The aim of this narrative review is to summarize evidence relating the importance of nutrient intake from diet and supplementation for paediatric mental health. We begin by reviewing several mechanisms by which nutrients maximize brain health, including enabling metabolic reactions to occur, supporting mitochondrial function, reducing inflammation and assisting with detoxification. Circumstances that may contribute to an individual requiring additional nutrients beyond what are available in the diet, such as consumption of nutritionally depleted food, individual differences in biological need, long-term medication use and gut-brain health needs are then reviewed. These factors underpin the importance of tackling deficiencies relative to individual metabolic requirements with a broad spectrum of micronutrients, as opposed to a single nutrient approach, to address personal metabolic needs and/or environmentally induced nutrient depletions. The evidence for treating psychological symptoms with supplementary micronutrients is presented, summarizing research using broad-spectrum micronutrients in the treatment of mental health issues including aggression, autism spectrum disorder, attention-deficit/hyperactivity disorder and emotional dysregulation, often with medium between-group effect sizes compared with placebo, with clinically meaningful changes. The breadth and consistency of the findings highlight the importance of receiving a complete foundation of nutrients to optimize brain health; however, the small number of studies identifies the importance of future work to replicate these preliminary findings. Documented safety in 8-week randomized controlled trials with open-label extensions up to 16 weeks and longer-term follow-up for 1.5-5 years in smaller samples provide reassurance that this treatment approach does not result in serious adverse events. We provide recommendations for future research including consistency in micronutrient interventions, scalable delivery models, effectiveness and implementation studies and the need to investigate these interventions in the prevention and management of less-studied childhood psychiatric conditions.
Background: Adolescent mental health is vital for public health, yet many interventions fail to recognise adolescents as proactive community contributors. This paper discusses the co-design and acceptability testing of a chat-story intervention to enhance Brazilian adolescents' participation in the promotion of mental health in their peer communities. We specifically highlight the iterative process of co-creating this intervention with community stakeholders.
Methods: The co-design was led by researchers, a youth collaborative group, and health-tech experts. Part 1 included quantitative (n = 1,768) and qualitative (n = 46) studies with Brazilian adolescents aged 15-18 for priority-setting. Part 2 involved co-creation and technical production, with input from youth advisors (n = 24), school staff (n = 11), and policy experts (n = 3). In Part 3, the chat-story was user tested (n = 32). Parts 4 and 5 assessed acceptability through a qualitative study in schools (n = 138) and initial efficacy during an online campaign (n = 795).
Results: Participants aspired to support their peers' mental health in schools, both one-to-one and collectively, but felt unprepared. This informed the chat-story's goal of enhancing peer support and collective action skills. Themes identified during Part 1, such as prejudice and academic pressure, were woven into the narrative to raise awareness of the social determinants of mental health, drawing from real-life stories. In the final story, players search for their missing best friend at school, uncovering his anxiety struggles and practicing skills such as empathic listening and partnership building. A manual for teachers was collaboratively designed for use within school settings, supplementing direct-to-user online applications. Acceptability testing showed participants found the tool authentic and user-friendly. Online users perceived the tool as preparing and motivating them to offer peer support and engage in collective action.
Conclusions: The immersive co-creation model, enriched by input from key stakeholders, yielded a relevant and well-received intervention for Brazilian adolescents. Co-designed creative tools like chat-stories hold promise as digital mental health tools, fostering awareness, critical reflection, and inspiring adolescents to drive positive social change.
Background: Mental health problems and traits capturing psychopathology are common and often begin during adolescence. Decades of twin studies indicate that genetic factors explain around 50% of individual differences in adolescent psychopathology. In recent years, significant advances, particularly in genomics, have moved this work towards more translational findings.
Methods: This review provides an overview of the past decade of genetically sensitive studies on adolescent development, covering both family and genomic studies in adolescents aged 10-24 years. We focus on five research themes: (1) co-occurrence or comorbidity between psychopathologies, (2) stability and change over time, (3) intergenerational transmission, (4) gene-environment interplay, and (5) psychological treatment outcomes.
Results: First, research shows that much of the co-occurrence of psychopathologies in adolescence is explained by genetic factors, with widespread pleiotropic influences on many traits. Second, stability in psychopathology across adolescence is largely explained by persistent genetic influences, whereas change is explained by emerging genetic and environmental influences. Third, contemporary twin-family studies suggest that different co-occurring genetic and environmental mechanisms may account for the intergenerational transmission of psychopathology, with some differences across psychopathologies. Fourth, genetic influences on adolescent psychopathology are correlated with a wide range of environmental exposures. However, the extent to which genetic factors interact with the environment remains unclear, as findings from both twin and genomic studies are inconsistent. Finally, a few studies suggest that genetic factors may play a role in psychological treatment response, but these findings have not yet been replicated.
Conclusions: Genetically sensitive research on adolescent psychopathology has progressed significantly in the past decade, with family and twin findings starting to be replicated at the genomic level. However, important gaps remain in the literature, and we conclude by providing suggestions of research questions that still need to be addressed.
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