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Artificial Intelligence Tools for Suicide Prevention in Adolescents and Young Adults 用于青少年和年轻人自杀预防的人工智能工具
IF 0.4 Q4 Medicine Pub Date : 2022-04-08 DOI: 10.2174/2210676612666220408095913
Mayank Gupta, D. Ramar, Rekha Vijayan, Nihit Gupta
Artificial Intelligence is making a significant transformation in human lives. Its application in the medical and healthcare field has been also observed making an impact and improving overall outcomes. There has been a quest for similar processes in mental health due to the lack of observable changes in the areas of suicide prevention. In the last five years, there has been an emerging body of empirical research applying the technology of artificial intelligence (AI) and machine learning (ML) in mental health.To review the clinical applicability of the AI/ML-based tools in suicide prevention.The compelling question of predicting suicidality has been the focus of this research. We performed a broad literature search and then identified 36 articles relevant to meet the objectives of this review. We review the available evidence and provide a brief overview of the advances in this field.In the last five years, there has been more evidence supporting the implementation of these algorithms in clinical practice. Its current clinical utility is limited to using electronic health records and could be highly effective in conjunction with existing tools for suicide prevention. Other potential sources of relevant data include smart devices and social network sites. There are some serious questions about data privacy and ethics which need more attention while developing these new modalities in suicide research.
人工智能正在使人类生活发生重大变化。它在医疗保健领域的应用也产生了影响并改善了整体结果。由于自杀预防领域缺乏可观察到的变化,人们一直在寻求心理健康方面的类似过程。在过去的五年里,有一批新兴的实证研究将人工智能(AI)和机器学习(ML)技术应用于心理健康。综述基于AI/ML的工具在自杀预防中的临床适用性。预测自杀这一令人信服的问题一直是这项研究的焦点。我们进行了广泛的文献检索,然后确定了36篇与本综述目标相关的文章。我们回顾了现有的证据,并简要概述了该领域的进展。在过去的五年里,有更多的证据支持这些算法在临床实践中的实施。它目前的临床应用仅限于使用电子健康记录,与现有的自杀预防工具相结合可能非常有效。相关数据的其他潜在来源包括智能设备和社交网站。在自杀研究中开发这些新模式时,有一些关于数据隐私和伦理的严重问题需要更多关注。
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引用次数: 0
Trauma & Disordered Eating in Adolescents: A Review 青少年创伤与饮食失调:综述
IF 0.4 Q4 Medicine Pub Date : 2022-04-05 DOI: 10.2174/2210676612666220405125502
Maria A. Tocco, Sarah Mohiuddin
Trauma exposure is common, with more than half of children and adolescents experiencing at least one traumatic event prior to adulthood. Although diagnoses of eating disorders are less prevalent, the majority of adolescents re-port engaging in disordered eating behaviors. The association between childhood trauma exposure and disordered eating behaviors has been well documented in adults, however less is known about this association in adolescents. This review summarizes the literature that exists in the adolescent population.Multiple large-scale studies have demonstrated that adolescents who have been exposed to trauma are more likely to engage in disordered eating behaviors. This association was shown to exist in both sexes, although there appears to be a higher prevalence reported in girls. There does not appear to be significant racial or cultural factors that con-tribute to this association. The experience of sexual trauma, increased trauma severity, and repeat victimization confer an increased risk of engaging in disordered eating behaviors. There are multiple mediators that play a role in the development of disordered eating following a traumatic experience.
创伤暴露是常见的,超过一半的儿童和青少年在成年前至少经历过一次创伤性事件。虽然饮食失调的诊断不太普遍,但大多数青少年都报告有饮食失调的行为。儿童期创伤暴露与饮食失调行为之间的联系在成人中已经有了很好的记录,但对青少年的这种联系知之甚少。这篇综述总结了存在于青少年人群的文献。多项大规模研究表明,经历过创伤的青少年更有可能出现饮食失调的行为。这种关联被证明存在于两性中,尽管在女孩中报告的患病率似乎更高。似乎没有明显的种族或文化因素促成这种联系。性创伤的经历,创伤严重程度的增加,以及反复的受害者行为增加了参与饮食失调行为的风险。有多种介质在创伤经历后饮食失调的发展中发挥作用。
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引用次数: 0
Cultivating Spiritual Community for Transgender Youth 培养跨性别青年的精神共同体
IF 0.4 Q4 Medicine Pub Date : 2022-03-01 DOI: 10.2174/2210676612666220301104845
A. Fornari, Melissa MacNish Nishman
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引用次数: 0
#Trending: A Systematic Review of Social Media Use’s Influence on Adolescent Anxiety and Depression #趋势:社交媒体使用对青少年焦虑和抑郁影响的系统综述
IF 0.4 Q4 Medicine Pub Date : 2022-02-25 DOI: 10.2174/2210676612666220225122720
Sreedevi Damodar, Cidney Lokemoen, Vikram Gurusamy, Manpreet Takhi, Daniel Bishev, A. Parrill, M. Deviney, U. Person, Ijendu Korie, Romain Branch
With new technological advancements, adolescents can obtaindevices that give them virtually unlimited access to social media (SM) which may impactadolescent mental health.This literature review aims to evaluate the influence of social media use onadolescent anxiety and depression.A literature search of PubMed from June 2010 through June 2020 was completedfor the following MeSH terms: social media, adolescent, anxiety, depression, and mentalhealth. English language articles that discussed adolescents aged 13 to 18 years, anxietyand/or depression and SM were included. Extracted data included the SM platform, impacton anxiety and depression, interventions, temporal and dose-response relationships, andobserved versus self-reported usage.The majority of articles positively associated depression (82.6%) and anxiety(78.3%) with SM use. depression corresponded with cyber-bullying (42.1%), negativesocial perspective (21.0%), diminished self-esteem (15.8%), and sleep disturbance (10.5%).Anxiety corresponded with a negative social perspective (44.4%), diminished self-esteem(33.3%), sleep disturbance (16.7%), and cyber-bullying (16.7%). Many studies suggestedthe use of interventions to reduce depression (72.7%) and anxiety (72.7%), such as screentime restrictions (n=6) and social support (n=4), but lacked evaluation of theirimplementation.Current literature suggests a positive association between adolescent SM usewith anxiety and depression. Our study highlights the need for further investigation oftemporal and dose-response associations between SM use and adolescent mental health, andthe potential benefits of SM-driven interventions.
随着新的技术进步,青少年可以获得几乎无限访问社交媒体的设备,这可能会影响他们的心理健康。这篇文献综述旨在评估社交媒体的使用对焦虑和抑郁的影响。2010年6月至2020年6月,PubMed完成了以下MeSH术语的文献检索:社交媒体、青少年、焦虑、抑郁和心理健康。包括讨论13至18岁青少年、焦虑和/或抑郁以及SM的英语文章。提取的数据包括SM平台、影响焦虑和抑郁、干预措施、时间和剂量反应关系,以及观察和自我报告的使用情况。大多数文章将抑郁(82.6%)和焦虑(78.3%)与SM的使用呈正相关。抑郁症与网络欺凌(42.1%)、消极社会视角(21.0%)、自尊下降(15.8%)和睡眠障碍(10.5%,如放映时间限制(n=6)和社会支持(n=4),但缺乏对其实施情况的评估。目前的文献表明,青少年SM使用与焦虑和抑郁呈正相关。我们的研究强调,需要进一步调查SM使用和青少年心理健康之间的时间和剂量反应相关性,以及SM驱动干预的潜在益处。
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引用次数: 0
Achnowledgement to Reviewers 评审员致谢
IF 0.4 Q4 Medicine Pub Date : 2021-12-30 DOI: 10.2174/221067661104211230111925
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引用次数: 0
Implementation of an Expressive Writing Intervention for Adolescents during Inpatient Psychiatric Hospitalization 青少年精神病住院期间表达性写作干预的实施
IF 0.4 Q4 Medicine Pub Date : 2021-12-22 DOI: 10.2174/2210676612666211222104647
Yuko Taniguchi, Mason Schlief, Jered Bright, Sue Simon, J. Leffler
Given the high rates of mental health concerns and communication difficulties for adolescents a treatment intervention to allow for effective expression may be therapeutic. One of the leading writing practices is Pennebaker’s Expressive Writing (EW) intervention. EW involves individuals writing about their feelings and thoughts regarding negative life experiences. Benefits of EW include a reduction of psychological symptoms and doctor visits, and better adjustment.To examine the role of using EW and creative writing as a group intervention for youth admitted to an inpatient psychiatric hospital (IPH)The current study evaluated participant engagement in a 3-day EW activity facilitated by nurses and graduate students on the IPH unit under the supervision of the IPH unit nurse manager and course instructor. Participants included 23 youth between 12- and 18-years-oldOf the 23 participants 49.69% discussed vivid descriptions of illness, 24.5% discussed negative emotions, 20.25% included casual explanation, 5.52% discussed polarized view, and 16.56% discussed their desires, wishes, and goals. The response rate of clinician’s review of the EW content included 58% of clinician’s coding was on the patient’s current state, 24% was on causal explanations, and 18% was on treatment options.The current EW intervention facilitated by nursing staff and graduate students in an IPH was found to be engaged in by participants and provide an additional therapeutic resource to participants. EW may foster patient communication with staff about their functioning, mental health concerns, and treatment needs.
鉴于青少年的心理健康问题和沟通困难率很高,允许有效表达的治疗干预可能是治疗性的。一个主要的写作实践是彭内贝克的表达写作(EW)干预。EW涉及个人写下他们对负面生活经历的感受和想法。EW的好处包括减少心理症状和医生就诊,以及更好地适应。研究使用电子战和创造性写作作为住院精神病医院(IPH)青年群体干预的作用。本研究评估了参与者在IPH单元护士经理和课程讲师的监督下,参与由IPH单元的护士和研究生促进的为期3天的电子战活动。参与者包括23名12至18岁的年轻人。在23名参与者中,49.69%讨论了对疾病的生动描述,24.5%讨论了负面情绪,20.25%讨论了随意的解释,5.52%讨论了两极分化的观点,16.56%讨论了他们的欲望、愿望和目标。临床医生对EW内容的审查的应答率包括58%的临床医生编码是关于患者的当前状态,24%是关于因果解释,18%是关于治疗方案。目前由IPH的护理人员和研究生促成的EW干预被发现是参与者参与的,并为参与者提供了额外的治疗资源。EW可以促进患者与工作人员就其功能、心理健康问题和治疗需求进行沟通。
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引用次数: 0
Marijuana’s Changing Legal Landscape and Its Implications for Adolescent Psychiatrists: A Report from California 大麻不断变化的法律环境及其对青少年精神病学家的影响:一份来自加州的报告
IF 0.4 Q4 Medicine Pub Date : 2021-11-26 DOI: 10.2174/2210676611666211126155735
L. Ponton, Samuel Judice, T. Petti
Thirty-three states and the District of Columbia (DC) have enacted some form of legalized cannabis or cannabinoid for medical conditions (MMJ), 11 of them and DC for recreational use. It has become critical for psychiatrists and other mental health professionals working with adolescents to be aware of diversion of marijuana (MJ) to youth and subsequent potential adverse effects in environments with widely different regulations. The experience of two office-based psychiatrists in California (the first state to legalize MMJ) through case presentations and an informal practice review illustrate the role that diverted MMJ plays in the clinical presentation of youth for psychiatric care, highlighting clinical implications and guidelines for treators as states legalize MJ for adult recreational use. Two child and adolescent psychiatrists practicing in California over the last twenty years report on their experiences working with adolescent patients and their families during the period of legalized MMJ. After a comprehensive literature review, they report their clinical observations and make recommendations for treators of adolescents.There is general confusion among adolescents and their parents about MJ and MMJ. There is a lack of clear regulatory guidelines and a need for better clinical training for prescribing physicians. Diversion of MMJ to teens during periods of legalization of medical marijuana is common in states where it has been not legislated or regulated sufficiently to provide effective safeguards. This lax approach is demonstrated by our case reports and clinical review. Similar experiences have been reported elsewhere. Increased problems with diversion are expected as legalization efforts continue. Professionals and their organizations need to become more active in advocating policies to protect youth from potential harm related to cannabis use and abuse and carefully evaluate its use among their teen patients.
33个州和哥伦比亚特区(DC)已经颁布了某种形式的合法大麻或大麻素用于医疗条件(MMJ),其中11个州和DC用于娱乐用途。精神病学家和其他从事青少年工作的心理健康专业人员必须意识到大麻(MJ)被转移到青少年身上,以及在法规差异很大的环境中可能产生的潜在不良影响。加利福尼亚州(第一个将MMJ合法化的州)的两名办公室精神病学家通过案例介绍和非正式实践审查的经验说明了转移MMJ在青少年精神病护理临床介绍中的作用,强调了各州将MJ合法化用于成人娱乐时对治疗者的临床影响和指南。在过去的二十年里,两名在加利福尼亚州执业的儿童和青少年精神病学家报告了他们在MMJ合法化期间与青少年患者及其家人合作的经历。在全面的文献综述后,他们报告了他们的临床观察结果,并为青少年的治疗者提出了建议。青少年及其父母普遍对MJ和MMJ感到困惑。缺乏明确的监管指南,也需要对处方医生进行更好的临床培训。在医用大麻合法化期间,将MMJ转移到青少年身上,在那些没有充分立法或监管以提供有效保障的州很常见。我们的病例报告和临床审查证明了这种松懈的方法。其他地方也报告了类似的经历。随着合法化工作的继续,预计转移问题会增加。专业人员及其组织需要更加积极地倡导保护青少年免受大麻使用和滥用相关潜在伤害的政策,并仔细评估青少年患者对大麻的使用情况。
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引用次数: 0
Mental Health Interventions in Juvenile Detention Institutions: A Systematic Review of What Works 青少年拘留机构的心理健康干预:有效措施的系统回顾
IF 0.4 Q4 Medicine Pub Date : 2021-11-16 DOI: 10.2174/2210676611666211116163220
Kishwen Kanna Yoga Ratnam, Abid Nordin, P. S. K. Tok, Nik Daliana Nik Farid, M. Dahlui
Incarcerated adolescents within the juvenile justice system aremore likely to be diagnosed with poor mental health compared with their non-incarceratedpeers. Conducting clinical trials on mental health interventions among an incarceratedadolescent population is challenging due to the nature of detention facilities.This systematic review examines available literature on Randomized ClinicalTrials (RCT) done to assess mental health interventions among incarcerated adolescentsglobally and to determine the type of intervention that would best work in this setting. Inthis study, a systematic review was conducted to search, identify, and recommend effectiveinterventions best suited to preserve and improve the mental wellbeing of incarceratedadolescents within the detention institution setting.The search was performed in Medline via Ovid, Cochrane Library, Scopus, andWeb of Science databases to retrieve related publications released between 1970 and March2021. The principal inclusion criteria were RCT articles issued in English that reported anymental health interventions performed in juvenile detention centers involving delinquentadolescents aged 10 to 19 years old. The search discovered 10 related articles that fulfilled the required inclusioncriteria. In total, there were seven different types of mental health interventions used in allthe studies. The three major themes identified among the selected studies are theinterventions for coping strategies, risky behavior, and attention disorder amongincarcerated adolescents. The efficacy of the interventions was dependent on the level ofintelligence, duration of incarceration, risk of treatment diffusion, and depression symptomsamong incarcerated adolescents.Cognitive behavioral therapy (CBT) intervention that is simple, brief, unique,and targets depressive symptoms, has the potential to be most efficacious in improvingmental health among incarcerated adolescents.
与未被监禁的同龄人相比,在少年司法系统中被监禁的青少年更容易被诊断出精神健康状况不佳。由于拘留所的性质,在被监禁的青少年人群中进行心理健康干预的临床试验具有挑战性。本系统综述检查了随机临床试验(RCT)的现有文献,以评估全球被监禁青少年的心理健康干预措施,并确定在这种情况下最有效的干预类型。在这项研究中,进行了系统的回顾,以寻找、识别和推荐最适合保护和改善拘留机构环境中被监禁青少年心理健康的有效干预措施。在Medline中通过Ovid、Cochrane Library、Scopus和web of Science数据库进行检索,检索1970年至2021年3月之间发布的相关出版物。主要纳入标准是用英文发表的随机对照试验文章,这些文章报告了在少年拘留中心进行的涉及10至19岁犯罪青少年的任何心理健康干预措施。搜索发现了10篇符合要求的纳入标准的相关文章。总的来说,所有研究中使用了七种不同类型的心理健康干预措施。在选定的研究中确定的三个主要主题是对被监禁青少年的应对策略、危险行为和注意力障碍的干预。干预的效果取决于被监禁青少年的智力水平、监禁时间、治疗扩散的风险和抑郁症状。认知行为疗法(CBT)干预简单、简短、独特,针对抑郁症状,有可能最有效地改善被监禁青少年的心理健康。
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引用次数: 0
Cumulative Effects of Prenatal and Concurrent Maternal Distress on Psychiatric Disorders in Adolescent Offspring 产前和同时发生的母亲痛苦对青少年后代精神疾病的累积效应
IF 0.4 Q4 Medicine Pub Date : 2021-11-16 DOI: 10.2174/2210676611666211116164115
Neda Mortaji, C. Savoy, K. Boylan, Bahar Amani, R. J. Lieshout
Mental disorders affect 20% of children and adolescentsglobally and are among the most chronic and costly problems affecting youth.Offspring exposure to maternal disorders (depression, anxiety, and/or stress)prenatally as well as in adolescence increases the risk of psychopathology inadolescence. Exposure to maternal distress in pregnancy, as well as in adolescence,has independently been linked to psychopathology in youth. However, ourunderstanding of the cumulative effects of exposure to maternal distress over timeremains incomplete.1964 participants enrolled in the 2014 Ontario Child Health Study(OCHS) aged 12-17 years completed the Mini-International NeuropsychiatricInterview for Children and Adolescents (MINI-KID). Maternal prenatal distresswas defined as mother-reported depression and/or anxiety during pregnancyrequiring treatment. Maternal concurrent distress was self-reported when offspringwere 12-17 years of age using the Kessler Psychological Distress Scale (K6). Weexamined associations between increasing levels of exposure to maternal distress(no exposure, prenatal exposure only, concurrent exposure only, both prenatal andconcurrent exposure) and the risk of psychiatric disorder in 12-17-year-olds.The odds of major depressive disorder (OR=1.29, 95% CI: 1.01- 1.67) andADHD (OR=1.30, 95% CI: 1.02-1.65) increased with increasing exposure tomaternal distress. Associations between increasing levels of maternal distress andseveral psychiatric disorders were amplified in males. The accumulation of exposure to maternal distress over time predictsoffspring psychopathology in adolescence and emphasizes the significance of theearly detection of maternal distress and ongoing monitoring and intervention toreduce the burden of mental disorders in offspring.
精神障碍影响着全球20%的儿童和青少年,是影响青少年的最慢性、最昂贵的问题之一。子女在产前和青春期暴露于母体疾病(抑郁、焦虑和/或压力)会增加心理病理学不成熟的风险。在怀孕和青春期暴露于母亲的痛苦,独立地与青年的精神病理学有关。然而,我们对暴露于母亲痛苦的累积影响的理解仍不完整。1964名12-17岁的参与者参加了2014年安大略省儿童健康研究(OCHS),完成了儿童和青少年迷你国际神经心理访谈(Mini-KID)。母亲的产前痛苦被定义为母亲在怀孕期间报告的需要治疗的抑郁和/或焦虑。使用Kessler心理痛苦量表(K6),在12-17岁时自我报告母亲并发的痛苦。在12-17岁儿童中,暴露于母亲痛苦(无暴露、仅产前暴露、仅同时暴露、产前和并发暴露)水平的增加与精神障碍风险之间的未经审查的相关性。严重抑郁障碍(OR=1.29,95%CI:1.01-1.67)和多动症(OR=1.30,95%CI:1.02-1.65)的几率随着暴露症状的增加而增加忧虑在男性中,母亲痛苦程度的增加与各种精神疾病之间的联系被放大了。随着时间的推移,暴露于母亲痛苦的积累预测了青春期的春季精神病理学,并强调了早期发现母亲痛苦以及持续监测和干预的重要性,以减少后代的精神障碍负担。
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引用次数: 0
Problematic Substance Use in Adolescent Psychiatric Inpatients: Rates, Clinical Correlates and Effects on Therapeutic Outcomes 青少年精神病住院患者使用问题药物的比率、临床相关性和对治疗结果的影响
IF 0.4 Q4 Medicine Pub Date : 2021-11-05 DOI: 10.2174/2210676611666211105115828
X. Benarous, P. Morales, C. Cravero, Barbara Jakubowicz, N. Bourvis, D. Cohen, Y. Edel
We aimed to document the clinical rates and correlates of problematic substance use among adolescent inpatients.Adolescents referred to psychiatric inpatient care are likely to present family and social risk factors making them at high-risk of substance use disorderTo document the rates, clinical correlates and effects on therapeutic outcomes of associated problematic substance use in adolescents referred to psychiatric inpatient care.The DEP-ADO questionnaire was used to systematically screen out problematic substance use in two 12-18 adolescent inpatient units between January 2017 and December 2018. Inpatients screened positively based on the DEP-ADO questionnaire and/or information gathered from repeated interviews with the youth and his/her family were reported to the liaison addiction unit for diagnosis. Chart-review procedure was used to document clinical correlates (i.e., suicidal behavior, DSM-5 psychiatric diagnoses, the Clinical Global Impression-Severity score) and therapeutic outcomes (i.e., the Clinical Global Impression-Improvement score, change in Children-Global Assessment Scale score during patients’ stay and length of stay).Over two years, 150 adolescents completed the DEP-ADO questionnaire (Mean Age =14.7 ± 1.7; 42% girls). Thirty percent of adolescent inpatients reported some type of problematic substance use, with a higher likelihood of daily tobacco use (OR=2.4), regular cannabis use (OR=2.3) and occasional opioid/heroin use (OR=9.8) compared to general population. Adolescent inpatients who misused illegal substance prior admission were 2.5 times more likely to report suicidal behaviors. A strong association was reported between binge drinking behavior and a discharge diagnosis of bipolar disorder (OR=11.0). Therapeutic outcomes were not statistically different with regards to alcohol or illicit substance use status. Inpatient adolescents were at high-risk of having associated problematic substance use. Patients with co-existing problematics seem to have more severe and chronic forms of mood disturbances, although the response rate to therapeutics provided during their stay were not lower compared to their counterparts without problematic substance use.
我们的目的是记录青少年住院患者中有问题物质使用的临床率和相关因素。在精神科住院治疗的青少年中,有可能出现家庭和社会风险因素,使他们成为物质使用障碍的高危人群。为了记录在精神科住院治疗的青少年中相关问题物质使用的比率、临床相关性和对治疗结果的影响。使用deep - ado问卷系统筛选2017年1月至2018年12月期间两个12-18岁青少年住院病房的问题物质使用情况。根据deep - ado问卷和/或从青少年及其家人的反复访谈中收集的信息筛选阳性的住院患者被报告给联络成瘾单位进行诊断。采用图表回顾程序记录临床相关因素(即自杀行为、DSM-5精神病学诊断、临床总体印象严重程度评分)和治疗结果(即临床总体印象改善评分、患者住院期间儿童总体评估量表评分的变化和住院时间)。在两年多的时间里,150名青少年完成了deep - ado问卷(平均年龄=14.7±1.7;42%的女孩)。30%的青少年住院患者报告了某种类型的问题物质使用,与一般人群相比,每天使用烟草(OR=2.4)、经常使用大麻(OR=2.3)和偶尔使用阿片类药物/海洛因(OR=9.8)的可能性更高。在入院前滥用非法药物的青少年住院患者报告自杀行为的可能性高出2.5倍。据报道,酗酒行为与双相情感障碍的出院诊断有很强的相关性(OR=11.0)。治疗结果在酒精或非法药物使用状况方面没有统计学差异。住院青少年有相关问题物质使用的高风险。同时存在问题的患者似乎有更严重和慢性形式的情绪障碍,尽管在他们住院期间提供治疗的反应率并不比没有问题物质使用的患者低。
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引用次数: 0
期刊
Adolescent Psychiatry
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