Journal of Child and Adolescent Mental Health最新文献

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.

Objectives: Among adolescents, suicide is a critical global concern, yet research is limited in low- and middle-income countries. The primary aim of this study is to investigate the interrelations among suicide-related factors (specifically, suicidal ideation, suicide literacy, attitudes toward suicide, and intended help-seeking sources) when experiencing suicidality in Vietnam. Additionally, it examines sex differences across these factors and identifies significant predictors of help-seeking intention for suicidality.Methods: A sample of 2 976 Vietnamese adolescents (mean age = 16.0 years, SD = 1.35 years; female = 50.6%) completed self-report measures as part of their annual school screenings.Results: More than one in four adolescents experienced some level of suicidal ideation. Overall, suicide literacy was low, particularly among males, who also reported higher levels of stigmatisation toward suicide. Low suicide literacy was linked to increased stigmatisation of suicidal individuals. Adolescents most commonly sought help from family and friends, rather than from professionals. Contrary to our hypothesis that females, those with lower stigma, and those with higher suicidal ideation would be more likely to seek help, it was found that males, those with higher stigma, and those with lower suicidal ideation demonstrated stronger help-seeking intentions. Additionally, male adolescents exhibited a polarised pattern, reporting both high intentions to seek and not seek help.Conclusion: These findings highlight the need for culturally sensitive and sex-based suicide prevention and intervention for Vietnamese adolescents, as cultural factors and sex roles may shape their perceptions and approaches to addressing suicide.

Background: Adolescence, acknowledged as a transformative developmental phase marked by socio-emotional challenges, introduces an elevated susceptibility to loneliness. As adolescents are exposed to loneliness, they concurrently navigate the dynamic landscape of problematic videogame use, characterised by deleterious gaming patterns with consequential impacts across various life domains. Empirical evidence indicates a significant correlation between experiences of cyberbullying victimisation and heightened feelings of loneliness, particularly within the context of peer relationships during this developmental epoch.Objectives: This study examined the critical relationships among loneliness, cyberbullying victimisation, and problematic videogame use, considering loneliness as a potential precursor to adverse developmental outcomes. Further, it assesses sex differences in these associations, seeking to elucidate the pathways through which these variables exert influence on the psychological well-being of adolescents.Methods: This study included 438 adolescents from Central Italy (50% boys), aged 11 to 16 (mean = 12.7 years, SD = 1.4 years). Participants completed a self-reported questionnaire during school hours.Results: Overall, 10.5% of participants reported experiencing cyberbullying victimisation, with no significant sex differences. Structural Equation Modelling revealed a significant association between loneliness with peers and well-being, mediated by cyberbullying victimisation and problematic videogame use. A significant interaction effect was found between sex and nervousness during gameplay, showing that nervousness was more strongly associated with problematic videogame use in boys compared to girls.Conclusions: These findings underscore the importance of targeted interventions to reduce peer-related loneliness in adolescence. Future research should explore the longitudinal, bidirectional effects of loneliness in adolescence on both problematic behaviours and well-being.

Background: COVID-19 mitigation measures disrupted many youths' lives. The burden that pandemic changes induced on children and adolescent's mental health requires further research.Objective: This study explores the associations between lifestyle changes during the COVID-19 pandemic and distress and/or social impairment (herein abbreviated as "distress") among children and adolescents in Montréal, Canada.Methods: Data were collected as part of a longitudinal survey and serology study of two to 20-year-olds at five different time points between October 2020 and June 2023. The outcome, distress, was the dichotomised score on the Strengths and Difficulties Questionnaire impact supplement. Lifestyle changes included changes in sleep, eating, and physical activity, among others. Adjusted risk ratios (RR) measuring associations between lifestyle changes and distress were estimated using regression models.Results: The 2 183 participants contributed 5 359 observations across the five waves of data collection. The crude prevalence of distress was 14.4% (95% CI 13.2, 15.7). In the adjusted analyses, distress was associated with spending both less and more time sleeping (e.g., less: RR = 2.28; 95% CI: 1.98, 2.98), less time engaged in physical activity (RR = 2.14; 95% CI: 1.78, 2.57), and with social media use of greater than three hours per day versus none (RR = 2.22, 95% CI: 1.69, 2.92).Conclusion: This study found that certain lifestyle changes occurring during the COVID-19 pandemic were associated with distress and social impairment among children and adolescents.