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Uno A, Nagaoka D, Usami S, Yamaguchi S, Minami R, Tanaka R, Sawai Y, Okuma A, Yamasaki S, Miyashita M, Nishida A, Kasai K, Ando S. Suicidal Thoughts and Trajectories of Psychopathological and Behavioral Symptoms in Adolescence. JAMA Netw Open 2024; 7:e2353166. [PMID: 38270951 PMCID: PMC10811562 DOI: 10.1001/jamanetworkopen.2023.53166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
Importance The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has not been well examined. This study comprehensively clustered trajectories of multiple psychopathological and behavioral symptoms and examined their associations with suicidal thoughts in adolescence. Objective To determine which categories and trajectories of psychopathological and behavioral symptoms are associated with suicidal thoughts in adolescence, accounting for comorbid symptoms. Design, Setting, and Participants This population-based cohort study in Japan used data from the Tokyo Teen Cohort (TTC) study, which was established in 2012 and is currently ongoing. Data from 3 waves of surveys conducted at ages 10, 12, and 16 years from October 2012 to September 2021 were used. Of the adolescents in the cohort, participants with at least 2 evaluations of psychopathological and behavioral symptoms were included. Data were analyzed from December 2022 to March 2023. Exposure Latent class growth analysis was used to cluster the trajectory of each psychopathological and behavioral symptom. Main Outcomes and Measures The associations between symptom trajectories and suicidal thoughts at age 16 were examined. Suicidal thoughts were assessed using a self-report questionnaire. Psychopathological and behavioral symptoms were assessed using the 8 subscale scores of the caregiver-report Child Behavior Checklist. Results This study included 2780 adolescents (1306 female participants [47.0%]). Of the 1920 adolescents with data on suicidal thoughts, 158 (8.2%) had suicidal thoughts. The median (IQR) age was 10.2 (10.0-10.3) years at the first evaluation, 11.9 (11.8-12.1) years at the second evaluation, and 16.3 (16.1-16.5) years at the last evaluation. The clustering pattern of trajectories varied depending on symptom categories. After adjusting for each symptom trajectory and confounders, adolescents with persistent high withdrawn symptoms (odds ratio [OR], 1.88; 95% CI, 1.10-3.21) and those with increasing somatic symptoms (OR, 1.97; 95% CI, 1.16-3.34) had a significantly higher risk of suicidal thoughts than adolescents without these symptoms. There was no interaction between these symptom trajectories and the risk of suicidal thoughts. Conclusions and Relevance This cohort study found that persistent withdrawn symptoms and increasing somatic symptoms during early to midadolescence were associated with an increased risk of suicidal thoughts in midadolescence, even after accounting for comorbid symptoms and confounders. Attention should be paid to the suicidal risk associated with these symptoms, particularly when they persist or increase in the longitudinal follow-up.
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Affiliation(s)
- Akito Uno
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daiki Nagaoka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Satoshi Yamaguchi
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Sawai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayako Okuma
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Li P, Wang Y, Kovess-Masfety V, Su X, Hou X, Li M, Li P, Li J, Pang J, Ma H, Yu H, Yang T, Yin H, Xu G. Suicidal ideation and its relationship with mental health reported by different informants among children aged 6-12. J Affect Disord 2023; 334:271-277. [PMID: 37156271 DOI: 10.1016/j.jad.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Suicidal ideation in children has received less attention than in adolescents. This study aimed to explore the self-reported prevalence of suicidal ideation among children aged 6-12 and to identify the relationship between self-reported suicidal ideation and children's mental health reported by different informants in Chinese setting. METHOD The study sample was 1479 children aged 6-12 from three elementary schools in Tianjin. Children completed the Dominic Interactive to report their mental health and suicidal ideation. Parents and teachers completed the Socio-Demographic Questionnaire and the Strengths and Difficulties Questionnaire (SDQ). RESULTS The prevalence of suicidal thoughts and death thoughts was 18.05 % and 16.90 %, respectively. Parent reported emotional symptoms, ADHD and externalized problems were associated with death thoughts, and ADHD was associated with suicidal thoughts. For teacher's reports, emotional symptoms, and impact were associated with death thoughts, and ADHD, peer problems, internalized problems, and internalized and externalized comorbidity were associated with suicidal thoughts. All of the children's self-reported mental health problems were associated with suicidal thoughts and death thoughts. LIMITATIONS Causality cannot be inferred in a cross-sectional study. CONCLUSION Suicidal ideation is not uncommon in Chinese children. The relationships between mental health problems and suicidal ideation varied in different informants. Suicide prevention in young children should be enhanced, and screening for suicidal ideation is recommended at the onset of different informants who reported specific mental health problems.
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Affiliation(s)
- Peiyao Li
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Yi Wang
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Viviane Kovess-Masfety
- LPPS, University of Paris, France; Department of Psychiatry, Mc Gill University, Montreal, Quebec, Canada
| | - Xuyang Su
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Xiaofei Hou
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Minghui Li
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Peiying Li
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Jinhao Li
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Jingjuan Pang
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - He Ma
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Hang Yu
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Tengfen Yang
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China
| | - Huifang Yin
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China.
| | - Guangming Xu
- Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin 300222, China.
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Nigg JT, Karalunas SL, Mooney MA, Wilmot B, Nikolas MA, Martel MM, Tipsord J, Nousen EK, Schmitt C, Ryabinin P, Musser ED, Nagel BJ, Fair DA. The Oregon ADHD-1000: A new longitudinal data resource enriched for clinical cases and multiple levels of analysis. Dev Cogn Neurosci 2023; 60:101222. [PMID: 36848718 PMCID: PMC9984785 DOI: 10.1016/j.dcn.2023.101222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
The fields of developmental psychopathology, developmental neuroscience, and behavioral genetics are increasingly moving toward a data sharing model to improve reproducibility, robustness, and generalizability of findings. This approach is particularly critical for understanding attention-deficit/hyperactivity disorder (ADHD), which has unique public health importance given its early onset, high prevalence, individual variability, and causal association with co-occurring and later developing problems. A further priority concerns multi-disciplinary/multi-method datasets that can span different units of analysis. Here, we describe a public dataset using a case-control design for ADHD that includes: multi-method, multi-measure, multi-informant, multi-trait data, and multi-clinician evaluation and phenotyping. It spans > 12 years of annual follow-up with a lag longitudinal design allowing age-based analyses spanning age 7-19 + years with a full age range from 7 to 21. Measures span genetic and epigenetic (DNA methylation) array data; EEG, functional and structural MRI neuroimaging; and psychophysiological, psychosocial, clinical and functional outcomes data. The resource also benefits from an autism spectrum disorder add-on cohort and a cross sectional case-control ADHD cohort from a different geographical region for replication and generalizability. Datasets allowing for integration from genes to nervous system to behavior represent the "next generation" of researchable cohorts for ADHD and developmental psychopathology.
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Affiliation(s)
- Joel T Nigg
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA.
| | | | - Michael A Mooney
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, USA
| | - Beth Wilmot
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, USA
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa, USA
| | | | - Jessica Tipsord
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Elizabeth K Nousen
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Colleen Schmitt
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Peter Ryabinin
- Knight Cancer Institute, Oregon Health & Science University, USA
| | - Erica D Musser
- Department of Psychology, Florida International University, USA
| | - Bonnie J Nagel
- Department of Psychiatry & Behavioral Neuroscience, Oregon Health & Science University, USA
| | - Damien A Fair
- Department of Pediatrics, Masonic Institute for the Developing Brain, Institute of Child Development, College of Education and Human Development, University of Minnesota, USA.
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Abstract
It is widely agreed that the DSM-5, the handbook of psychiatric diagnosis, suffers from both high overlap among its putative disorders and high heterogeneity (variability) within each disorder. While these may appear to be opposite problems, in fact both may stem from failure to recognize transdiagnostic dimensions of emotion, cognition, and personality, among others, that inform psychopathology. These fundamental nosological challenges are exemplified in the case of attention-deficit/hyperactivity disorder (ADHD). In ADHD, broad clinical heterogeneity has defied easy clinical prediction of outcomes or clean statistical differentiation of meaningful, biologically informative sub-groups. Progress for ADHD heterogeneity looks promising, however, when we consider dimensions of trait affectivity such as surgency and negative affectivity, their constituent lower order traits such as irritability, and the integrative function of self-regulation. Focusing on developments in the study of temperament traits and ADHD as they relate to emotional dysregulation, several lines of investigation are proving useful. Utilization of selective computational models, biological validators, and longitudinal analyses points toward potential improvements in nosology and clinical assessment in the future by taking temperament traits into account.
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Santos S, Ferreira H, Martins J, Gonçalves J, Castelo-branco M. Male sex bias in early and late onset neurodevelopmental disorders: shared aspects and differences in autism spectrum disorder, attention deficit/hyperactivity disorder, and schizophrenia. Neurosci Biobehav Rev 2022. [DOI: 10.1016/j.neubiorev.2022.104577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/23/2022] [Accepted: 02/11/2022] [Indexed: 12/22/2022]
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Orri M, Boivin M, Chen C, Ahun MN, Geoffroy MC, Ouellet-Morin I, Tremblay RE, Côté SM. Cohort Profile: Quebec Longitudinal Study of Child Development (QLSCD). Soc Psychiatry Psychiatr Epidemiol 2021; 56:883-894. [PMID: 33185737 DOI: 10.1007/s00127-020-01972-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The Quebec Longitudinal Study of Child Development (QLSCD) was designed to examine the long-term associations of preschool physical, cognitive, social, and emotional development with biopsychosocial development across childhood, adolescence, and young adulthood. METHODS QLSCD is an ongoing prospective cohort including 2120 singletons born in 1997/1998 in the Canadian province of Quebec. So far, data have been collected annually or every 2 years from child ages 5 months to 21 years. The cohort currently includes 1245 participants. Data available include a range of environmental (e.g., family characteristics, child behaviour, educational attainment, mental health), biological (e.g., hair cortisol, genetic, epigenetic), and administrative data. RESULTS QLSCD has contributed to the understanding of children's psychosocial development, including the development of physical aggression and anxiety. QLSCD articles have advanced scientific knowledge on the influence of early childhood factors on childhood, adolescent, and young adult mental health, including the effect of participation in early childcare on cognitive and behavioural development, the developmental origins of adolescent and young adult mental health problems and suicide risk, and the development of interpersonal difficulties (e.g., peer victimisation) from preschool years to adolescence. CONCLUSION QLSCD has given major contributions to our understanding of the link between different aspects of child development and biopsychosocial development during the first two decades of life. Unique features include the presence of environmental, biological, and administrative data, long-term follow-up with frequent data collections, and use of data from multiple informants, including teachers, mothers, fathers, and the children themselves.
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Affiliation(s)
- Massimiliano Orri
- McGill Group for Suicide Studies, Department of Psychiatry, Department, Montreal, Douglas Mental Health University Institute, McGill University, Frank B. Common Pavilion, F-2101 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France
| | - Michel Boivin
- School of Psychology, Université Laval, Quebec, QC, Canada
| | - Chelsea Chen
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
| | - Marilyn N Ahun
- Sainte-Justine Hospital Research Center, Montreal, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 3050 Edouard Montpetit, Montreal, QC, H3T 1J7, Canada
| | - Marie-Claude Geoffroy
- McGill Group for Suicide Studies, Department of Psychiatry, Department, Montreal, Douglas Mental Health University Institute, McGill University, Frank B. Common Pavilion, F-2101 6875 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada
- Department of Education and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Isabelle Ouellet-Morin
- School of Criminology, University of Montreal, Montreal, QC, Canada
- Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada
| | - Richard E Tremblay
- Department of Pediatrics and Psychology, University of Montreal, Montreal, QC, Canada
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Bordeaux Population Health Research Centre, Inserm U1219, University of Bordeaux, Bordeaux, France.
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 3050 Edouard Montpetit, Montreal, QC, H3T 1J7, Canada.
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Abstract
ADHD represents a powerful entry point for developmental approaches to psychopathology due to its major role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seem to have largely benign outcomes, while a larger group continue on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland OR, USA
| | - Margaret H Sibley
- University of Washington and Seattle Children's Research Institute, Seattle WA, USA
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Abstract
ADHD represents a powerful entry point for developmental approaches to psychopathology due to its major role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seem to have largely benign outcomes, while a larger group continue on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland OR, USA
| | - Margaret H Sibley
- University of Washington and Seattle Children's Research Institute, Seattle WA, USA
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Garas P, Balazs J. Long-Term Suicide Risk of Children and Adolescents With Attention Deficit and Hyperactivity Disorder-A Systematic Review. Front Psychiatry 2020; 11:557909. [PMID: 33408650 PMCID: PMC7779592 DOI: 10.3389/fpsyt.2020.557909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Attention deficit and hyperactivity disorder (ADHD) is one of the most common mental disorders in childhood. Recently, several studies showed the high suicide risk of patients with ADHD; however, most of these studies had a cross-sectional design. Aims: The aim of the current research is to complete a systematic review of published studies which investigate the suicide risk of ADHD patients with longitudinal design. Methods: The systematic search was made on OVID Medline, PsychInfo, PubMed, Scopus, and Web of Science. The search terms were (ADHD OR attention deficit hyperactivity disorder) AND (suicide OR suicidal OR suicidality) AND (follow-up OR longitudinal study OR prospective study). The inclusion criteria were as follows: written in English; the participants were under 18 years at baseline; longitudinal, prospective studies; ADHD population at baseline and at follow-up; and suicide behavior as a primary outcome. The exclusion criteria were as follows: the study did not contain empirical data and reviews/meta-analyses and studies which aimed to investigate the drug treatment efficacy of ADHD. Results: After the screening process, 18 papers were included in the systematic review. Ten articles were altogether published in the last 5 years. The range of follow-up periods varied between 2 and 17 years. Several different assessment tools were used to investigate the symptoms and/or the diagnosis of ADHD and the suicidal risk. Nine studies enrolled children aged under 12 at baseline, and three studies used birth cohort data, where there was no strict age-based inclusion criteria. A total of 17 studies found a positive association between ADHD diagnosis at baseline and the presence of suicidal behavior and/or attempts at the follow-up visits. Limitations: The main limitation of this review is the methodological heterogeneity of the selected studies. A further limitation is the relatively low number of studies that examined a population with balanced gender ratios. Additionally, only one study published data about the treatment of ADHD. Finally, though we carefully chose the keywords, we still may be missing some relevant papers on this topic. Conclusions: In spite of the methodological diversity of the included studies, the results of the current systematic review highlight the importance of screening suicidality in the long term in patients with ADHD. Therefore, further studies that compare the suicidal risk of treated and untreated groups of ADHD patients in the long term are needed.
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Affiliation(s)
- Peter Garas
- Mental Health Sciences School of Ph.D., Semmelweis University, Budapest, Hungary
| | - Judit Balazs
- Mental Health Sciences School of Ph.D., Semmelweis University, Budapest, Hungary.,Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Department of Psychology, Bjørknes University College, Oslo, Norway
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