Journal of Child and Adolescent Mental Health最新文献

Background: Exam anxiety is beginning to affect an increasing number of students.Aim: We sought to examine whether there is an association between exam anxiety and life orientation in secondary school learners.Methods: We used the Suinn's Test Anxiety Behavior Scale questionnaire to assess exam anxiety and the Life Orientation Test-Revised questionnaire to determine students' life orientation.Findings: Results revealed that the participants experienced a level of exam stress that could motivate them and prepare them for the evaluation situation. Female and secondary grammar school students had more exam anxiety than males and business school students. There was a moderate relationship between exam anxiety and life orientation, which was slightly pessimistic.Conclusion: A pessimistic or optimistic life orientation is one of the factors that may influence exam anxiety levels of secondary school learners.

Introduction: Given worsening youth mental health over the past years, mobile medical units are a potential avenue to increase access to mental healthcare services.Methods: This 1-year retrospective study examined a self-administered psychosocial assessment, and referrals made to mental health services for adolescent patients served by a mobile medical unit. We extracted psychosocial assessment responses, Patient Health Questionnaire (PHQ-9) scores, and mental health referral information for patients seen by the mobile medical unit in 2022 and examined rates and predictors of depression and referral to mental health services.Results: Of the 326 patients who completed the psychosocial assessment, one in five had moderate to severe depression symptoms based on PHQ-9 scores. Factors associated with referral to mental healthcare included female gender identity, LGBTQ+ identity, and several factors from the psychosocial assessment. Additionally, 13.8% wanted a mental health referral, and 16.6% were referred to mental healthcare. Patients who desired to see a mental health provider had higher odds of being referred (p < 0.0001). All patients with moderate to severe depression who were not already connected to mental healthcare and wanted a referral were referred.Conclusion: This study documents the impact of a mobile medical unit programme in identifying adolescent patients with mental health needs and referring them to mental healthcare.

Background: Primary results of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) 2002 trial showed that cognitive behavioural therapy (CBT) and medication management algorithm (MMA) (COMB-R) significantly improved depression in youth with HIV (YWH) compared with enhanced standard care (ESC). Acceptability and satisfaction were examined among study participants and clinicians.Method: Between March 2017 and March 2019, 13 U.S. sites enrolled YWH, aged 12-24, diagnosed with nonpsychotic depression. Sites were randomised to either COMB-R (CBT by a therapist and licensed prescriber) or ESC (standard psychotherapy and medication management). After the intervention (week 24), participants, prescribers, and therapists rated acceptability and satisfaction. We compared site-level means using Wilcoxon tests.Results: Both COMB-R (n = 69) and ESC (n = 71) participants had a mean age of 21.4 years, with 53% female, and 54% having acquired HIV perinatally. Baseline age, sex, depression levels, RNA viral load, and CD4 count were comparable between arms. The distribution of site-level mean participant acceptability was greater in COMB-R compared with ESC (p = 0.04). The distribution of site-level mean prescriber satisfaction was greater in COMB-R (p = 0.01). The was no evidence that the site-level mean therapist satisfaction did not differ between arms (p = 0.52).Discussion: Acceptability and satisfaction for participants and licensed prescribers were higher at COMB-R sites compared with standard of care, indicating that this tailored, manual-guided, collaborative, measured care intervention was less burdensome in terms of the number of visits. Patient and medication provider satisfaction rates were higher than standard of care.Conclusion: While these results support the use of CBT and MMA in treating depression among YWH, further research is required to determine generalisability.

Background: Compulsory interventions, including compulsory nasogastric tube feeding, are sometimes necessary for youth with life-threatening anorexia nervosa. However, these interventions are also potentially traumatic for patients and clinicians alike.Objective: To improve early recognition and prevention of compulsory interventions, we evaluated common factors among youth with anorexia nervosa who receive compulsory treatment.Method: We conducted a systematic literature search of peer-reviewed studies in PubMed, Embase, Medline, PsycINFO, and WOS core collection. Two authors independently screened 7 447 articles and conducted a quality appraisal of the included studies. We thematically synthesised patient, contextual, and treatment factors of youth (≤ 24 years) who received compulsory treatment for anorexia nervosa.Results: We included 16 studies and five themes, with ten subthemes, emerged from the data, most with a medium strength of evidence. Patients exhibited common character traits, various comorbidities, and lives marked by instability or adversity. Furthermore, patients experienced complicated contextual factors, including family dysfunction and social isolation.Discussion: Prolonged and inconsistent treatment histories may increase social isolation and anorexia identification, which in turn may lead to increased treatment resistance and a higher likelihood of compulsory interventions.Conclusion: The diversity of presented factors in this systematic review emphasises the importance of personalised care. Early acknowledgement of factors associated with the illness is crucial for working towards recovery and preventing further deterioration. Furthermore, even when anorexia nervosa diverts all attention to dangerous levels of weight loss, attention to quality of life may help a patient find treatment motivation.

Background: Reducing anxiety and depression in adolescents is a global health priority. Personal and social resources (e.g., hobbies and socialising) may reduce distress. Yet, there is insufficient understanding of how adolescents use such resources to reduce distress.Objective: To identify resources that reduced distress in the everyday lives of adolescents and whether resource use differed according to symptoms of anxiety and depression.Methods: The experience sampling method was used, a longitudinal method requiring participants to report on context and mood at randomly selected moments across a week. A total of 5 558 reports were contributed by 151 adolescents, including 90 with symptoms of anxiety and/or depression. The study was conducted in the poorest neighbourhoods of Bogotá, Buenos Aires, and Lima.Results: Multi-level modelling indicated that using resources was significantly associated with less nervousness and sadness. Adolescents with symptoms of anxiety and/or depression were less likely to use some resources (e.g., sport). Cross-level interactions showed the efficacy of resources differed according to the severity of symptomatology. For adolescents with symptoms of anxiety and depression, some resources (e.g., peer support) improved mood, while others (e.g., music listening) did not.Discussion: Personal and social resources are important for reducing distress in the everyday life of adolescents, giving insight into potential interventions to help mitigate symptoms of anxiety and depression before escalation. Further research could assess the quality of experiences (e.g., appraisal) to deepen understanding of how engagement promotes resilience.Conclusions: Care must be taken when recommending resource use, since some forms (e.g., music listening) may be unhelpful to adolescents with symptoms of anxiety and depression.

Objective: To qualitatively explore the multifaceted impacts of the early months of the COVID-19 pandemic on the lives of American university students.Method: Undergraduate students in general education courses at a mid-sized public Western U.S. university were recruited to complete a Qualtrics survey that evaluated their perceptions, beliefs, and behaviours towards COVID-19. Thematic analysis identified prevailing themes regarding the positive and negative changes to students' lives during the pandemic.Results: Participants included undergraduate students (N = 241) between the ages of 18 and 24 (74.7% women), with 49.4% identifying as White. Thematic analysis of the survey identified several codes encompassed by six key themes: (1) shifting social interactions; (2) wellness; (3) school; (4) financial changes; (5) loss of experiences; and (6) political turmoil.Conclusion: Some students identified positive consequences (e.g., more family time, more flexible schedule), while almost all students reported negative consequences (e.g., difficulty with time management and organisation, loss of job or income) of the COVID-19 pandemic. University communities should consider providing additional academic, financial, and mental health resources to students to further mitigate the lasting consequences of the pandemic.

Introduction: Early preventive interventions may support adolescent mothers' mental health during the perinatal period. However, adolescent maternal mental health interventions have received little empirical research attention. This scoping review maps the evidence on interventions appropriate for adolescent mothers during the perinatal period in Sub-Saharan African countries.Methods: The process was guided by the Joanna Briggs Institute's methodology for scoping reviews. Five databases, MEDLINE, EMBASE, PsycInfo, CINAHL, Google Scholar, and ProQuest, were searched for citations of studies published from 2000. The reporting is according to Preferred Reporting for Systematic Reviews and Meta-analysis (PRISMA).Results: The initial search of databases resulted in 2 757 records. After duplicates were removed, 311 records were screened, and eight records included. Interventions included five key strategies: cognitive behavioural therapy; group problem-solving; psychoeducation; psychosocial group counselling; and integrated mothers and babies course and early childhood development group-based intervention. None of the interventions specifically targeted adolescent mothers, however.Discussion and conclusion: There is limited evidence of interventions specific to adolescent mothers. There is a need for the development, implementation and evaluation of specific interventions relevant to this population group.

Objective: We aimed to investigate the effect of play therapy combined with the standard psychotropic medication treatment, compared to only standard psychotropic medication treatment in ADHD children as measured by the test of variables of attention (TOVA).Methods: This is a case-control study conducted at Soerojo Hospital, Magelang, Indonesia. Children (N = 66) were purposively recruited. The children were divided into two groups based on the intervention received: the experimental group (play therapy and standard psychotropic medication) and control group (standard psychotropic medication only). Methylphenidate was used as the standard psychotropic therapy. The TOVA was performed before and after intervention. The pre-intervention and post-intervention mean difference (MD) in the Attention Comparison Score (ACS) and Comparison to the Normative Sample (CNS) for each group was compared and statistically analysed using t-tests and Wilcoxon tests.Results: There was a significant difference between the ACS score of the experimental group's MD and the control group's MD (p < 0.05). For most TOVA parameters on CNS scores, the experimental group had a significantly higher MD than the control group.Conclusion: Play therapy coupled with psychotropic medication reduced ADHD symptoms, including inattention and impulsivity, as objectively measured by the TOVA.

Objectives: A great deal of attention is being directed at the use of seclusion in adolescent inpatient psychiatric units due to its forceful nature and negative impact on inpatients and staff. This mixed methods study aimed to explore and compare the level of satisfaction with the services received and perspectives on seclusion in secluded and non-secluded adolescent inpatients.Methods: This study included 188 participants, across three adolescent inpatient psychiatric units in Australia; 17% reported having experienced seclusion. A mixed methods approach was employed. Participants completed the Consumer Satisfaction Questionnaire-8 and Perceptions of Treatment and Seclusion Questionnaire shortly before or at discharge. Qualitative data was analysed using thematic analysis.Results: Secluded participants were more likely to report issues with broader care experiences on the Consumer Satisfaction Questionnaire-8. Secluded individuals reported ongoing negative effects from seclusion but were more likely than non-secluded participants to believe seclusion is necessary. Qualitative analyses showed that both secluded and non-secluded individuals considered seclusion to be traumatic, many did not agree with its use.Conclusions: Communication between inpatients and staff regarding seclusion needs to be improved and there needs to be ongoing support in relation to seclusion during and after discharge. Many adolescent inpatients acknowledge the necessity of seclusion whilst advocating for reduced seclusion.