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Dong T, Yu C, Mao Q, Han F, Yang Z, Yang Z, Pires N, Wei X, Jing W, Lin Q, Hu F, Hu X, Zhao L, Jiang Z. Advances in biosensors for major depressive disorder diagnostic biomarkers. Biosens Bioelectron 2024; 258:116291. [PMID: 38735080 DOI: 10.1016/j.bios.2024.116291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 05/14/2024]
Abstract
Depression is one of the most common mental disorders and is mainly characterized by low mood or lack of interest and pleasure. It can be accompanied by varying degrees of cognitive and behavioral changes and may lead to suicide risk in severe cases. Due to the subjectivity of diagnostic methods and the complexity of patients' conditions, the diagnosis of major depressive disorder (MDD) has always been a difficult problem in psychiatry. With the discovery of more diagnostic biomarkers associated with MDD in recent years, especially emerging non-coding RNAs (ncRNAs), it is possible to quantify the condition of patients with mental illness based on biomarker levels. Point-of-care biosensors have emerged due to their advantages of convenient sampling, rapid detection, miniaturization, and portability. After summarizing the pathogenesis of MDD, representative biomarkers, including proteins, hormones, and RNAs, are discussed. Furthermore, we analyzed recent advances in biosensors for detecting various types of biomarkers of MDD, highlighting representative electrochemical sensors. Future trends in terms of new biomarkers, new sample processing methods, and new detection modalities are expected to provide a complete reference for psychiatrists and biomedical engineers.
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Affiliation(s)
- Tao Dong
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China; Chongqing Key Laboratory of Micro-Nano Transduction and Intelligent Systems, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China.
| | - Chenghui Yu
- Chongqing Key Laboratory of Micro-Nano Transduction and Intelligent Systems, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China.
| | - Qi Mao
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Feng Han
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Zhenwei Yang
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Zhaochu Yang
- Chongqing Key Laboratory of Micro-Nano Transduction and Intelligent Systems, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China
| | - Nuno Pires
- Chongqing Key Laboratory of Micro-Nano Transduction and Intelligent Systems, Collaborative Innovation Center on Micro-Nano Transduction and Intelligent Eco-Internet of Things, Chongqing Key Laboratory of Colleges and Universities on Micro-Nano Systems Technology and Smart Transducing, National Research Base of Intelligent Manufacturing Service, Chongqing Technology and Business University, Nan'an District, Chongqing, 400067, China
| | - Xueyong Wei
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Weixuan Jing
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Qijing Lin
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Fei Hu
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Xiao Hu
- Engineering Research Center of Ministry of Education for Smart Justice, School of Criminal Investigation, Southwest University of Political Science and Law, Chongqing, 401120, China.
| | - Libo Zhao
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Zhuangde Jiang
- X Multidisciplinary Research Institute, School of Instrument Science and Technology, Xi'an Jiaotong University, Xi'an, 710049, China; State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
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Myint MT, Yue H, Zalpuri I, Sharma N, Stewart C. Workforce Initiatives to Advance Health Equity and Diverse Representation. Child Adolesc Psychiatr Clin N Am 2024; 33:437-445. [PMID: 38823815 DOI: 10.1016/j.chc.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with "all of the above" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.
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Affiliation(s)
- Myo Thwin Myint
- Tulane University, Children's Hospital New Orleans, 1430 Tulane Avenue, #8055, New Orleans, LA 70112, USA.
| | - Han Yue
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Isheeta Zalpuri
- Stanford University, 401 Quarry Road, Palo Alto, CA 94304, USA
| | - Neha Sharma
- Tufts University, 800 Washington Street Pratt Building 2nd Floor, Boston, MA 02111, USA
| | - Colin Stewart
- Georgetown University, 2115 Wisconsin Avenue Northwest, Washington, DC 20016, USA
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Soleimanpour S, Simmons C, Saphir M, Ng S, Jenks K, Geierstanger S. Equity in Mental Health Care Receipt among Youth Who Use School-Based Health Centers. Am J Prev Med 2024:S0749-3797(24)00195-8. [PMID: 38876296 DOI: 10.1016/j.amepre.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Youth experience significant mental health (MH) needs, and gender- and racially/ethnically-diverse youth are less likely than peers to receive care. School-based health centers (SBHCs) are a healthcare delivery model that may decrease disparities. This study examined the role of SBHCs in reducing disparities in MH care receipt among SBHC clients. METHODS Data from electronic health records of 5,396 youth ages 12 to 21 years who visited 14 SBHCs in one California county from 2021-2023 were analyzed in 2023-2024 using multiple logistic regression to assess disparities in MH care receipt and depression screenings. RESULTS Receipt of MH care from SBHCs varied significantly by gender but not age, sexual orientation, or race/ethnicity. Compared to female clients, males had reduced odds (AOR: 0.50) and gender-diverse clients had higher odds (AOR: 2.70) of receiving MH care. For receipt of depression screenings, male clients had reduced odds (AOR: 0.86); Latino clients had higher odds than white clients (AOR: 1.80); and older adolescents and young adults had higher odds than younger adolescents (AORs: 1.44 and 1.45, respectively). Receipt of follow-up MH care after a positive depression result varied only by gender, with male clients having reduced odds (AOR: 0.63). CONCLUSIONS SBHCs may reach youth who are traditionally less likely to seek care in other settings, including racially/ethnically- and gender-diverse youth. As in other settings, engaging males in healthcare is an area for improvement. These findings help to demonstrate the potential of SBHCs for decreasing disparities in mental health care.
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Affiliation(s)
- Samira Soleimanpour
- Philip R. Lee Institute for Health Policy Studies & Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
| | - Cailey Simmons
- Public Health and Preventive Medicine Residency Program, California Department of Public Health, Berkeley, CA
| | - Melissa Saphir
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA
| | - Sandy Ng
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA
| | - Kale Jenks
- Center for Healthy Schools and Communities, Alameda County Health Care Services Agency, San Leandro, CA
| | - Sara Geierstanger
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA
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Montag C, Demetrovics Z, Elhai JD, Grant D, Koning I, Rumpf HJ, M Spada M, Throuvala M, van den Eijnden R. Problematic social media use in childhood and adolescence. Addict Behav 2024; 153:107980. [PMID: 38387131 DOI: 10.1016/j.addbeh.2024.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
At the time of writing, about 4.59 billion people use social media with many adolescents using their social media accounts across a myriad of applications and platforms. According to recent statistics, in 2022 individuals spent an average of 151 minutes on social media each day, illustrating the global relevance of social media (Dixon, 2022a,b). One of the pressing questions, internationally, is whether social media use is harmful and/or addictive. This question is of particular importance because many teenagers - and younger adolescents - spend considerable time on these platforms, which have increasingly become an integral part of their lives. Moreover, considering lifespan development, adolescents may be particularly vulnerable to specific features and advertisements shown to them on social media platforms. Growing prevalence of poor mental health in young people has led to recent recommendations in the United States to routinely screen for anxiety in 8-18 year olds, and for depression and suicide risk for adolescents between 12-18 years of age (US Preventive Services Task Force et al., 2022 a,b) - the conditions often accompanying problematic social media use. The present work not only provides insights into the current state of the literature but provides also recommendations.
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Affiliation(s)
- Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, OH, United States; Department of Psychiatry, University of Toledo, Toledo, OH, United States
| | - Don Grant
- Center for Research and Innovation, Newport Healthcare, United States
| | - Ina Koning
- Faculty of Behavioural and Movement Sciences, Clinical Child and Family Studies, Vrije Universiteit Amsterdam, the Netherlands
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | | | - Melina Throuvala
- International Gaming Research Unit, Department of Psychology, Nottingham Trent University, Nottingham, UK; Inclusion West Midlands Gambling Harms Clinic, Stafford, UK; Leicestershire Partnership NHS Trust, Paediatric Psychology, Child and Adolescent Mental Health Services, Leicester, UK
| | - Regina van den Eijnden
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
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Duarte M, Salamanca M, Gonzalez JM, Roman Laporte R, Gattamorta K, Lopez Martinez FE, Clochesy J, Rincon Acuna JC. Prediction of Positive Patient Health Questionnaire-2 Screening Using Area Deprivation Index in Primary Care. Clin Nurs Res 2024; 33:355-369. [PMID: 38801166 DOI: 10.1177/10547738241252887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Depression is recognized as a significant public health issue in the United States. The National Survey on Drug Use and Health reports that 21.0 million adults aged 18 or older had major depressive disorder in 2020, including 14.8 million experiencing a major depressive episode with severe impairment. The aim is to predict the positivity of Patient Health Questionnaire-2 (PHQ-2) outcomes among patients in primary care settings by analyzing a range of variables, including socioeconomic status, demographic characteristics, and health behaviors, thereby identifying those at increased risk for depression. Employing a machine learning approach, the study utilizes retrospective data from electronic health records across 15 primary care clinics in South Florida to explore the relationship between social determinants of health (SDoH), including area of deprivation index (ADI) and PHQ-2 positivity. The study encompasses 15 primary care clinics located in South Florida, where a diverse patient population receives care. Analysis included 94,572 patient visits; 74,636 records were included in the study. If a zip+4 was not available or an ADI score did not exist, the visit was not included in the final analysis. Screening involved the PHQ-2, assessing depressed mood and anhedonia, with a cutoff >2 indicating positive screening. ADI was used to assess SDoH by matching patients' residential postal codes to ADI national percentiles. Demographics, sexual history, tobacco use, caffeine intake, and community involvement were also evaluated in the study. Over 40 machine learning algorithms were explored for their accuracy in predicting PHQ-2 outcomes, using software tools including Scikit-learn and stats models in Python. Variables were normalized, scored, and then subjected to predictive regression models, with Random Forest showing outstanding performance. Feature engineering and correlation analysis identified ADI, age, education, visit type, coffee intake, and marital status as significant predictors of PHQ-2 positivity. The area under the curve and model accuracies varied across clinics, with specific clinics showing higher predictive accuracy and others (p > .05). The study concludes that the ADI, as a proxy for SDoH, alongside other individual factors, can predict PHQ-2 positivity. Health organizations can use this information to anticipate health needs and resource allocation.
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Affiliation(s)
| | | | - Juan M Gonzalez
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | | | - Karina Gattamorta
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | | | - John Clochesy
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
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House TR, Marks SD, Freeman MA. Holistic care and symptom management for pediatric kidney transplant recipients. Pediatr Nephrol 2024; 39:1759-1769. [PMID: 37851087 DOI: 10.1007/s00467-023-06175-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/16/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023]
Abstract
While many aspects of life may improve substantially for children and young people undergoing kidney transplant, there may be new challenges including symptoms that can be detrimental to health-related quality of life. Addressing symptoms requires attention to patient and family perspectives and a holistic approach grounded in symptom management. The interdisciplinary pediatric nephrology transplant team should be attuned to the prevalence of common symptoms including fatigue, anxiety, depression, post-traumatic stress, pain, and sleep disturbances, as well as poor body image and sexual health. These common symptoms require regular assessment with a focus on appropriate interventions and how care may be impacted by transplant status.
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Affiliation(s)
- Taylor R House
- Division of Nephrology, Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, 53792, USA
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Michael A Freeman
- Division of Pediatric Nephrology and Hypertension, Departments of Pediatrics and Humanities, Penn State College of Medicine, Penn State Health Children's Hospital, 90 Hope Drive, PO Box 855, Hershey, PA, 17036, USA.
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Ajluni V, Amarasinghe D. Youth suicide crisis: identifying at-risk individuals and prevention strategies. Child Adolesc Psychiatry Ment Health 2024; 18:58. [PMID: 38783338 PMCID: PMC11119010 DOI: 10.1186/s13034-024-00753-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Victor Ajluni
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Daniel Amarasinghe
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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Butler W, Lewis KL, Benheim TS, Arauz Boudreau A, Brigham KS, Feldman M, Jellinek M, Murphy JM. Screening and Follow-Up Treatment Practices for Suicide Risk in Adolescent Primary Care: A Retrospective Chart Review. Clin Pediatr (Phila) 2024:99228241253158. [PMID: 38742439 DOI: 10.1177/00099228241253158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Universal depression screening in adolescent primary care often encompasses questions about suicide risk. We conducted a retrospective chart review of well-child visits where adolescents (ages 13-17.9) had endorsed self-injurious thoughts and behaviors or suicidal ideation. The goal was to investigate primary care providers' follow-up actions, including documentation, further assessment, and referrals. Over 3-quarters of the progress notes showed evidence of further assessment, and two-thirds documented same-day actions, including mental health referrals, emergency department referrals, safety plans, medication changes, primary-care follow-up, and talking to parents. Actions varied by depression severity. Cases without interventions often had justifications. Owing to the variety of possible meanings and severity underlying positive screens, providers implemented an array of interventions, using clinical judgment to tailor actions to patients' individual needs and preferences. From these observations, we propose that standardized guidelines for suicide risk screening and follow-up should involve a clinical assessment and individualized treatment planning.
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Affiliation(s)
- William Butler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kristina L Lewis
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Talia S Benheim
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alexy Arauz Boudreau
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Kathryn S Brigham
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mitchell Feldman
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael Jellinek
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM, Freeman EE, Keri JE, Stein Gold LF, Tan JKL, Tollefson MM, Weiss JS, Wu PA, Zaenglein AL, Han JM, Barbieri JS. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024; 90:1006.e1-1006.e30. [PMID: 38300170 DOI: 10.1016/j.jaad.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. OBJECTIVE The objective of this study was to provide evidence-based recommendations for the management of acne. METHODS A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. LIMITATIONS Analysis is based on the best available evidence at the time of the systematic review. CONCLUSIONS These guidelines provide evidence-based recommendations for the management of acne vulgaris.
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Affiliation(s)
- Rachel V Reynolds
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Carol E Cheng
- Division of Dermatology, Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Fran Cook-Bolden
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Seemal R Desai
- Innovative Dermatology, Plano, Texas; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelly M Druby
- Penn State Health Hampden Medical Center, Enola, Pennsylvania
| | - Esther E Freeman
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonette E Keri
- University of Miami, Miller School of Medicine, Miami, Florida; Miami VA Medical Center, Miami, Florida
| | | | - Jerry K L Tan
- Western University, London, Ontario, Canada; Windsor Clinical Research Inc., Windsor, Ontario, Canada
| | - Megha M Tollefson
- Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Jonathan S Weiss
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia; Georgia Dermatology Partners, Snellville, Georgia
| | - Peggy A Wu
- Department of Dermatology, University of California Davis, Sacramento, California
| | - Andrea L Zaenglein
- Departments of Dermatology and Pediatrics, Penn State/Hershey Medical Center, Hershey, Pennsylvania
| | - Jung Min Han
- American Academy of Dermatology, Rosemont, Illinois.
| | - John S Barbieri
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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Doan TT, Hutton DW, Wright DR, Prosser LA. Estimating Transition Probabilities for Modeling Major Depression in Adolescents by Sex and Race or Ethnicity Combinations in the USA. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:375-390. [PMID: 38253972 DOI: 10.1007/s40258-024-00872-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE About one-fifth of US adolescents experienced major depressive symptoms, but few studies have examined longitudinal trends of adolescents developing depression or recovering by demographic factors. We estimated new transition probability inputs, and then used them in a simulation model to project the epidemiologic burden and trajectory of depression of diverse adolescents by sex and race or ethnicity combinations. METHODS Transition probabilities were first derived using parametric survival analysis of data from the National Longitudinal Study of Adolescent to Adult Health and then calibrated to cross-sectional data from the National Survey on Drug Use and Health. We developed a cohort state-transition model to simulate age-specific depression outcomes of US adolescents. A hypothetical adolescent cohort was modeled from 12-22 years with annual transitions. Model outcomes included proportions of youth experiencing depression, recovery, or depression-free cases and were reported for a US adolescent population by sex, race or ethnicity, and sex and race or ethnicity combinations. RESULTS At 22 years of age, approximately 16% of adolescents had depression, 12% were in recovery, and 72% had never developed depression. Depression prevalence peaked around 16-17 years-old. Adolescents of multiracial or other race or ethnicity, White, American Indian or Alaska Native, and Hispanic, Latino, or Spanish descent were more likely to experience depression than other racial or ethnic groups. Depression trajectories generated by the model matched well with historical observational studies by sex and race or ethnicity, except for individuals from American Indian or Alaska Native and multiracial or other race or ethnicity backgrounds. CONCLUSIONS This study validated new transition probabilities for future use in decision models evaluating adolescent depression policies or interventions. Different sets of transition parameters by demographic factors (sex and race or ethnicity combinations) were generated to support future health equity research, including distributional cost-effectiveness analysis. Further data disaggregated with respect to race, ethnicity, religion, income, geography, gender identity, sexual orientation, and disability would be helpful to project accurate estimates for historically minoritized communities.
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Affiliation(s)
- Tran T Doan
- Department of Pediatrics, University of Pittsburgh School of Medicine, 3414 Fifth Avenue, 1st Floor, Pittsburgh, PA, 15213-3205, USA.
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Davene R Wright
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Lisa A Prosser
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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Green DM, Lahiri T, Raraigh KS, Ruiz F, Spano J, Antos N, Bonitz L, Christon L, Gregoire-Bottex M, Hale JE, Langfelder-Schwind E, La Parra Perez Á, Maguiness K, Massie J, McElroy-Barker E, McGarry ME, Mercier A, Munck A, Oliver KE, Self S, Singh K, Smiley M, Snodgrass S, Tluczek A, Tuley P, Lomas P, Wong E, Hempstead SE, Faro A, Ren CL. Cystic Fibrosis Foundation Evidence-Based Guideline for the Management of CRMS/CFSPID. Pediatrics 2024; 153:e2023064657. [PMID: 38577740 DOI: 10.1542/peds.2023-064657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 04/06/2024] Open
Abstract
A multidisciplinary committee developed evidence-based guidelines for the management of cystic fibrosis transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen-positive, inconclusive diagnosis (CRMS/CFSPID). A total of 24 patient, intervention, comparison, and outcome questions were generated based on surveys sent to people with CRMS/CFSPID and clinicians caring for these individuals, previous recommendations, and expert committee input. Four a priori working groups (genetic testing, monitoring, treatment, and psychosocial/communication issues) were used to provide structure to the committee. A systematic review of the evidence was conducted, and found numerous case series and cohort studies, but no randomized clinical trials. A total of 30 recommendations were graded using the US Preventive Services Task Force methodology. Recommendations that received ≥80% consensus among the entire committee were approved. The resulting recommendations were of moderate to low certainty for the majority of the statements because of the low quality of the evidence. Highlights of the recommendations include thorough evaluation with genetic sequencing, deletion/duplication analysis if <2 disease-causing variants were noted in newborn screening; repeat sweat testing until at least age 8 but limiting further laboratory testing, including microbiology, radiology, and pulmonary function testing; minimal use of medications, which when suggested, should lead to shared decision-making with families; and providing communication with emphasis on social determinants of health and shared decision-making to minimize barriers which may affect processing and understanding of this complex designation. Future research will be needed regarding medication use, antibiotic therapy, and the use of chest imaging for monitoring the development of lung disease.
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Affiliation(s)
- Deanna M Green
- Johns Hopkins All Children's Hospital, St Petersburg, Florida
| | - Thomas Lahiri
- University of Vermont Children's Hospital, Burlington, Vermont
| | - Karen S Raraigh
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Jacquelyn Spano
- Stanford University School of Medicine, Stanford, California
| | - Nicholas Antos
- Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin
| | - Lynn Bonitz
- Cohen Children's Medical Center of NY/Northwell Health, New Hyde Park, New York
| | - Lillian Christon
- Medical University of South Carolina, Charleston, South Carolina
| | - Myrtha Gregoire-Bottex
- Advanced Pediatric Pulmonology, Pllc, Miramar, Florida
- Memorial Health Network, Hollywood, Florida
| | - Jaime E Hale
- University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | | | - Álvaro La Parra Perez
- John B. Goddard School of Business and Economics, Weber State University, Ogden, Utah
| | - Karen Maguiness
- Riley Hospital for Children at IU Health, Indianapolis, Indiana
| | - John Massie
- University of Melbourne Murdoch Childrens Research Institute, Melbourne, Australia
| | | | - Meghan E McGarry
- University of California San Francisco, San Francisco, California
| | - Angelique Mercier
- Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Anne Munck
- Hospital Necker Enfants malades, AP-HP, Paris, France
| | | | - Staci Self
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathryn Singh
- University of California, Irvine, Orange, California Miller Children's and Women's Hospital, Long Beach, California
| | | | | | | | | | - Paula Lomas
- The Cystic Fibrosis Foundation, Bethesda, Maryland
| | - Elise Wong
- The Cystic Fibrosis Foundation, Bethesda, Maryland
| | | | - Albert Faro
- The Cystic Fibrosis Foundation, Bethesda, Maryland
| | - Clement L Ren
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Danzo S, Kuklinski MR, Sterling SA, Beck A, Braciszewski JM, Boggs J, Briney JS, Charvat-Aguilar N, Eisenberg N, Kaffl A, Kline-Simon A, Loree AM, Lyons VH, Morse EF, Morrison KM, Negusse R, Scheuer H. Anxiety, depression, and suicidal ideation among early adolescents during the COVID-19 pandemic. J Adolesc 2024. [PMID: 38678440 DOI: 10.1002/jad.12333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND Anxiety and depression are among the most common and debilitating psychiatric disorders affecting youth, with both related to increased suicide risk. While rates of youth anxiety and depression were increasing before the COVID-19 pandemic, the pandemic further negatively impacted adolescent mental health. Unfortunately, few studies have examined prevalence of these concerns among early adolescents (ages 10-13) longitudinally during the pandemic. METHOD The current study examined self-reported anxiety and depression symptoms, and suicidal ideation amongst a general pediatrics population of 11- to 13-year-olds (n = 623) from March through September 2020 (early-pandemic) and approximately 7 months later (September 2020 through May 2021; mid-pandemic). Paired samples proportions were used to examine changes in prevalence of moderate to severe anxiety, depression, and suicidal ideation from early- to mid-pandemic. RESULTS Results highlight high initial rates and stability in anxiety and suicidal ideation, as well as a significant increase in depression (42.9% increase; p < .05) among the full sample during the COVID-19 pandemic. Prevalance of concerns were greatest for females and Hispanic youth during the early-pandemic, and generally highest for females and Medicaid insured youth at mid-pandemic. DISCUSSION Results extend recent research and underscore the need for continued monitoring of mental health concerns across development for youth who grew up during the COVID-19 pandemic; highlighting the need for sustainable, effective, and accessible early detection, prevention, and intervention strategies. Improving these services is critical to support youth who experienced pandemic-related stressors, and to prepare for supporting youth during future disruptive and isolating events.
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Affiliation(s)
- Sarah Danzo
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Margaret R Kuklinski
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
| | - Stacy A Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, USA
| | - Jordan M Braciszewski
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, USA
| | - Jennifer Boggs
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, USA
| | - John S Briney
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
| | | | - Nicole Eisenberg
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
| | - Abnette Kaffl
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Andrea Kline-Simon
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Amy M Loree
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan, USA
| | - Vivian H Lyons
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
- Department of Psychiatry & Behavioral Sciences, Allies in Healthier Systems for Health & Abundance in Youth, University of Washington, Seattle, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, USA
| | - Erica F Morse
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, USA
| | - Kristi M Morrison
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
| | - Rahel Negusse
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Hannah Scheuer
- School of Social Work, Social Development Research Group, University of Washington, Seattle, USA
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Flores JP, Kahn G, Penfold RB, Stuart EA, Ahmedani BK, Beck A, Boggs JM, Coleman KJ, Daida YG, Lynch FL, Richards JE, Rossom RC, Simon GE, Wilcox HC. Adolescents Who Do Not Endorse Risk via the Patient Health Questionnaire Before Self-Harm or Suicide. JAMA Psychiatry 2024:2818039. [PMID: 38656403 PMCID: PMC11044012 DOI: 10.1001/jamapsychiatry.2024.0603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/16/2024] [Indexed: 04/26/2024]
Abstract
Importance Given that the Patient Health Questionnaire (PHQ) item 9 is commonly used to screen for risk of self-harm and suicide, it is important that clinicians recognize circumstances when at-risk adolescents may go undetected. Objective To understand characteristics of adolescents with a history of depression who do not endorse the PHQ item 9 before a near-term intentional self-harm event or suicide. Design, Setting, and Participants This was a retrospective cohort study design using electronic health record and claims data from January 2009 through September 2017. Settings included primary care and mental health specialty clinics across 7 integrated US health care systems. Included in the study were adolescents aged 13 to 17 years with history of depression who completed the PHQ item 9 within 30 or 90 days before self-harm or suicide. Study data were analyzed September 2022 to April 2023. Exposures Demographic, diagnostic, treatment, and health care utilization characteristics. Main Outcome(s) and Measure(s) Responded "not at all" (score = 0) to PHQ item 9 regarding thoughts of death or self-harm within 30 or 90 days before self-harm or suicide. Results The study included 691 adolescents (mean [SD] age, 15.3 [1.3] years; 541 female [78.3%]) in the 30-day cohort and 1024 adolescents (mean [SD] age, 15.3 [1.3] years; 791 female [77.2%]) in the 90-day cohort. A total of 197 of 691 adolescents (29%) and 330 of 1024 adolescents (32%), respectively, scored 0 before self-harm or suicide on the PHQ item 9 in the 30- and 90-day cohorts. Adolescents seen in primary care (odds ratio [OR], 1.5; 95% CI, 1.0-2.1; P = .03) and older adolescents (OR, 1.2; 95% CI, 1.0-1.3; P = .02) had increased odds of scoring 0 within 90 days of a self-harm event or suicide, and adolescents with a history of inpatient hospitalization and a mental health diagnosis had twice the odds (OR, 2.0; 95% CI, 1.3-3.0; P = .001) of scoring 0 within 30 days. Conversely, adolescents with diagnoses of eating disorders were significantly less likely to score 0 on item 9 (OR, 0.4; 95% CI, 0.2-0.8; P = .007) within 90 days. Conclusions and Relevance Study results suggest that older age, history of an inpatient mental health encounter, or being screened in primary care were associated with at-risk adolescents being less likely to endorse having thoughts of death and self-harm on the PHQ item 9 before a self-harm event or suicide death. As use of the PHQ becomes more widespread in practice, additional research is needed for understanding reasons why many at-risk adolescents do not endorse thoughts of death and self-harm.
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Affiliation(s)
- Jean P. Flores
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Geoffrey Kahn
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan
| | | | | | - Brian K. Ahmedani
- Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan
| | | | | | - Karen J. Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | | | | | | | | | | | - Holly C. Wilcox
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Huang D, Zhong S, Song X, Zhang R, Lai S, Jia Y. Effect of novel accelerated intermittent theta burst stimulation on suicidal ideation in adolescent patients with major depressive episode: a randomised clinical trial. Gen Psychiatr 2024; 37:e101394. [PMID: 38665940 PMCID: PMC11043680 DOI: 10.1136/gpsych-2023-101394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/13/2024] [Indexed: 04/28/2024] Open
Affiliation(s)
- Dong Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Xiaodong Song
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Rongxu Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
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15
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Zhou Y, Chen X, Gu R, Xiang YT, Hajcak G, Wang G. Personalized identification and intervention of depression in adolescents: A tertiary-level framework. Sci Bull (Beijing) 2024; 69:867-871. [PMID: 38302329 DOI: 10.1016/j.scib.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- Yuan Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xu Chen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Ruolei Gu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao 999078, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao 999078, China
| | - Greg Hajcak
- School of Education and Counseling Psychology, Santa Clara University, Santa Clara CA 95053, USA
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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16
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Milatz F, Klotsche J, Niewerth M, Sengler C, Windschall D, Kallinich T, Dressler F, Trauzeddel R, Holl RW, Foeldvari I, Brück N, Temming S, Hospach T, Warschburger P, Berendes R, Erbis G, Kuemmerle-Deschner JB, Weller-Heinemann F, Haas JP, Müller-Stierlin AS, Mutter A, Meissner T, Baumeister H, Minden K. Anxiety and depression symptoms in adolescents and young adults with juvenile idiopathic arthritis: results of an outpatient screening. Arthritis Res Ther 2024; 26:82. [PMID: 38600543 PMCID: PMC11005270 DOI: 10.1186/s13075-024-03312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Previous studies have shown that growing up with rheumatic conditions can fuel dissatisfaction and psychological distress, which in turn affects disease self-management and treatment adherence. Primary objective of this study was to estimate the prevalence of anxiety and depression symptoms in adolescents and young adults (AYA) with juvenile idiopathic arthritis (JIA) and to identify correlates of conspicuous screening results. METHODS Initiated as part of the COACH multicenter observational study, outpatients aged 12 to 21 years participating in the National Pediatric Rheumatological Database (NPRD) were prospectively screened for mental health using the Patient Health Questionnaire-9 (PHQ-9) and the Generalised Anxiety Disorder Scale-7 (GAD-7). RESULTS Data from 1,150 adolescents with JIA (mean age 15.6 ± 2.2 years; mean disease duration 7.2 ± 4.9 years, 69% female, 43% oligoarthritis, 26% polyarthritis) were analysed. Overall, 32.7% (n = 316) of AYA showed conspicuous screening results, of whom 30.4% reported clinically relevant suicidal or self-harm thoughts. About 19% of screened patients showed moderate to severe depressive or anxious symptoms. AYA with conspicuous screening results were older (15.8 vs. 15.2 years; p < 0.0001), more often female (81% vs. 64%; p < 0.0001) and more often overweight (25% vs. 17%; p = 0.006). They had higher disease activity (physician global assessment on NRS 0-10; 1.7 vs. 1.2; p < 0.0001), more functional limitations (CHAQ; 0.44 vs. 0.14; <0.0001) and rated their health status worse (NRS 0-10; 3.5 vs. 1.8; p < 0.0001) than AYA with inconspicuous screening results. Females (OR 2.33 [CI 1.53-3.56]; p < 0.0001), older age (OR 1.09 [CI 1.01-1.18]; p = 0.026), patients with more functional limitations (OR 3.36 [CI 1.98-5.72]; p < 0.0001), and patients with worse subjective health status (OR 1.17 [CI 1.07-1.27]; p < 0.0001) were more likely to have a conspicuous screening result. Regular sports participation was associated with a lower likelihood of conspicuous screening result (OR 0.69 [CI 0.49-0.98]; p = 0.039). CONCLUSIONS A large-scale outpatient screening of AYA with JIA in Germany shows a high prevalence of anxiety and depression symptoms. The need for routine screening for early detection of mental health problems became apparent.
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Affiliation(s)
- Florian Milatz
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jens Klotsche
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Martina Niewerth
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Claudia Sengler
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Windschall
- Clinic of Paediatric and Adolescent Rheumatology, Northwest German Centre for Rheumatology, St. Josef- Stift Sendenhorst, Sendenhorst, Germany
- Medizinische Fakultät, Universität Halle-Wittenberg, Halle, Germany
| | - Tilmann Kallinich
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
- Programme area Systems Rheumatology, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Berlin, Germany
| | - Frank Dressler
- Department of Paediatric Pneumology, Allergology and Neonatology, Children's Hospital, Hannover Medical School, Hannover, Germany
| | - Ralf Trauzeddel
- Department of Paediatrics, Paediatric and Adolescent Rheumatology, Helios Klinik Berlin-Buch, Berlin, Germany
| | - Reinhard W Holl
- Institute for Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Centre for Diabetes Research (DZD), Munich, Germany
| | - Ivan Foeldvari
- Hamburg Centre for Paediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany
| | - Normi Brück
- Department of Paediatrics, Carl Gustav Carus, University Hospital, Technical University Dresden, Dresden, Germany
| | - Svenja Temming
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Toni Hospach
- Department of Paediatrics, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Rainer Berendes
- Pediatric Rheumatology, Children's Hospital St. Marien, Landshut, Germany
| | - Gabriele Erbis
- Division of Pediatric Rheumatology and autoinflammation reference centre Tuebingen (arcT), Department of Pediatrics, University Hospital Tuebingen, member of ERN-RITA, Tuebingen, Germany
| | - Jasmin B Kuemmerle-Deschner
- Division of Pediatric Rheumatology and autoinflammation reference centre Tuebingen (arcT), Department of Pediatrics, University Hospital Tuebingen, member of ERN-RITA, Tuebingen, Germany
| | - Frank Weller-Heinemann
- Department of Pediatrics and Adolescent Medicine, Pediatric Rheumatology, Eltern-Kind-Zentrum Prof. Hess, Klinikum Bremen-Mitte, Bremen, Germany
| | - Johannes-Peter Haas
- German Centre for Paediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany
| | | | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - Thomas Meissner
- Department of General Paediatrics, Neonatology and Paediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Faculty of Engineering, Computer Science and Psychology, Ulm University, Ulm, Germany
| | - Kirsten Minden
- Programme area Epidemiology and Health Services Research, Deutsches Rheuma-Forschungszentrum Berlin, ein Institut der Leibniz-Gemeinschaft, Charitéplatz 1, 10117, Berlin, Germany
- Department of Paediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
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Braund TA, Baker STE, Subotic-Kerry M, Tillman G, Evans NJ, Mackinnon A, Christensen H, O'Dea B. Potential mental health-related harms associated with the universal screening of anxiety and depressive symptoms in Australian secondary schools. Child Adolesc Psychiatry Ment Health 2024; 18:46. [PMID: 38566202 PMCID: PMC10985850 DOI: 10.1186/s13034-024-00734-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. METHODS A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. RESULTS Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. CONCLUSIONS The intensive screening procedure did not appear to adversely impact adolescents' mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821 .
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Affiliation(s)
- Taylor A Braund
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia.
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
| | | | - Mirjana Subotic-Kerry
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Gabriel Tillman
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC, Australia
| | - Nathan J Evans
- School of Psychology, University of Queensland, St Lucia, QLD, Australia
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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18
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Cong X, Zhang T, Bian R, Li Y, Liu J, Zhang X. Prevalence and related factors of first-time suicide attempts in the past 14 days in Chinese adult patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2024; 15:1366475. [PMID: 38585486 PMCID: PMC10995384 DOI: 10.3389/fpsyt.2024.1366475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Background This study aimed to identify socio-demographic, physiologic, and psychologic related factors of the first-time suicide attempt (FSA) in the past 14 days in Chinese adult patients with first-episode drug-naïve (FEDN) major depressive disorder (MDD). Methods A total of 1718 adult patients with FEDN MDD were enrolled in this cross-sectional survey. Depression, anxiety symptoms, and suicide attempts were assessed. Additionally, biological samples were collected and measured, while Logistic regression analysis was employed to explore the risk factors for FSA in the past 14 days among FEDN MDD patients. Results Among suicide attempters, 12.11% (208 out of 1718) reported experiencing FSA in the past 14 days. Logistic regression analysis showed that the risk factors for FSA included more severe anxiety symptoms (OR=1.37, 95%CI: 1.28-1.48, p<0.001), higher levels of total cholesterol (TC) (OR=1.42, 95%CI: 1.13-1.77, p=0.003), and elevated thyroid-stimulating hormone (TSH) (OR=1.13, 95%CI: 1.03-1.25, p=0.01). The regression model exhibited good discriminatory power for FSA with an area under the curve (AUC) of 0.82. Conclusion FEDN MDD patients with more severe anxiety and higher levels of TSH and TC are more likely to develop FSA in the past 14 days. These factors are risk factors for short-term (in the past 14 days) FSA and may serve as indicators for early intervention.
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Affiliation(s)
- Xiaoyin Cong
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Tian Zhang
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Rongrong Bian
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yong Li
- Department of Clinical Psychology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Junjun Liu
- Department of Psychiatry, Nanjing Meishan Hospital, Nanjing, China
| | - Xiangyang Zhang
- Chinese Academy of Sciences (CAS) Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Lostelius PV, Gustavsson C, Adolfsson ET, Söderlund A, Revenäs Å, Zakrisson AB, Mattebo M. Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System. BMC Med Inform Decis Mak 2024; 24:64. [PMID: 38443898 PMCID: PMC10913260 DOI: 10.1186/s12911-024-02465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. METHODS This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16-23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants' quantitative Youth Health Report System data were analyzed for descriptive statistics. RESULTS Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. CONCLUSIONS The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.
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Affiliation(s)
- Petra V Lostelius
- Centre for Innovation, Research and Education, Region Västmanland, Västmanland Hospital Västerås, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden.
| | - Catharina Gustavsson
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
- Orthopedic Clinic, Västerås Hospital Region Västmanland, Västerås, Sweden
| | - Ann-Britt Zakrisson
- University Health Care Research Center, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Chen Y, Guo M, Wang Z, Mo X, Hu F, Du Y. A novel electrochemical immunosensor for sensitive detection of depression marker Apo-A4 based on bipyridine-functionalized covalent organic frameworks. Mikrochim Acta 2024; 191:179. [PMID: 38443677 DOI: 10.1007/s00604-024-06260-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
A novel electrochemical immunosensor for detecting potential depression biomarker Apolipoprotein A4 (Apo-A4) was developed using a multi-signal amplification approach. Firstly, the sensor utilized a modified electrode material, NG-PEI-COF, combining bipyridine-functionalized covalent organic framework (COF) and polyethyleneimine-functionalized nitrogen-doped graphene (NG-PEI), providing high surface area and excellent electron transfer capability for the first-stage amplification in electrical signal conduction. Subsequently, gold nanoparticles (AuNPs) were further electrodeposited onto the electrode, providing good biocompatibility and abundant binding sites for immobilizing the target antigen, thus achieving the second-stage amplification in target recognition and binding. To address the lack of redox properties of the antigen, a tracer probe was formed by loading AuNPs, anti-Apo-A4, and toluidine blue (TB) successively onto COF, leading to the third-stage amplification in signal conversion. The constructed electrochemical immunosensor TB/Ab/AuNPs/COF-Apo-A4/AuNPs/NG-PEI-COF/GCE exhibited excellent detection performance against Apo-A4 with a linear range of 0.01 to 300 ng mL-1 and had a low detection limit of 2.16 pg mL-1 (S/N = 3). In addition, the biosensor had good reproducibility (RSD = 2.31%), stability, and significant anti-interference performance toward other depression biomarkers. The sensor has been successfully used for the quantitative detection of Apo-A4 in serum, providing potential applications for detecting Apo-A4 in the clinic and serving as a reference for constructing sensing methods based on COF.
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Affiliation(s)
- Yan Chen
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, Codonopsis Radix Industrial Technology Engineering Research Center, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Min Guo
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, Codonopsis Radix Industrial Technology Engineering Research Center, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Zixia Wang
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, Codonopsis Radix Industrial Technology Engineering Research Center, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Xiaohui Mo
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, Codonopsis Radix Industrial Technology Engineering Research Center, Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Fangdi Hu
- School of Pharmacy, State Key Laboratory of Applied Organic Chemistry, Codonopsis Radix Industrial Technology Engineering Research Center, Lanzhou University, Lanzhou, 730000, Gansu Province, China.
| | - Yongling Du
- College of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, 730000, China.
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21
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Cambron C, Jaggers JW. Examining area- and individual-level differences in suicide ideation severity and suicide attempt among youth. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:35-44. [PMID: 37873580 DOI: 10.1111/jora.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023]
Abstract
Youth suicide is a pressing problem and suicide rates are not equally distributed across geographic areas or socioeconomic status (SES). Death by suicide is often preceded factors including hopelessness and suicide ideation, planning, and attempt. The current study examined area- and individual-level differences in suicide ideation severity and suicide attempt in a state-representative sample of youth from 2019 (N = 78,740) and 2021 (N = 61,396). Youth from higher SES and rural areas showed lower suicide ideation severity and odds of suicide attempt. After including individual-level covariates, SES differences in ideation severity and suicide attempt persisted for 2019 but not 2021. Rural differences for ideation severity persisted across years but not for suicide attempt. Further research on geographic variation in suicide risk is needed.
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Melnyk BM. The evidence-based COPE program: Reducing the time between diagnosing and treating depression and anxiety in youth. Nurse Pract 2024; 49:40-47. [PMID: 38386473 PMCID: PMC10878455 DOI: 10.1097/01.npr.0000000000000152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
ABSTRACT The soaring prevalence of depression and anxiety in children, teenagers, and young adults is now a public health epidemic, yet access to timely evidence-based mental health treatment is often lacking due to a severe shortage of mental health providers. This article provides an overview of the current state of depression and anxiety in children and adolescents as well as first-line evidence-based treatment. The Creating Opportunities for Personal Empowerment (COPE) program, a cognitive-behavioral skills-building intervention, is highlighted as an evidence-based intervention for timely treatment that can be delivered by NPs, physicians, and physician associates/assistants in primary care settings, school-based health centers, and chronic care clinics with reimbursement as well as in schools and universities as a preventive mental health intervention.
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Affiliation(s)
- Bernadette Mazurek Melnyk
- Bernadette Mazurek Melnyk is creator of the COPE program and founder of COPE2Thrive, LLC. She is a globally recognized expert, speaker, author, and researcher in the areas of evidence-based practice, mental health and well-being, and intervention research
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23
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Muth ND, Bolling C, Hannon T, Sharifi M. The Role of the Pediatrician in the Promotion of Healthy, Active Living. Pediatrics 2024; 153:e2023065480. [PMID: 38404207 PMCID: PMC11042797 DOI: 10.1542/peds.2023-065480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Few children and adolescents meet federal nutrition or physical activity recommendations, and many experience poor or inadequate sleep and negative health effects from screen use and social media. These lifestyle factors exacerbate physical and mental health risks for children and adolescents. This clinical report provides guidance to help pediatricians address the nutritional, physical activity, sleep, media and screen use, and social-emotional factors that affect child and adolescent health and wellness. The recommendations in this clinical report aim to promote health and wellness practices for infants, children, and adolescents across several domains of influence, including the individual, interpersonal, institutional, community, and public policy levels.
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Affiliation(s)
- Natalie D. Muth
- Children’s Primary Care Medical Group, Carlsbad, Californiaand Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California
| | - Christopher Bolling
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Tamara Hannon
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Indiana University School of Medicine, Bloomington, Indiana
| | - Mona Sharifi
- Departments of Pediatrics and Biostatistics, Yale School of Medicine, New Haven, Connecticut
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Meyer N, Lok R, Schmidt C, Kyle SD, McClung CA, Cajochen C, Scheer FAJL, Jones MW, Chellappa SL. The sleep-circadian interface: A window into mental disorders. Proc Natl Acad Sci U S A 2024; 121:e2214756121. [PMID: 38394243 PMCID: PMC10907245 DOI: 10.1073/pnas.2214756121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Sleep, circadian rhythms, and mental health are reciprocally interlinked. Disruption to the quality, continuity, and timing of sleep can precipitate or exacerbate psychiatric symptoms in susceptible individuals, while treatments that target sleep-circadian disturbances can alleviate psychopathology. Conversely, psychiatric symptoms can reciprocally exacerbate poor sleep and disrupt clock-controlled processes. Despite progress in elucidating underlying mechanisms, a cohesive approach that integrates the dynamic interactions between psychiatric disorder with both sleep and circadian processes is lacking. This review synthesizes recent evidence for sleep-circadian dysfunction as a transdiagnostic contributor to a range of psychiatric disorders, with an emphasis on biological mechanisms. We highlight observations from adolescent and young adults, who are at greatest risk of developing mental disorders, and for whom early detection and intervention promise the greatest benefit. In particular, we aim to a) integrate sleep and circadian factors implicated in the pathophysiology and treatment of mood, anxiety, and psychosis spectrum disorders, with a transdiagnostic perspective; b) highlight the need to reframe existing knowledge and adopt an integrated approach which recognizes the interaction between sleep and circadian factors; and c) identify important gaps and opportunities for further research.
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Affiliation(s)
- Nicholas Meyer
- Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals NHS Foundation Trust, LondonWC1N 3HR, United Kingdom
- Department of Psychosis Studies, Institute of Psychology, Psychiatry, and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA94305
| | - Christina Schmidt
- Sleep & Chronobiology Group, GIGA-Institute, CRC-In Vivo Imaging Unit, University of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology, Speech and Language, University of Liège, Liège4000, Belgium
| | - Simon D. Kyle
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, OxfordOX1 3QU, United Kingdom
| | - Colleen A. McClung
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA15219
| | - Christian Cajochen
- Centre for Chronobiology, Department for Adult Psychiatry, Psychiatric Hospital of the University of Basel, BaselCH-4002, Switzerland
- Research Cluster Molecular and Cognitive Neurosciences, Department of Biomedicine, University of Basel, BaselCH-4055, Switzerland
| | - Frank A. J. L. Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA02115
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Neurology, Brigham and Women’s Hospital, Boston, MA02115
- Division of Sleep Medicine, Harvard Medical School, Boston, MA02115
| | - Matthew W. Jones
- School of Physiology, Pharmacology and Neuroscience, Faculty of Health and Life Sciences, University of Bristol, BristolBS8 1TD, United Kingdom
| | - Sarah L. Chellappa
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, SouthamptonSO17 1BJ, United Kingdom
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Davis M, Jones JD, Schwartz KTG, Dysart G, So A, Young JF. Emerging Risk of Adolescent Depression and Suicide Detected Through Pediatric Primary Care Screening. J Pediatr Psychol 2024; 49:111-119. [PMID: 38001561 DOI: 10.1093/jpepsy/jsad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE The goal of the current study was to document patterns of stability and change in adolescent depression and suicide risk detected via universal depression screening in pediatric primary care and to determine who may go on to experience emerging risk. METHODS Retrospective electronic health record information (sociodemographic data and depression screening results for 2 timepoints) was extracted for adolescents aged 12-17 who attended well-visits between November 15, 2017, and February 1, 2020, in a large pediatric primary care network. A total of 27,335 adolescents with 2 completed depression screeners were included in the current study. RESULTS While most adolescents remained at low risk for depression and suicide across the 2 timepoints, others experienced emerging risk (i.e., low risk at time 1 but elevated risk at time 2), decreasing risk (i.e., high risk at time 1 but low risk at time 2) or stable high risk for depression or suicide. Odds of experiencing emerging depression and suicide risk were higher among adolescents who were female (compared to males), Black (compared to White), and had Medicaid insurance (compared to private insurance). Odds of experiencing emerging depression risk were also higher among older adolescents (compared to younger adolescents) as well as adolescents who identified as Hispanic/Latino (compared to non-Hispanic/Latino). CONCLUSIONS Findings can inform symptom monitoring and opportunities for prevention in primary care.
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Affiliation(s)
- Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Clinical Futures, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, USA
| | - Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
| | - Karen T G Schwartz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Gillian Dysart
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Amy So
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, USA
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Davis M, Jones JD, Gallop R, So A, Dysart G, Young JF. Adolescent Depression Symptom Trajectories Detected Via Universal Screening in Pediatric Primary Care. Res Child Adolesc Psychopathol 2024; 52:183-194. [PMID: 37642920 DOI: 10.1007/s10802-023-01116-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
Unique trajectories of adolescent depression symptoms have been identified, yet less is known about whether such patterns translate to real-world clinical settings. Because annual adolescent depression screening is becoming more prevalent in primary care, we examined whether longitudinal patterns of depression symptoms documented in the developmental psychopathology literature can also be detected via routine screening in primary care and explored how membership in the identified trajectories varied based on concurrent suicide risk and sociodemographic factors. A total of 1,359 adolescents aged 12-16 years old at the first timepoint were included in the current analyses. These adolescents completed three depression screeners during their well-visits in a large pediatric primary care network between November 15, 2017 and February 1, 2020. Retrospective electronic health record data were extracted, including sociodemographic variables and depression screening results. Dynamic functional time series clustering results indicated the optimal number of clusters was five. The five depression symptom trajectories were: (1) A-Shaped (i.e., relatively low depression symptoms at Time 1, a substantial increase in symptoms at Time 2, and a return to low symptoms at Time 3), (2) Increasing, (3) Low-Stable, (4) High-Decreasing, and (5) Low-Decreasing. Cluster differences in suicide risk largely mapped onto depression symptom levels at each assessment. We found cluster differences based on practice location, insurance type, and adolescent race. The symptom trajectories observed in this study resemble those found in the developmental psychopathology literature, though some key differences were noted. Findings can inform future research and symptom monitoring in primary care.
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Affiliation(s)
- Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA.
| | - Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Robert Gallop
- Department of Mathematics, West Chester University, West Chester, PA, USA
| | - Amy So
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Psychology Department at Montclair State University, Montclair, NJ, USA
| | - Gillian Dysart
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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He XQ, Hu JH, Peng XY, Zhao L, Zhou DD, Ma LL, Zhang ZY, Tao WQ, Liu XY, Kuang L, Wang W. EEG microstate analysis reveals large-scale brain network alterations in depressed adolescents with suicidal ideation. J Affect Disord 2024; 346:57-63. [PMID: 37949236 DOI: 10.1016/j.jad.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Accumulating evidence showed abnormalities in brain network connectivity in depressive individuals with suicidal ideation (SI). We aimed to investigate the large-scale brain network dynamics in adolescents with SI and major depressive disorder (MDD). METHODS We recruited 47 first-episode drug-naïve adolescents with MDD and SI, 26 depressed adolescents without SI (noSI), and 26 age-matched healthy controls (HC). The Columbia Suicidal Ideation Severity Scale (C-SSRS) was utilized to assess suicide ideation. We acquired 64-channel resting-state EEG recordings from all subjects and used microstate analysis to investigate the large-scale brain network dynamics. RESULTS We observed a significant reduction in the occurrence and coverage of microstate B within the SI group when contrasted with the noSI group. Conversely, there was a significant increase in the occurrence and coverage of microstate A in the SI group as compared to the HC group. Additionally, we observed heightened transition probabilities from microstates D and C to microstate A in the SI group; meanwhile, transitions from microstate D to B were more prevalent in the noSI group. Furthermore, the noSI group exhibited a significant decline in the transition probabilities from microstate D to microstate C. LIMITATIONS The cross-sectional nature limits the capacity to determine whether microstate dynamics have prognostic significance for SI. CONCLUSION We provided evidence that depressed adolescents with SI have a distinct pattern in microstate dynamics compared to those without SI. These findings suggest that microstate dynamics might serve as a potential neurobiomarker for identifying SI in depressed adolescents.
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Affiliation(s)
- Xiao-Qing He
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jin-Hui Hu
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Xin-Yu Peng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dong-Dong Zhou
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China.
| | - Ling-Li Ma
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng-Yong Zhang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Wan-Qing Tao
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Xin-Yi Liu
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China.
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Beck A, Dryburgh N, Bennett A, Shaver N, Esmaeilisaraji L, Skidmore B, Patten S, Bragg H, Colman I, Goldfield GS, Nicholls SG, Pajer K, Meeder R, Vasa P, Shea BJ, Brouwers M, Little J, Moher D. Screening for depression in children and adolescents in primary care or non-mental health settings: a systematic review update. Syst Rev 2024; 13:48. [PMID: 38291528 PMCID: PMC10829174 DOI: 10.1186/s13643-023-02447-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The transition from childhood to adolescence is associated with an increase in rates of some psychiatric disorders, including major depressive disorder, a debilitating mood disorder. The aim of this systematic review is to update the evidence on the benefits and harms of screening for depression in primary care and non-mental health clinic settings among children and adolescents. METHODS This review is an update of a previous systematic review, for which the last search was conducted in 2017. We searched Ovid MEDLINE® ALL, Embase Classic+Embase, PsycINFO, Cochrane Central Register of Controlled Trials, and CINAHL on November 4, 2019, and updated on February 19, 2021. If no randomized controlled trials were found, we planned to conduct an additional search for non-randomized trials with a comparator group. For non-randomized trials, we applied a non-randomized controlled trial filter and searched the same databases except for Cochrane Central Register of Controlled Trials from January 2015 to February 2021. We also conducted a targeted search of the gray literature for unpublished documents. Title and abstract, and full-text screening were completed independently by pairs of reviewers. RESULTS In this review update, we were unable to find any randomized controlled studies that satisfied our eligibility criteria and evaluated the potential benefits and harms of screening for depression in children and adolescents. Additionally, a search for non-randomized trials yielded no studies that met the inclusion criteria. CONCLUSIONS The findings of this review indicate a lack of available evidence regarding the potential benefits and harms of screening for depression in children and adolescents. This absence of evidence emphasizes the necessity for well-conducted clinical trials to evaluate the effectiveness of depression screening among children and adolescents in primary care and non-mental health clinic settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020150373 .
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Affiliation(s)
- Andrew Beck
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Knowledge Synthesis Group, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Nicole Dryburgh
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Psychology, Faculty of Science, McGill University, Montreal, Canada
| | - Alexandria Bennett
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Nicole Shaver
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Leila Esmaeilisaraji
- Knowledge Synthesis Group, Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Becky Skidmore
- Independent Information Specialist, Ottawa, Ontario, Canada
| | - Scott Patten
- Department of Community Health Services and Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Heather Bragg
- Children's Hospital of Eastern Ontario, Out-Patient Mental Health, Ottawa, Ontario, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Gary S Goldfield
- Department of Pediatrics, Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kathleen Pajer
- Department of Psychiatry, uOttawa Faculty of Medicine Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Robert Meeder
- Department of Pediatrics, Orillia Soldiers Memorial Hospital, Orillia, Ontario, Canada
| | - Priya Vasa
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Beverley J Shea
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Melissa Brouwers
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Julian Little
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - David Moher
- Knowledge Synthesis and Application Unit, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Agyapong B, Shalaby R, Eboreime E, Hay K, Pattison R, Korthuis M, Wei Y, Agyapong VIO. Subscribers' Perspectives and Satisfaction with the MoreGoodDays Supportive Text Messaging Program and the Impact of the Program on Self-Rated Clinical Measures. J Clin Med 2024; 13:580. [PMID: 38276086 PMCID: PMC10816810 DOI: 10.3390/jcm13020580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Background: Young adults (18 to 30 years of age) are confronted with numerous challenges, such as academic stressors and peer pressure. The MoreGoodDays program was co-designed with young adults to alleviate psychological issues, improve their mental well-being and provide support for young adults in Alberta during the COVID-19 pandemic and beyond. Objective: The current study aimed to explore subscribers' perspectives and satisfaction with the MoreGoodDays supportive text messaging program and the impact of the program on self-rated clinical measures. Methods: Subscribers of the MoreGoodDays program were invited via a link delivered in a text message to complete online evaluation surveys at six weeks, three months and six months. Program perception and satisfaction questions were adapted from those used to evaluate related programs. Anxiety, depression and PTSD symptoms were respectively assessed using the Generalized Anxiety Disorder-7 scale, the Patient Health Questionnaire-9 scale and the PTSD Civilian Checklist 5, and resilience levels were assessed using the Brief Resilience Scale (BRS). Data were analyzed with SPSS version 26 for Windows utilizing descriptive and inferential statistics. Results: There was a total of 168 respondents across the three follow-up time points (six weeks, three months and six months). The overall mean satisfaction with the MoreGoodDays program was 8.74 (SD = 1.4). A total of 116 (69.1%) respondents agreed or strongly agreed that MoreGoodDays messages helped them cope with stress, and 118 (70.3) agreed the messages helped them cope with loneliness. Similarly, 130 (77.3%) respondents agreed that MoreGoodDays messages made them feel connected to a support system, and 135 (80.4) indicated the program helped to improve their overall mental well-being. In relation to clinical outcomes, the ANOVA test showed no significant differences in mean scores for the PHQ-9, GAD-7 and PCL-C scales and the BRS from baseline to the three follow-up time points. In addition, there was no statistically significant difference in the prevalence of likely GAD, likely MDD, likely PTSD and low resilience at baseline and at six weeks. Conclusions: Notwithstanding the lack of statistically significant clinical improvement in subscribers of the MoreGoodDays program, the high program satisfaction suggests that subscribers accepted the technology-based intervention co-created with young adults, and this offers a vital tool to complement existing programs.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | | | | | - Mark Korthuis
- Glenrose Rehabilitation Hospital Foundation, Edmonton, AB T5G 0B7, Canada
| | - Yifeng Wei
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 2E2, Canada
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Garza C, Chapa D, Hernandez C, Aramburu H, Mayes TL, Emslie GJ. Measurement-Based Care for Depression in Youth: Practical Considerations for Selecting Measures to Assess Depression, Associated Features and Functioning. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01652-4. [PMID: 38217644 DOI: 10.1007/s10578-023-01652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/15/2024]
Abstract
Identification and management of major depressive disorder (MDD) in children and adolescents remains a significant area of public health need. The process for identifying depression (e.g. screening) and management (e.g. measurement based care [MBC]) is substantially enhanced by utilization of clinical measures and rating scales. Measures can be self- or caregiver reported or clinician rated. They can aid recognition of at-risk individuals for future assessment and assist in clinical diagnosis and management of depression. In addition to assessing symptoms of depression, rating scales can be used to assess important associated features (e.g. anxiety, trauma) and functional outcomes (e.g. quality of life, performance/productivity). In this manuscript, we discuss practical considerations for clinicians and researchers when selecting rating instruments for assessing depression, associated factors, functioning, and treatment outcomes (i.e. adherence and side effects) as part of MBC in youth and provide a summary of rating scales commonly used in research and clinical settings.
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Affiliation(s)
- Cynthia Garza
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA.
| | - Diana Chapa
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Catherine Hernandez
- Department of Psychiatry, University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - Hayley Aramburu
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Graham J Emslie
- Children's Health, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Batterham PJ, Werner-Seidler A, O'Dea B, Calear AL, Maston K, Mackinnon A, Christensen H. Psychometric properties of the Distress Questionnaire-5 (DQ5) for measuring psychological distress in adolescents. J Psychiatr Res 2024; 169:58-63. [PMID: 38000185 DOI: 10.1016/j.jpsychires.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/21/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Screening for psychological distress may assist in identifying at-risk adolescents. While several measures of adolescent psychological distress have been used, most have limited or suboptimal psychometric properties. This study aimed to assess the psychometric properties of the Distress Questionnaire-5 (DQ5), a brief measure of psychological distress, in a large community-based sample of adolescents. Data for the study (n = 3117) were drawn from the baseline and 6-week follow-up assessments of the Future Proofing Study, which collected data from three cohorts of Year 8 students (M = 13.9 years; 48% female) between August 2019 and May 2022. Participants completed the DQ5 at each measurement occasion, as well as measures of depression, generalised and social anxiety, and suicidal ideation. The DQ5 had good fit to a unidimensional construct, with standardised factor loadings ranging between 0.69 and 0.90. The scale had strong criterion (AUC ranged from 0.84 to 0.93) and predictive (AUC ranged from 0.81 to 0.87) validity when compared against indicators for depression, generalised anxiety, social anxiety and suicidal ideation. The DQ5 cut-point of ≥14 had 80% sensitivity and 90% specificity for identifying adolescents meeting symptom thresholds for any of the assessed mental health conditions. Changes in DQ5 scores over 6 weeks had moderate associations with changes in other symptom scales, suggesting sensitivity to change. In conclusion, the DQ5 demonstrates strong psychometric properties and is a reliable measure of psychological distress in adolescents. Given its brevity and ease of interpretation, the DQ5 could be readily used in schools to screen for psychological distress in students.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia.
| | - Aliza Werner-Seidler
- Black Dog Institute, Sydney, Australia; Faculty of Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Bridianne O'Dea
- Black Dog Institute, Sydney, Australia; Faculty of Medicine and Health, The University of New South Wales, Sydney, Australia
| | - Alison L Calear
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | | | | | - Helen Christensen
- Faculty of Medicine and Health, The University of New South Wales, Sydney, Australia
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32
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ElSayed NA, Aleppo G, Bannuru RR, Beverly EA, Bruemmer D, Collins BS, Darville A, Ekhlaspour L, Hassanein M, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S77-S110. [PMID: 38078584 PMCID: PMC10725816 DOI: 10.2337/dc24-s005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Busby DR, Hughes JL, Walters M, Ihediwa A, Adeniran M, Goodman L, Mayes TL. Measurement Choices for Youth Suicidality. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01627-5. [PMID: 38147138 DOI: 10.1007/s10578-023-01627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/27/2023]
Abstract
Suicide is among the leading causes of death among individuals ages 10-24, making suicidal thoughts and behaviors (STBs) a serious public health crisis among youth. Suicide risk screening and assessment are vital to addressing this public health crisis. In fact, many youths that screen positive for suicidal ideation do not have known mental health concerns and would have been missed if not asked directly. Medical settings are an optimal setting to detect suicidality early and provide appropriate follow-up monitoring and care as needed. To support effective and efficient screening and assessment of suicidal thoughts and behaviors, providers must choose measures with both strong psychometric properties and clinical utility. While measurement of STBs can vary across health settings, suicide risk screening and assessment typically involves gathering information about current suicidal ideation, suicidal behaviors, and suicidal plans via self-report questionnaires, clinical interviews, and/or computerized adaptive screens. In alignment with measurement-based care efforts, the current manuscript will provide a scoping review of measures of youth suicidal ideation, behavior, plans, and their risk factors. Specifically, the psychometric properties, clinical utility, and other key considerations for screening and assessment of adolescent suicide risk are discussed.
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Affiliation(s)
- Danielle R Busby
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, USA.
| | - Jennifer L Hughes
- Department of Psychiatry and Behavioral Health, Nationwide Children's Hospital, College of Medicine, and the Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mallory Walters
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, USA
| | - Adannaya Ihediwa
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, USA
| | - Michel Adeniran
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, USA
| | - Lynnel Goodman
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute and the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Zhou J, Radojčić MR, Ashton-James CE, Yang H, Chen Z, Wang R, Yang Y, Si J, Yao L, Li G, Chen L. Optimal cut-offs of depression screening tools during the COVID-19 pandemic: a systematic review. BMC Psychiatry 2023; 23:953. [PMID: 38114961 PMCID: PMC10729515 DOI: 10.1186/s12888-023-05455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Studies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the "Spectrum Effect". METHODS First, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before. RESULT Four original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults). CONCLUSION The optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy.
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Affiliation(s)
- Jieru Zhou
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Maja R Radojčić
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Claire E Ashton-James
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Hanqiao Yang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichua, 610041, People's Republic of China
| | - Ziyi Chen
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Ruijia Wang
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, People's Republic of China
| | - Ying Yang
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Jinhua Si
- Tianjin University of Traditional Chinese Medicine Library, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Ge Li
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, 301617, People's Republic of China.
| | - Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China.
- Sydney Musculoskeletal Health, School of Health Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Hankin BL, Griffith JM. What Do We Know About Depression Among Youth and How Can We Make Progress Toward Improved Understanding and Reducing Distress? A New Hope. Clin Child Fam Psychol Rev 2023; 26:919-942. [PMID: 37285011 PMCID: PMC10245370 DOI: 10.1007/s10567-023-00437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
This paper summarizes many findings about depression among children and adolescents. Depression is prevalent, highly distressing, and exerts considerable burden worldwide. Rates surge from childhood through young adulthood and have increased over the last decade. Many risk factors have been identified, and evidence-based interventions exist targeting mostly individual-level changes via psychological or pharmacological means. At the same time, the field appears stuck and has not achieved considerable progress in advancing scientific understanding of depression's features or delivering interventions to meet the challenge of youth depression's high and growing prevalence. This paper adopts several positions to address these challenges and move the field forward. First, we emphasize reinvigoration of construct validation approaches that may better characterize youth depression's phenomenological features and inform more valid and reliable assessments that can enhance scientific understanding and improve interventions for youth depression. To this end, history and philosophical principles affecting depression's conceptualization and measurement are considered. Second, we suggest expanding the range and targets of treatments and prevention efforts beyond current practice guidelines for evidence-based interventions. This broader suite of interventions includes structural- and system-level change focused at community and societal levels (e.g., evidence-based economic anti-poverty interventions) and personalized interventions with sufficient evidence base. We propose that by focusing on the FORCE (Fundamentals, Openness, Relationships, Constructs, Evidence), youth depression research can provide new hope.
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Affiliation(s)
- Benjamin L Hankin
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA.
| | - Julianne M Griffith
- Department of Psychology, University of Illinois Urbana Champaign, 603 E. Daniel Street, Champaign, IL, 61820, USA
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Esposito J, Davis M, Boyd RC. Suicide Prevention in Pediatric Health Care Settings. Pediatr Clin North Am 2023; 70:1115-1124. [PMID: 37865434 DOI: 10.1016/j.pcl.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Given recent trends demonstrating increased suicide risk among youth, particularly those from minoritized populations, youth suicide is a major public health concern. Evidence-based practices for the identification and management of youth suicide risk have been developed, yet many challenges exist to implementing them routinely in health care settings. Suggestions for leveraging publicly available resources, gathering input from a range of stakeholders to inform implementation, and enhancing multidisciplinary collaboration are provided with the aim of offering tangible steps toward addressing the youth suicide crisis.
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Affiliation(s)
- Jeremy Esposito
- Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA.
| | - Molly Davis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, USA
| | - Rhonda C Boyd
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, 3440 Market Street, Suite 200, Philadelphia, PA 19104, USA; Department of PolicyLab, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Zhu AY, Crawford MH. Risk factors associated with adolescent suicidality before and during the COVID-19 pandemic. Suicide Life Threat Behav 2023; 53:981-993. [PMID: 37650548 DOI: 10.1111/sltb.12997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To evaluate the impact of the coronavirus disease 2019 pandemic on youth suicidal behaviors. METHOD This study examined two national surveys of high school students, the 2019 Youth Risk Behavior Survey (YRBS) and the 2021 Adolescent Behaviors and Experiences Survey (ABES). RESULTS The YRBS 2019 had 13,677 entries: 18.6% (17.5-19.8) (weighted percentage and 95% confidence intervals [CIs]) of youth had suicidal ideation (SI) and 8.9% (7.9-10.0) had at least one suicide attempt (SA). The ABES 2021 had 7705 entries: 19.9% (18.0-22.0) of youth had SI and 9.0% (7.7-10.5) had SA. In ABES 2021, both the percentage of youth with SI or SA was highest at age 14, at 21.8% (16.9-27.8) and 10.0% (6.6-14.8), respectively. The top factors associated with both SI and SA were parental abuse, sexual violence, illicit drug use, misuse of prescription pain medicine, and being bullied electronically. Screen time ≥3 h per day (not including schoolwork) was associated with a lower risk of SA (odds ratio [OR] 0.553, 95% CI: 0.382-0.799), but not SI (OR 1.011, 0.760-1.344). CONCLUSIONS Earlier onset of adolescent suicidality, at age 14, was noted during the pandemic. The association of higher non-school work-related screen time with lower SA is unexpected and warrants validation.
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Affiliation(s)
- Allison Y Zhu
- The Lawrenceville School, Lawrenceville, New Jersey, USA
| | - Michael H Crawford
- University of California, San Francisco School of Medicine, San Francisco, California, USA
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38
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Bryan CJ, Allen MH, Bryan AO, Thomsen CJ, Baker JC, May AM. Does Suicide Risk Screening Improve the Identification of Primary Care Patients Who Will Attempt Suicide Versus Depression Screening Alone? Jt Comm J Qual Patient Saf 2023; 49:680-688. [PMID: 37739828 DOI: 10.1016/j.jcjq.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE The effectiveness of suicide risk screening relative to depression screening alone among primary care patients has not been tested rigorously. This study compared the performance of multiple depression screening methods (Patient Health Questionnaire [PHQ]-2, PHQ-8, and PHQ-9) and multiple suicide risk screening methods (PHQ-9 item 9 and suicide-focused screening of "thoughts of killing yourself" during the entire lifespan, within the past month, and within the past week) in a convenience sample of primary care patients. METHODS A total of 2,744 patients (military personnel, family members, and retirees) from six military primary care clinics completed the PHQ-9 and screening for suicidal ideation (SI) during routine clinic visits. Follow-up phone interviews were conducted for one year post-baseline to assess the incidence of suicide attempts, the study's primary outcome. Sensitivity, specificity, accuracy, and F1 statistics were calculated for each screening method for identifying patients who attempted suicide. RESULTS More than 65% of patients who screened positive for SI also screened positive for depression on the PHQ-9. Depression screening with the PHQ-9 correctly identified more patients who attempted suicide during follow-up than the PHQ-2, past week SI, and past month SI. The PHQ-9 correctly identified more patients who attempted suicide within 3 months than lifetime SI, but lifetime SI correctly identified more patients who attempted suicide within 6 and 12 months. CONCLUSION Depression screening with the PHQ-9 was the most effective strategy for identifying patients who attempted suicide in the near term. Universal suicide risk screening is unlikely to meaningfully improve identification of higher-risk patients beyond PHQ-9 depression screening.
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Doan TT, DeJonckheere M, Wright DR, Hutton DW, Prosser LA. Preferences and experiences of pediatricians on implementing national guidelines on universal routine screening of adolescents for major depressive disorder: A qualitative study. Compr Psychiatry 2023; 127:152412. [PMID: 37717343 DOI: 10.1016/j.comppsych.2023.152412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND To explore the preferences of pediatricians for key factors around the implementation of universal routine screening guidelines for major depressive disorder in adolescent patients in a primary care setting. METHOD Semi-structured qualitative interviews were conducted with U.S. pediatricians. Participants were recruited by convenience sampling and snowball sampling. Qualitive data were summarized using thematic analysis to identify themes relevant to preferences around implementing screening strategies for adolescent patients. Recruitment ended upon reaching thematic saturation when no new themes were revealed. RESULTS Of the 14 participants, 11 identified as female, 3 male, 10 white, and 4 Asian. Top themes among pediatrician participants were around the screening modality (14/14 participants), screening validity (14/14), time barriers (14/14), and confidentiality barriers (12/14). Less frequently mentioned themes by pediatricians were workplace coordination and logistics (7/14), alternative starting ages for screening (7/14), more frequent screenings than annual screenings (3/14), and additional clinical training regarding depression diagnosis and treatment (2/14). LIMITATIONS Pool of interviewed participants was limited by diversity in terms of geography, race/ethnicity, or practice settings. CONCLUSIONS To promote the uptake of universal routine screening of adolescent major depression, pediatricians expressed it was important to address key implementation factors regarding the screening modality, screening validity, time constraints, and confidential care concerns in a primary care delivery context. Findings could be used to inform the development of implementation strategies to facilitate depression screening in primary care. Future research is needed to quantitively assess decisions and tradeoffs that pediatricians make when implementing universal screening to support adolescent mental health.
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Affiliation(s)
- Tran T Doan
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Melissa DeJonckheere
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Davene R Wright
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lisa A Prosser
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA; Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, MI, USA
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Hamdan SZ, Davis M, Faig W, Guthrie W, Yerys BE, Wallis KE. Lower Completion of Depression Screening and Higher Positivity Among Autistic Adolescents Across a Large Pediatric Primary Care Network. Acad Pediatr 2023; 23:1561-1571. [PMID: 37393034 PMCID: PMC10755081 DOI: 10.1016/j.acap.2023.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE To examine rates of depression screening and positivity among autistic adolescents where electronic depression screening is administered universally; to compare rates between autistic and nonautistic youth; and to explore sociodemographic and clinical factors associated with screening completion and results. METHODS We conducted a retrospective cohort study comparing 12-17-year-old autistic and nonautistic adolescents presenting for well-child care in a large pediatric primary care network between November 2017 and January 2019 (N = 60,181). Sociodemographic and clinical data, including PHQ-9-M completion status and results, were extracted digitally from the electronic health record and compared between autistic and nonautistic youth. Logistic regression explored the relationship between sociodemographic and clinical factors and screen completion and results, stratified by autism diagnosis. RESULTS Autistic adolescents were significantly less likely to have a completed depression screen compared to nonautistic adolescents [67.0% vs 78.9%, odds ratio (OR) = 0.54, P < .01]. Among those with a completed screen, a higher percentage of autistic youths screened positive for depression (39.1% vs 22.8%; OR = 2.18, P < .01,) and suicidal ideation/behavior (13.4% vs 6.8%; OR = 2.13, P < .01). Factors associated with screening completion and positivity differed between autistic and nonautistic groups. CONCLUSIONS Autistic adolescents were less likely to have a completed depression screen when presenting for well-child care. However, when screened, they were more likely to endorse depression and suicide risk. This suggests disparities in depression screening and risk among autistic youth compared to nonautistic youth. Additional research should evaluate the source of these disparities, explore barriers to screening, and examine longitudinal outcomes of positive results among this population.
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Affiliation(s)
- Samar Z Hamdan
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI) (M Davis), University of Pennsylvania, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
| | - Walter Faig
- Biostatistics and Data Management Core (W Faig), Children's Hospital of Philadelphia, Philadelphia, Pa.
| | - Whitney Guthrie
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Benjamin E Yerys
- Department of Child and Adolescent Psychiatry and Behavioral Sciences (M Davis, W Guthrie, and BE Yerys), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Psychiatry (M Davis, W Guthrie, and BE Yerys), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Kate E Wallis
- Division of Developmental and Behavioral Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics (SZ Hamdan, W Guthrie, and KE Wallis), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa; Center for Autism Research (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa; Clinical Futures (W Guthrie, BE Yerys, and KE Wallis), Children's Hospital of Philadelphia, Philadelphia, Pa. Dr Hamdan is now with the Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
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Hilliard M, Parkhurst JT. Suicide Risk Assessment and Safety Planning in Pediatric Primary Care. Pediatr Ann 2023; 52:e422-e425. [PMID: 37935394 DOI: 10.3928/19382359-20230906-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Suicidal thoughts and behavior are an increasing concern for youth. Pediatricians can prevent youth suicide through a stepwise process of screening, risk assessment, and safety planning incorporated into their practice. This article describes practical steps for pediatric clinicians to effectively detect and assess risks associated with suicidal thoughts and behaviors in youth while concurrently providing effective intervention. [Pediatr Ann. 2023;52(11):e422-e425.].
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Parsons SK, Beauchemin MP, Dupuis L, Sugalski A, Wolfson JA, Santacroce SJ, Marchak JG, Sung L, Roth ME. Children's Oncology Group 2023 blueprint for research: Cancer care delivery research. Pediatr Blood Cancer 2023; 70 Suppl 6:e30579. [PMID: 37469004 PMCID: PMC10686255 DOI: 10.1002/pbc.30579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Abstract
The National Cancer Institute (NCI) has a 40-year history of initiatives to encourage the participation of community oncology sites into clinical trials research and clinical care. In 2014, the NCI re-organized to form the NCI Community Oncology Research Program (NCORP) network across seven research bases, including the Children's Oncology Group (COG), and numerous community sites. The COG portfolio for Cancer Care Delivery Research (CCDR), mirroring the larger NCORP network, has included two studies addressing guideline congruence, as an important marker of quality cancer care, and another focusing on financial toxicity, addressing the pervasive problems of healthcare cost. CCDR is a cross-cutting field that frequently examines intersectional aspects of healthcare delivery. With that in mind, we explicitly define domains of CCDR to propel our research agenda into the next phase of the NCORP CCDR program while acknowledging the complex and dynamic fields of clinical care, policy level decisions, research findings, and needs of communities served by the NCORP network that will inform the subsequent research questions. To ensure programmatic success, we will engage a broad interdisciplinary group of investigators and clinicians with expertise and dedication to community oncology and the populations they serve.
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Affiliation(s)
- Susan K. Parsons
- Institute for Clinical Research and Health Policy Studies and the Division of Hematology/Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA
| | - Melissa P. Beauchemin
- Columbia University School of Nursing, CUIMC Minority/Underserved NCI Community Oncology Research Program, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Lee Dupuis
- Department of Pharmacy, The Hospital for Sick Children and Leslie Dan Faculty of Pharmacy, University of Toronto, Canada
| | - Aaron Sugalski
- University Health System Pediatric Blood and Cancer Center, Division Hematology/Oncology, University of Texas Health San Antonio, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, Texas
| | - Julie Anna Wolfson
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Division of Pediatric Hematology-Oncology, University of Alabama at Birmingham
| | - Sheila J. Santacroce
- School of Nursing and Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, North Carolina
| | - Jordan G. Marchak
- Emory University School of Medicine, Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta, Georgia
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Michael E. Roth
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Chen H, Hong L, Tong S, Li M, Sun S, Xu Y, Liu J, Feng T, Li Y, Lin G, Lu F, Cai Q, Xu D, Zhao K, Zheng T. Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study. BMC Psychiatry 2023; 23:247. [PMID: 37046299 PMCID: PMC10099683 DOI: 10.1186/s12888-023-04726-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempts (SAs) by adolescent patients with depression have become serious public health problems. There is still insufficient research evidence on the effects of NSSI and SAs on neurocognitive functioning in adolescents. Cognitive function alterations may be associated with SAs and self-injury. NSSI and SAs have different influencing factors. METHODS Participants were recruited from outpatient clinics and included 142 adolescent patients with depression (12-18 years old). This cohort included the SAs group (n = 52), NSSI group (n = 65), and depression without SAs/NSSI control group (n = 25). All participants underwent a clinical interview and neuropsychological assessment for group comparisons, and post-hoc tests were performed. Finally, partial correlation analysis was used to explore factors related to changes in cognitive function. RESULTS The SAs group performed significantly worse than the control group in executive function and working memory. The depression score was directly proportional to the executive function of the SAs group, whereas cognitive functioning in the NSSI group was associated with borderline traits and rumination. CONCLUSIONS These findings suggest that impairment of executive function and working memory may be a common pattern in adolescent depressed patients with SAs. However, borderline traits and rumination may be indicative of NSSI but not SAs.
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Affiliation(s)
- Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, 325035, Wenzhou, China
| | - Lan Hong
- The Third Hospital of QuZhou, 324000, Quzhou, China
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Mengjia Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Tianqi Feng
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yuting Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Guangyao Lin
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Fanfan Lu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Qiaole Cai
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Ke Zhao
- Lishui Second People's Hospital Afliated to Wenzhou Medical University, 323000, Lishui, China.
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China.
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Iwatate E, Atem FD, Jones EC, Hughes JL, Yokoo T, Messiah SE. Association of Obesity, Suicide Behaviors, and Psychosocial Wellness Among Adolescents in the United States. J Adolesc Health 2023; 72:526-534. [PMID: 36646564 DOI: 10.1016/j.jadohealth.2022.11.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adolescents with obesity are more likely to exhibit suicide behaviors, but this association may be confounded by psychosocial stigma related to obesity. We examined whether the obesity is independently associated with suicide behaviors among United States adolescents, after adjusting for the psychosocial factors. METHODS We analyzed data from 2019 Youth Risk Behavior Survey data (N = 13,871 United States adolescents) on recent (past year) suicide behavior (attempt, ideation, and plan); demographics (age, sex, and race/ethnicity); and psychosocial factors (feeling sad/hopeless, alcohol and illegal drug use, being bullied, and sexually abused). Participants were classified as having obesity (Y/N) per standardized percentiles. Logistic regression was employed to examine the association between obesity and suicide attempt, ideation, and plan, while adjusting for psychosocial covariates. RESULTS The prevalence of suicide attempt, ideation, and plan was 8.90%, 18.75%, and 15.71%, respectively. Obesity prevalence was 15.5%. The odds of suicide attempt, ideation, and plan were 1.65 (1.30-2.11), 1.31 (0.89-1.61), and 1.27 (1.02-1.57), respectively, among those with obesity versus without obesity. DISCUSSION Obesity is significantly associated with a suicide attempt, ideation, and plan among United States adolescents, even after adjusting for confounding psychosocial factors. Further research on the temporality and causality of this association is needed.
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Affiliation(s)
- Eriko Iwatate
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas.
| | - Folefac D Atem
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, Texas
| | - Eric C Jones
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas
| | - Jennifer L Hughes
- Department of Psychiatry and Behavioral Health, Big Lots Behavioral Health Services, College of Medicine, Nationwide Children's Hospital, Columbus, Ohio; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Takeshi Yokoo
- Department of Radiology, University of Texas Southwestern, Dallas, Texas
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, Texas
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Wu Y, Yan D, Yang J. Effectiveness of yoga for major depressive disorder: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1138205. [PMID: 37032928 PMCID: PMC10077871 DOI: 10.3389/fpsyt.2023.1138205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/11/2023] Open
Abstract
Objective Major depressive disorder (MDD) has a relapse rate that cannot be ignored and places a tremendous burden on the patient in the prevention and treatment process. Yoga, a combination of physical and mental exercises, is effective and acceptable for the adjunctive treatment of MDD. This study aimed to explore further the evidence of yoga's efficacy for patients with MDD. Methods PubMed, Embase, Cochrane library, PsycINFO, SinoMed, CNKI, Wanfang, and VIP databases from their inception to 13 October 2022 were searched by a pre-defined search strategy. RCTs of patients with MDD who met diagnostic criteria for yoga treatment were included. RoB2.0 was used to evaluate the quality of the literature. Improvement in depressive symptoms was assessed by the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), or other scales were used as primary outcome indicators, and improvement in anxiety was assessed by the Hamilton Anxiety Scale (HAMA) and State-Trait Anxiety Inventory (STAI) scale as secondary outcome indicators. RR and Cohen's d at 95% CI were used as effect size estimates, and Q and I2 were used to evaluate the size of heterogeneity, with a p-value less than 0.05 indicating statistical significance. Results Thirty-four RCT studies, including 1,269 patients in the treatment group and 1,072 patients in the control group, 48.4% of whom were women, were included in the study. Compared to the control group, the BDI-II results yielded a moderate effect of yoga on the improvement of depressive symptoms (Cohen's d = -0.60; 95% CI: -1.00 to -0.21; p < 0.01), the HAMD results yielded a moderate improvement of yoga on the severity of depressive symptoms (Cohen's d = -0.64; 95% CI: -0.98 to -0.30; p < 0.01), and the STAI results can be concluded that yoga had a negligible effect on the improvement of the level of anxiety (Cohen's d = -0.26; 95% CI: -0.48 to -0.04; p = 0.02). No adverse events occurred in the yoga group during the treatment. Conclusion Yoga can improve depressive symptoms and anxiety in patients with MDD and has a safe and wide patient acceptance. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [PROSPERO, CRD42022373282].
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Affiliation(s)
| | | | - Jianli Yang
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China
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Kass M, Alexander L, Moskowitz K, James N, Salum GA, Leventhal B, Merikangas K, Milham MP. Robust Parental Preferences in Mental Health Screening in Youth From a Multinational Online Survey. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.09.23285610. [PMID: 36798244 PMCID: PMC9934784 DOI: 10.1101/2023.02.09.23285610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Importance Screening youth for mental disorders may assist in prevention, promote early identification, and reduce related lifetime impairment and distress. Objective The goal was to survey parents about their comfort and preferences for pediatric mental health screening, as well as factors associated with these preferences. Design The online survey was available July 11-14, 2021 on Prolific Academic. Analyses were conducted from November 2021 to November 2022. Setting Online survey. Participants The survey was administered to English-speaking parents with at least one 5-21-year old child at home. The sample included 972 parents, aged 21 and older, from the United States ( n =265), United Kingdom ( n =282), Canada ( n =171), and Other Countries ( n =254). Exposures None. Main Outcomes/Measures Parental preferences regarding the screening content, implementation preferences, and screener reviewing preferences of pediatric mental health screening were assessed in a novel survey. Mixed effects logistic models were employed to evaluate factors that influence parental comfort levels. Results Parents, aged 21 to 65 ( M =39.4; 62.3% female), supported annual mental health screening for their child and preferred reviewing the screening results with professional staff (e.g., physicians). Parents preferred parent-report over child self-reports, though they were generally comfortable with both options. Despite slight variations based on country of residence, screening topic, and child's age, parents were generally comfortable discussing all 21 topics. The greatest comfort was with sleep problems; the least comfort was with firearms, gender identity, suicidality, and substance use/abuse. Conclusions/Relevance Our data indicated that parents support annual parent- and child self-report mental health screening in primary care settings, but comfort levels differ according to various factors, such as screening topic. Parents preferred screening to occur in the healthcare office and to discuss screening results with professional staff. In addition to parental need for expert guidance, the growing awareness of child mental health needs highlights the importance of addressing mental health concerns early via regular mental health screenings. KEY POINTS Question: What are parents' attitudes towards pediatric mental health screening in primary care settings?Findings: The vast majority of parents surveyed online ( N=972) expressed comfort with the screening of children for mental health concerns in the primary care setting. Variations in comfort were noted in relation to age of child and topics included. Parents expressed a preference for parent report over child report, as well as for reviewing screening results with professional medical staff. These findings were robust to the country of residence (e.g., United States, Canada, United Kingdom). Meaning: Our findings document parental preferences that should be incorporated to enhance the feasibility of mental health screening in primary care settings.
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Zhu J, Li Y, Zhang C, He J, Niu L. Trends in mortality and causes of death among Chinese adolescents aged 10-19 years from 1990 to 2019. Front Public Health 2023; 11:1075858. [PMID: 36825144 PMCID: PMC9941149 DOI: 10.3389/fpubh.2023.1075858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/10/2023] [Indexed: 02/10/2023] Open
Abstract
Objective Promoting adolescent health is essential to achieving the goals of the Healthy China 2030 (HC 2030) initiative. As socioeconomic conditions improve and medical practices and disease patterns evolve, adolescent mortality rates and causes of death vary considerably. This study provides up-to-date data on adolescent mortality and causes of death in China, highlighting key areas of focus for investment in adolescent health. Methods Data regarding mortality and causes of death in Chinese adolescents aged 10-19 years were extracted from the Global Burden of Disease study from 1990 to 2019. The data variables were examined according to year, sex, and age. The autoregressive integrated moving average model was used to predict non-communicable disease (NCD) mortality rates and rank changes in the leading causes of death until 2030. Results The all-cause mortality rate (per 100,000 population) of Chinese adolescents aged 10-19 years steadily declined from 1990 (72.6/100,000) to 2019 (28.8). Male adolescents had a higher mortality (37.5/100,000 vs. 18.6 in 2019) and a slower decline rate (percent: -58.7 vs. -65.0) than female adolescents. Regarding age, compared with those aged 10-14 years, the mortality rate of adolescents aged 15-19 years had a higher mortality (35.9/100,000 vs. 21.2 in 2019) and a slower decrease rate (percent: -57.6 vs. -63.2). From 1990 to 2019, the rates of communicable, maternal, and nutritional diseases declined the most (percent: -80.0), while injury and NCDs mortality rates were relatively slow (percent: -50.0 and -60.0). In 2019, the five leading causes of death were road injuries (6.1/100,000), drowning (4.5), self-harm (1.9), leukemia (1.9), and congenital birth defects (1.3). Furthermore, NCDs' mortality rate decreased by -46.6% and -45.4% between 2015-2030 and 2016-2030, respectively. Conclusion A notable decline was observed in all-cause mortality rates among Chinese adolescents aged 10-19 years. In addition, the mortality rates of NCDs are projected to meet the target from the Global Strategy for Women's, Children's, and Adolescents' Health (2016-2030) and HC2030 reduction indicators by 2030. However, it should be noted that injury is the leading cause of death, with sexual and age disparities remaining consistent.
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Affiliation(s)
- Jiaxin Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Chengcheng Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Lu Niu
- *Correspondence: Lu Niu ✉
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