International Review of Psychiatry最新文献

Adolescents face a critical developmental stage marked by physical, psychological, and social changes, and may show increased vulnerability to difficulties in body comfort, self-perception, and eating behaviours, particularly under the influence of sociocultural appearance ideals. This study evaluated the effects of a structured psychoeducational intervention on 65 second-year secondary school students. Assessments targeted binge-eating behaviours, orthorexia nervosa, body image, body compassion, and alexithymia, with pre- (T0) and post-intervention (T1) comparisons. Post-intervention, Orthorexia Nervosa (TOS) scores, Body Uneasiness Test (BUT) Avoidance and Depersonalization significantly decreased by 14.8%, 34.5%, and 33.3% (all p ≤ 0.0045), respectively. Body Compassion Scale (BCS) total and Defusion scores increased by 6.36% and 6.35% (all p ≤ 0.0428), indicating enhanced self-compassion. Binge Eating Scale (BES) scores showed a downward trend (p = 0.0508). Overweight/obese adolescents had higher baseline Externally-Oriented Thinking and retained elevated BES, TOS, and BUT scores post-intervention. Underweight participants showed higher BCS scores. Finally, females exhibited higher baseline binge-eating severity, alexithymia, and body image disturbance, whereas males showed larger reductions in Weight Phobia and Avoidance after intervention. Psychoeducational interventions may reduce orthorexic tendencies, improve body-related emotional processing and body compassion in adolescents. These preliminary findings support the potential development of psychoeducational strategies within school settings.

Psychological trauma is a universal experience among humans; when suffered during developmental ages it might affect development and be at the base of psychopathology. Having a parent diagnosed with cancer is a highly distressing experience for a child and may influence the development of future psychopathology. This PRISMA-adhering systematic review focused on studies of children with a parent diagnosed with cancer and reporting psychiatric diagnoses or clinically significant symptoms assessed with validated instruments. The review included 25 studies spanning from 1994 to 2025. Studies found increased prevalence of anxiety, depressive, and posttraumatic stress disorder in children and adolescents with a parent affected by cancer compared to controls. Internalizing problems were higher than externalizing problems in children and adolescents, especially girls. There have been few implemented programs for children with a parent with cancer, despite recognition of higher psychopathological risk. The few psychotherapeutic trials yielded results with small effect sizes, while there is a dearth of pharmacological trials that does not allow drawing conclusions. There is need to prioritize programs that take care of children with parents with cancer so to reduce future psychopathology. Psychotherapeutic interventions must target the internalizing and externalizing symptoms and address the posttraumatic aspects of the child's suffering.

Sexual and gender minority youth (SGMY) face unique psychosocial stressors that increase vulnerability to substance use. However, evidence from low- and middle-income countries (LMICs) remains limited. Objective: To compare the lifetime prevalence and age of onset of substance use between LGBTQIAPN+ and cisgender heterosexual adolescents in Brazil. Data were drawn from the Brazilian High-Risk Cohort Study for Mental Health Conditions (BHRC), a longitudinal, community-based study. A total of 1,492 participants aged 9-18 at wave 1 and 12-21 at wave 2 provided complete data on sexual orientation, gender identity, and lifetime use of alcohol, tobacco, cannabis, and cocaine. LGBTQIAPN+ adolescents had higher lifetime prevalence of tobacco (OR = 1.66; 95% CI: 1.22-2.26; p = 0.001), cannabis (OR = 1.94; 95% CI: 1.42-2.64; p < 0.001), and cocaine use (OR = 2.28; 95% CI: 1.21-4.13; p = 0.008) than cisgender heterosexual peers. These differences were driven by participants assigned female at birth, with no significant differences among males. LGBTQIAPN+ females also reported earlier initiation of alcohol (p = 0.001), tobacco (p < 0.001), and cannabis (p < 0.001). Conclusions: Brazilian LGBTQIAPN+ youth, especially females, show elevated substance use and earlier initiation, underscoring the need for targeted, gender-sensitive prevention strategies.

This study explored whether structural magnetic resonance imaging (MRI) data from the Brazilian High-Risk Cohort for Mental Conditions (BHRCS) could be used to predict anxiety disorders in youth through machine learning. The sample included 209 participants with any anxiety disorder and 232 healthy controls, aged 6 to 14 years at baseline, followed across three waves from 2010 to 2019. Youth in the anxiety group had a diagnosis at any timepoint and valid MRI scans, while controls had no psychiatric diagnoses. Structural brain features extracted via FreeSurfer were used to train a random forest classifier to differentiate the two groups. The model incorporated feature selection, ComBat harmonization to address site effects, and 5-fold cross-validation. Performance was evaluated on a test sample and on a hold-out validation sample comprising 20% of the total dataset (n = 88). The model achieved an accuracy of 64% and an area under the curve (AUC) of 0.70 in the test set. However, performance in the validation sample was near chance, with an AUC of 0.51. These findings suggest that while structural MRI may capture some neurobiological differences in youth with anxiety, its predictive value for clinical classification remains limited in this context.

Adolescence is a critical period of biopsychosocial development often marked by engagement in risk behaviors, including psychoactive substance use and early sexual initiation. Emerging evidence suggests a robust association between these behaviors, particularly early sexual debut (i.e. before age 15). This cross-sectional analytical study draws on data from the 2019 National School Health Survey (PeNSE) to examine the relationship between recent psychoactive substance use and early sexual initiation among Brazilian adolescents aged 15-17 years (n = 72,679). Substance use in the past 30 days was assessed for nine substances: alcohol, conventional cigarettes, hookah, electronic cigarettes, clove cigarettes, hand-rolled cigarettes, marijuana, crack and other illicit drugs. Early sexual initiation was reported by 33.3% of participants. Use of all substances was significantly associated with early sexual debut, with the strongest associations observed for crack (adjusted OR = 1.91; 95% CI = 1.56-2.33), marijuana (OR = 1.58; 95% CI = 1.43-1.75), other illicit drugs (OR = 1.50; 95% CI = 1.37-1.64) and alcohol (OR = 1.47; 95% CI = 1.35-1.59). These findings highlight a strong association between recent substance use and early sexual initiation in Brazilian adolescents, underscoring the need for comprehensive, multisectoral public policies that integrate substance use prevention and sexual health education within school, family and healthcare contexts.

Major depressive disorder (MDD) significantly impairs adolescents' development, with increasing rates of treatment resistance and suicide risk. Ketamine has emerged as a promising, rapid-acting antidepressant in adults, but its efficacy and safety in adolescents remain unclear. This systematic review and meta-analysis aimed to evaluate short-term outcomes of ketamine administration in youth with mood disorders. Following PRISMA guidelines and PROSPERO registration (CRD42024568658), four studies were included, comprising 272 adolescents aged 12-18 years. Three studies (n = 189) contributed data to the meta-analysis. At 24 hours post-administration, ketamine showed a small, non-significant effect on depressive symptoms compared to placebo (SMD = -0.19; 95% CI: -0.41 to 0.04). Clinical response and remission were not significantly different between groups, but ketamine was associated with a significantly higher rate of suicidal ideation remission (RR = 1.49; 95% CI: 1.06 to 2.08). Adverse events were generally mild, transient, and consistent with known pharmacological effects. While findings support ketamine's potential role in acute presentations, current evidence is preliminary. Larger randomized controlled trials with extended follow-up are needed to clarify the clinical utility, optimal protocols, and long-term safety of this approach in adolescent populations.

Research indicates that sociodemographic, clinical, and global functioning are associated with autism spectrum disorder (ASD). To measure and compare sociodemographic, clinical, and global functioning vulnerability profiles of a sample of Mexican children and adolescents with and without ASD. The study was done at two outpatient institutions in Mexico City. The assessment used semi-structured interviews with rating scales, and t-tests and chi-squared (χ²) tests were run to evaluate group comparisons. A latent class analysis was executed to generate probabilistic vulnerability profiles. A total of 103 participants were recruited, 22 with ASD (21.3%, mean age 12.8 ± 3.17, 77.27% male). Those without ASD showed a significantly special education placement (χ² = 3.91, p = 0.048), had oppositional and defiant symptoms (t = 3.32, p = 0.001), and lower global functioning as measured by the Children's Global Assessment Scale (t = 11.78; p = 0.001) and the World Health Organization Disability Assessment Schedule 2.0 (t = -4.10; p = 0.001). Vulnerability was identified in a subgroup of participants with ASD due to increased psychosocial and psychopathological symptoms and lower global functionality. Mexican children and adolescents with ASD experience special education placement and impaired global functioning.

Adolescence is a critical developmental period during which many mental and substance use disorders first emerge, yet global estimates remain limited. Using data from the Institute for Health Metrics and Evaluation for the Global Burden of Disease Study 2021, we examined prevalence among adolescents aged 10-19 years across 204 countries. In 2021, 15.2% had at least one mental disorder. Anxiety disorders were most prevalent (4.9%), followed by conduct disorder (2.7%), ADHD (2.6%), and depressive disorders (2.4%), with major depressive disorder affecting 2.0%. Autism spectrum disorders accounted for 0.9%, intellectual disability 1.7%, bipolar disorder 0.3%, and eating disorders 0.3% (anorexia 0.1%, bulimia 0.2%). Schizophrenia (0.04%) and other disorders (0.2%) contributed smaller fractions. Substance use disorders affected 0.8%, mainly drug use (0.5%) and alcohol (0.3%), with cannabis use disorders at 0.4%. Prevalence varied by sex, region, and socio-demographic development: females showed higher internalizing conditions, males higher externalizing disorders. High-SDI regions had highest prevalence (20.7%) versus low-SDI (13.4%); High-Income North America recorded 22.8%, South Asia 9.7%, and Sub-Saharan Africa 11.6%, likely reflecting under-recognition, stigma, and limited diagnostic capacity. These findings highlight the global significance of adolescent mental health, disparities across sexes and regions, and the need for context-specific prevention and treatment strategies.

Problematic smartphone use (PSU) among youths has emerged as a significant public health concern. PSU is defined as a pattern of smartphone use characterized by loss of control, preoccupation, and continued use despite negative consequences, often resembling behavioral addiction in its impact on daily functioning and well-being. A nationwide case-control study explored the prevalence and predictive role of boredom and loneliness in a cohort of Italian university students aged 18-24 years, as assessed by Smartphone Addiction Scale-short version (SAS-SV) for the presence/absence of PSU. Among enrolled 1,660 participants, PSU was identified in 31.7% of the sample. Multivariate regression model (sex weighted) revealed that SAS-SV levels were positively predicted by boredom inattention (p < 0.001) and disengagement (p = 0.007), emotional loneliness (p = 0.002) and general loneliness (p < 0.001). Logistic binomial regression analysis documented that PSU is significantly predicted only by higher levels of emotional loneliness and boredom state. Our findings underline the need for early preventive strategies and tailored therapeutic interventions targeting emotional regulation and coping strategies to manage boredom state, in order to reduce the risk of PSU in youths. Both boredom and emotional loneliness seem to be essential psychopathological targets for promoting youth psychological well-being in the digital era.