This paper examines the hostile public debate surrounding children experiencing gender dysphoria and its impact on research. In recent years, this field has become entangled in wider ideological conflicts, inflamed by online discourse and diverging views on sex and gender. As the number of children presenting with gender dysphoria rose through the 2010s, concerns were raised regarding the appropriateness of treatments and the quality of supporting research. The Cass Review and responses to it exposed weaknesses in the evidence base and revealed how politicisation has influenced clinical practice, discouraged open inquiry, fuelled personal attacks on researchers and shaped publication decisions. These dynamics have impeded robust research and fostered mistrust between clinicians, researchers and advocates. This paper argues that safeguarding children's welfare requires a renewed commitment to impartial, methodologically rigorous research and responsible editorial oversight. Without this, ideological partisanship will continue to undermine scientific credibility and entrench uncertainty, perpetuating harm to affected children and their families.
{"title":"Debate: Standing up for science – how to combat misinformation in child mental health? Evidence and ideology in gender dysphoria research","authors":"Tim Doran","doi":"10.1111/camh.70054","DOIUrl":"10.1111/camh.70054","url":null,"abstract":"<p>This paper examines the hostile public debate surrounding children experiencing gender dysphoria and its impact on research. In recent years, this field has become entangled in wider ideological conflicts, inflamed by online discourse and diverging views on sex and gender. As the number of children presenting with gender dysphoria rose through the 2010s, concerns were raised regarding the appropriateness of treatments and the quality of supporting research. The Cass Review and responses to it exposed weaknesses in the evidence base and revealed how politicisation has influenced clinical practice, discouraged open inquiry, fuelled personal attacks on researchers and shaped publication decisions. These dynamics have impeded robust research and fostered mistrust between clinicians, researchers and advocates. This paper argues that safeguarding children's welfare requires a renewed commitment to impartial, methodologically rigorous research and responsible editorial oversight. Without this, ideological partisanship will continue to undermine scientific credibility and entrench uncertainty, perpetuating harm to affected children and their families.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"68-70"},"PeriodicalIF":5.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769683","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}
In 2025, the Coalition of Autism Scientists was formed to counter the misinformation and pseudoscience that was being advanced at the highest levels of the federal government in the United States. The background and history of how the Coalition was formed and its major activities, which include regular meetings, issuing public statements, and providing information and interviews to the media, are described. The importance of engaging in active advocacy in support of autism science is discussed along with some examples of the Coalition's impact. Given the direction that politics is going, sowing greater dissent between science and the public, continued vigilance in support of the highest quality research is critical if we are to meet the urgent needs of autistic people and their families.
{"title":"Debate: Standing up for science – how to combat misinformation in child mental health: protecting the integrity of autism research and practice in the United States","authors":"Helen Tager-Flusberg","doi":"10.1111/camh.70058","DOIUrl":"10.1111/camh.70058","url":null,"abstract":"<p>In 2025, the Coalition of Autism Scientists was formed to counter the misinformation and pseudoscience that was being advanced at the highest levels of the federal government in the United States. The background and history of how the Coalition was formed and its major activities, which include regular meetings, issuing public statements, and providing information and interviews to the media, are described. The importance of engaging in active advocacy in support of autism science is discussed along with some examples of the Coalition's impact. Given the direction that politics is going, sowing greater dissent between science and the public, continued vigilance in support of the highest quality research is critical if we are to meet the urgent needs of autistic people and their families.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"71-73"},"PeriodicalIF":5.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769722","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}
Joshua S. Steinberg, Sean H. Toh, Patrick Mair, John R. Weisz
Bucci et al. (Child and Adolescent Mental Health, 13, 1) report on a thoughtfully designed feasibility trial of i-Minds, a digital intervention for youths who have been exposed to technology-assisted sexual abuse. The study represents an important step toward addressing an emerging and deeply concerning threat to youth mental health. More broadly, it highlights a familiar challenge for intervention scientists: how to make go/no-go decisions about larger clinical trials based on small feasibility studies, and how to balance careful, evidence-based treatment development with the urgent public health need for intervention. This tension is especially salient as new harms associated with the internet emerge faster than intervention evaluation can respond. To address this, we suggest balancing urgency with rigor by employing efficient evaluation strategies, including Bayesian analysis to quantify clinically meaningful effects, target trial emulation to create treatment-versus-control comparisons, and adaptive trial designs that allow for refining interventions mid-trial.
{"title":"Commentary: Bridging the gap between emerging harms and evidence-based care: a commentary on Bucci et al. (2025)","authors":"Joshua S. Steinberg, Sean H. Toh, Patrick Mair, John R. Weisz","doi":"10.1111/camh.70057","DOIUrl":"10.1111/camh.70057","url":null,"abstract":"<p>Bucci et al. (<i>Child and Adolescent Mental Health</i>, 13, 1) report on a thoughtfully designed feasibility trial of <i>i-Minds</i>, a digital intervention for youths who have been exposed to technology-assisted sexual abuse. The study represents an important step toward addressing an emerging and deeply concerning threat to youth mental health. More broadly, it highlights a familiar challenge for intervention scientists: how to make go/no-go decisions about larger clinical trials based on small feasibility studies, and how to balance careful, evidence-based treatment development with the urgent public health need for intervention. This tension is especially salient as new harms associated with the internet emerge faster than intervention evaluation can respond. To address this, we suggest balancing urgency with rigor by employing efficient evaluation strategies, including Bayesian analysis to quantify clinically meaningful effects, target trial emulation to create treatment-versus-control comparisons, and adaptive trial designs that allow for refining interventions mid-trial.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"61-64"},"PeriodicalIF":5.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769703","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}
<p>Anastasia Andreou</p><p>National and Kapodistrian University of Athens</p><p>Most individuals with childhood Attention-Deficit/Hyperactivity Disorder (ADHD) experience remittance of their ADHD diagnosis over time, but impairing symptoms of ADHD may persist, and psychiatric disorders are highly prevalent in these individuals. There is limited understanding about childhood factors that may predict these outcomes.</p><p>van der Plas et al. (2025) conducted a systematic review and meta-analysis aimed at identifying childhood factors that predict psychiatric problems in adults diagnosed with childhood ADHD. The final analysis included 36 longitudinal studies investigating 119 unique predictors, although a majority (66%) were studied only once. Meta-analyses were conducted when at least three studies examined the same predictor (10 predictors) with comparable effect sizes; otherwise, narrative reviews were performed (31 predictors). Study quality was assessed using the Newcastle–Ottawa Scale (NOS), with only 44% of studies rated as fair or good quality. Additionally, 53% of studies did not control for confounding variables. Five predictors of ADHD persistence were meta-analyzed. A childhood history of stimulant treatment was associated with an increased risk for persistent ADHD, although children with more severe symptoms may be more likely to receive these medications. Higher childhood Full Scale IQ was associated with a decreased risk, but this association lost significance when one poor-quality study was excluded. ADHD persistence was linked to an increased risk of substance use disorders (SUDs) and major depressive disorder (MDD) in adulthood but not to adult anxiety disorders. Childhood oppositional defiant disorder/conduct disorder (ODD/CD), male sex, and severity of childhood ADHD-related impairment were not associated with adult ADHD persistence. Childhood ODD/CD and stimulant treatment did not predict adult SUDs. Narratively reviewed predictors from fair/good quality studies showed some evidence that ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, and low socioeconomic status increase the risk of ADHD persistence. There was also some narrative evidence linking persistent ADHD to adult antisocial personality disorder (ASPD), late initiation of stimulant treatment to increased risk of SUDs in adulthood, and stimulant treatment generally to decreased risk of adult MDD. This study confirms many findings from previous meta-analyses but highlights discrepancies regarding childhood IQ, ODD/CD, and severity of ADHD impairment. Unlike earlier work, childhood MDD was not found to predict adult ADHD persistence.</p><p>The authors emphasize the need for further investigation into predictors such as ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, thought problems, parental psychopathology, and socioeconomic status. They h
大多数患有儿童注意力缺陷/多动障碍（ADHD）的个体随着时间的推移会经历ADHD诊断的转移，但ADHD的损害症状可能持续存在，精神疾病在这些个体中非常普遍。对可能预测这些结果的童年因素的了解有限。van der Plas等人（2025）进行了一项系统回顾和荟萃分析，旨在确定儿童时期的因素，预测被诊断患有儿童多动症的成年人的精神问题。最终的分析包括36项纵向研究，调查119个独特的预测因素，尽管大多数（66%）只研究了一次。当至少有三项研究检验了具有可比效应量的相同预测因子（10个预测因子）时，进行荟萃分析；否则，进行叙述性回顾（31个预测因子）。研究质量使用纽卡斯尔-渥太华量表（NOS）进行评估，只有44%的研究被评为公平或质量良好。此外，53%的研究没有控制混杂变量。对ADHD持续性的五个预测因素进行meta分析。儿童期兴奋剂治疗史与持续性ADHD的风险增加有关，尽管症状更严重的儿童更有可能接受这些药物治疗。较高的儿童全量表智商与风险降低有关，但当排除一项质量较差的研究时，这种联系就失去了意义。ADHD的持续存在与成年后物质使用障碍（sud）和重度抑郁症（MDD）的风险增加有关，但与成年焦虑症无关。儿童对立违抗性障碍/行为障碍（ODD/CD）、男性和儿童ADHD相关损害的严重程度与成人ADHD持续性无关。儿童ODD/CD和兴奋剂治疗不能预测成人sud。从公平/高质量的研究中叙述性地回顾预测因子，一些证据表明ADHD合并型、多动/冲动症状、焦虑障碍、外化问题、社会功能障碍和低社会经济地位增加了ADHD持续存在的风险。还有一些叙述性证据表明，持续性ADHD与成人反社会人格障碍（ASPD）有关，较晚开始兴奋剂治疗会增加成年期sud的风险，而兴奋剂治疗通常会降低成年期MDD的风险。这项研究证实了先前荟萃分析的许多发现，但强调了儿童智商、ODD/CD和ADHD损害严重程度方面的差异。与早期的研究不同，儿童时期的重度抑郁症并不能预测成人多动症的持续存在。作者强调需要进一步研究ADHD合并型、多动/冲动症状、焦虑障碍、外化问题、社会功能障碍、思想问题、父母精神病理和社会经济地位等预测因素。他们强调了由于现有研究的数量以及所研究的预测因素和结果的类型所造成的局限性。未来的研究建议包括更广泛的潜在预测因素，利用先进的方法，如机器学习，并应用个体参与者数据荟萃分析，以更好地了解儿童多动症的综合预测效应和罕见的成人结果。van der Plas, n.e., Noordermeer, s.d.s., Oosterlaan， J.和Luman， M.（2025）。系统回顾和荟萃分析：儿童注意缺陷/多动障碍成人精神结局的预测因素。美国儿童与青少年精神病学学会杂志：S0890-8567(25)00215-1。doi: 10.1016 / j.jaac.2025.04.012。雅典大学的Dimitrios ApostolouNational和Kapodistrian教授：内化问题（如焦虑、抑郁、社交退缩和躯体抱怨）和外化问题（如攻击性、冲动和行为困难）通常出现在儿童早期，并可能持续到青春期和成年期，导致不利的发展结果。虽然传统上研究是分开的途径，但越来越多的研究表明，内化和外化问题不是独立的，而是经常在发展过程中共同发生和相互作用。这种共存与更严重的心理社会失调、更差的学业成绩和更高的后期精神病理风险有关。Bista等人（2025）进行了一项约2000名参与者从出生到青春期后期的大型出生前队列研究。使用潜在阶级增长分析（LCGA），作者根据家长和老师的重复报告，确定了具有内化和外化问题明显共同发生轨迹的儿童亚组。目的是确定这两个领域的精神病理学是否遵循独立或相互关联的发展过程。出现了四个主要的轨迹组。 低稳定组代表了大多数症状水平持续较低的参与者。中度下降组在童年时期表现出较高的困难，随着时间的推移而减少。增长组的内化和外化问题都在逐步上升，而高稳定组在所有发展阶段都保持高水平。大约8-10%的参与者属于两种最具症状的轨迹。一些早期的危险因素将这些群体区分开来。暴露于母亲精神病理和产前压力、较低的社会经济地位、不一致或严厉的父母以及早期气质失调的儿童更有可能遵循增加或高稳定的轨迹。这些发现支持了发育共病的概念，即情绪和行为问题交织在一起，并随着时间的推移相互加强。该研究的优势包括前瞻性设计，多信息重复评估，以及使用先进的统计模型，可以对发育异质性进行细致入微的描述。然而，局限性包括依赖于父母报告，潜在的损耗偏见，以及对介导生物学或上下文机制的有限探索。总之，这项研究提供了令人信服的证据，表明从童年到青春期，内化和外化问题通常以可识别的模式共同发展。早期家庭和个人因素在形成这些轨迹方面发挥关键作用，强调了长期监测和早期以家庭为重点的预防战略在促进儿童和青少年心理健康方面的重要性。Bista， S., Tait， R. J., Straker， L. M., Lin， A., Steinbeck， K., Graham， P. L.，…& Skinner， S. R.（2025）。儿童期中期到青春期后期内化和外化问题的共同发展轨迹和儿童期风险因素：来自前瞻性产前队列的研究结果。中国精神病学杂志，2011(1),344 - 344。doi: 10.1017 / S0954579423001505。兴奋剂是治疗注意力缺陷/多动障碍（ADHD）的一线药物。尽管它们对多动症的核心症状有好处，但它们也有一些副作用。有人认为兴奋剂可能会诱发精神病和躁狂症状，从而导致精神障碍或双相情感障碍。Salazar de Pablo等人（2025）进行了一项系统回顾和荟萃分析，探讨了兴奋剂对接受ADHD药物治疗的个体的精神病症状或躁狂症/双相情感障碍症状的影响。搜索包括PubMed、Web of Science、Ovid/PsycINFO和Cochrane Central Register of Reviews等数据库，涵盖了从开始到2024年10月1日的文献。共纳入16项研究，包括391,043名年龄在8.5至31.1岁之间（平均12.6岁）的个体。参与者根据DSM或ICD被诊断为ADHD，并在服用兴奋剂时报告有双相情感障碍、精神病或这些症状。荟萃分析结果显示，2.76%的ADHD患者服用兴奋剂后出现精神病症状，2.29%出现精神障碍，3.72%出现双相情感障碍。在纳入的研究中，精神病和双相情感障碍症状的异质性具有统计学意义（I2 > 95%）。根据亚组分析，在研究地域和随访时间方面存在差异。服用安非他明的个体比服用哌甲酯的个体表现出更多的精神病症状（高出57%的几率）。较高的女性比例、兴奋剂剂量和较小的样本量导致了发表偏倚。在质量评估中，71.4%的队列研究被评为良好。一项随机对照试验被评估为低偏倚风险，另一项被评估为存在一些问题。引发精神病或双相情感障碍的机制尚不完全清楚。有些人在服用兴奋剂后可能出现这种症状，但这可能不代表因果关系。确定了几个限制。首先，这些研究没有对照组比较（接受非兴奋剂治疗的个体），只有三项研究比较了安非他明和哌醋甲酯。此外，不可能对与兴奋剂使用相关的躁狂症状发展的数据进行荟萃分析。此外，尽管
{"title":"Clinical research updates","authors":"Marinos Kyriakopoulos, Anastasia Andreou, Dimitrios Apostolou, Paraskevi Lampropoulou","doi":"10.1111/camh.70053","DOIUrl":"10.1111/camh.70053","url":null,"abstract":"<p>Anastasia Andreou</p><p>National and Kapodistrian University of Athens</p><p>Most individuals with childhood Attention-Deficit/Hyperactivity Disorder (ADHD) experience remittance of their ADHD diagnosis over time, but impairing symptoms of ADHD may persist, and psychiatric disorders are highly prevalent in these individuals. There is limited understanding about childhood factors that may predict these outcomes.</p><p>van der Plas et al. (2025) conducted a systematic review and meta-analysis aimed at identifying childhood factors that predict psychiatric problems in adults diagnosed with childhood ADHD. The final analysis included 36 longitudinal studies investigating 119 unique predictors, although a majority (66%) were studied only once. Meta-analyses were conducted when at least three studies examined the same predictor (10 predictors) with comparable effect sizes; otherwise, narrative reviews were performed (31 predictors). Study quality was assessed using the Newcastle–Ottawa Scale (NOS), with only 44% of studies rated as fair or good quality. Additionally, 53% of studies did not control for confounding variables. Five predictors of ADHD persistence were meta-analyzed. A childhood history of stimulant treatment was associated with an increased risk for persistent ADHD, although children with more severe symptoms may be more likely to receive these medications. Higher childhood Full Scale IQ was associated with a decreased risk, but this association lost significance when one poor-quality study was excluded. ADHD persistence was linked to an increased risk of substance use disorders (SUDs) and major depressive disorder (MDD) in adulthood but not to adult anxiety disorders. Childhood oppositional defiant disorder/conduct disorder (ODD/CD), male sex, and severity of childhood ADHD-related impairment were not associated with adult ADHD persistence. Childhood ODD/CD and stimulant treatment did not predict adult SUDs. Narratively reviewed predictors from fair/good quality studies showed some evidence that ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, and low socioeconomic status increase the risk of ADHD persistence. There was also some narrative evidence linking persistent ADHD to adult antisocial personality disorder (ASPD), late initiation of stimulant treatment to increased risk of SUDs in adulthood, and stimulant treatment generally to decreased risk of adult MDD. This study confirms many findings from previous meta-analyses but highlights discrepancies regarding childhood IQ, ODD/CD, and severity of ADHD impairment. Unlike earlier work, childhood MDD was not found to predict adult ADHD persistence.</p><p>The authors emphasize the need for further investigation into predictors such as ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunction, thought problems, parental psychopathology, and socioeconomic status. They h","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"84-86"},"PeriodicalIF":5.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764387","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}
<p>Sanders et al. (<span>2025</span>) make a valuable contribution to the literature by examining the co-occurrence of autism and gender dysphoria diagnoses in a large, community-based sample of children and adolescents. One of the most notable strengths of this study is its use of electronic health record data, encompassing over 750,000 individuals. Previous research has been limited to smaller samples within more specialist settings, such as academic medical centres. As well as exploring the prevalence of gender dysphoria among autistic and nonautistic participants, they investigated co-occurring rates of depressive disorder, generalised anxiety disorder and suicide attempts. The study found that autistic children and adolescents were more likely to have recorded diagnoses of gender dysphoria than nonautistic children and adolescents. In addition, children and adolescents who were both autistic and had gender dysphoria were more likely to have higher rates of recorded diagnoses of depression, anxiety and suicide attempts compared to those who were not autistic and/or did not have a diagnosis of gender dysphoria.</p><p>The size of the sample allows for a robust comparison across four groups of young people (autistic only, gender dysphoria diagnosis only, autistic with a gender dysphoria diagnosis and nonautistic without a diagnosis of gender dysphoria), enabling insights into the prevalence and co-occurrence of mental health difficulties associated with these intersecting identities. The findings underscore the clinical relevance of the co-occurrence of autism and gender dysphoria. These results reinforce the importance of integrated, developmentally informed approaches to assessment and care.</p><p>While Sanders et al. (<span>2025</span>) provide valuable evidence of the association between autism and gender dysphoria in a large community sample, several limitations and further opportunities for inclusivity and nuance warrant attention. First, the reliance on formal diagnoses recorded in electronic health records needs to be carefully considered. We note that this is an inevitable consequence of using large health system data, which also contributes to the strength of the large, community sample. Many young people face barriers to accessing timely and accurate diagnoses of autism and gender dysphoria due to systemic inequities, lack of specialist services or stigma (Crane, Batty, Adeyinka, et al., <span>2018</span>; Smith-Young, Pike, Swab, & Chafe, <span>2025</span>; Squires, Laws, Joubert, & Greenhill, <span>2024</span>). It is not possible from the dataset to understand the clinical processes that led to diagnoses of autism, gender dysphoria, depression and anxiety. Diagnostic overshadowing may have occurred and diagnostic accuracy is likely to be dependent on clinician speciality (i.e. primary care, mental health and gender specialist). As such, the study may not accurately represent the prevalence of conditions reported.</p><p>The
{"title":"Commentary: Interpreting diagnostic data on autism and gender dysphoria: clinical and research implications – a commentary on Sanders et al. (2025)","authors":"Kai Thomas, Kate Cooper","doi":"10.1111/camh.70056","DOIUrl":"10.1111/camh.70056","url":null,"abstract":"<p>Sanders et al. (<span>2025</span>) make a valuable contribution to the literature by examining the co-occurrence of autism and gender dysphoria diagnoses in a large, community-based sample of children and adolescents. One of the most notable strengths of this study is its use of electronic health record data, encompassing over 750,000 individuals. Previous research has been limited to smaller samples within more specialist settings, such as academic medical centres. As well as exploring the prevalence of gender dysphoria among autistic and nonautistic participants, they investigated co-occurring rates of depressive disorder, generalised anxiety disorder and suicide attempts. The study found that autistic children and adolescents were more likely to have recorded diagnoses of gender dysphoria than nonautistic children and adolescents. In addition, children and adolescents who were both autistic and had gender dysphoria were more likely to have higher rates of recorded diagnoses of depression, anxiety and suicide attempts compared to those who were not autistic and/or did not have a diagnosis of gender dysphoria.</p><p>The size of the sample allows for a robust comparison across four groups of young people (autistic only, gender dysphoria diagnosis only, autistic with a gender dysphoria diagnosis and nonautistic without a diagnosis of gender dysphoria), enabling insights into the prevalence and co-occurrence of mental health difficulties associated with these intersecting identities. The findings underscore the clinical relevance of the co-occurrence of autism and gender dysphoria. These results reinforce the importance of integrated, developmentally informed approaches to assessment and care.</p><p>While Sanders et al. (<span>2025</span>) provide valuable evidence of the association between autism and gender dysphoria in a large community sample, several limitations and further opportunities for inclusivity and nuance warrant attention. First, the reliance on formal diagnoses recorded in electronic health records needs to be carefully considered. We note that this is an inevitable consequence of using large health system data, which also contributes to the strength of the large, community sample. Many young people face barriers to accessing timely and accurate diagnoses of autism and gender dysphoria due to systemic inequities, lack of specialist services or stigma (Crane, Batty, Adeyinka, et al., <span>2018</span>; Smith-Young, Pike, Swab, & Chafe, <span>2025</span>; Squires, Laws, Joubert, & Greenhill, <span>2024</span>). It is not possible from the dataset to understand the clinical processes that led to diagnoses of autism, gender dysphoria, depression and anxiety. Diagnostic overshadowing may have occurred and diagnostic accuracy is likely to be dependent on clinician speciality (i.e. primary care, mental health and gender specialist). As such, the study may not accurately represent the prevalence of conditions reported.</p><p>The ","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"65-67"},"PeriodicalIF":5.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764462","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}
Nina Higson-Sweeney, Douglas Badenoch, André Tomlin
The rising use of digital technologies and social media means that individuals, including young people, are increasingly searching for and consuming health-related information online. Although there are benefits to this, there has also been an increase in health-related misinformation, with growing concerns about the impact of this in the context of child mental health. This debate article outlines what misinformation is and why it is an issue in child mental health, before considering the impact that misinformation can have in relation to decision-making, help-seeking, medical mistrust, and stigma. Drawing on experiences with science communication, five recommendations are then presented for combating misinformation, focusing on what individuals can do when confronted with misinformation, how to have conversations with others about misinformation, and what can be done to promote digital literacy.
{"title":"Debate: Standing up for science – how to combat misinformation in child mental health? Five recommendations for disentangling fact from fiction","authors":"Nina Higson-Sweeney, Douglas Badenoch, André Tomlin","doi":"10.1111/camh.70055","DOIUrl":"10.1111/camh.70055","url":null,"abstract":"<p>The rising use of digital technologies and social media means that individuals, including young people, are increasingly searching for and consuming health-related information online. Although there are benefits to this, there has also been an increase in health-related misinformation, with growing concerns about the impact of this in the context of child mental health. This debate article outlines what misinformation is and why it is an issue in child mental health, before considering the impact that misinformation can have in relation to decision-making, help-seeking, medical mistrust, and stigma. Drawing on experiences with science communication, five recommendations are then presented for combating misinformation, focusing on what individuals can do when confronted with misinformation, how to have conversations with others about misinformation, and what can be done to promote digital literacy.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":"74-76"},"PeriodicalIF":5.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745276","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}
Florence Sheen, Bethany Mullarkey, Gemma L Witcomb, Marie-Christine Opitz, Ellen Maloney, Saffron M Baldoza, Hannah J White
Background: Body image and eating behaviours are common areas of concern for early adolescents. Artificial Intelligence (AI) interactions are becoming commonplace, including with chatbots that provide human-like communication. Adolescents may prefer using chatbots to anonymously ask sensitive questions, rather than approaching trusted adults or peers. It is unclear how chatbots answer such questions. We explored how chatbots would respond to eating, weight or appearance-related queries from adolescents.
Method: Ten fictitious adolescent personas and scripts were created to facilitate conversations with ChatGPT and Claude.AI. Personas asked questions about eating, body weight and/or appearance, presenting as 'curious', 'worried' or 'having a potential eating disorder'. Conversation outputs were analysed using reflexive thematic analysis to explore the content of chatbot responses.
Results: Five themes were identified: (1) Live a 'healthy' adolescent lifestyle; (2) Eat 'healthily'; (3) Promoting regular physical activity; (4) Seek support; (5) Focus on you. Advice was often framed within societal ideals relating to eating, body weight and/or appearance. Chatbots signposted to trusted adults and healthcare professionals for support, but not to regulated resources (e.g., NHS).
Conclusion: Framings around eating, weight and/or appearance may be problematic for adolescents with eating disorder symptomatology. A lack of prompting for further information or signposting to regulated support means vulnerable adolescents may receive unhelpful information or not reach adequate support. Understanding how AI could be supportive and/or unhelpful to adolescent users presenting with eating, body or appearance-related concerns is important. Findings can inform policy regulating AI chatbots' communications with adolescents.
{"title":"How do Artificial Intelligence chatbots respond to questions from adolescent personas about their eating, body weight or appearance?","authors":"Florence Sheen, Bethany Mullarkey, Gemma L Witcomb, Marie-Christine Opitz, Ellen Maloney, Saffron M Baldoza, Hannah J White","doi":"10.1111/camh.70047","DOIUrl":"https://doi.org/10.1111/camh.70047","url":null,"abstract":"<p><strong>Background: </strong>Body image and eating behaviours are common areas of concern for early adolescents. Artificial Intelligence (AI) interactions are becoming commonplace, including with chatbots that provide human-like communication. Adolescents may prefer using chatbots to anonymously ask sensitive questions, rather than approaching trusted adults or peers. It is unclear how chatbots answer such questions. We explored how chatbots would respond to eating, weight or appearance-related queries from adolescents.</p><p><strong>Method: </strong>Ten fictitious adolescent personas and scripts were created to facilitate conversations with ChatGPT and Claude.AI. Personas asked questions about eating, body weight and/or appearance, presenting as 'curious', 'worried' or 'having a potential eating disorder'. Conversation outputs were analysed using reflexive thematic analysis to explore the content of chatbot responses.</p><p><strong>Results: </strong>Five themes were identified: (1) Live a 'healthy' adolescent lifestyle; (2) Eat 'healthily'; (3) Promoting regular physical activity; (4) Seek support; (5) Focus on you. Advice was often framed within societal ideals relating to eating, body weight and/or appearance. Chatbots signposted to trusted adults and healthcare professionals for support, but not to regulated resources (e.g., NHS).</p><p><strong>Conclusion: </strong>Framings around eating, weight and/or appearance may be problematic for adolescents with eating disorder symptomatology. A lack of prompting for further information or signposting to regulated support means vulnerable adolescents may receive unhelpful information or not reach adequate support. Understanding how AI could be supportive and/or unhelpful to adolescent users presenting with eating, body or appearance-related concerns is important. Findings can inform policy regulating AI chatbots' communications with adolescents.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662417","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}
Sam Amar, Gabriel Côté-Corriveau, Mimi Israël, Howard Steiger, Nancy Low, Nicholas Chadi, Émilie Brousseau, Nahantara Lafleur, Nathalie Auger
Background: Anorexia nervosa has the potential to affect fetal neurodevelopment. We examined the association between maternal anorexia nervosa and mental, substance-related, and neurodevelopmental morbidity in offspring.
Methods: We conducted a retrospective cohort study of 1,269,370 children in Quebec, Canada, between 2006 and 2022. The main exposure was maternal anorexia nervosa requiring admission. The outcome was childhood hospitalization for mental, substance-related, or neurodevelopmental disorders between birth and age 17 years, with follow-up ending in 2023. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal anorexia nervosa and child outcomes using Cox regression models adjusted for patient characteristics.
Results: In total, 2,447 (0.2%) children had a mother admitted for anorexia nervosa. Children of mothers with anorexia nervosa had higher hospitalization rates for mental, substance-related, and neurodevelopmental morbidity than other children (104.7 vs. 51.4 per 1,000 by age 17 years). Children whose mothers had anorexia nervosa were particularly at risk of mental health hospitalization (HR 2.30, 95% CI 1.52-3.49), especially for anorexia nervosa (HR 10.62, 95% CI 5.06-22.29) and anxiety and stress disorders (HR 1.84, 95% CI 1.09-3.08), compared with unexposed children. Maternal anorexia nervosa was associated with substance-related (HR 2.01, 95% CI 1.26-3.21) and neurodevelopmental morbidity in children (HR 1.55, 95% CI 1.19-2.01).
Conclusion: Maternal anorexia nervosa is associated with childhood hospitalization for mental health, substance-related, and neurodevelopmental morbidity, although results should be interpreted with caution owing to potential confounders. Mothers with anorexia nervosa may benefit from psychosocial support to prevent mental and neurodevelopmental morbidity in offspring.
背景：神经性厌食症有可能影响胎儿神经发育。我们研究了母亲神经性厌食症与后代精神、物质相关和神经发育发病率之间的关系。方法：我们在2006年至2022年间对加拿大魁北克省的1,269,370名儿童进行了回顾性队列研究。主要暴露为产妇神经性厌食症。结果是儿童在出生至17岁期间因精神、物质相关或神经发育障碍住院，随访于2023年结束。我们使用经患者特征调整的Cox回归模型估计了母亲神经性厌食症与儿童结局之间关联的风险比（HR）和95%置信区间（CI）。结果：共有2447例（0.2%）患儿的母亲因神经性厌食症入院。神经性厌食症母亲的孩子在精神、物质相关和神经发育疾病方面的住院率高于其他儿童（17岁时为104.7比51.4）。与未暴露的儿童相比，母亲患有神经性厌食症的儿童尤其有精神健康住院的风险（HR 2.30, 95% CI 1.52-3.49），特别是神经性厌食症（HR 10.62, 95% CI 5.06-22.29）和焦虑和应激障碍（HR 1.84, 95% CI 1.09-3.08）。母亲神经性厌食症与儿童的物质相关发病率（HR 2.01, 95% CI 1.26-3.21）和神经发育发病率相关（HR 1.55, 95% CI 1.19-2.01）。结论：母亲神经性厌食症与儿童因精神健康、物质相关和神经发育疾病住院有关，尽管由于潜在的混杂因素，结果应谨慎解释。神经性厌食症的母亲可能受益于社会心理支持，以防止后代的精神和神经发育疾病。
{"title":"Maternal anorexia nervosa and risk of mental and neurodevelopmental morbidity in offspring.","authors":"Sam Amar, Gabriel Côté-Corriveau, Mimi Israël, Howard Steiger, Nancy Low, Nicholas Chadi, Émilie Brousseau, Nahantara Lafleur, Nathalie Auger","doi":"10.1111/camh.70051","DOIUrl":"https://doi.org/10.1111/camh.70051","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa has the potential to affect fetal neurodevelopment. We examined the association between maternal anorexia nervosa and mental, substance-related, and neurodevelopmental morbidity in offspring.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 1,269,370 children in Quebec, Canada, between 2006 and 2022. The main exposure was maternal anorexia nervosa requiring admission. The outcome was childhood hospitalization for mental, substance-related, or neurodevelopmental disorders between birth and age 17 years, with follow-up ending in 2023. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association between maternal anorexia nervosa and child outcomes using Cox regression models adjusted for patient characteristics.</p><p><strong>Results: </strong>In total, 2,447 (0.2%) children had a mother admitted for anorexia nervosa. Children of mothers with anorexia nervosa had higher hospitalization rates for mental, substance-related, and neurodevelopmental morbidity than other children (104.7 vs. 51.4 per 1,000 by age 17 years). Children whose mothers had anorexia nervosa were particularly at risk of mental health hospitalization (HR 2.30, 95% CI 1.52-3.49), especially for anorexia nervosa (HR 10.62, 95% CI 5.06-22.29) and anxiety and stress disorders (HR 1.84, 95% CI 1.09-3.08), compared with unexposed children. Maternal anorexia nervosa was associated with substance-related (HR 2.01, 95% CI 1.26-3.21) and neurodevelopmental morbidity in children (HR 1.55, 95% CI 1.19-2.01).</p><p><strong>Conclusion: </strong>Maternal anorexia nervosa is associated with childhood hospitalization for mental health, substance-related, and neurodevelopmental morbidity, although results should be interpreted with caution owing to potential confounders. Mothers with anorexia nervosa may benefit from psychosocial support to prevent mental and neurodevelopmental morbidity in offspring.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656254","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}
Welsey-Smith, O., & Fleming, T. (2025). Debate: Social media in children and young people – time for a ban? From polarised debate to precautionary action – a population mental health perspective on social media and youth well-being. Child and Adolescent Mental Health, 30, 416–418. https://doi.org/10.1111/camh.70033
The first author's name was published as Oonagh Welsey-Smith. It should have been Oonagh Wesley-Smith.
{"title":"Correction to ‘Debate: Social media in children and young people—time for a ban? From polarised debate to precautionary action—a population mental health perspective on social media and youth well-being’","authors":"","doi":"10.1111/camh.70052","DOIUrl":"10.1111/camh.70052","url":null,"abstract":"<p>Welsey-Smith, O., & Fleming, T. (2025). Debate: Social media in children and young people – time for a ban? From polarised debate to precautionary action – a population mental health perspective on social media and youth well-being. <i>Child and Adolescent Mental Health</i>, 30, 416–418. https://doi.org/10.1111/camh.70033</p><p>The first author's name was published as Oonagh <b>Welsey</b>-Smith. It should have been Oonagh <b>Wesley</b>-Smith.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":"31 1","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acamh.onlinelibrary.wiley.com/doi/epdf/10.1111/camh.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662496","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}
André O Werneck, Chih-Sung Liang, Lee Smith, Dara Aldisi, Nasser Al-Daghri, Arnold Baca, Liye Zou, Qian Yu, Jin Kuang, Zhihao Zhang, Marco Solmi, Brendon Stubbs
Background: The present study aimed to analyze associations between device-measured physical activity and sedentary time during childhood with mental health-related outcomes throughout adolescence.
Methods: Data from the Millennium Cohort Study were used. Device-measured physical activity (i.e., light and moderate-to-vigorous physical activity) and sedentary time were assessed at 7 years. Internalizing and externalizing symptoms were assessed at three time points (11 years, 14 years, and 17 years) via the Strengths and Difficulties Questionnaire. Depressive symptoms were estimated using the Mood and Feelings Questionnaire at 14 years. Psychological distress was assessed using the six-item Kessler psychological distress scale at 17 years. Negative binomial regression models, adjusting for potential confounders were used.
Results: Among boys, greater time spent in moderate-to-vigorous physical activity at 7 years was associated with higher hyperactivity and lower peer problems throughout adolescence. Higher moderate-to-vigorous (incidence rate ratio [IRR]: 0.95; 95% confidence interval [CI]: 0.93-0.98), light (0.90; 0.85-0.95), and total activity time (0.95; 0.93-0.98) at 7 years were associated with lower, while sedentary time was associated with higher (1.11; 1.07-1.16) psychological distress at 17 years in the adjusted models. Girls who spent more time in light physical activity at 7 years were more likely to have lower hyperactivity levels over adolescence, while higher sedentary time at the same age was associated with higher hyperactivity levels. Higher sedentary time at 7 years was associated with higher depressive symptoms at 14 years (1.06; 1.01-1.10), whereas light physical activity at 7 years (0.91; 0.85-0.97) was associated with lower depressive symptoms at 14 years in the adjusted models.
Conclusion: Higher moderate-to-vigorous, light physical activity, and lower sedentary time were associated with lower peer problems, depressive symptoms, and psychological distress throughout adolescence.
{"title":"Prospective association of device-based physical activity and sedentary time during childhood with mental health outcomes during adolescence.","authors":"André O Werneck, Chih-Sung Liang, Lee Smith, Dara Aldisi, Nasser Al-Daghri, Arnold Baca, Liye Zou, Qian Yu, Jin Kuang, Zhihao Zhang, Marco Solmi, Brendon Stubbs","doi":"10.1111/camh.70048","DOIUrl":"https://doi.org/10.1111/camh.70048","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to analyze associations between device-measured physical activity and sedentary time during childhood with mental health-related outcomes throughout adolescence.</p><p><strong>Methods: </strong>Data from the Millennium Cohort Study were used. Device-measured physical activity (i.e., light and moderate-to-vigorous physical activity) and sedentary time were assessed at 7 years. Internalizing and externalizing symptoms were assessed at three time points (11 years, 14 years, and 17 years) via the Strengths and Difficulties Questionnaire. Depressive symptoms were estimated using the Mood and Feelings Questionnaire at 14 years. Psychological distress was assessed using the six-item Kessler psychological distress scale at 17 years. Negative binomial regression models, adjusting for potential confounders were used.</p><p><strong>Results: </strong>Among boys, greater time spent in moderate-to-vigorous physical activity at 7 years was associated with higher hyperactivity and lower peer problems throughout adolescence. Higher moderate-to-vigorous (incidence rate ratio [IRR]: 0.95; 95% confidence interval [CI]: 0.93-0.98), light (0.90; 0.85-0.95), and total activity time (0.95; 0.93-0.98) at 7 years were associated with lower, while sedentary time was associated with higher (1.11; 1.07-1.16) psychological distress at 17 years in the adjusted models. Girls who spent more time in light physical activity at 7 years were more likely to have lower hyperactivity levels over adolescence, while higher sedentary time at the same age was associated with higher hyperactivity levels. Higher sedentary time at 7 years was associated with higher depressive symptoms at 14 years (1.06; 1.01-1.10), whereas light physical activity at 7 years (0.91; 0.85-0.97) was associated with lower depressive symptoms at 14 years in the adjusted models.</p><p><strong>Conclusion: </strong>Higher moderate-to-vigorous, light physical activity, and lower sedentary time were associated with lower peer problems, depressive symptoms, and psychological distress throughout adolescence.</p>","PeriodicalId":49291,"journal":{"name":"Child and Adolescent Mental Health","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656229","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}
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