European Child & Adolescent Psychiatry最新文献

Adolescents in Gaza have been repeatedly exposed to war-related trauma, mass displacement, and severe humanitarian crises, placing them at heightened risk of psychological distress. Drawing on cognitive-behavioral and social-ecological frameworks, this study examined how posttraumatic stress and prosocial behavior shape the relationship between cumulative trauma exposure and psychosocial functioning among war-affected adolescents. A cross-sectional study was conducted between July and August 2025 among 717 displaced adolescents (aged 12-17 years) and their caregivers living in shelters and tented camps across the Gaza Strip. Participants completed the Child and Adolescent Trauma Screen (CATS), Strengths and Difficulties Questionnaire (SDQ), and Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). Mediation and moderation analyses were used to examine posttraumatic stress as a mechanism linking cumulative trauma exposure to emotional-behavioral difficulties and to test prosocial behavior as a potential resilience factor. Nearly four in five adolescents (78.4%) met the CATS cutoff for probable PTSD, and almost half (48.5%) met full DSM-5 diagnostic criteria. SDQ assessments indicated that more than half of the participants were classified in the abnormal range for total difficulties on both self- and parent-reports (54.1% and 55.4%, respectively). Peer relationship problems and emotional symptoms were the most prominent, affecting 90.5% and 43.2% of adolescents, respectively. In contrast, prosocial behavior remained relatively preserved, with about three-quarters scoring within the normal range. Strong agreement between self- and parent-reported ratings (r = 0.63) supported the robustness of these findings. PTSD symptoms statistically explained roughly two-thirds of the link between cumulative trauma and emotional-behavioral difficulties, emphasizing posttraumatic stress as a key factor in psychosocial impairment. Conversely, higher prosocial tendencies appeared to buffer the effect of trauma on PTSD severity, suggesting that empathy, cooperation, and helping behaviors help reduce the psychological impact of war exposure. The findings reveal an alarming prevalence of posttraumatic stress and psychosocial dysfunction among Gazan adolescents amid ongoing conflict. Although the findings are cross-sectional and cannot confirm causal mediation, PTSD symptoms appear to represent a key pathway linking trauma exposure to emotional and behavioral difficulties, while prosocial engagement serves as a significant resilience factor. Trauma-informed, family-centered, and strength-based interventions are urgently warranted to address both psychological distress and the social capacities that foster recovery and resilience.

Sexual harassment is widespread among adolescents and linked to adverse mental health outcomes. However, little attention has been paid to the gender of the perpetrator and its potential influence on the mental health of the victims. This study examines how the perpetrator's gender relates to the prevalence and mental health correlates of sexual harassment among Norwegian adolescents aged 13 to 15. Cross-sectional data from 1,988 pupils in 40 secondary schools were used to assess boys' and girls' experiences of sexual harassment by both genders and to examine associations with depressive and anxiety symptoms. Overall, boys were more frequently identified as perpetrators, while girls were more often victims. Harassment by boys was associated with higher levels of depressive and anxiety symptoms in both girls and boys. In contrast, harassment by girls was associated with depressive and anxiety symptoms only in girls. The findings highlight the importance of considering perpetrator gender when assessing the impact of peer sexual harassment. Greater attention should be given to the experiences of young adolescents, who appear vulnerable to male-perpetrated harassment in particular. Targeted measures are needed to reduce the mental health burden of sexual harassment, and clinicians should consider these experiences in the assessment and treatment of adolescent anxiety and depression.

Oppositional defiant disorder (ODD) is prevalent in school-age children and closely linked to family environments. Yet few studies have systematically examined how multilevel family factors interrelate and associate with ODD symptoms. This three-wave longitudinal study investigated associations between entire-level (family socioeconomic status, (SES)), dyadic-level (mother-child conflict), individual-level factors (maternal anger expression, child self-control), and ODD symptoms among 785 Chinese school-age children (34.5% boys). Results revealed cascading pathways: lower socioeconomic status predicted higher mother-child conflict, greater maternal anger expression, and poorer child self-control, contributing to increased ODD symptoms. Furthermore, bidirectional associations were identified between child self-control and ODD symptoms. These results elucidated the multifaceted cascading pathways from multilevel family factors to ODD symptoms, highlighting the importance of integrated family-based interventions. Meanwhile, it is suggested that child individual factors are most proximally associated with ODD symptoms, indicating that child factors, such as child self-regulation, are potentially effective targets for intervention and prevention. Integrating these findings, we proposed the potential conceptualization of a Reciprocal Cascade System for the relationship between multilevel family factors and ODD.

This study investigates trends in the incidence and clinical management of self-harm among adolescents and young adults in Catalonia from 2013 to 2022, using data from the Information System for Research in Primary Care (SIDIAP). A population-based cohort analysis was conducted to examine temporal trends, demographic inequalities, and clinical care patterns. The study population comprised 1,707,471 eligible individuals aged 10 to 24, contributing 8,868,472 person-years of observation. The incidence of self-harm increased significantly over the study period (Incidence Rate Ratio [IRR] 2022 vs. 2013 for the total cohort: 2.67; 95% CI: 2.31-3.10), particularly during the COVID-19 pandemic (IRR 2022 vs. 2019: 2.06; 95 CI: 1.81-2.35), with rates in girls approximately three times higher than in boys. Socioeconomic deprivation emerged as a major risk factor, with individuals from deprived areas demonstrating elevated self-harm rates. Comorbid mental health disorders, notably anxiety and depression, were highly prevalent among individuals engaging in self-harm. Clinical management strategies differed by age and sex; girls were more frequently referred to mental health services, while psychotropic medication was commonly prescribed for both sexes. The incidence of self-harm has steadily increased reaching unprecedented levels during the pandemic, with significant disparities by sex, age, and socioeconomic status. The findings underscore the need for an appropriate healthcare response addressing the social determinants of health. Monitoring incidence trends and implementing targeted strategies are essential to support youth mental health in the post-pandemic context.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both common neurodevelopmental disorders (NDDs), but their association between maternal thyroid dysfunction and NDDs in offspring remains equivocal. This study aimed to evaluate the association between maternal thyroid dysfunction, related medications, and neurodevelopmental disorders in offspring. This population-based retrospective birth cohort study included children born between 2004 and 2020, with surveillance continuing through 2021. Maternal thyroid dysfunction during pregnancy was identified by any outpatient or inpatient diagnosis of hyperthyroidism or hypothyroidism. Medications for hyperthyroidism during pregnancy, including propylthiouracil (PTU) and methimazole (MMI), as well as levothyroxine for hypothyroidism, were also examined. Associations between maternal thyroid dysfunction with medication use and child NDDs were modeled using Cox proportional hazards regression. The study cohort consisted of 3,175,328 live-born children. Among them, 39,294 (1.2%) were born to mothers with hyperthyroidism, and 14,630 (0.5%) had mothers with hypothyroidism. A higher risk of ADHD was noted in children whose mothers had thyroid dysfunction, whether they had hyperthyroidism (adjusted HR, 1.19; 95% CI,1.14-1.24) or hypothyroidism (adjusted HR,1.28; 95% CI,1.19-1.37), and a similarly increased risk of ASD was observed in association with maternal hyperthyroidism (adjusted HR, 1.14; 95% CI, 1.03-1.27) or hypothyroidism (adjusted HR, 1.34; 95% CI, 1.19-1.51). For medications in treating hyperthyroidism during pregnancy, continuous propylthiouracil (PTU) use was associated with a lower risk of ADHD (adjusted HR, 0.91; 95% CI, 0.83-0.99) or ASD (adjusted HR, 0.80; 95% CI, 0.67-0.96). This study identified the association between maternal thyroid dysfunction during pregnancy and offspring ADHD. Moreover, we observed that continuous use of PTU for treating maternal hyperthyroidism during pregnancy may be associated with a reduced risk of childhood ADHD.

Sleep problems are common among children and adolescents; however, the potential role of exercise in mitigating these issues is often overlooked. To examine the relationship between exercise interventions and sleep parameters in children and adolescents. The review adhered to the PRISMA 2020 guidelines. A comprehensive literature search was conducted on 8 databases from inception to February 2025. Randomised controlled trials of children and adolescents aged 6-18 years who applied exercise interventions and reported at least one sleep parameter were included. Data include participant characteristics, intervention details, and sleep parameter. Evidence quality graded by GRADE. 27 studies were used for meta-analysis. The results of the studies showed that exercise had a significant effect on sleep quality (standardized mean difference [SMD] =-1.06; 95% CI=-1.76 to -0.36), sleep efficiency (SMD=-2.17; 95% CI=-3.69 to -0.65), sleep duration (SMD=-0.70; 95% CI=-1.27 to -0.13), wake after sleep onset (SMD=-0.53; 95% CI=-0.91 to -0.15), sleep anxiety (SMD=-0.54; 95% CI=-0.98 to -0.10), sleep resistance (SMD=-0.33; 95% CI=-0.75 to -0.10), sleep latency (SMD=-1.05; 95% CI=-3.29 to 1.19), parasomnias (SMD=-0.67; 95% CI=-1.74 to 0.40), sleep onset delay (SMD=-0.30; 95% CI=-0.60 to -0.00), sleep-disordered breathing (SMD=-0.19; 95% CI=-0.50 to 0.13), and daytime dysfunction (SMD=-0.30; 95% CI=- 0.72 to 0.11) had an effect, but not on total sleep time (SMD = 0.02; 95% CI=-0.23 to 0.27). The findings emphasize the role of exercise in sleep among children and adolescents. Exercise interventions balancing effectiveness and efficiency may serve as an additional approach to sleep issues beyond sleep hygiene education.

Internalizing disorders (INTs), including anxiety (AD) and depressive disorders (DD), frequently emerge during adolescence. Studies suggest that certain core domains of executive functioning (EF), i.e. inhibition, shifting and working memory (WM) may show selectively lower performance in certain INTs. This systematic review aimed to evaluate the evidence of associations between INTs and EF in adolescents. A systematic search was conducted in Medline, Psych-INFO, Scopus, and Web of Science in May 2023. Inclusion focused on adolescents (12-17) with AD (including obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD)) or DD. After screening 2,551 titles/abstracts, 818 records underwent full-text review, on which independent reviewers reached 93% agreement on eligibility. EF parameters, measured through task-performance or ratings, were extracted from 32 eligible articles published since 2014. Performance-based EF differences were reported in 22 studies, most frequently in adolescents with DD. Task-based inhibition showed lower scores most consistently in DD (n = 5). Findings were mixed across other INTs. Three studies found evidence for improved inhibition performance in OCD (n = 2) and AD (n = 1). Finally, 6 studies reporting on self- or parent-rated EF found significant difficulties across EF domains, of which 3 contrasted with intact performances on task-based measurements of EF. Findings suggest both objective and subjective EF difficulties across INTs with no conclusive evidence for selective domain-specific differences. We highlight a discrepancy between subjectively experienced or observed deficits in daily EF and performance on structured tasks. This suggests that rating-based EF may be more sensitive for capturing subtle EF difficulties and therefore adds value in research and clinical settings. Finally, the quality of studies is discussed and directions for future studies are identified, namely, the use of both task and rating-based measures of EF as well as inclusion of larger sample sizes.

Continuous exposure to maternal depressive symptoms throughout childhood has been consistently linked to poorer executive functions in offspring. However, the mechanisms underlying this association remain understudied, particularly with respect to long-term effects in adolescence. This study aimed to test whether harsh parenting mediates the effect of maternal depressive trajectories on executive functions. Data were drawn from 1,949 participants of the 2004 Pelotas Birth Cohort. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale from 3 months to 11 years. Harsh parenting was measured using the Parent-Child Conflict Tactics Scale at 11 years. Executive functions were evaluated at 15 years using the Cambridge Automated Neuropsychological Test Battery. Path analyses were conducted using structural equation modeling. 75% of the mothers belonged to the "moderate-low" or "low" depressive symptom trajectories, while 10.8% were in the "decreasing", 9.0% in the "increasing", and 5.2% in the "chronic-high" trajectories. Mothers with severe and persistent depressive symptoms displayed more harsh parenting behaviors (β(SE) = 0.218(0.030), 95%CI [0.160, 0.277]), which, in turn, were linked to poorer adolescents' sustained attention (β(SE)=-0.093(0.022), 95%CI [-0.137, -0.049]). Adolescents whose mothers belonged to either the high-chronic or decreasing trajectories exhibited poorer sustained attention and episodic memory through harsh parenting, suggesting that early exposure to maternal depressive symptoms may have lasting consequences on cognitive development. Maternal depressive symptoms impact adolescents' executive functions through harsh parenting. Interventions addressing maternal mental health and parenting, especially in early childhood, may foster healthier cognitive development.