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Child and Adolescent Mental Health最新文献

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Bullying victimization among adolescents during the early phase of war in Ukraine – A comparative cross-sectional study in 2016–2017 乌克兰战争初期青少年的欺凌受害——2016-2017年的一项比较横断面研究
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-03-18 DOI: 10.1111/camh.12770
Sanju Silwal, Minja Westerlund, Olga Osokina, Susanna Hinkka-Yli-Salomäki, Matthew Hodes, Norbert Skokauskas, Andre Sourander

Background

War profoundly impacts adolescent development and may increase the likelihood of aggressive responses when such behavior is perceived as acceptable and accessible. War may, hence, exacerbate a form of interpersonal violence already prevalent among children and adolescents.

Methods

We conducted a comparative cross-sectional study 2 years after the Russian invasion of Eastern Ukraine in 2014 by comparing the prevalence of bullying victimization among adolescents aged 11–17 years (N = 2766) in two administrative regions with different levels of wartime traumatic stressor exposure.

Results

Female adolescents in the war-affected region were bullied more often compared to those in the non-affected region [65.3% vs. 56.3%, adjusted Odds Ratio (aOR) = 1.5, 95% CI 1.2–1.9]. For both boys and girls, symptoms of psychopathology were associated with bullying victimization often [girls: depression (aOR = 2.9, 95% CI 2.4–3.4); boys: depression (aOR = 3.3, 95% CI 2.6–4.1) and PTSD (aOR = 1.7, 95% CI 1.4–2.02)]. In the war-affected region, a dose–response relationship between bullying victimization often and war-event exposure was observed in both sexes [girls: 1–3 war-events (aOR = 1.4, 95% CI 0.7–2.6), 4–6 (aOR = 2.4, 95% CI 1.3–4.5) and ≥7 (aOR = 5.5, 95% CI 2.7–11.1); boys: 1–3 (aOR = 1.4, 95% CI 0.7–2.8), 4–6 (aOR = 3.2, 95% CI 1.7–6.3), and ≥7 (aOR = 6.8, 95% CI 3.1–14.8)].

Conclusions

War exposure was associated with bullying victimization, with girls being bullied more often than boys. Bullying victimization was linked to cumulative traumatic stressor exposure in the war-affected region for both sexes.

背景:战争深刻影响青少年的发展,并可能增加攻击性反应的可能性,当这种行为被认为是可接受的和可获得的。因此,战争可能加剧已经在儿童和青少年中普遍存在的一种形式的人际暴力。方法:在2014年俄罗斯入侵乌克兰东部2年后,我们进行了一项比较横断面研究,比较了两个行政区域11-17岁青少年(N = 2766)在战争创伤应激源暴露水平不同的情况下遭受欺凌的发生率。结果:受战争影响地区的女性青少年受欺凌的频率高于未受战争影响地区的女性青少年[65.3%对56.3%,调整优势比(aOR) = 1.5, 95% CI 1.2-1.9]。对于男孩和女孩来说,精神病理症状通常与欺凌受害有关[女孩:抑郁症(aOR = 2.9, 95% CI 2.4-3.4);男孩:抑郁症(aOR = 3.3, 95% CI 2.6-4.1)和创伤后应激障碍(aOR = 1.7, 95% CI 1.4-2.02)。在受战争影响的地区,在两性中均观察到欺凌受害与战争事件暴露之间的剂量-反应关系[女孩:1-3次战争事件(aOR = 1.4, 95% CI 0.7-2.6), 4-6次(aOR = 2.4, 95% CI 1.3-4.5)和≥7次(aOR = 5.5, 95% CI 2.7-11.1);男孩:1 - 3 (aOR = 1.4, 95% CI 0.7 - -2.8), 4 - 6(优势比= 3.2,95% CI 1.7 - -6.3),和≥7(优势比= 6.8,95% CI 3.1 - -14.8)]。结论:战争暴露与欺凌受害有关,女孩比男孩更常受到欺凌。在受战争影响的地区,无论男女,受欺凌的受害者都与累积的创伤性压力源暴露有关。
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引用次数: 0
Debate: Urban versus rural environments – which is better for mental health? Beyond the urban and rural dichotomy, a call to consider quality, typology and space in greenspace strategies for mental health 辩论:城市环境和农村环境——哪个对心理健康更好?除了城市和农村的二分法,还呼吁在绿色空间策略中考虑质量、类型和空间,以促进心理健康。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-03-10 DOI: 10.1111/camh.12762
Liza Griffin, Athina Petsou, Ruth Hynes, Gemma Moore

There is growing evidence about the positive impact of greenspaces on mental health and wellbeing. In their various forms, greenspaces such as parks, gardens, sports fields, and open spaces serve as crucial public amenities. This paper contributes to current debates on the mental health benefits of rural and urban environments by arguing for a nuanced and contextual understanding that goes beyond the urban–rural dichotomy, as access to these spaces has been shown to reduce stress and significantly improve mental wellbeing in both urban and rural settings. Through a critical examination of the literature, we focus on specific characteristics of greenspaces connected to mental health benefits. We then explore the ways in which specific urban environments and their qualities play crucial roles in mental health outcomes. The paper discusses the unique challenges and benefits of urban and rural greenspaces, emphasising the need for context-specific strategies. We argue that urban planning and policy must prioritise the quality of greenspaces, particularly in urban environments, to recognise them as fundamental public health infrastructure and maximise their mental health benefits.

越来越多的证据表明,绿色空间对心理健康和福祉有积极影响。各种形式的绿地,如公园、花园、运动场和开放空间,都是重要的公共设施。本文为当前关于农村和城市环境的心理健康益处的辩论做出了贡献,论证了一种超越城乡二分法的细致入微的背景理解,因为进入这些空间已被证明可以减轻压力,并显着改善城市和农村环境中的心理健康。通过对文献的批判性检查,我们关注与心理健康益处相关的绿色空间的具体特征。然后,我们探讨了具体的城市环境及其质量在心理健康结果中发挥关键作用的方式。本文讨论了城市和农村绿色空间的独特挑战和好处,强调了针对具体情况制定战略的必要性。我们认为,城市规划和政策必须优先考虑绿色空间的质量,特别是在城市环境中,认识到它们是基本的公共卫生基础设施,并最大限度地提高其心理健康效益。
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引用次数: 0
Debate: Where to next for universal school-based mental health interventions? Tensions in prevention – To build better school-based programming, we must start with what we know 辩论:以学校为基础的普遍心理健康干预措施下一步走向何方?预防方面的紧张关系——为了建立更好的基于学校的规划,我们必须从我们所知道的开始。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-02-28 DOI: 10.1111/camh.12758
Katherine A. Cohen, Eric J. Bruns, Jessica L. Schleider

Researchers and education leaders have suggested that universal school-based prevention programs could improve youth mental health at a population level, yet recent trials of universal school-based prevention programs (e.g., MYRIAD, CSC) found null or iatrogenic results. In this debate piece, we argue that these results must be contextualized alongside existing knowledge that universal programs are ideally implemented within multitiered systems, promoting student autonomy tends to promote uptake and adherence, and individual trials do not outweigh decades of academic and community expertise. We offer suggestions for moving forward in research on and implementation of universal school-based prevention programs.

研究人员和教育领导者建议,普遍的以学校为基础的预防项目可以在人口水平上改善青少年的心理健康,但最近对普遍的以学校为基础的预防项目(例如,MYRIAD, CSC)的试验发现无效或医源性结果。在这篇辩论文章中,我们认为这些结果必须与现有的知识相结合,即普遍计划理想地在多层系统中实施,促进学生自主权往往会促进吸收和坚持,个人试验不会超过数十年的学术和社区专业知识。我们为研究和实施普遍的以学校为基础的预防项目提供了一些建议。
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引用次数: 0
Letter to the Editor: Mindfulness will only be in decline if we stop being mindful 致编辑的信:如果我们停止正念,正念只会衰退。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-02-27 DOI: 10.1111/camh.12759
Edward J. Miller

Despite widespread research and academic pressures, mindfulness researchers have an ethical responsibility to take a careful and considered approach to their work, particularly when investigating the mental health of children. This Letter to the Editor addresses an earlier debate article published in the journal by further elaborating on the issues raised by a recent large trial of a mindfulness-informed school-based intervention, and the ethical implications for mindfulness research.

尽管有广泛的研究和学术压力,正念研究人员有道德责任采取谨慎和深思熟虑的方法来完成他们的工作,特别是在调查儿童的心理健康时。这封致编辑的信通过进一步阐述最近一项基于正念的学校干预的大型试验所提出的问题,以及正念研究的伦理含义,回应了该杂志上早些时候发表的一篇辩论文章。
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引用次数: 0
Debate: Where to next for universal school-based mental health interventions? Can research led by young people shape universal solutions for mental health and suicide prevention in school settings? 辩论:以学校为基础的普遍心理健康干预措施下一步走向何方?由年轻人领导的研究能否形成学校环境中心理健康和自杀预防的普遍解决方案?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-23 DOI: 10.1111/camh.12754
Sarah Hetrick, Vartika Sharma

We have engaged in work that aligns with the call from Birrell et al. (Child and Adolescent Mental Health, 2024), particularly in terms of thinking about co-design with young people to develop new outcomes and targets of universal school-based interventions. We engaged young people in a Cochrane systematic review and co-designed the outcomes for this review. What emerged was the need for research led by young people to develop and evaluate innovative universal school-based interventions that focus on creating environments that build and support young people's ability to cope by expressing and managing emotions. Whole-of-school approaches that ensure compassionate and caring responses can support the development of coping skills to manage distress, mental illness, self-harm and suicidal ideation.

我们所从事的工作与Birrell等人的呼吁一致(儿童和青少年心理健康,2024),特别是在考虑与年轻人共同设计以制定新的结果和普遍学校干预措施的目标方面。我们让年轻人参与Cochrane系统评价,并共同设计了本评价的结果。因此,需要由年轻人主导的研究,以开发和评估创新的普遍学校干预措施,重点是创造环境,建立和支持年轻人通过表达和管理情绪来应对的能力。确保富有同情心和关怀的全校方法可以支持发展应对技能,以管理痛苦、精神疾病、自残和自杀意念。
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引用次数: 0
Clinical research updates 临床研究更新。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-22 DOI: 10.1111/camh.12742
Marinos Kyriakopoulos, Ifigenia Metaxa, Caitriona Cotter, Isidora Fili
<p>Ifigenia Metaxa</p><p>National and Kapodistrian University of Athens</p><p>Depression constitutes a serious burden to adolescents all around the world. Understanding the perspective of those living with the disorder may assist in better identification and development of effective treatment approaches.</p><p>Viduani et al. (2024) conducted a systematic review of qualitative studies exploring the subjective experience of depression in young people (age range 10–24 years). A total of 39 studies were included, representing the experiences of 884 adolescents with depression from 16 different countries. The authors identified 47 features of depression. Among the 10 most cited features, 5 were part of DSM/ICD diagnostic criteria, namely, sadness, worthlessness, loss of energy, hopelessness and motivational anhedonia. The remaining features listed were social withdrawal, loneliness and anger together with stress and frustration or feelings of failure.</p><p>Following a meta-synthesis approach, it was found that lived experience of adolescent depression can be understood through the lens of 3 overarching themes. The first theme is related to the meaning that adolescents give to depression, including the impact on their life, relationship difficulties, self-blame, guilt, fear of isolation and mood changes. Most adolescents reported using self-reliant strategies, such as distraction or expressing negative emotions through art or religion, but some used alcohol, drugs, self-harm or other risky behaviours to manage their feelings. The second theme involved cultural and societal aspects of depression. Depression was found to be related to factors including cultural norms, social conditions, life events, family relations and peer group pressure. Some adolescents reported being victims of sexual abuse. Across contexts, interpretations and expectations related to depression differ between boys and girls and seem to also be affected by race and ethnicity. Depression was also found to have a long-term impact on education, while fatigue and low motivation may negatively affect academic progress. Social relationships were also affected, with adolescents reporting an influence on communication and social withdrawal. In these situations, they reported thoughts of dying and suicide. The third theme highlights adolescents' efforts to access care and support networks. Different factors were identified as barriers to help-seeking. First, adolescents avoid self-disclosure because of fear of stigma and negative reactions from parents and peers. They also mentioned feeling let down by the systems, leading to a lack of hope in sources of help, while limited resources were also an issue. In addition, adolescents reported distrust in professionals and perception of inefficacy of treatments, both pharmacological and psychotherapeutic. They also expressed a sense of not being heard or explained about the purpose and utility of treatments used (mostly medication) and expressed t
通过审查和连接代码的迭代过程,与共同研究人员合作创建了四个主要主题:(a) CAMHS可能令人沮丧和无助,但有时可以挽救生命,(b)年轻人可以感觉到他们的痛苦被CAMHS无效,(c) CAMHS使年轻人感到对他们的痛苦负责,(d)年轻人可能觉得CAMHS专业人员不值得信赖。调查结果表明,对CAMHS的普遍不满,年轻人认为干预措施是无效的和无效的,是对他们“做”的,而不是与他们合作的。例如,临床医生似乎通过提供“基本”建议来应对严重的痛苦,例如洗个澡或喝杯茶;而且似乎隐瞒了正式的诊断,让许多年轻人感到困惑,认为他们没有抑郁症,只是情绪低落,这进一步加剧了权力的不平衡。系统问题,包括漫长的等待时间和临床医生更关注行政管理风险而不是直接心理健康需求的感觉,增加了年轻人对CAMHS的负面看法。然而,少数视频传达了积极的经历,突出了年轻人感到CAMHS临床医生倾听他们并积极参与他们的护理的例子。这项研究表明,TikTok似乎为年轻人提供了一个表达自己经历并寻求同龄人认可的空间,或许填补了CAMHS没有填补的空白。在新冠肺炎大流行期间,CAMHS可能会遇到重大的组织挑战,在发布这些发现的背景下考虑这些发现是相关的。此外,要考虑这些帖子的目的是纯粹的信息,还是也引起情绪反应。本研究建议CAMHS临床医生加强治疗参与的实际考虑,包括验证年轻人的痛苦;阐明应对策略的目的及其在生理上如何起作用;透明地讨论保密问题;更积极地让年轻人参与他们的护理决策。进一步的研究可以探索专业人员如何与年轻人有效沟通,尊重他们的自主权,同时考虑接受诊断或不接受诊断的风险和益处。该研究的优势包括创新地使用TikTok来获取年轻人对其CAMHS经历的看法,以及让年轻人作为共同研究人员参与数据分析。限制包括可能缺乏代表性,因为视频可能不能反映所有CAMHS用户的经验。样本中的大多数视频似乎都是由白人女性制作的,但之前的研究表明,男性和少数民族人群的求助行为明显较低,这表明了一个有待进一步研究的领域。参考文献福斯特,M,弗里思,H, &;约翰,M.(2024)。“我还是这么!”“当你完成文书工作时就去做”:对TikTok上#camhs的归纳框架主题分析。儿童心理与精神病学杂志,65,1258-1269。双相情感障碍是一种高度遗传性的疾病,发病率很高。父母患有双相情感障碍的孩子也有多种其他精神疾病、躯体疾病和事故的风险。Takami Lageborn等人(2024)通过瑞典的一项队列研究探索了双相情感障碍父母的后代的结局。瑞典人口登记与有(N = 24,788)和没有(N = 247,880)父母患有双相情感障碍的后代在精神诊断和精神药物、出生相关和躯体疾病、社会结果、事故和死亡率方面进行了比较。这些人被跟踪到18岁。还评估了终生父母精神共病、双相情感障碍亚型和性别的影响。研究发现,父母患有双相情感障碍的孩子患所有精神疾病的风险增加了2-3倍,其中双相情感障碍的风险最高(高出11倍)。父母双方都被诊断为双相情感障碍,其后代患双相情感障碍的风险最高(高出15倍)。如果父母双方都患有双相情感障碍,父母一方患有2型双相情感障碍,母亲患有双相情感障碍,那么接受任何精神诊断和服用ADHD药物和褪黑素的风险都会增加。父母的双相情感障碍也与围产期状况、先天性畸形和儿童几种躯体健康状况的相对风险增加有关。此外,父母双相情感障碍与后代哮喘之间存在关联,特别是在患有该疾病的母亲的后代中。
{"title":"Clinical research updates","authors":"Marinos Kyriakopoulos,&nbsp;Ifigenia Metaxa,&nbsp;Caitriona Cotter,&nbsp;Isidora Fili","doi":"10.1111/camh.12742","DOIUrl":"10.1111/camh.12742","url":null,"abstract":"&lt;p&gt;Ifigenia Metaxa&lt;/p&gt;&lt;p&gt;National and Kapodistrian University of Athens&lt;/p&gt;&lt;p&gt;Depression constitutes a serious burden to adolescents all around the world. Understanding the perspective of those living with the disorder may assist in better identification and development of effective treatment approaches.&lt;/p&gt;&lt;p&gt;Viduani et al. (2024) conducted a systematic review of qualitative studies exploring the subjective experience of depression in young people (age range 10–24 years). A total of 39 studies were included, representing the experiences of 884 adolescents with depression from 16 different countries. The authors identified 47 features of depression. Among the 10 most cited features, 5 were part of DSM/ICD diagnostic criteria, namely, sadness, worthlessness, loss of energy, hopelessness and motivational anhedonia. The remaining features listed were social withdrawal, loneliness and anger together with stress and frustration or feelings of failure.&lt;/p&gt;&lt;p&gt;Following a meta-synthesis approach, it was found that lived experience of adolescent depression can be understood through the lens of 3 overarching themes. The first theme is related to the meaning that adolescents give to depression, including the impact on their life, relationship difficulties, self-blame, guilt, fear of isolation and mood changes. Most adolescents reported using self-reliant strategies, such as distraction or expressing negative emotions through art or religion, but some used alcohol, drugs, self-harm or other risky behaviours to manage their feelings. The second theme involved cultural and societal aspects of depression. Depression was found to be related to factors including cultural norms, social conditions, life events, family relations and peer group pressure. Some adolescents reported being victims of sexual abuse. Across contexts, interpretations and expectations related to depression differ between boys and girls and seem to also be affected by race and ethnicity. Depression was also found to have a long-term impact on education, while fatigue and low motivation may negatively affect academic progress. Social relationships were also affected, with adolescents reporting an influence on communication and social withdrawal. In these situations, they reported thoughts of dying and suicide. The third theme highlights adolescents' efforts to access care and support networks. Different factors were identified as barriers to help-seeking. First, adolescents avoid self-disclosure because of fear of stigma and negative reactions from parents and peers. They also mentioned feeling let down by the systems, leading to a lack of hope in sources of help, while limited resources were also an issue. In addition, adolescents reported distrust in professionals and perception of inefficacy of treatments, both pharmacological and psychotherapeutic. They also expressed a sense of not being heard or explained about the purpose and utility of treatments used (mostly medication) and expressed t","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 1","pages":"112-114"},"PeriodicalIF":5.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial Perspective: What do we need to know about the manosphere and young people's mental health? 编辑视角:我们需要了解庄园和年轻人心理健康的哪些方面?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-13 DOI: 10.1111/camh.12747
Harriet Over, Carl Bunce, Delali Konu, David Zendle

The manosphere is an international network of social media influencers and communities promoting male supremacy and antifeminist ideologies. Young men are engaging with this extremist content at high rates. Despite growing concerns among educators, policymakers and researchers, systematic data on the long-term impact of the manosphere on young people's mental health and behaviour remains limited. However, preliminary data suggest that the manosphere is encouraging sexist attitudes, exacerbating existing inequalities in schools, and spreading dangerous messages about mental health. We discuss the current state of research, highlight the challenges of measuring engagement with online misogyny, and propose priorities for future work. Our commentary underscores the urgent need for multilevel interventions to counteract the negative effects of the manosphere on the attitudes of young men, and their downstream consequences for the mental health and well-being of women and girls.

manosphere是一个由社交媒体影响者和社区组成的国际网络,提倡男性至上主义和反女权主义意识形态。年轻人接触极端主义内容的比例很高。尽管教育工作者、政策制定者和研究人员越来越关注,但关于大气对年轻人心理健康和行为的长期影响的系统数据仍然有限。然而,初步数据表明,管理圈正在鼓励性别歧视态度,加剧了学校中现有的不平等,并传播了有关心理健康的危险信息。我们讨论了目前的研究状况,强调了衡量在线厌女症参与度的挑战,并提出了未来工作的重点。我们的评论强调,迫切需要采取多层次干预措施,以抵消大气对青年男子态度的负面影响及其对妇女和女孩心理健康和福祉的下游后果。
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引用次数: 0
Debate: Where to next for universal school-based mental health interventions? The value of student voices in informing the design and implementation of universal school-based mental health interventions 辩论:以学校为基础的普遍心理健康干预措施下一步走向何方?学生声音在为设计和实施普遍校本心理健康干预措施提供信息方面的价值。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-13 DOI: 10.1111/camh.12750
Emma Carter

Universal school-based mental health interventions present a promising approach to addressing youth mental health challenges; however, evidence suggests their effectiveness is often limited and unsustained. One contributing factor to this issue is the frequent superficial involvement of students in the design, implementation and evaluation of initiatives. In response, this paper advocates for the urgent prioritisation of student voice within these programmes, using in-depth and purposive qualitative approaches that empower youth to actively co-create and shape interventions. Research highlights that incorporating student voice can yield vital insights into what is effective and ineffective in programmes, particularly for marginalised groups. Moreover, engaging students in co-designing methodologies that help amplify their voices ensures research processes are better aligned with their needs and preferences, fostering greater ownership and improved outcomes. This shift, which repositions students as active collaborators rather than passive recipients, has the potential to enhance both the effectiveness and equity of initiatives.

普遍的以学校为基础的心理健康干预措施是解决青少年心理健康挑战的一种有希望的方法;然而,有证据表明,它们的效果往往是有限和不可持续的。造成这一问题的一个因素是学生经常肤浅地参与计划的设计、实施和评估。作为回应,本文主张在这些项目中紧急优先考虑学生的声音,使用深入和有目的的定性方法,使青年能够积极地共同创造和塑造干预措施。研究强调,将学生的声音纳入课程中,可以对哪些课程有效、哪些课程无效产生至关重要的见解,尤其是对边缘化群体而言。此外,让学生参与有助于放大他们声音的共同设计方法,可以确保研究过程更好地符合他们的需求和偏好,从而培养更大的自主权,并改善结果。这种转变将学生重新定位为积极的合作者,而不是被动的接受者,有可能提高倡议的有效性和公平性。
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引用次数: 0
Review: Animal-assisted intervention for children with attention-deficit/hyperactivity disorder – a systematic review and meta-analysis 综述:动物辅助干预儿童注意力缺陷/多动障碍-系统回顾和荟萃分析。
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-10 DOI: 10.1111/camh.12744
Shuxin Yu, Hui Xue, Yuqing Xie, Guanyue Shao, Yihui Hao, Lijun Fan, Wei Du

Background

Animal-assisted interventions (AAIs) have emerged as a promising nonpharmacological intervention option for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, recent systematic reviews have been primarily narrative. Additionally, the pooled effectiveness of AAIs was absent from these systematic reviews.

Methods

We conducted a comprehensive systematic review and meta-analysis, searching multiple databases, including Web of Science, MEDLINE, CINAHL, Scopus, PsycINFO, EMBASE and Cochrane, from inception of the databases to March 2024. We retrieved 17 randomised controlled trials or quasi-experimental studies and used Review Manager 5.4.1 software to perform a meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects meta-analyses to estimate standardised mean differences (SMD) with 95% confidence intervals (CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention.

Results

In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD (SMD = −0.42, 95% CI = −0.71 to −0.13), self-esteem (0.46, 0.14 to 0.78), learning and cognition problems (−0.69, −0.98 to −0.39) and motor proficiency (0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group (0.10, −0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction (−0.22, −0.51 to 0.06), social skills (−0.32, −0.87 to 0.24), problematic behaviours (−0.10, −0.54 to 0.35) or emotional problems, including depression and anxiety (−0.13, −0.51 to 0.24).

Conclusions

As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.

背景:动物辅助干预(AAIs)已成为诊断为注意力缺陷/多动障碍(ADHD)儿童的一种有前途的非药物干预选择。然而,最近的系统综述主要是叙述性的。此外,在这些系统评价中缺乏AAIs的综合有效性。方法:检索Web of Science、MEDLINE、CINAHL、Scopus、PsycINFO、EMBASE、Cochrane等数据库,从建库至2024年3月,进行综合系统评价和meta分析。我们检索了17项随机对照试验或准实验研究,并使用Review Manager 5.4.1软件对人工智能治疗儿童多动症的效果进行了荟萃分析。我们进行了一组随机效应荟萃分析,使用从8项随机对照试验中提取的不同结果域的亚组数据,估计与干预前后307名ADHD儿童的行为、精神和身体功能变化有关的标准化平均差异(SMD), 95%置信区间(CI)。结果:与非aai组相比,aai显著改善了ADHD儿童的注意力问题(SMD = -0.42, 95% CI = -0.71 ~ -0.13)、自尊(0.46,0.14 ~ 0.78)、学习和认知问题(-0.69,-0.98 ~ -0.39)和运动熟练程度(0.77,0.11 ~ 1.42)。实验组AAIs对ADHD症状严重程度的综合影响与对照组常规治疗的影响无显著差异(0.10,-0.31 ~ 0.52)。同样,人工智能对社会互动(-0.22,-0.51至0.06),社交技能(-0.32,-0.87至0.24),问题行为(-0.10,-0.54至0.35)或情绪问题,包括抑郁和焦虑(-0.13,-0.51至0.24)没有显著的积极影响。结论:作为一种与金标准方法(如药物或多模式干预)相补充的ADHD管理策略,人工智能在改善儿童大多数核心ADHD结局方面似乎并不更有效。未来的研究应纳入严格的大样本量研究设计和标准方案,以获得更有效和可靠的结论。
{"title":"Review: Animal-assisted intervention for children with attention-deficit/hyperactivity disorder – a systematic review and meta-analysis","authors":"Shuxin Yu,&nbsp;Hui Xue,&nbsp;Yuqing Xie,&nbsp;Guanyue Shao,&nbsp;Yihui Hao,&nbsp;Lijun Fan,&nbsp;Wei Du","doi":"10.1111/camh.12744","DOIUrl":"10.1111/camh.12744","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Animal-assisted interventions (AAIs) have emerged as a promising nonpharmacological intervention option for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, recent systematic reviews have been primarily narrative. Additionally, the pooled effectiveness of AAIs was absent from these systematic reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive systematic review and meta-analysis, searching multiple databases, including Web of Science, MEDLINE, CINAHL, Scopus, PsycINFO, EMBASE and Cochrane, from inception of the databases to March 2024. We retrieved 17 randomised controlled trials or quasi-experimental studies and used Review Manager 5.4.1 software to perform a meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects meta-analyses to estimate standardised mean differences (SMD) with 95% confidence intervals (CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD (SMD = −0.42, 95% CI = −0.71 to −0.13), self-esteem (0.46, 0.14 to 0.78), learning and cognition problems (−0.69, −0.98 to −0.39) and motor proficiency (0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group (0.10, −0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction (−0.22, −0.51 to 0.06), social skills (−0.32, −0.87 to 0.24), problematic behaviours (−0.10, −0.54 to 0.35) or emotional problems, including depression and anxiety (−0.13, −0.51 to 0.24).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 1","pages":"34-52"},"PeriodicalIF":5.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Debate: Where to next for universal school-based mental health interventions? 辩论:以学校为基础的普遍心理健康干预措施下一步走向何方?
IF 5 3区 医学 Q1 PEDIATRICS Pub Date : 2025-01-09 DOI: 10.1111/camh.12749
Louise Birrell, Lucinda Grummitt, Scarlett Smout, Pallab Maulik, Maree Teesson, Nicola Newton

In this article, we evaluate the current state of universal school-based mental health prevention. We argue that the field is at another pivotal turning point, with many unanswered questions. As youth mental health issues rise in prominence and prevalence, schools increasingly adopt mental health and well-being programmes. However, recent large-scale trials have reported varied effects, raising questions about their effectiveness. We critically analyse these findings and place them in a global context. We contend results in high-income countries should not be seen as a failure of universal prevention overall and unpack key learnings from trials that have not found significant preventive effects. A comprehensive perspective of the data reveals both negative and positive aspects, as well as some signposts for the way forward. We advocate for programme adaptation based on feedback, embracing proportionate universalism and exploring alternative prevention strategies without discarding universal prevention. We urge continued research with stakeholder involvement, emphasising a nuanced approach to universal school-based mental health prevention, is urgently needed to move the field forward.

在这篇文章中,我们评估目前普遍的学校为基础的心理健康预防的状况。我们认为,该领域正处于另一个关键的转折点,有许多悬而未决的问题。随着青少年心理健康问题日益突出和普遍,学校越来越多地采用心理健康和福祉方案。然而,最近的大规模试验报告了不同的效果,对其有效性提出了质疑。我们批判性地分析这些发现,并将其置于全球背景下。我们认为,不应将高收入国家的结果视为普遍预防的总体失败,并从没有发现显著预防效果的试验中总结出关键经验教训。从全面的角度来看,这些数据既有消极的一面,也有积极的一面,同时也为未来指明了方向。我们主张在反馈的基础上调整方案,接受适当的普遍性,并在不放弃普遍预防的情况下探索其他预防战略。我们敦促在利益相关者参与的情况下继续进行研究,强调迫切需要一种微妙的方法来普及以学校为基础的心理健康预防,以推动该领域的发展。
{"title":"Debate: Where to next for universal school-based mental health interventions?","authors":"Louise Birrell,&nbsp;Lucinda Grummitt,&nbsp;Scarlett Smout,&nbsp;Pallab Maulik,&nbsp;Maree Teesson,&nbsp;Nicola Newton","doi":"10.1111/camh.12749","DOIUrl":"10.1111/camh.12749","url":null,"abstract":"<p>In this article, we evaluate the current state of universal school-based mental health prevention. We argue that the field is at another pivotal turning point, with many unanswered questions. As youth mental health issues rise in prominence and prevalence, schools increasingly adopt mental health and well-being programmes. However, recent large-scale trials have reported varied effects, raising questions about their effectiveness. We critically analyse these findings and place them in a global context. We contend results in high-income countries should not be seen as a failure of universal prevention overall and unpack key learnings from trials that have not found significant preventive effects. A comprehensive perspective of the data reveals both negative and positive aspects, as well as some signposts for the way forward. We advocate for programme adaptation based on feedback, embracing proportionate universalism and exploring alternative prevention strategies without discarding universal prevention. We urge continued research with stakeholder involvement, emphasising a nuanced approach to universal school-based mental health prevention, is urgently needed to move the field forward.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"30 1","pages":"92-95"},"PeriodicalIF":5.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Child and Adolescent Mental Health
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