ImportanceRussia first invaded Ukraine in 2014, annexing the Crimean Peninsula and occupying parts of eastern Ukraine. On February 24, 2022, Russia launched a full-scale invasion that is currently ongoing. Despite the chronic nature of the armed conflict, evidence of its cumulative impact on adolescent mental health since 2014 remains limited.ObjectiveTo assess the prevalence of wartime traumatic stressors, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and suicidality and to examine the differential associations of war exposure with adolescent mental health.Design, Setting, and ParticipantsThe Ukraine Adolescent Mental Health Study is a repeated cross-sectional study based on 2 school surveys conducted in 2016-2017 (n = 2766) and again in 2023-2024 (n = 2720). Adolescents aged 11 to 17 years (grades 6 to 9) living in Ukraine were recruited from 2 regions: Donetsk and Kirovograd. Data were analyzed from January 13, 2025, to May 28, 2025.ExposureFirst phase (2014) and second phase (2022) of the Russian invasion.Main Outcomes and MeasuresAdolescents self-reported wartime traumatic stressors, PTSD symptoms, depressive symptoms, suicidal ideation, and suicide attempts using standardized tools. The association between demographic variables and wartime traumatic stressors, mental health symptoms, and suicidality were also evaluated.ResultsA total of 5486 adolescent participants residing in Ukraine after 2 phases of the Russian invasion were included in the analyses, of whom 2907 (53.0%) were female; the mean (SD) age was 13.4 (1.7) years. Adolescents exposed to the second phase of the invasion experienced high levels of PTSD symptoms and depressive symptoms, with particularly high rates among adolescents who were living in the war-affected region during the first phase of the invasion (PTSD symptoms: 180 of 1122 participants [16.0%]; odds ratio, 14.08 [95% CI, 8.36-23.72]; severe depressive symptoms: 118 of 1122 participants [10.5%]; odds ratio, 4.83 [95% CI, 3.28-7.11]) compared with adolescents who had no war exposure. War exposure was associated with suicidality in all study groups. A cumulative association was observed between wartime traumatic stressors and mental health outcomes.Conclusions and RelevanceThe findings of this cross-sectional study suggest that the Russian-Ukrainian war has had a psychological toll on Ukrainian adolescents, indicating long-term consequences for their mental health, resilience, and development. These findings indicate an urgent need to prioritize and scale up mental health interventions to address the needs of adolescents during the ongoing war.
{"title":"Mental Health of Ukrainian Adolescents After Russian Invasions.","authors":"Andre Sourander,Sanju Silwal,Minja Westerlund,Matthew Hodes,Emmi Heinonen,Susanna Hinkka-Yli-Salomäki,Yuliia Yaschchyshyna,Gennadiy Putyatin,James Scott,Norbert Skokauskas,Olga Osokina","doi":"10.1001/jamapediatrics.2025.5094","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5094","url":null,"abstract":"ImportanceRussia first invaded Ukraine in 2014, annexing the Crimean Peninsula and occupying parts of eastern Ukraine. On February 24, 2022, Russia launched a full-scale invasion that is currently ongoing. Despite the chronic nature of the armed conflict, evidence of its cumulative impact on adolescent mental health since 2014 remains limited.ObjectiveTo assess the prevalence of wartime traumatic stressors, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and suicidality and to examine the differential associations of war exposure with adolescent mental health.Design, Setting, and ParticipantsThe Ukraine Adolescent Mental Health Study is a repeated cross-sectional study based on 2 school surveys conducted in 2016-2017 (n = 2766) and again in 2023-2024 (n = 2720). Adolescents aged 11 to 17 years (grades 6 to 9) living in Ukraine were recruited from 2 regions: Donetsk and Kirovograd. Data were analyzed from January 13, 2025, to May 28, 2025.ExposureFirst phase (2014) and second phase (2022) of the Russian invasion.Main Outcomes and MeasuresAdolescents self-reported wartime traumatic stressors, PTSD symptoms, depressive symptoms, suicidal ideation, and suicide attempts using standardized tools. The association between demographic variables and wartime traumatic stressors, mental health symptoms, and suicidality were also evaluated.ResultsA total of 5486 adolescent participants residing in Ukraine after 2 phases of the Russian invasion were included in the analyses, of whom 2907 (53.0%) were female; the mean (SD) age was 13.4 (1.7) years. Adolescents exposed to the second phase of the invasion experienced high levels of PTSD symptoms and depressive symptoms, with particularly high rates among adolescents who were living in the war-affected region during the first phase of the invasion (PTSD symptoms: 180 of 1122 participants [16.0%]; odds ratio, 14.08 [95% CI, 8.36-23.72]; severe depressive symptoms: 118 of 1122 participants [10.5%]; odds ratio, 4.83 [95% CI, 3.28-7.11]) compared with adolescents who had no war exposure. War exposure was associated with suicidality in all study groups. A cumulative association was observed between wartime traumatic stressors and mental health outcomes.Conclusions and RelevanceThe findings of this cross-sectional study suggest that the Russian-Ukrainian war has had a psychological toll on Ukrainian adolescents, indicating long-term consequences for their mental health, resilience, and development. These findings indicate an urgent need to prioritize and scale up mental health interventions to address the needs of adolescents during the ongoing war.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1001/jamapediatrics.2025.5087
Ning Lyu,Sebastian Schneeweiss,Florence T Bourgeois,Timothy J Savage
{"title":"US Food and Drug Administration Approval of Biologic Drugs for Use in Children and Adolescents.","authors":"Ning Lyu,Sebastian Schneeweiss,Florence T Bourgeois,Timothy J Savage","doi":"10.1001/jamapediatrics.2025.5087","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5087","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"136 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4744
Xiaoran Sun,Kimberly Molaib,Ting Xu,Nilàm Ram,Byron Reeves,Manisha Desai,Thomas N Robinson
{"title":"Objectively Measured Social Media Use and Weight Concerns and Dieting in Adolescents.","authors":"Xiaoran Sun,Kimberly Molaib,Ting Xu,Nilàm Ram,Byron Reeves,Manisha Desai,Thomas N Robinson","doi":"10.1001/jamapediatrics.2025.4744","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4744","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"150 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4950
Claes Ohlsson,Rebecka Bramsved,Maria Bygdell,Jari Martikainen,Annika Rosengren,Jenny M Kindblom
ImportanceChildhood overweight is associated with adult coronary heart disease (CHD); the extent to which this risk can be mitigated by remission of childhood overweight before young adulthood is not clear.ObjectiveTo evaluate if remission of elevated childhood weight before young adulthood mitigates the risk of adult CHD.Design, Setting, and ParticipantsThis population-based cohort study was conducted among individuals born between 1945 and 1968 in Gothenburg, Sweden, as a part of the BMI Epidemiology Study (BEST). Archived child and school health records were linked to national high-quality registers in November 2022. Data analysis was performed from 2024 to 2025.ExposuresChildhood (women at age 7 years and men at age 8 years) and young adult (women age 18 years and men age 20 years) overweight derived from weight and height measurements in school health records and at conscription.Main Outcomes and MeasuresThe primary outcome was register-derived CHD diagnosis (fatal or nonfatal) in adult age.ResultsThis study included 103 232 individuals (45 965 women [44.5%]; mean [SD] childhood body mass index, calculated as weight in kilograms divided by height in meters squared, of 15.6 [1.5]) born 1945-1968 in Gothenburg, Sweden. Childhood and young adult overweight were associated with increased risk of CHD in both men and women. No significant sex interaction was observed for these associations. Remission of childhood overweight before young adulthood resulted in a similar risk of CHD as in individuals who had persistent normal weight (reference category; hazard ratio [HR], 0.98; 95% CI, 0.84-1.14). Both pubertal onset overweight (ie, normal weight in childhood and overweight in young adulthood; HR, 1.83; 95% CI, 1.66-2.03) and persistent overweight (ie, overweight in both childhood and young adulthood; HR, 1.53; 95% CI, 1.30-1.78) were associated with increased risk of adult CHD events. However, individuals with pubertal onset overweight had higher risk of CHD than individuals with persistent overweight (HR, 1.23; 95% CI, 1.03-1.49; P = .03).Conclusions and RelevanceIn this population-based cohort study, increased risk of CHD in Swedish individuals with childhood overweight was reversed with remission of overweight before young adulthood; furthermore, overweight in young adulthood with pubertal onset was associated with higher risk of adult CHD compared to overweight persistent throughout childhood and puberty. These findings have implications for public health planning, emphasizing the importance of early detection and treatment of overweight during childhood and adolescence.
{"title":"Change in Weight Status From Childhood to Young Adulthood and Risk of Adult Coronary Heart Disease.","authors":"Claes Ohlsson,Rebecka Bramsved,Maria Bygdell,Jari Martikainen,Annika Rosengren,Jenny M Kindblom","doi":"10.1001/jamapediatrics.2025.4950","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4950","url":null,"abstract":"ImportanceChildhood overweight is associated with adult coronary heart disease (CHD); the extent to which this risk can be mitigated by remission of childhood overweight before young adulthood is not clear.ObjectiveTo evaluate if remission of elevated childhood weight before young adulthood mitigates the risk of adult CHD.Design, Setting, and ParticipantsThis population-based cohort study was conducted among individuals born between 1945 and 1968 in Gothenburg, Sweden, as a part of the BMI Epidemiology Study (BEST). Archived child and school health records were linked to national high-quality registers in November 2022. Data analysis was performed from 2024 to 2025.ExposuresChildhood (women at age 7 years and men at age 8 years) and young adult (women age 18 years and men age 20 years) overweight derived from weight and height measurements in school health records and at conscription.Main Outcomes and MeasuresThe primary outcome was register-derived CHD diagnosis (fatal or nonfatal) in adult age.ResultsThis study included 103 232 individuals (45 965 women [44.5%]; mean [SD] childhood body mass index, calculated as weight in kilograms divided by height in meters squared, of 15.6 [1.5]) born 1945-1968 in Gothenburg, Sweden. Childhood and young adult overweight were associated with increased risk of CHD in both men and women. No significant sex interaction was observed for these associations. Remission of childhood overweight before young adulthood resulted in a similar risk of CHD as in individuals who had persistent normal weight (reference category; hazard ratio [HR], 0.98; 95% CI, 0.84-1.14). Both pubertal onset overweight (ie, normal weight in childhood and overweight in young adulthood; HR, 1.83; 95% CI, 1.66-2.03) and persistent overweight (ie, overweight in both childhood and young adulthood; HR, 1.53; 95% CI, 1.30-1.78) were associated with increased risk of adult CHD events. However, individuals with pubertal onset overweight had higher risk of CHD than individuals with persistent overweight (HR, 1.23; 95% CI, 1.03-1.49; P = .03).Conclusions and RelevanceIn this population-based cohort study, increased risk of CHD in Swedish individuals with childhood overweight was reversed with remission of overweight before young adulthood; furthermore, overweight in young adulthood with pubertal onset was associated with higher risk of adult CHD compared to overweight persistent throughout childhood and puberty. These findings have implications for public health planning, emphasizing the importance of early detection and treatment of overweight during childhood and adolescence.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4662
{"title":"Error in Table and Figure.","authors":"","doi":"10.1001/jamapediatrics.2025.4662","DOIUrl":"10.1001/jamapediatrics.2025.4662","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"179 12","pages":"1367"},"PeriodicalIF":18.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1001/jamapediatrics.2025.4935
João Guilherme G Tedde,Thiago Cerqueira-Silva,Orlagh Carroll,Laura C Rodrigues,Maria Gloria Teixeira,Nuria Sanchez Clemente,Mauricio L Barreto,Enny S Paixão
ImportanceEpilepsy is a major clinical concern in children with congenital Zika syndrome (CZS). However, whether in utero exposure to Zika virus (ZIKV) without development of CZS is associated with increased epilepsy risk compared with unexposed children remains unclear.ObjectiveTo compare the risk of epilepsy-related hospitalizations during the first 4 years of life among children exposed to ZIKV during pregnancy (with and without CZS) vs an unexposed group.Design, Setting, and ParticipantsThis was a population-based cohort study conducted in Brazil among live-born singleton children with 22 or more weeks' gestation born from January 2015 to November 2018. Data analysis was conducted from December 2024 to March 2025.ExposureIn utero exposure to ZIKV by maternal notification during pregnancy.Main Outcomes and MeasuresThe primary outcome was the time from birth to the first epilepsy-related hospitalization. Hazard ratios (HRs) and 95% CIs were estimated using a cause-specific Cox regression model, adjusting for maternal education level, maternal self-reported race and ethnicity, maternal age, year of child birth, and adequacy of the number of antenatal appointments. All-cause deaths were also considered as competing events.ResultsAmong 10 828 887 children (5 275 628 [48.7%] female; mean [SD] gestational age, 38.5 [2.0] weeks), 2780 (0.03%) had CZS and 8361 (0.08%) were exposed to ZIKV during pregnancy without developing CZS. After adjusting for confounders, CZS was associated with an increased risk of epilepsy-related hospital admission (adjusted HR [aHR], 34.22 [95% CI, 29.16-40.16]). Age-specific aHRs peaked at age 7 to 18 months (aHR [95% CI], 33.72 [24.70-46.04] for 0-6 months, 44.58 [35.89-55.36] for 7-18 months, and 20.62 [14.31-29.72] for 19-48 months). Children with CZS who were microcephalic, normocephalic, or macrocephalic showed similar associations with epilepsy-related admissions. Children exposed to ZIKV without CZS did not show increased risk compared with unexposed peers (aHR, 0.66 [95% CI, 0.34-1.27]).Conclusions and RelevanceIn this population-based cohort study, CZS was associated with elevated risk of epilepsy-related hospitalization in early childhood in Brazil. In contrast, children exposed to ZIKV during pregnancy without CZS did not appear to have higher risk of epilepsy-related admission compared with unexposed children.
{"title":"Prenatal Exposure to Zika Virus and Risk of Epilepsy-Related Hospitalization During Early Childhood.","authors":"João Guilherme G Tedde,Thiago Cerqueira-Silva,Orlagh Carroll,Laura C Rodrigues,Maria Gloria Teixeira,Nuria Sanchez Clemente,Mauricio L Barreto,Enny S Paixão","doi":"10.1001/jamapediatrics.2025.4935","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4935","url":null,"abstract":"ImportanceEpilepsy is a major clinical concern in children with congenital Zika syndrome (CZS). However, whether in utero exposure to Zika virus (ZIKV) without development of CZS is associated with increased epilepsy risk compared with unexposed children remains unclear.ObjectiveTo compare the risk of epilepsy-related hospitalizations during the first 4 years of life among children exposed to ZIKV during pregnancy (with and without CZS) vs an unexposed group.Design, Setting, and ParticipantsThis was a population-based cohort study conducted in Brazil among live-born singleton children with 22 or more weeks' gestation born from January 2015 to November 2018. Data analysis was conducted from December 2024 to March 2025.ExposureIn utero exposure to ZIKV by maternal notification during pregnancy.Main Outcomes and MeasuresThe primary outcome was the time from birth to the first epilepsy-related hospitalization. Hazard ratios (HRs) and 95% CIs were estimated using a cause-specific Cox regression model, adjusting for maternal education level, maternal self-reported race and ethnicity, maternal age, year of child birth, and adequacy of the number of antenatal appointments. All-cause deaths were also considered as competing events.ResultsAmong 10 828 887 children (5 275 628 [48.7%] female; mean [SD] gestational age, 38.5 [2.0] weeks), 2780 (0.03%) had CZS and 8361 (0.08%) were exposed to ZIKV during pregnancy without developing CZS. After adjusting for confounders, CZS was associated with an increased risk of epilepsy-related hospital admission (adjusted HR [aHR], 34.22 [95% CI, 29.16-40.16]). Age-specific aHRs peaked at age 7 to 18 months (aHR [95% CI], 33.72 [24.70-46.04] for 0-6 months, 44.58 [35.89-55.36] for 7-18 months, and 20.62 [14.31-29.72] for 19-48 months). Children with CZS who were microcephalic, normocephalic, or macrocephalic showed similar associations with epilepsy-related admissions. Children exposed to ZIKV without CZS did not show increased risk compared with unexposed peers (aHR, 0.66 [95% CI, 0.34-1.27]).Conclusions and RelevanceIn this population-based cohort study, CZS was associated with elevated risk of epilepsy-related hospitalization in early childhood in Brazil. In contrast, children exposed to ZIKV during pregnancy without CZS did not appear to have higher risk of epilepsy-related admission compared with unexposed children.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"55 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：