Journal of Child and Adolescent Mental Health最新文献

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: Adverse childhood experiences (ACEs) and childhood socioeconomic disadvantage have been independently associated with depression. It has also been established that ACEs are more likely to occur in socioeconomically disadvantaged populations. However, the complex associations among all three factors together remain unclear.Objective: The purpose of this scoping review was to analyse the state of the literature on the associations among ACEs, childhood socioeconomic disadvantage, and depression-related outcomes (e.g., depression symptoms) for individuals aged 25 or younger.Method: We conducted a systematised search of four databases using terms that included "adverse childhood experiences", "socioeconomic status", "poverty", and "depression".Results: Of the 7 922 abstracts screened, 18 relevant articles were identified. Nine studies found ACEs and childhood socioeconomic disadvantage were independently associated with depression-related outcomes. Seven studies reported that ACEs were significantly associated with depression-related outcomes, after accounting for childhood socioeconomic disadvantage, but not vice versa. Four studies assessed for synergistic effects between childhood socioeconomic disadvantage and ACEs on depression-related outcomes. Of these, only two studies found that childhood socioeconomic disadvantage modified the association between ACEs and depression-related outcomes.Conclusion: Associations existed between ACEs and depression-related outcomes despite controlling for childhood socioeconomic disadvantage. However, there was inconclusive evidence regarding the nature of childhood socioeconomic disadvantage when it was introduced into the relationship.

Background: Adolescence is marked by profound developmental changes in an individual with an increased risk of developing various mental health illnesses. Previous studies have explored anxiety and its correlates among urban adolescents in Bangladesh. This study aimed to explore the magnitude of anxiety and its associated factors among adolescents attending school in rural areas of the country.Method: A cross-sectional study was conducted among adolescents (aged 10 to 19 years, mean = 15.9 years, SD = 1.12 years; male = 61.15%) attending high schools in a Southern district of Bangladesh between August and December 2022. A pre-tested semi-structured questionnaire was used for data collection via face-to-face interviews. A total of 260 adolescents were included.Results: Overall, participants suffered from minimal (38.08%), mild (39.62%), moderate (17.69%), and severe (4.62%) anxiety symptoms. Female sex (Adjusted Odds Ratio [aOR]: 4.94, 95% Confidence Interval [CI]: 1.75 - 13.94), less than six hours sleep duration (aOR: 3.81, 95% CI: 1.49 - 9.74), unsatisfactory sleep quality (aOR: 3.25, 95% CI: 1.20 - 8.85), more than two hours of daily usage of social media (aOR: 3.53; 95% CI: 1.15 - 10.85), and academic performance being not good (aOR: 3.30; 95%CI: 1.07 - 10.17) were independent determinants of moderate-to-severe anxiety symptoms.Conclusion: This study revealed crucial determinants of anxiety among adolescents. Policymakers should address these factors to prevent the development of anxiety and support the healthy mental growth of teens in the country.

Background: Mental health problems of adolescents have escalated significantly in recent years, categorising this population as a high-risk group for suicide.Objective: This study aims to investigate the developmental trajectories of suicidal ideation among junior high school students in mainland China, as well as its influencing factors.Methods: Longitudinal data were collected in three-waves, with three-month intervals in Zhenjiang City. A valid sample of 129 students completed questionnaires on suicidal ideation, life events, perceived stress, psychological flexibility, and demographic information.Results: Unconditional latent growth models revealed a significant increasing trend in suicidal ideation, characterised by an initial gradual increase and an accelerated rise afterwards. Conditional latent growth models indicated that both life events and perceived stress elevated the level of suicidal ideation, whereas psychological flexibility did not.Conclusions: These findings have significant implications for the development of targeted prevention and intervention strategies for adolescent at risk of suicide, highlighting the need for early identification. Life events and perceived stress are key risk factors to consider. The findings also emphasise the importance of promoting psychological flexibility as a potential protective factor in reducing suicidal ideation.

Background: Mental disorders contribute to 13% of the global burden of disease among adolescents aged 10 to 19 years. Adolescent suicide is often unreported due to the stigma attached to mental health issues and the unavailability of reporting mechanisms, particularly in developing countries. The current study aimed to determine the suicidality burden and associated factors in adolescents in a rural part of Eastern Nepal through a mixed methods approach.Methods: A community-based mixed methods cross-sectional study was conducted from October to November 2020 among 443 adolescents (aged 13 to 19 years, mean = 15.93 years, SD = 1.79 years). Frequencies and percentages were computed to assess suicidality burden, while bivariate and multivariate logistic regressions were performed to identify the factors associated with suicidality. Braun and Clarke's thematic analysis was used to explore qualitative factors associated with adolescent suicidality.Results: The quantitative findings revealed that the prevalence of suicidal attempts over the past year was 12.42 % among adolescents. The multivariate analysis revealed a significant relationship between suicidal attempts and depressive symptoms (AOR, 8.84, p = 0.001). Parental support was a protective factor against suicidal attempts (AOR, 0.08, p = 0.012). Qualitative findings indicated that loneliness, substance misuse, a lack of support system from family, and friends influenced adolescents' suicidality.Conclusions: The study provided evidence that Nepalese adolescents in rural Eastern areas are at a high risk of suicidality, likely due to limited access to mental health services and support systems. Addressing this issue requires systemic changes to expand mental health resources in rural Nepal, where such services remain significantly less available than in urban areas.

Background: The transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) is a vulnerable time for young people.Objective: This study aimed to explore young people's experiences of transitioning from CAMHS to AMHS in the United Kingdom and sought their views on improving the process.Method: Eight young people, purposively sampled from a local database, were interviewed post-transition using videoconferencing software. Data were analysed using reflexive thematic analysis and the presence of four recommended components of an 'optimal transition' was assessed.Results: Three main themes and nine subthemes were identified. These included young people's feelings concerning 'leaving CAMHS behind', their experience of 'the transition process', and 'adjusting to adult services' post-transition. Participants made six recommendations for improving transitions: providing more information about the process, greater involvement of young people and family members, more joint working between CAMHS and AMHS, better communication from AMHS, training clinicians to ensure AMHS foster age-appropriate and welcoming environments, and the development of an 18 to 25-year-old service. At least three of four optimal transition components were absent for 62.5% (n = 5) of the participants.Conclusions: The young people interviewed had predominantly negative experiences before, during, and after transitioning from CAMHS to AMHS. Further research with larger and more diverse samples is needed to understand how to improve transitions for young people from a range of backgrounds and across different services.

Background: Coping strategies are important in the development and prevention of mental health problems in adolescents. However, there is a paucity of research investigating the links between specific coping strategies and mental health in at-risk adolescents from socioeconomically vulnerable communities in South Africa.Objective: This study aimed to determine whether specific coping strategies predicted anxiety and/or depression among South African adolescents living in an impoverished township.Method: Data were collected from 415 adolescents from two secondary schools in Etwatwa, Gauteng, using a cross-sectional survey design. Adolescents ranged in age from 15 to 19 years (mean = 16.09 years, SD = 1.03 years), and 70% identified as female. Participants completed the Brief Coping Orientation to Problems Experienced Inventory, the 10-item Centre for Epidemiologic Studies Depression scale, and the 7-item Generalized Anxiety Disorder scale.Results: Prevalence rates of depression and anxiety were high, with girls reporting significantly more symptoms than boys. Hierarchical multiple regression analyses indicated that using substances, behavioural disengagement, and self-blame predicted more symptoms of both anxiety and depression among adolescents. Denial was associated with more symptoms of anxiety, while venting was associated with more symptoms of depression.Conclusion: While longitudinal research is recommended to determine the direction of effects, the findings of this study suggest that interventions targeting maladaptive coping strategies may help to prevent emotional distress among vulnerable adolescents.

Background: Long-term mental health support is not routinely offered to families of neonatal intensive care unit (NICU) graduates treated for non-cardiac congenital anomalies. This may reflect the paucity of evidence-based guidance for clinical practice in these diagnostic groups.Objective: This systematic review aimed to explore long-term mental health outcomes of NICU graduates and their parents, following treatment for non-cardiac congenital anomalies.Methods: A systematic review of empirical literature was conducted for the following diagnoses: congenital diaphragmatic hernia, oesophageal atresia, gastroschisis, exomphalos, Pierre Robin sequence, and Vein of Galen aneurysmal malformations. Embase, MEDLINE, and PsycINFO were comprehensively searched to identify relevant articles. Risk of bias assessments were conducted using the QualSyst quality assessment tool for articles meeting the following inclusion criteria: English- language articles published in peer-reviewed journals on or before 9 May 9 2025, that used validated quantitative mental health measures.Results: Of the 45 included articles, 38 examined child mental health and 14 investigated parental mental health (seven studies explored both child and parent mental health). Twenty-six measures were used, most commonly the Child Behavior Checklist for child mental health and the Short Form Health Survey for parental mental health. Although methodological heterogeneity yielded conflicting results, overall, the evidence summarised suggested both the child and parents were at an increased risk of long-term mental health difficulties.Conclusion: The evidence presented in this review highlights the value of incorporating routine mental health follow-up into the standard clinical care of children and families affected by congenital anomalies.