Journal of Child and Adolescent Mental Health最新文献

Background: Mental health concerns have been steadily rising worldwide, including in the Philippines. Given the shortage of mental health specialists in the country, it is crucial to make psychosocial support more accessible and available to Filipino youth.Objective: This study evaluated the feasibility of implementing Katatagan Plus, a resilience intervention for youth at risk of mental health issues, in seven local government units across two regions in the Philippines. Specifically, it aimed to measure the effectiveness of the Katatagan Plus program in developing resilience through adaptive coping, socio-emotional skills, and well-being, and reducing the risk of substance use and depressive symptoms.Method: Seventy-one adolescents screened as being at risk for mental health problems were invited to participate in the program. Most (68%) were participants in community-based programs facilitated by municipal health officers, whereas the remaining (32%) participated in school-based programs facilitated by school guidance personnel. Pre- and post-test surveys were conducted to measure program efficacy and changes in mental health outcomes.Results: Significant improvements in adaptive coping and well-being were observed from the pre- and post-tests. The proportion of participants with scores indicating good well-being rose from 49% to 70% before and after the program. There was also a significant decrease in depression symptoms and substance use. No differences were found in terms of setting/service provider for adaptive coping, substance use, and depression. However, improvements in well-being were greater among students in school-based settings compared to community settings.Conclusion: Results suggest the potential of this early mental health intervention for young people at risk, as well as the need for referrals for those who may need more specialised support.

Background: In sub-Saharan Africa, young people face high burdens of food insecurity and sexual and gender-based violence (SGBV), both linked to poor mental health.Objective: This study tested whether food insecurity predicts common mental disorders through household SGBV, and conversely, whether SGBV predicts common mental disorders through food insecurity.Method: Data were drawn from 534 participants aged 13 to 25 years in the longitudinal Bidirectional, Upbeat communication and Differentiated Distanced care for Young people (BUDDY) cohort study in Cape Town (2021-2022), surveyed at baseline, three months follow-up, and six months follow-up.Results: At six months follow-up, 24% reported common mental disorder symptoms, 52% had experienced food insecurity, and 33% had witnessed household SGBV. When food insecurity was modelled as the primary exposure, it was not associated with common mental disorders at six months follow-up (OR = 1.00; p = 0.99), and SGBV did not mediate this relationship (Average Direct Effect (ADE) = -0.05; Average Causal Mediated Effect (ACME) = 0.02). In contrast, when witnessing SGBV was the exposure, it was strongly associated with common mental disorders (OR = 2.19; p = 0.006). Food insecurity at three months follow-up was more common among those exposed to SGBV at baseline (OR = 1.55; 95% CI [1.06-2.27]; p = 0.024). Mediation analysis indicated most of SGBV's effect on common mental disorders was direct (ADE = 0.17; 95% CI 0.05-0.30), with only a small proportion mediated by food insecurity (5%).Conclusion: Findings were contrary to our primary hypothesis that food insecurity would drive common mental disorders via SGBV. Instead, household SGBV emerged as the stronger predictor of common mental disorders, with food insecurity playing a modest role. Preventing household violence may be critical to improving youth mental health, while research should further examine food insecurity's mental health impacts across contexts and timeframes.

Background: Adolescence is a critical period for the development of mental health disorders, making early identification during this time essential for enabling targeted interventions and preventing long-term adverse consequences. Globally, one in seven adolescents experiences poor mental health, including depression and anxiety, yet many countries, especially in sub-Saharan Africa, face a scarcity of mental healthcare provisions.Method: To aid early identification and intervention of adolescent mental health problems, this study assessed the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ) in a representative sample of n = 2 178 (n = 1 366 female, aged 10-19 years, mean age = 14.758 years, SD = 1.902 years) in Nigeria. Further, we specifically examined the measure's factor structure and measurement invariance across demographic groups of sex, age, parental education, and parental marital status.Results: Our results demonstrated that the original five-factor model of the SDQ did not fit well for the Nigerian sample, consistent with previous studies in sub-Saharan Africa. A three-factor model previously proposed for Nigeria similarly did not achieve good model fit, necessitating further psychometric probing. We propose a modified five-factor model (releasing three items, 'I am restless', 'I get very angry', and 'I am usually on my own'), which showed excellent fit and full scalar measurement invariance across sex and age groups, supporting its utility in diverse demographic groups. Partial scalar invariance across parental marital status indicated that family dynamics may influence responses to certain items.Conclusions: These findings underscore the importance of refining the SDQ for use in sub-Saharan Africa and highlight the need for culturally appropriate tools to address adolescent mental health challenges across diverse settings.

Background: In recent years, mental health issues among adolescents have gained significant attention. Like many other nations, Panama is experiencing a growing prevalence of these challenges within its youth. It is crucial to investigate the prevalence of, and the underlying factors associated with, loneliness, anxiety-related sleep disturbances, and suicide ideation to develop effective intervention strategiesObjectives: The study aimed to assess the prevalence of loneliness, anxiety-induced sleep disturbance, and suicidal ideation in Panama's school-going adolescents and to identify the risk factors that make this age group vulnerable to these psychological problems using sex-stratified data.Methods: We used cross-sectional survey data from the Panama Global School-based Student Health Survey 2018 and performed descriptive and inferential statistical analyses.Results: Suicidal ideation was more common (18.5%) than loneliness (16.3%) or anxiety-induced sleep disturbance (10.4%) among adolescents in Panama. Higher odds of loneliness were found among those who had no close friends [AOR =3.553, 95% CI = 2.417 - 5.223], experienced hunger [AOR = 2.606, 95% CI = 1.314 - 5.168], and were bullied on school property [AOR = 1.747, 95% CI = 1.307 - 2.334] than their counterparts (i.e., those who had close friends, did not experienced hunger, and were not bullied on school property. Respondents who had no close friends [AOR = 1.624, 95% CI = 1.016 - 2.598] and suffered bullying both inside [AOR = 1.939, 95% CI = 1.406 - 2.674] and outside [AOR = 1.453, 95% CI = 1.013 - 2.084] of school property were more prone than their counterparts to experience anxiety-induced sleep disturbances. Additionally, adolescents who experienced hunger [AOR = 2.675, 95% CI = 1.396 - 5.126], had no close friends [AOR = 1.605, 95% CI = 1.077 - 2.393], were bullied on school property [AOR = 1.964, 95% CI = 1.499 - 2.571], and consumed alcohol [AOR = 1.425, 95% CI = 1.113 - 1.825] encountered higher odds of suicidal ideation. However, girls were more susceptible to suicidal ideation than boys if they had no close friends, experienced hunger, and were bullied on school property. Conversely, parents' understanding significantly lowered the odds of suicidal ideation compared to their counterparts.Conclusions: Gender-sensitive and proactive community-based initiatives should be implemented to improve adolescents' mental health in Panama. Moreover, an inclusive school curriculum is needed to address adolescents' psychological issues.

Background: In Ireland, acute hospital emergency departments (ED) become the default service for youth aged 16 to 18 years; and in the absence of paediatric EDs, for youth under 16 years. No previous research has explored adolescent presentations to non-paediatric hospitals with thoughts of self-harm or suicide at a national level.Aim: This study examines child and adolescent self-harm and suicidal ideation-related presentations to 24 non-paediatric hospital EDs in Ireland.Method: National data from a dedicated ED service for a suicidal crisis were used. Descriptive analyses were run for four age bands (≤ 15, 16-17, 18-19, and all other adults < 20 years), based on sociodemographic characteristics, clinical information, and type of self-harm or ideation.Results: Between 2018 and 2022, the National Clinical Programme for Self-Harm and Suicide-related Ideation (NCPSHI) clinicians assessed 53 359 presentations due to self-harm and suicide-related ideation. Among those 15 years and younger, 1.7% presented for self-harm, 0.9% for suicidal ideation, and 0.2% for self-harm ideation. Among the 16-17-year-olds, 3.4% presented with self-harm and 1.6% for suicidal ideation. Presentations for self-harm decreased with age, while suicide-related ideation increased. Cutting was most common among the youngest group (23%), and overdose was more frequent among 16 to 17-year-olds. Notably, 41% of those 15 year and younger were already attending mental health services.Conclusions: Our findings highlight that a significant number of adolescents with a self-harm-related crisis attend non-paediatric acute hospitals in Ireland. Careful initial assessment and transitional care are needed to ensure that youth at risk of suicide and/or mental illness are referred to appropriate services.

Background: Adolescence is a critical period marked by increased vulnerability to anxiety-related conditions. With the widespread use of the internet, persistent concerns about health may manifest as cyberchondria in this age group.Objective: The study aimed to evaluate the effect of students' characteristics (e.g., sex, student's grade level) and their cyberchondria levels on their health anxiety levels.Methods: A descriptive cross-sectional study was completed with 328 students (mean age = 15.63 years, SD = 2.07 years). The study was conducted among 14 to 17-year-old students studying in the 1^st, 2^nd, 3^rd, and 4^th grades of a public high school between February 2021 and April 2023. Study data were collected using sociodemographic information, health anxiety, and cyberchondria severity measures. Backward elimination linear regression analyses were performed to reveal the factors that predicted health anxiety.Results: Almost half of the sample (n = 132, 40.2%) were male and 196 (59.8%) were female. There were statistically significant differences in terms of total and subscale scores of the Health Anxiety Inventory by sex. Specifically, the mean scores of female students (mean = 16.41, SD = 7.19) were significantly higher than those of male students (mean = 13.49, SD = 6.49) on the total scale (p < 0.001). Accordingly, the mean hypersensitivity to physical symptoms and anxiety subscale scores were significantly higher for female students (mean = 12.83, SD = 5.84) than for males (mean = 10.41, SD = 5.14) (p < 0.05). Similarly, the mean negative consequences of illness subscale scores were significantly higher for females (mean = 3.58, SD = 2.41), than for males (mean = 3.08, SD = 2.49) (p < 0.05). Regression analysis results indicated that sex (β = -0.222), doing research on the internet very frequently (β = 0.175), and Cyberchondria Severity Scale total scores (β = 0.428) significantly predicted health anxiety scores, respectively (F(3.324) = 47.732, p < 0.001). Together, all three significant variables explain 31% of the variance.Conclusions: There was a positive and weak to moderate correlation between students' health anxiety levels and cyberchondria levels, and their health anxiety levels increased with an increase in their cyberchondria levels.

Background: During the COVID-19 pandemic, students in Victoria, Australia, completed two years of virtual schooling, which has been reported to contribute to many academic, social, and mental health impacts. Thus, it is important to capture the voices of the students as they adjust to schooling in a post-pandemic era.Method: The current study utilised focus groups and semi-structured interviews to explore the experiences and needs of eight secondary school students in Victoria. Thematic analysis was employed to elicit themes.Findings: Participants' lived realities formed four main themes: (i) social interactions, (ii) academic pressure and classroom dynamics, (iii) mixed views about school well-being efforts, and (iv) re-learning school routines and expectations. A diverse range of experiences (i.e., categorised into sub-themes) were captured across these four themes. Some participants struggled to adapt to socialising in person again, whilst others indicated that their social networks broadened after forming unlikely friendships online. Participants reported that school well-being approaches felt ingenuine and tokenistic. Participants also discussed their challenges with having to stick to routines and timetables and missed the flexibility of home-based learning during lockdowns.Conclusion: The implications of these findings are discussed, and student-identified strategies are outlined to facilitate student engagement and well-being in a post-pandemic era.

Background: There is large variability in the way that outcomes are measured for avoidant/restrictive food intake disorder (ARFID), with many studies focusing solely on weight gain or using measures that are not designed or validated to assess ARFID symptoms, such as the widely used Eating Disorders Examination-Questionnaire (EDE-Q).Objective: The current study compared treatment outcomes for children/adolescents with ARFID to children/adolescents with anorexia nervosa-restricting subtype (AN-R) on weight variables (% of expected body weight (%EBW)), ARFID symptoms as measured using the Eating Disorders in Youth-Questionnaire (EDY-Q), and eating disorder (ED) symptoms (as measured using the EDE-Q). Scores for both groups of patients on each measure were examined to preliminarily determine the appropriateness of each measure for each diagnosis.Method: Participants were 220 children/adolescents aged 9 to 17 receiving treatment at a large multisite treatment facility between November 2020 and June 2023. Self-report questionnaires were completed at intake and discharge, and weight was recorded throughout treatment.Results: EDY-Q, EDE-Q, and %EBW scores changed significantly (p < 0.001) from admission to discharge for both groups of patients. Effect sizes for changes in EDY-Q were similarly large for patients with AN-R (d = 0.91) and ARFID (d = 0.83). Effect sizes for changes in EDE-Q were large for patients with AN-R (d = 0.79) and small-to-medium for patients with ARFID (d = 0.47).Conclusions: Results suggest that the EDY-Q may be assessing symptoms present in both patients with ARFID and patients with AN-R. The study's findings suggest that the EDE-Q is not an appropriate measure for assessing outcomes among patients with ARFID.

Background: Increasing evidence supports the mental health benefits of outdoor, cold-water immersion in adults. This explorative study aimed to see if evidence found in adult populations regarding changes associated with the activity on mood could be replicated in adolescents through an educational and practical half-day course. Results will show whether further research is justified in this age group.Methods: Eighty high school students were recruited, 62 from two upper secondary schools in Kristiansand, Norway and 18 from one school in Brighton, United Kingdom. Mood state was assessed using the Profile of Mood States (POMS) questionnaires before and after a cold-water immersion.Results: There were significant reductions in negative subscales and significant increases in positive subscales of the POMS questionnaire. Total Mood Disturbance (TMD) was significantly reduced overall (mean pre-post difference 23.40, 95% CI 16.52 - 30.28) across the four swimming groups (Norway lake, two sheltered beaches in Norway, and the open sea in England). These results indicate a positive effect on mood. Overall, 95% of respondents both enjoyed the experience and would "definitely" or "maybe" like to repeat it.Conclusion: Outdoor cold-water immersion had a significantly positive effect on mood state in adolescents and was enjoyed by most participants. Further studies are therefore warranted.

Background: Transgender adolescents and adults appear to be at increased risk of suicidality, but the risk factors are unclear.Aim: This study aimed to examine suicidality in treatment-seeking adolescents and adults. We examined whether autism traits, anxiety/depression, access to gender affirming treatments, or self-identification category affected suicidality in this group.Methods: We conducted a cross-sectional study of 123 patients (16 years and older) currently attending, or previously attended, specialist gender services in Northern Ireland. Main outcome measures included a demographic information questionnaire, the Suicide Behaviour Questionnaire Revised, the Childhood Trauma Questionnaire or the Recent Trauma Questionnaire, and the Hospital Anxiety and Depression Scale. Autism traits were measured using the Autism Quotient, the Ritvo Autism and Asperger Diagnostic Scale-Revised, and the Cambridge Behaviour Scale (Empathy Quotient).Results: Only autism traits and anxiety/depression were independently associated with higher levels of suicidality. Self-reported future risk of suicidality was markedly lower than self-reported past suicidality for the patients who were attending the specialist gender service. This apparent reduction in suicidality is possibly attributable to the impact of being able to access the specialist service. Conclusion: This study highlights increased vulnerability in this population for suicidality, particularly those with autism traits and anxiety/depression. These findings are important in the context of the reclassification of gender incongruence to conditions of sexual health. While a move away from mental health services reduces stigma for individuals seeking gender-affirming interventions, the treatment of co-existing mental health needs requires close involvement with mental health services.