis and neuropsychological functions: a cross-sectional analysis of Walnuts Smart Snack cohort 原文:利用主成分分析和神经心理功能得出的青少年饮食模式:对核桃智能零食队列的横断面分析
IF 6.4 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-18 DOI: 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.

均衡饮食与神经心理功能有关。我们的目的是分析巴塞罗那市核桃智能零食(WSS)队列中健康青少年样本的饮食模式与神经心理学结果之间的关联。我们采用主成分分析法(PCA),通过食物频率问卷(60 个项目)确定青少年样本的饮食模式。我们采用多元线性回归模型来分析 PCA 饮食模式与神经心理学结果之间的关联:优势与困难(SDQ)外化和内化得分、注意力网络测试(ANT)冲动指数和情绪识别任务(ERT)得分。此外,我们还根据儿童的性别、年龄、体重指数(BMI)、体力活动和母亲教育程度对模型进行了调整。在 PCA 分析中确定了六种饮食模式。"低热量高密度食物摄入量 "饮食模式与SDQ结果均呈负相关(保护性)(p值为0.001),"坚果 "饮食模式与冲动指数呈负相关(保护性)(:{(beta:}_{1})= -24.60, 95% CI = -36.80, -12.41, p值为0.001)。总之,我们的主要研究结果表明,健康的膳食模式,包括摄入更多的 "坚果 "和偏好 "低热量高密度食物 "的膳食模式,会对青少年时期的神经心理功能产生有益的影响。这种关联可能包括改善外化和内化问题症状以及冲动性。
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引用次数: 0
The correlation of inflammation, tryptophan-kynurenine pathway, and suicide risk in adolescent depression 炎症、色氨酸-犬尿氨酸通路与青少年抑郁症自杀风险的相关性
IF 6.4 2区 医学 Q1 PEDIATRICS Pub Date : 2024-09-17 DOI: 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。
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引用次数: 0
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European Child & Adolescent Psychiatry
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