Child and Adolescent Psychiatry and Mental Health最新文献

Purpose: To describe the trajectories of health-risk behaviors (HRBs) among college students through four consecutive surveys and explore the relationship between chronotype, sleep duration and different trajectories of HRBs.

Methods: We used a data sample of 1,042 college students from the College Student Behavior and Health Cohort Study. Students reported sleep parameters, including chronotype (Morningness-Eveningness Questionnaire-5, MEQ-5) and sleep duration. The behavior scale was used to evaluate four HRBs (smoking, alcohol use, low physical activity, smartphone addiction). The latent class growth analysis (LCGA) was used to estimate the trajectory of self-reported HRBs. Multivariate logistic regression models were used to study whether sleep parameters (chronotype and sleep duration) correlated with HRBs^' trajectories.

Results: Four unique trajectories of behaviors were identified: unhealthy group (7.4%), increasing group (21.3%), decreasing group (10.3%) and healthy group (61.0%). Compared with the normal sleep, results from logistic regression analyses indicated that long sleep (> 9 h) was associated with the decreasing group and the unhealthy group (P < 0.05), while short sleep (< 7 h) was associated with the increasing group and the unhealthy group (P < 0.05). Compared with the M-type, the E-type were positively correlated with the unhealthy group, the increasing group, and the decreasing group (P < 0.05).

Conclusion: E-type, short sleep duration and long sleep duration were significantly associated with the trajectory of HRBs. Findings underscore the need for targeted screening and prevention of modifiable sleep behaviors with the aim of improving HRBs in college students.

Background: Social anxiety is one of the most prevalent anxiety-related disorders among adolescents with many adverse effects on the social and academic lives of this population. In addition, poor social problem-solving skills can aggravate anxiety in individuals suffering from anxiety. Emotion regulation can help adolescents control and moderate their feelings, thereby enabling them to understand their emotions better, cope with their negative emotions in a positive way, and adopt a more realistic approach to solving their problems. The objective of the present study is to investigate the effects of educating female students in emotion regulation techniques on their social problem-solving skills and social anxiety.

Method: This study was a randomized controlled trial conducted in Iran, utilizing a pretest-posttest design with control and intervention groups. The subjects were 47 female high-school second graders who were randomly divided into a control (25 students) and an intervention group (22 students). The intervention group was collectively educated in emotion regulation techniques in weekly one-hour sessions for eight weeks. The control group did not receive any intervention. The social anxiety and social problem-solving scales were completed by both groups before, immediately after, and one month after the intervention. The collected data were analyzed in SPSS v. 22 and level of significance was set at p < 0.05.

Result: Data analysis of the intervention group compared to the control group demonstrated that group training in emotional regulation techniques effectively increased social problem-solving skills scores (p = 0.003) and decreased social anxiety scores (p < 0.0001) among students in the intervention group compared to their pretest scores. These effects remained stable during the follow-up phase.

Conclusion: In view of the prevalence of social anxiety among adolescents, it is suggested that the policymakers and administrators in the education system promote emotion regulation skills in adolescent students to facilitate their psychological adaptation and improve their emotional capabilities.

Trial registration: The present study was registered under the code IRCT20220413054521N1 (Registration date: 27/02/2024) in the Iranian Registry of Clinical Trials.

Background: Physical activity (PA) can improve mental health, including anxiety/depression, in individuals with attention-deficit/hyperactivity disorder (ADHD) with minimal side effects, unlike pharmacotherapy that can result in significant side effects. However, the influence of PA on mental health among children with ADHD is understudied. Also, immigrants tend to have better mental health, but the influence of parental nativity on children's mental health is unknown. We examined the relationship between PA, parental nativity, and current anxiety/depression among U.S. children with and without ADHD. We also analyzed whether ADHD diagnosis status moderates the relationship between anxiety/depression and PA or parental nativity.

Methods: We used national annual cross-sectional data from the 2016 to 2021 National Survey of Children's Health to conduct weighted multivariable logistic regression and moderation analyses, with current anxiety/depression status as the outcome variable. The sampling involves selecting households with children and rostering children in the household from each state and the District of Columbia. A parent or caregiver of the selected child completes the surveys. We restricted the analysis to children aged 6-17 years (N = 140,977).

Results: The prevalence of current anxiety/depression was higher in children with ADHD diagnosis (37.34%) than those without ADHD diagnosis (7.42%). Children with ADHD (versus no ADHD) had higher odds of anxiety/depression. Engaging in PA (versus no PA) and having immigrant parents (versus non-immigrant parents) were associated with lower anxiety/depression odds. ADHD diagnosis status significantly moderated the association between anxiety/depression and PA or parental nativity. However, the three-way interaction between ADHD status, parental nativity, and physical activity was not statistically significant. Stratified by ADHD diagnosis status, those who engaged in PA (versus did not) for 1 to 3 days, 4 to 6 days, and daily were less often diagnosed with anxiety/depression disorder among those with or without ADHD, especially children without ADHD. The odds were also lower for children with or without ADHD whose parents were immigrants than children with non-immigrant parents, particularly children without ADHD who had immigrant parents. Parental nativity did not significantly moderate the association between PA and anxiety/depression among children with and without ADHD.

Conclusions: Physical activity was associated with lower risks of diagnosed with anxiety/depression disorder among children, especially children without ADHD and those with immigrant parents. Considering parental nativity and incorporating personalized PA in ADHD and anxiety/depression management can improve mental illness and ADHD symptoms among children.

Background: Substance use among adolescents is strongly associated with adverse physical, mental health, and social outcomes. Prevention and early intervention can reduce the likelihood of future problems, but requires valid and reliable screening tools capable of assessing risk across a range of substances. This study assessed the validity, reliability, and clinical utility of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-Y) for adolescents aged 15-17 years.

Methods: A sample of adolescent males (N = 101), aged 15-17 years, held in a juvenile detention facility on substance-related offences in Barcelona, Spain were eligible. Participants were administered a battery of standardized substance-use screening tools by a clinical psychologist, and underwent a diagnostic interview assessing DSM-IV-TR substance abuse and dependence by an addiction medicine specialist. Scores on the various assessments were compared to establish validity (concurrent with interview, convergent with other measures), reliability, and clinical utility of ASSIST-Y.

Results: Majority of participants (n = 77) completed assessments. While tobacco was not assessed as part of the interview, concurrent validity in detecting substance abuse was established for all remaining substances. Concurrent validity for detecting dependence was established for alcohol, cannabis, cocaine, stimulants and sedatives. Fewer numbers in higher-risk groups for inhalants, opioids and hallucinogen use limited confirmation of validity for those substances. ASSIST-Y also demonstrated good convergent validity with the other screening tools for all substances, except hallucinogens. Reliability for each subscale was established, except for tobacco (too few items), sedatives, and hallucinogens. Finally, clinical utility indices were significant for most substances (except sedatives and opioids); whilst clinical utility indices were significant for ruling out cases of non-dependence (all substances).

Conclusions: As a screening tool, the purpose of ASSIST-Y is designed to help identify adolescents who may be at-risk of substance-related harm. While the instrument was found to be valid and reliable in identifying risky use across a variety of substances, further research is needed to validate the instrument in other population groups, and for other substances. Future research should investigate the effect of the linked brief intervention to reduce risk of harm, especially for non-specialist clinicians.

Background: Numerous studies have investigated the relevance of callous-unemotional traits in relation to externalizing psychopathology among children and adolescents. However, less research has examined the connections between callous-unemotional traits and internalizing psychopathology and findings were inconsistent. Consequently, the present study aimed to elucidate the role of callous-unemotional traits in the context of depression and anxiety while controlling for conduct problems, age, and gender.

Methods: The study utilized self-report questionnaire data from 978 adolescent psychiatric inpatients (M_age = 15.18, SD = 1.44) presenting a range of psychopathological conditions. A network analysis was conducted, incorporating callous-unemotional traits, depressive symptoms, anxiety symptoms, conduct problems, and covariates (age, gender). Additionally, comparisons were made between the networks of inpatients diagnosed with conduct disorders and those with internalizing disorders.

Results: The findings indicated that callous-unemotional traits were relevant within the general network, as well as in both the conduct disorder and internalizing networks. In both contexts, callous-unemotional traits were predominately positively associated with depression and conduct problems. Within the conduct disorder network, callous-unemotional traits exhibited primarily negative associations with anxiety, whereas the relationships within the internalizing network were more varied.

Conclusions: Our findings suggest that callous-unemotional traits hold substantial relevance for internalizing symptoms, supporting the notion that these traits should be considered potentially transdiagnostic factors.

Background: The parenting of children by deaf parents has many challenges that require a barrier-breaking approach to ensure inclusivity and accessibility. Therefore, this study explored pathways for crafting inclusive parenting programs, fostering a future where every family thrives, regardless of hearing ability.

Methods: This was a qualitative study that employed in-depth interviews with 20 deaf parents and utilized thematic content analysis. This study was carried out at events organized by the Uganda National Association of the Deaf (UNAD) at Makerere College School. Deaf parents were purposively selected from attendees at events organised by the Uganda National Association of the Deaf (UNAD) during the specified celebrations.

Results: An analysis of interviews with deaf parents identified six crucial themes for inclusive parenting programs. Language education was highlighted for strengthening family bonds. Communication and relationship building emphasized equal treatment and love for deaf children. Cultural sensitivity and education were deemed essential, as visual tools and district associations were used. Tailoring content for deaf children emphasized playful and educational materials, such as sign language videos. The utilization of technology for accessible programs and the promotion of community involvement are recognized as critical components.

Conclusion: This study emphasized the unique experiences of deaf parents, highlighting the need for sign language education, cultural sensitivity, and technology while addressing challenges like limited resources, stigma, and advocacy gaps in parenting programs.

Background: We aimed at investigating the efficacies of probiotics in alleviating the core and associated symptoms of autism spectrum disorder (ASD).

Methods: Randomized placebo-controlled trials were identified from major electronic databases from inception to Nov 2023. The outcomes of interests including improvements in the total and associated symptoms of ASD were quantitatively expressed as effect size (ES) based on standardized mean difference (SMD) with 95% confidence interval (CI).

Results: Ten studies with 522 participants (mean age = 8.11) were included in this meta-analysis. The primary results revealed significant improvement in total symptoms in the probiotics group compared with the controls (SMD = - 0.19, p = 0.03, ten studies, n = 522) but not the core symptoms (i.e., repetitive restricted behaviors, As affiliations 3 and 5 are same, we have deleted the duplicate affiliations and renumbered accordingly. Please check and confirm.problems with social behaviors/communication). Subgroup analyses demonstrated improvement in total symptoms in probiotics users relative to their controls only in studies using multiple-strain probiotics (SMD = - 0.26, p = 0.03, five studies, n = 288) but not studies using single-strain regimens. Secondary results showed improvement in adaptation (SMD = 0.37, p = 0.03, three studies, n = 139) and an improvement trend in anxiety symptoms in the probiotics group compared with controls (SMD = - 0.29, 95% CI - 0.60 to 0.02, p = 0.07, three studies, n = 163) but failed to demonstrate greater improvement in the former regarding symptoms of irritability/aggression, hyperactivity/impulsivity, inattention, and parental stress.

Conclusions: Our study supported probiotics use against the overall behavioral symptoms of ASD, mainly in individuals receiving multiple-strain probiotics as supplements. However, our results showed that probiotics use was only associated with improvement in adaptation and perhaps anxiety, but not core symptoms, highlighting the impact of adaptation on quality of life rather than just the core symptoms. Nevertheless, the limited number of included trials warrants further large-scale clinical investigations.

Background: Cannabinoids have been of increasing interest mainly due to their putative efficacy in a wide array of psychiatric, psychosomatic, and neurological conditions.

Aims: This systematic review aims to synthesize results from randomized placebo-controlled trials regarding the efficacy and the dosage of cannabinoids as therapeutics in psychiatric disorders in children, adolescents, and young adults.

Methods: All publications up to June 30th, 2024, were included from PubMed and Embase. Eligibility criteria in accordance with the PRISMA-guidelines was applied. RCTs providing pre- and post-treatment parameters on cannabinoid therapies for mental disorders in comparison to controls in an age range from 0 to 25 years were included. Effect sizes were calculated as Hedges' g for primary outcomes, and a multilevel random-effects meta-analysis was conducted to account for dependent outcomes from same study populations.

Results: We identified 7603 records, of which 8 independent clinical trials (reported in 9 publications) met the pre-established eligibility criteria, comprising 474 unique participants (245 treatment, 229 control). Analysis of 13 primary outcomes (of 7 clinical trials) revealed a modest positive overall effect for symptom improvement or normalization of brain physiology (Hedges' g = 0.308, 95% CI: 0.167, 0.448). Autism spectrum disorder studies showed the most consistent evidence (g = 0.264, 95% CI: 0.107, 0.421), while other conditions showed wider confidence intervals. Age-stratified analysis showed that adult populations (mean age 23.3 years, n = 5 outcomes) demonstrated higher effect sizes (g = 0.463, SD = 0.402) compared to pediatric populations (mean age 11.8 years, n = 8 outcomes; g = 0.318, SD = 0.212). Whole plant preparations (g = 0.328, 95% CI: 0.083, 0.573) and pharmaceutical cannabinoids (g = 0.292, 95% CI: 0.069, 0.515) showed comparable effects. CBD dosages ranged from 17.5 mg to 600 mg per day, with no significant correlation between dosage and effect size (ρ = -0.014, p = 0.963). Mild to moderate side effects were reported, but no serious adverse events. Risk of bias assessment ranged from low (n = 3) to high (n = 5).

Conclusion: While meta-analysis of effect sizes for primary outcomes revealed modest positive effects, particularly for autism spectrum disorders, the current evidence remains insufficient to broadly recommend cannabinoids for treating mental disorders in youth populations. Larger, controlled studies with standardized outcomes are needed to establish definitive clinical recommendations.

Background: The prevalence of mental health disorders in children, teens, and young adults is rising at an alarming rate. This study aims to explore time trends in the incidence of mental disorders among young people in Catalonia, Spain from 2008 to 2022, focusing on the effects of the COVID-19 pandemic and from the perspective of social inequities.

Methods: A cohort study using primary care records from the SIDIAP database was conducted. It included 2,088,641 individuals aged 10 to 24 years. We examined the incidence of depressive, anxiety, eating, and attention deficit/hyperactivity disorders, stratified by sex, age, deprivation, and nationality.

Results: All disorders reflected an increasing trend throughout the study period: depressive disorders (IRR: 2.44, 95% CI: 2.31-2.59), anxiety disorders (IRR: 2.33, 95% CI: 2.27-2.39), ADHD (IRR: 2.33, 95%CI: 2.17-2.50), and eating disorders (IRR: 3.29, 95% CI: 3.01-3.59). A significant increase in incidence was observed after the outbreak of the COVID-19 pandemic. In 2022, anxiety disorders were most frequent, with an incidence rate (IR) of 2,537 per 100,000 persons-year (95% CI: 2,503-2,571). Depressive disorders followed with an IR of 471 (95% CI: 458-486), ADHD with an IR of 306 (95% CI: 295-317) and eating disorders with an IR of 249 (95% CI: 239-259). Significant associations were reported with sex, age, deprivation, and nationality.

Conclusion: The incidence of all studied disorders has steadily increased, reaching unprecedented levels during the pandemic. Understanding these trends is essential for an appropriate healthcare response, while addressing the non-medical determinants, requires action across all sectors of society.

Objective: The objective is to examine barriers and facilitators to recovery in children and adolescents with obsessive-compulsive disorder (OCD) using a qualitative approach.

Methods: Ten semi-structured interviews were conducted, audio-recorded, and analyzed using thematic analysis. Findings were validated through investigator triangulation, peer validation and member check.

Results: Barriers to recovery were internal-lack of awareness; poor motivation to seek treatment; and perceived stigma, or external-poor parental support; parental anxiety; inadequate awareness in schools; social misconceptions about illness; myths about medication; and frustrations in treatment processes. Facilitators were internal-will and determination; self-discipline; keeping calm; sense of purpose, and external-general awareness; parental support; peer support; and good therapeutic engagement.

Conclusions: To the best of our knowledge, this is the first study to explore barriers and facilitators to recovery in-depth in pediatric OCD. Findings underscore the importance of tailored interventions, robust support networks, and cultural sensitivity for successful recovery outcomes.