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Tindall L, Kerrigan P, Li J, Hayward E, Gega L. Is behavioural activation an effective treatment for depression in children and adolescents? An updated systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02429-3. [PMID: 38615316 DOI: 10.1007/s00787-024-02429-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/15/2024]
Abstract
Behavioural Activation (BA)-a brief therapy based on the scheduling of enjoyable, purposeful and rewarding activities-is an effective and cost-effective treatment for depression in adults that shows promise for children and adolescents. We provide an update on a previous systematic review of evidence on BA-delivered in-person, telephone, or online-for depression and comorbid anxiety in children and adolescents. We conducted systematic literature searches in 6 databases up to February 2024. We included all study designs evaluating BA with participants up to 18 years old with diagnosable depression, as established by a validated screening tool or diagnostic manual. We used the Moncrieff Scale and the Cochrane Risk of Bias tool to assess study quality. We summarised the findings of all study types with a narrative synthesis and of randomised controlled trials (RCTs) with a meta-analysis. Overall, 24 studies (6 RCTs, 18 pre-post evaluations, n = 2,758) met our inclusion criteria. A meta-analysis of 4 RCTs (n = 156) showed that BA has a small effect of 0.24 (Hedge's adjusted g) in reducing depression symptoms compared to a waiting-list control, usual care and other therapies. Online and telephone-facilitated BA was shown to be feasible in 3 studies and effective in 1. Outcomes on comorbid anxiety were mixed. No economic evaluations met our inclusion criteria. BA shows sufficient promise as an intervention for reducing depression symptoms in children and adolescents to justify the need for further RCTs, providing that five conditions are met: studies are powered to detect a minimal clinically important difference; BA materials are fit-for-purpose to produce clinically meaningful change; follow-ups are longer than 6 months; primary outcomes are child-reported; and intervention costs, resource use and adverse events are reported.
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Affiliation(s)
- Lucy Tindall
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK.
| | - Philip Kerrigan
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Jinshuo Li
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Emily Hayward
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Lina Gega
- Hull York Medical School, University of York, Heslington, UK
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Rawat N, Kumar P. Interventions for improving indoor and outdoor air quality in and around schools. Sci Total Environ 2023; 858:159813. [PMID: 36411671 DOI: 10.1016/j.scitotenv.2022.159813] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/14/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Students spend nearly one third of their typical day in the school environment, where they may be exposed to harmful air pollutants. A consolidated knowledge base of interventions to reduce this exposure is required for making informed decisions on their implementation and wider uptake. We attempt to fill this knowledge gap by synthesising the existing scientific literature on different school-based air pollution exposure interventions, their efficiency, suitability, and limitations. We assessed technological (air purifiers, HVAC - Heating Ventilation and Air Conditioning etc.), behavioural, physical barriers, structural, school-commute and policy and regulatory interventions. Studies suggest that the removal efficiency of air purifiers for PM2.5, PM10, PM1 and BC can be up to 57 %, 34 %, 70 % and 58 %, respectively, depending on the air purification technology compared with control levels in classroom. The HVAC system combined with high efficiency filters has BC, PM10 and PM2.5 removal efficiency up to 97 %, 34 % and 30 %, respectively. Citizen science campaigns are effective in reducing the indoor air pollutants' exposure up to 94 %. The concentration of PM10, NO2, O3, BC and PNC can be reduced by up to 60 %, 59 %, 16 %, 63 % and 77 %, respectively as compared to control conditions, by installing green infrastructure (GI) as a physical barrier. School commute interventions can reduce NO2 concentration by up to 23 %. The in-cabin concentration reduction of up to 77 % for PM2.5, 43 % for PNC, 89 % for BC, 74 % for PM10 and 75 % for NO2, along with 94 % reduction in tailpipe emission of total particles, can be achieved using clean fuels and retrofits. No stand-alone method is found as the absolute solution for controlling pollutants exposure, their combined application can be effective in most of the scenarios. More research is needed on assessing combined interventions, and their operational synchronisation for getting the optimum results.
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Affiliation(s)
- Nidhi Rawat
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Prashant Kumar
- Global Centre for Clean Air Research (GCARE), School of Sustainability, Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom.
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Halladay J, MacKillop J, Munn C, Amlung M, Georgiades K. Individual- and school-level patterns of substance use and mental health symptoms in a population-based sample of secondary students: A multilevel latent profile analysis. Drug Alcohol Depend 2022; 240:109647. [PMID: 36244138 DOI: 10.1016/j.drugalcdep.2022.109647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions. METHODS A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety. RESULTS Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types. CONCLUSIONS The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
| | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7.
| | - Michael Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, the United States of America.
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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Las-Hayas C, Mateo-Abad M, Vergara I, Izco-Basurko I, González-Pinto A, Gabrielli S, Mazur I, Hjemdal O, Gudmundsdottir DG, Knoop HH, Olafsdottir AS, Fullaondo A, González N, Mar-Medina J, Krzyżanowski D, Morote R, Anyan F, Ledertoug MM, Tidmand L, Arnfjord UB, Kaldalons I, Jonsdottir BJ, de Manuel Keenoy E. Relevance of well-being, resilience, and health-related quality of life to mental health profiles of European adolescents: results from a cross-sectional analysis of the school-based multinational UPRIGHT project. Soc Psychiatry Psychiatr Epidemiol 2022; 57:279-291. [PMID: 34417859 PMCID: PMC8379563 DOI: 10.1007/s00127-021-02156-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE The existing evidence suggests that a complete evaluation of mental health should incorporate both psychopathology and mental well-being indicators. However, few studies categorize European adolescents into subgroups based on such complete mental health data. This study used the data on mental well-being and symptoms of mental and behavioral disorders to explore the mental health profiles of adolescents in Europe. METHODS Data collected from adolescents (N = 3767; mean age 12.4 [SD = 0.9]) from five European countries supplied the information on their mental well-being (personal resilience, school resilience, quality of life, and mental well-being) and mental and behavioral disorder symptoms (anxiety, depression, stress, bullying, cyber-bullying, and use of tobacco, alcohol, or cannabis). Multiple correspondence analysis and cluster analysis were combined to classify the youths into mental health profiles. RESULTS Adolescents were categorized into three mental health profiles. The "poor mental health" profile (6%) was characterized by low levels of well-being and moderate symptoms of mental disorders. The "good mental health" profile group (26%) showed high well-being and few symptoms of mental disorders, and the "intermediate mental health" profile (68%) was characterized by average well-being and mild-to-moderate symptoms of mental disorders. Groups with higher levels of well-being and fewer symptoms of mental disorders showed lower rates of behavioral problems. Mental well-being indicators strongly contributed to this classification. CONCLUSION Adolescents with the "intermediate" or "poor" mental health profiles may benefit from interventions to improve mental health. Implications for school-based interventions are discussed. TRIAL REGISTRATION NUMBER (TRN) AND DATE OF REGISTRATION ClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019.
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Affiliation(s)
- Carlota Las-Hayas
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
| | - Maider Mateo-Abad
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
- REDISSEC (Health Services Research On Chronic Patients Network), Barakaldo, Basque Country Spain
| | - Itziar Vergara
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
- REDISSEC (Health Services Research On Chronic Patients Network), Barakaldo, Basque Country Spain
- Biodonostia Health Research Institute, San Sebastián, Spain
| | - Irantzu Izco-Basurko
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
| | - Ana González-Pinto
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria - Gasteiz, Basque Country Spain
- University of the Basque Country UPV/EHU, Leioa, Spain
- CIBERSAM (CIBER of Mental Health Area), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
| | - Silvia Gabrielli
- Bruno Kessler Foundation, Via Santa Croce 77, 38122 Trento, Italy
| | - Iwona Mazur
- Daily Centre for Psychiatry and Speech Disorders, Wrocław, Poland
- Wroclaw Medical University, Wrocław, Poland
| | - Odin Hjemdal
- Norwegian University of Science and Technology, Hogskoleringen 1, 7491 Trondheim, Norway
| | | | - Hans Henrik Knoop
- Aarhus University, Nordre Ringgade 1, C 8000 Aarhus, Denmark
- Optentia Research Focus Area, North-West University, P O Box 1174, Vanderbijlpark, 1900 South Africa
| | | | - Ane Fullaondo
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
| | - Nerea González
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
- REDISSEC (Health Services Research On Chronic Patients Network), Barakaldo, Basque Country Spain
- Osakidetza Basque Health Service, Barrualde-Galdakao Integrated Health Organisation, Galdakao, Spain
| | - Javier Mar-Medina
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
- REDISSEC (Health Services Research On Chronic Patients Network), Barakaldo, Basque Country Spain
- Biodonostia Health Research Institute, San Sebastián, Spain
- Research Unit, Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Arrasate-Mondragón, Spain
| | - Dominik Krzyżanowski
- Division of Medical Social Science, Wroclaw Medical University, Wrocław, Poland
- Department of Health, Lower Silesia Voivodeship Marshal Office, Wrocław, Poland
| | - Roxanna Morote
- Norwegian University of Science and Technology, Hogskoleringen 1, 7491 Trondheim, Norway
- Catholic University of Peru, Avenida Universitaria s/n, 18, Lima, Peru
| | - Frederick Anyan
- Norwegian University of Science and Technology, Hogskoleringen 1, 7491 Trondheim, Norway
| | | | - Louise Tidmand
- Aarhus University, Nordre Ringgade 1, C 8000 Aarhus, Denmark
| | - Unnur Björk Arnfjord
- School of Education, University of Iceland, Saemundargotu 2, 101 Reykjavik, Iceland
| | - Ingibjorg Kaldalons
- School of Education, University of Iceland, Saemundargotu 2, 101 Reykjavik, Iceland
| | | | - Esteban de Manuel Keenoy
- Kronikgune Institute for Health Services Research, Ronda de Azkue 1 torre del Bilbao Exhibition Centre, 48902 Barakaldo, Basque Country Spain
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Lassander M, Hintsanen M, Suominen S, Mullola S, Vahlberg T, Volanen SM. Effects of school-based mindfulness intervention on health-related quality of life: moderating effect of gender, grade, and independent practice in cluster randomized controlled trial. Qual Life Res 2021; 30:3407-3419. [PMID: 34169412 PMCID: PMC8602227 DOI: 10.1007/s11136-021-02868-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/11/2022]
Abstract
Object We investigated the impact of a school-based 9-week mindfulness program vs. active control program (relaxation) and inactive control group on children’s self-reported Health-Related Quality of Life (HRQoL) moderated by gender, grade, and independent practice. Method In total 3519 (50/50% boys/girls) Finnish students aged 12–15 years from 56 schools were randomized into mindfulness intervention, active, and inactive control groups. HRQoL was measured at baseline, at 9 weeks, and at 26 weeks and analyzed with multilevel linear modeling. Results Significant improvement on HRQoL was found (β = mean difference) (β = 1.587, 95% CI 0.672–2.502, p < 0.001) after 9 weeks and at 26 weeks of follow-up among students in the mindfulness group as compared to the active control group. Moderating effects on HRQoL were found for gender, grade, and independent practice: girls, 7th and 8th grade students, and students with regular independent mindfulness practice benefited most. Conclusions Gender and developmental stage may moderate the effects of mindfulness interventions on HRQoL and offer guidance in designing effective promotive interventions for children and adolescents. Trial Registration Information Healthy Learning Mind—a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial (RCT) ISRCTN18642659 retrospectively registered on 13 October 2015. The full trial protocol can be accessed at http://rdcu.be/t57S. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02868-4.
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Affiliation(s)
- Maarit Lassander
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Parrulaituri 16 D 62, 00540, Helsinki, Finland.
| | | | - Sakari Suominen
- Department of Public Health, University of Skövde, Skövde, Sweden.,Department of Public Health, University of Turku, Turku, Finland
| | - Sari Mullola
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Teachers College, National Center for Children and Families (NCCF), Columbia University, New York, NY, USA
| | - Tero Vahlberg
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Salla-Maarit Volanen
- Folkhälsan Research Center, Helsinki, Finland.,Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
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Abstract
This article reviews the evidence regarding behavioral science approaches to the prevention of substance use disorders. Prevention science grew out of research on family and school-based interventions that were designed to treat common behavioral problems of children and adolescents. That research showed that the amelioration of problems such as aggressive behavior could prevent the development of later problems including substance use, depression, and academic failure. We begin by reviewing evidence regarding the risk factors that contribute to the development of substance use disorders, as well as the protective factors that can reduce their likelihood. We then describe a variety of family, school, and community prevention programs that have been shown to prevent youthful use and abuse of substances. We conclude by describing the progress that has been made in getting these programs widely and effectively implemented, and the challenges we face in getting to the point where most communities are achieving considerable success in prevent substance use and the other common and costly behavioral and psychological problems of children and adolescents.
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Abstract
This study offers a commentary on the articles contained in the special issue of Prevention Science, "Readiness to implement Social- Emotional Learning interventions." The commentary also puts these articles into current context by summarizing important findings in implementation research and listing some priorities for future work.
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