Pub Date : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5274
Brae Anne McArthur,Kristine Lyn Pesigan,Lindsay Berg,Glorianna Sin,Samarpreet Singh,Caitlin McClurg
ImportanceTransgender and gender diverse (TGD) youth face adversities that increase risks for suicidality and nonsuicidal self-injury (NSSI). However, substantial variability in prevalence rates have been reported across the literature.ObjectiveTo provide meta-analytic syntheses of research investigating the prevalence of suicidal ideation, suicide attempts, and NSSI in TGD youth and to examine the moderating effects of sample characteristics and study methods on estimates.Design, Setting, and ParticipantsMEDLINE, Embase, CINAHL, Web of Science, Social Work Abstracts, Scopus, PsycINFO, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses Global databases were searched in January 2025. This meta-analysis included studies of TGD youth aged 25 years and younger measuring suicidal ideation, suicide attempts, and/or NSSI published in English. These data were analyzed from June 2025 to September 2025.Data Extraction and SynthesisData extraction followed the PRISMA guidelines. Random-effects meta-analyses were used to derive the pooled prevalence estimates.Main Outcomes and MeasuresOutcomes included prevalence rates of suicidal ideation, suicide attempts, and NSSI. Sample characteristics (ie, race and ethnicity and gender identity group) and study methods (ie, assessment modality, timeframe, geographical region, and study quality) acted as moderator variables.ResultsFrom 137 studies, 262 nonoverlapping samples with a total of 131 429 TGD youth (mean age, 17.0 [range, 7.5-23.4] years) were included. Pooled prevalence estimates of suicidal ideation, suicide attempts, and NSSI were 48.8% (95% CI, 45.6%-52.0%), 26.2% (95% CI, 23.9%-28.6%), and 46.6% (95% CI, 40.5%-52.7%), respectively. Survey studies yielded higher prevalence rates across all outcomes compared with interview and medical record reviews. Significant moderating effects for ethnicity, gender identity group, timeframe, geographical region, and study quality varied across outcomes.Conclusions and RelevanceIn this meta-analyis, pooled estimates suggested that 1 in 2 TGD youth globally are experiencing suicidal ideation and/or NSSI, and 1 in 4 have experienced a suicide attempt. These pooled estimates are 2 to 3.5 times greater in TGD youth compared with those established for cisgender peers. There is a critical need for improved prevention and intervention efforts to address TGD mental health concerns.
跨性别和性别多元化（TGD）青年面临的逆境增加了自杀和非自杀性自伤（NSSI）的风险。然而，文献中报道的患病率存在很大差异。目的对TGD青少年自杀意念、自杀企图和自伤的患病率进行meta分析，并检验样本特征和研究方法对估计的调节作用。设计、设置和参与者medline、Embase、CINAHL、Web of Science、Social Work Abstracts、Scopus、PsycINFO、Cochrane Central Register of Controlled Trials和ProQuest disserthesis & Theses全球数据库于2025年1月检索。本荟萃分析包括25岁及以下TGD青年的研究，测量自杀意念、自杀企图和/或自伤。这些数据的分析时间为2025年6月至2025年9月。数据提取和合成数据提取遵循PRISMA指南。随机效应荟萃分析用于得出汇总的患病率估计。主要结局和测量结果包括自杀意念、自杀企图和自伤的患病率。样本特征（即种族、民族和性别认同群体）和研究方法（即评估方式、时间框架、地理区域和研究质量）作为调节变量。结果137项研究共纳入262个非重叠样本，共131 429名TGD青年（平均年龄17.0[范围，7.5-23.4]岁）。自杀意念、自杀企图和自伤的合并患病率估计分别为48.8% （95% CI, 45.6%-52.0%）、26.2% （95% CI, 23.9%-28.6%）和46.6% （95% CI, 40.5%-52.7%）。与访谈和病历回顾相比，调查研究得出的所有结果的患病率都更高。种族、性别认同群体、时间框架、地理区域和研究质量的显著调节作用因结果而异。结论和相关性在这项荟萃分析中，综合估计表明，全球每2名TGD青年中就有1名有自杀意念和/或自伤，每4名中就有1名有自杀企图。这些综合估计在TGD青年中比在顺性别同龄人中高2至3.5倍。迫切需要改进预防和干预工作，以解决TGD心理健康问题。
{"title":"Suicidality and Nonsuicidal Self-Injury in Transgender and Gender Diverse Youth: A Systematic Review and Meta-Analysis.","authors":"Brae Anne McArthur,Kristine Lyn Pesigan,Lindsay Berg,Glorianna Sin,Samarpreet Singh,Caitlin McClurg","doi":"10.1001/jamapediatrics.2025.5274","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5274","url":null,"abstract":"ImportanceTransgender and gender diverse (TGD) youth face adversities that increase risks for suicidality and nonsuicidal self-injury (NSSI). However, substantial variability in prevalence rates have been reported across the literature.ObjectiveTo provide meta-analytic syntheses of research investigating the prevalence of suicidal ideation, suicide attempts, and NSSI in TGD youth and to examine the moderating effects of sample characteristics and study methods on estimates.Design, Setting, and ParticipantsMEDLINE, Embase, CINAHL, Web of Science, Social Work Abstracts, Scopus, PsycINFO, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses Global databases were searched in January 2025. This meta-analysis included studies of TGD youth aged 25 years and younger measuring suicidal ideation, suicide attempts, and/or NSSI published in English. These data were analyzed from June 2025 to September 2025.Data Extraction and SynthesisData extraction followed the PRISMA guidelines. Random-effects meta-analyses were used to derive the pooled prevalence estimates.Main Outcomes and MeasuresOutcomes included prevalence rates of suicidal ideation, suicide attempts, and NSSI. Sample characteristics (ie, race and ethnicity and gender identity group) and study methods (ie, assessment modality, timeframe, geographical region, and study quality) acted as moderator variables.ResultsFrom 137 studies, 262 nonoverlapping samples with a total of 131 429 TGD youth (mean age, 17.0 [range, 7.5-23.4] years) were included. Pooled prevalence estimates of suicidal ideation, suicide attempts, and NSSI were 48.8% (95% CI, 45.6%-52.0%), 26.2% (95% CI, 23.9%-28.6%), and 46.6% (95% CI, 40.5%-52.7%), respectively. Survey studies yielded higher prevalence rates across all outcomes compared with interview and medical record reviews. Significant moderating effects for ethnicity, gender identity group, timeframe, geographical region, and study quality varied across outcomes.Conclusions and RelevanceIn this meta-analyis, pooled estimates suggested that 1 in 2 TGD youth globally are experiencing suicidal ideation and/or NSSI, and 1 in 4 have experienced a suicide attempt. These pooled estimates are 2 to 3.5 times greater in TGD youth compared with those established for cisgender peers. There is a critical need for improved prevention and intervention efforts to address TGD mental health concerns.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"56 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801002","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 : 2025-12-22DOI: 10.1001/jamapediatrics.2025.5328
Josna Jojo
{"title":"Clarifying the Burden of Obesity in Youth: Measurement Choices.","authors":"Josna Jojo","doi":"10.1001/jamapediatrics.2025.5328","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5328","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800999","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}
{"title":"Toward Antifragility-Calling Health Care Systems to Evolve.","authors":"Moushumi Sur,Katri Typpo,Lara Shekerdemian,Satid Thammasitboon","doi":"10.1001/jamapediatrics.2025.4999","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4999","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"112 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752713","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 : 2025-12-15DOI: 10.1001/jamapediatrics.2025.5192
Jackson M A Hewitt,Sheri Madigan,Brae Anne McArthur
{"title":"Disentangling Maternal-Child Depression Dynamics Across Early Adolescence-Reply.","authors":"Jackson M A Hewitt,Sheri Madigan,Brae Anne McArthur","doi":"10.1001/jamapediatrics.2025.5192","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5192","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752661","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 : 2025-12-15DOI: 10.1001/jamapediatrics.2025.5181
Ashley A Foster,Anna M Cushing,Jennifer A Hoffmann,Katherine A Nash,Chuan-Mei Lee,Kenneth A Michelson
ImportancePediatric behavioral health conditions are common and may confer substantial health care costs and financial strain on families.ObjectiveTo quantify 2022 US pediatric behavioral health care expenditures, evaluate 2011 to 2022 changes in expenditures, and examine the association between child behavioral health spending and family financial burden.Design, Setting, and ParticipantsCross-sectional study of US children aged 6 to 17 years, using 2011-2022 Medical Expenditure Panel Survey household component files, with analysis performed from January 11, 2024, to October 15, 2025.ExposureExpenditure trends analysis included year. Family financial burden analysis included child behavioral health spending.Main Outcomes and MeasuresBehavioral health care and overall pediatric health care spending was totaled for 2022, using survey-weighted linear regression models to estimate trends. The association between child behavioral health spending and high family financial burden (sliding-scale income-based threshold) and extreme financial burden (>10% of income) was evaluated with weighted logistic regression. Analyses were inflation adjusted.ResultsPediatric behavioral health care expenditures in 2022 totaled $41.8 billion (95% CI, $17.0-$66.7 billion). The proportion of pediatric care expenditures for behavioral health increased from 22.4% in 2011 to 40.2% in 2022. Simultaneously, pediatric behavioral health out-of-pocket spending increased from $2.1 to $2.9 billion, by 6.4% annually (95% CI, 3.5%-9.0%). For families with at least 1 child with behavioral health spending, 12.5% of out-of-pocket spending among families with high financial burden and 14.4% of out-of-pocket spending among families with extreme financial burden were for child behavioral health care. Having a child with behavioral health spending was associated with high family financial burden (adjusted odds ratio, 1.60; 95% CI, 1.44-1.78) and extreme family financial burden (adjusted odds ratio, 1.42; 95% CI, 1.22-1.65).Conclusions and RelevanceBehavioral health expenditures nearly doubled to 40% of US child health spending by 2022. Behavioral health spending was associated with high family financial burden, which reflects increased demand and cost for services and supports expanding access through insurance coverage and clinician availability.
{"title":"Expenditures for Pediatric Behavioral Health Care Over Time and Estimated Family Financial Burden.","authors":"Ashley A Foster,Anna M Cushing,Jennifer A Hoffmann,Katherine A Nash,Chuan-Mei Lee,Kenneth A Michelson","doi":"10.1001/jamapediatrics.2025.5181","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5181","url":null,"abstract":"ImportancePediatric behavioral health conditions are common and may confer substantial health care costs and financial strain on families.ObjectiveTo quantify 2022 US pediatric behavioral health care expenditures, evaluate 2011 to 2022 changes in expenditures, and examine the association between child behavioral health spending and family financial burden.Design, Setting, and ParticipantsCross-sectional study of US children aged 6 to 17 years, using 2011-2022 Medical Expenditure Panel Survey household component files, with analysis performed from January 11, 2024, to October 15, 2025.ExposureExpenditure trends analysis included year. Family financial burden analysis included child behavioral health spending.Main Outcomes and MeasuresBehavioral health care and overall pediatric health care spending was totaled for 2022, using survey-weighted linear regression models to estimate trends. The association between child behavioral health spending and high family financial burden (sliding-scale income-based threshold) and extreme financial burden (>10% of income) was evaluated with weighted logistic regression. Analyses were inflation adjusted.ResultsPediatric behavioral health care expenditures in 2022 totaled $41.8 billion (95% CI, $17.0-$66.7 billion). The proportion of pediatric care expenditures for behavioral health increased from 22.4% in 2011 to 40.2% in 2022. Simultaneously, pediatric behavioral health out-of-pocket spending increased from $2.1 to $2.9 billion, by 6.4% annually (95% CI, 3.5%-9.0%). For families with at least 1 child with behavioral health spending, 12.5% of out-of-pocket spending among families with high financial burden and 14.4% of out-of-pocket spending among families with extreme financial burden were for child behavioral health care. Having a child with behavioral health spending was associated with high family financial burden (adjusted odds ratio, 1.60; 95% CI, 1.44-1.78) and extreme family financial burden (adjusted odds ratio, 1.42; 95% CI, 1.22-1.65).Conclusions and RelevanceBehavioral health expenditures nearly doubled to 40% of US child health spending by 2022. Behavioral health spending was associated with high family financial burden, which reflects increased demand and cost for services and supports expanding access through insurance coverage and clinician availability.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"20 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752698","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.2025.4801
Sara B DeMauro,Haresh Kirpalani,Susan Hintz,Kristi L Watterberg,Victoria Watson,Jean Lowe,Seetha Shankaran,Sanjay Chawla,Betty Vohr,Michael E Msall,Carl T D'Angio,Bradley A Yoder,Khanh Lai,Sarah Winter,Tarah T Colaizy,Stephanie L Merhar,Kristina Ziolkowski,Carla M Bann,Marissa Trotta,Jamie E Newman,Michele C Walsh,Rosemary D Higgins,Tanya E Cahill,Andrea F Duncan,Deanne E Wilson-Costello,Myriam Peralta-Carcelen,Hope Arnold,Ricardo A Mosquera,Roy J Heyne,Janell Fuller,Elisabeth C McGowan,Brenna Cavanaugh,Heidi M Harmon,Nathalie L Maitre,Mary Lauren Neel,Krisa P Van Meurs,Laurie A Richards,Howard W Kilbride,Abbey C Hines,Girija Natarajan,Andrea Trembath,Kristen L Benninger,Kalpashri Kesavan,William F Malcolm,Dinorah Zanger,Ann Marie Reynolds,Martha Carlson,Abhik Das,
ImportanceBronchopulmonary dysplasia (BPD) is the most common in-hospital morbidity of prematurity, associated with significant long-term medical and neurodevelopmental sequelae and health resource utilization. The Neonatal Research Network (NRN) Hydrocortisone for BPD Trial evaluated the efficacy and safety of hydrocortisone to prevent BPD in high-risk very preterm infants; the impact of hydrocortisone on school-age outcomes in this trial cohort is previously unreported.ObjectiveTo evaluate the impact of neonatal hydrocortisone treatment on early school-age functional motor, cognitive, academic, and pulmonary outcomes among children who participated in the Hydrocortisone for BPD Trial.Design, Setting, and ParticipantsThis prospective long-term cohort study is a follow-up of a randomized clinical trial, the Hydrocortisone for BPD Trial, conducted at 19 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development NRN. Participants, enrolled from August 2011 to February 2018, included intubated infants who had been born before 30 weeks' gestational age and had been mechanically ventilated for at least 7 days by postnatal day 14 to 28. They were eligible for a single, in-person, early school-age visit between corrected age 5 years 0 months and 7 years 11 months, conducted from September 2017 to July 2024. Data analysis was performed from July 2024 to September 2025.InterventionParticipants were randomized to a 10-day tapering course of hydrocortisone or placebo beginning at 14 to 28 postnatal days.Main Outcomes and MeasuresEarly school-age study visits were performed by certified, masked assessors. The primary outcome of functional impairment was defined as any of the following: cognitive delay, motor delay, academic delay, or poor functional exercise capacity.ResultsThe primary outcome was available for 545 of 674 eligible children (80.9%), including 272 children in the hydrocortisone group (152 [55.9%] female; mean [SD] gestational age, 24.9 [1.5] weeks; mean [SD] age at visit, 5.3 [0.6] years) and 273 in the placebo group (108 [39.6%] female; mean [SD] gestational age, 24.8 [1.5] weeks; mean [SD] age at visit, 5.4 [0.6] years). There was no difference in the rate of functional impairment between the hydrocortisone group (194 of 272 children [71.3%]) and the placebo group (200 of 273 children [73.3%]) (adjusted relative risk, 0.99; 95% CI, 0.89-1.10), nor were there differences in the rates of the individual components. Motor delay was the most common impairment (308 of 510 children [60.4%]), followed by poor functional exercise capacity (175 of 484 children [36.2%]).Conclusions and RelevanceIn this study, neonatal hydrocortisone treatment of preterm infants with high risk for BPD did not impact functional impairment or its components; nearly three-quarters of the children demonstrated functional impairment at school age.Trial RegistrationClinicalTrials.gov Identifier: NCT01353313.
{"title":"Hydrocortisone in Preterm Infants and School-Age Functional Outcomes: Follow-Up of a Randomized Clinical Trial.","authors":"Sara B DeMauro,Haresh Kirpalani,Susan Hintz,Kristi L Watterberg,Victoria Watson,Jean Lowe,Seetha Shankaran,Sanjay Chawla,Betty Vohr,Michael E Msall,Carl T D'Angio,Bradley A Yoder,Khanh Lai,Sarah Winter,Tarah T Colaizy,Stephanie L Merhar,Kristina Ziolkowski,Carla M Bann,Marissa Trotta,Jamie E Newman,Michele C Walsh,Rosemary D Higgins,Tanya E Cahill,Andrea F Duncan,Deanne E Wilson-Costello,Myriam Peralta-Carcelen,Hope Arnold,Ricardo A Mosquera,Roy J Heyne,Janell Fuller,Elisabeth C McGowan,Brenna Cavanaugh,Heidi M Harmon,Nathalie L Maitre,Mary Lauren Neel,Krisa P Van Meurs,Laurie A Richards,Howard W Kilbride,Abbey C Hines,Girija Natarajan,Andrea Trembath,Kristen L Benninger,Kalpashri Kesavan,William F Malcolm,Dinorah Zanger,Ann Marie Reynolds,Martha Carlson,Abhik Das, ","doi":"10.1001/jamapediatrics.2025.4801","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4801","url":null,"abstract":"ImportanceBronchopulmonary dysplasia (BPD) is the most common in-hospital morbidity of prematurity, associated with significant long-term medical and neurodevelopmental sequelae and health resource utilization. The Neonatal Research Network (NRN) Hydrocortisone for BPD Trial evaluated the efficacy and safety of hydrocortisone to prevent BPD in high-risk very preterm infants; the impact of hydrocortisone on school-age outcomes in this trial cohort is previously unreported.ObjectiveTo evaluate the impact of neonatal hydrocortisone treatment on early school-age functional motor, cognitive, academic, and pulmonary outcomes among children who participated in the Hydrocortisone for BPD Trial.Design, Setting, and ParticipantsThis prospective long-term cohort study is a follow-up of a randomized clinical trial, the Hydrocortisone for BPD Trial, conducted at 19 centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development NRN. Participants, enrolled from August 2011 to February 2018, included intubated infants who had been born before 30 weeks' gestational age and had been mechanically ventilated for at least 7 days by postnatal day 14 to 28. They were eligible for a single, in-person, early school-age visit between corrected age 5 years 0 months and 7 years 11 months, conducted from September 2017 to July 2024. Data analysis was performed from July 2024 to September 2025.InterventionParticipants were randomized to a 10-day tapering course of hydrocortisone or placebo beginning at 14 to 28 postnatal days.Main Outcomes and MeasuresEarly school-age study visits were performed by certified, masked assessors. The primary outcome of functional impairment was defined as any of the following: cognitive delay, motor delay, academic delay, or poor functional exercise capacity.ResultsThe primary outcome was available for 545 of 674 eligible children (80.9%), including 272 children in the hydrocortisone group (152 [55.9%] female; mean [SD] gestational age, 24.9 [1.5] weeks; mean [SD] age at visit, 5.3 [0.6] years) and 273 in the placebo group (108 [39.6%] female; mean [SD] gestational age, 24.8 [1.5] weeks; mean [SD] age at visit, 5.4 [0.6] years). There was no difference in the rate of functional impairment between the hydrocortisone group (194 of 272 children [71.3%]) and the placebo group (200 of 273 children [73.3%]) (adjusted relative risk, 0.99; 95% CI, 0.89-1.10), nor were there differences in the rates of the individual components. Motor delay was the most common impairment (308 of 510 children [60.4%]), followed by poor functional exercise capacity (175 of 484 children [36.2%]).Conclusions and RelevanceIn this study, neonatal hydrocortisone treatment of preterm infants with high risk for BPD did not impact functional impairment or its components; nearly three-quarters of the children demonstrated functional impairment at school age.Trial RegistrationClinicalTrials.gov Identifier: NCT01353313.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"20 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696782","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.2025.4996
Alexander I Parry
{"title":"Why We Should Defend the Consumer Product Safety Commission.","authors":"Alexander I Parry","doi":"10.1001/jamapediatrics.2025.4996","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.4996","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"31 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696785","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}
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}
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