Non-suicidal self-injury (NSSI) in adolescent depression is a prevalent and clinically significant behavior linked to dysregulated peripheral inflammation and corticostriatal circuitry dysfunction. However, the neuroimmune mechanisms bridging these systems remain poorly understood. Here, we combined peripheral cytokine profiling with static/dynamic functional connectivity (sFC/dFC) analysis to investigate the potential influence of inflammaton on corticostriatal circuit related to NSSI. A set of peripheral blood inflammatory markers and resting-state functional magnetic resonance imaging (rs-fMRI) were collected in depression with NSSI (NSSI+), depression without NSSI (NSSI-), and healthy controls (HC). We first ascertain group differences in level of pro- and anti-inflammatory cytokines. And using ventral/dorsal striatal seeds, we compared whole-brain, voxel-wise sFC and dFC differences across three groups. Further, we tested the mediation effects of connectivity in the association between inflammatory markers and NSSI frequency. NSSI+ group exhibited elevated pro-inflammatory cytokines (C-reactive protein (CRP), interleukin (IL)-1, and IL-6) whereas reduced anti-inflammatory cytokines (IL-10), compared to NSSI- and HC. Neuroimaging analysis revealed corticostriatal dysconnectivity mainly characterized by static hyperconnectivity between dorsal striatum and thalamus, dynamic instability in dorsal striatum-lingual pathways, and dynamic rigidity in ventral striatum-prefrontal/temporal/occipital gyrus circuits. Critically, sFC of dorsal striatum-thalamus and dFC of dorsal striatum-lingual gyrus mediated the prospective association between altered CRP and NSSI frequency, establishing corticostriatal circuits as conduits for inflammatory effects on NSSI. By bridging molecular psychiatry with circuit neuroscience, this work advances precision management of NSSI in adolescent depression, prioritizing biomarker-driven strategies to disrupt neuroimmune maladaptation.

Compassion and compassionate care for children and young people (CYP) encompass a variety of emotions, including sympathy, empathy, and sadness for their suffering, alongside actions intended to alleviate their distress. While compassion is a well-recognised concept in health and social care, literature has identified various barriers and facilitators that affect the delivery of compassionate care. These include compassion fatigue, time limitations, organisational and clinical culture, insufficient resources or support, technological advancements, and burdensome administrative tasks. Despite being viewed as essential in health care, the concept of compassionate care remains poorly defined and expressed, particularly in the context of mental health services for CYP. This review explored the perspectives of CYPs, their parents, and staff regarding the compassionate care provided in community services. Additionally, it aimed to identify factors that facilitate or obstruct compassionate care for CYPs in both mental health and community settings services. From June to August 2024, a search was carried out for peer-reviewed articles and grey literature, with additional searches conducted in October 2024. The initial search produced 7,461 articles, with 23 selected for this review. A thematic synthesis organised the studies based on the main themes identified: 'Compassionate care is all about humanity' and 'the complex interplay of facilitators and barriers to compassionate care'. The identified articles highlighted the increasing need for compassionate care in community-based services for CYP, along with the range of facilitators and barriers to providing this care. Lastly, we propose an alternative definition of compassionate care tailored to these services.

Childhood maltreatment (CM) is a pivotal risk factor for depression, yet its potential contribution to major depressive disorder (MDD) in adolescents requires further investigation. This study aims to scrutinize the specific impact of CM on neurovascular coupling (NVC) in adolescents with MDD. A cohort of 189 adolescents, comprising 54 MDD with CM, 45 MDD without CM, 33 healthy controls (HC) with CM, and 57 HC without CM, underwent multimodal MRI scans. Cerebral blood flow (CBF) was computed to evaluate vascular responses, while functional connectivity strength (FCS) and amplitude of low-frequency fluctuation (ALFF) were measured to assess neuronal activity. NVC was calculated using whole gray matter CBF-neuronal activity correlation coefficients and regional CBF/neuronal activity ratios. MDD×CM interactions on NVC, CBF, and neuronal activity were analyzed, with further exploration of the associations between these abnormal NVC ratios and CM experience. Support vector machine classifiers were employed to differentiate MDD adolescents. Results revealed a significant MDD×CM interactive effect on CBF-FCS coefficients at whole gray matter level. Regionally, these interactions on NVC ratios primarily occurred in the reward systems, including bilateral anterior cingulate/orbitofrontal cortex, thalamus/mesial temporal lobe, and left occipitotemporal lobe, correlating with CM measurements. Notably, the integration of NVC ratio, CBF, and neuronal activity yielded robust classification performance in distinguishing MDD adolescents. These findings reinforce the importance of reward system for MDD adolescents related to CM, proposing a novel neuroimaging biomarker for early recognition of adolescent depression.

This study investigates the patterns of antipsychotic drug dispensations among children and adolescents from 2015 to 2023, with a focus on the impact of introducing national health reform (2015) and the COVID-19 pandemic. Data from Maccabi Healthcare Services, encompassing 1,105,439 individuals aged 6-18 years, were analyzed using a retrospective cohort study. We investigated the incidence rates of antipsychotic prescriptions by age, sex, socioeconomic status, and geographical region. During the study period, there was a 15% overall increase in antipsychotics prescriptions. Higher prescription rates were observed among boys aged 6-11 years and girls aged 14-18 years. Significant increases in prescriptions were observed in the year immediately following the mental health reform and the COVID-19 pandemic. Low socioeconomic status and peripheral regions exhibited higher and increasing prescription rates. Seasonal patterns revealed peaks in the fourth quarter of each year. The study highlights an overall increase in antipsychotic prescriptions, influenced by policy changes and the pandemic. Inequality in prescription rates by socioeconomic status and geographical location underscores the need for targeted mental health interventions. The findings also suggest enduring changes in the utilization of antipsychotic medications among youth, which may reflect broader impacts of the COVID-19 pandemic on mental health care needs.

The COVID-19 pandemic negatively affected child and adolescent mental health, but it is unclear which subgroups were affected most. We investigated to what extent severity and type of mental health problems during and after the pandemic were related to preexisting mental disorders in children in care at child and adolescent mental health services. We employed a repeated cross-sectional design involving data collection at seven time points (April 2020 to April 2023) in a total sample of 2,545 children (age 8-18 years). We grouped diagnostic classifications in four categories: Autism, ADHD, Anxious/Depressive disorders, and 'Other'. Mental health was assessed with parent-reported data on internalizing and externalizing problems and with self-reported data from the standardized PROMIS questionnaires 'Anxiety', 'Depressive symptoms', 'Sleep-related impairments', 'Anger', 'Global health', and 'Peer relations'. We tested for main effects between diagnostic categories and for different trajectories over time. We found that mental health outcomes varied substantially between diagnostic categories, with internalizing problems being largest in children with Anxious/Depressive disorders, and externalizing problems being largest in children with Autism and ADHD. However, we found no evidence for differences between diagnostic categories in trajectories in mental health outcomes during and after the COVID-19 pandemic. The results show that during the pandemic mental health outcomes worsened over time in children and adolescents in care, and that this negative effect on mental health did not differ between children with different diagnostic classifications. Regular high-quality monitoring is vital to recognize changing trajectories of youth mental health and to adapt to crisis situations.

Paediatric emergency department (ED) presentations for self-harm and suicidality have significantly increased worldwide in the past decade, making paediatric EDs a key point of contact for young people experiencing suicidal ideation. Since 2022, four systematic reviews have been conducted on interventions for self-harm/suicidality in paediatric EDs, but findings were limited by small sample sizes and high heterogeneity. This meta-review provides recommendations to guide clinical practice and future research to enhance the quality of interventions in paediatric EDs for addressing self-harm and suicide related behaviours. Of 286 studies identified, five reviews synthesising 14 individual studies on ED-based interventions published up to May 2022 were included. Key themes and conclusions were synthesised. Three main themes emerged including: lack of informative trials, low levels of intervention effectiveness and common intervention elements. Informativeness of prior trials was limited by small sample sizes, lack of globally relevant research and limited stakeholder perspectives. Common intervention elements included: follow-up contact post-ED discharge, family involvement and psychoeducation with safety planning. Limited progress has been made in this field, likely due to challenges in conducting rigorous trials in paediatric EDs. Research has failed to incorporate voices of young people and their families, crucial for meeting their needs. Future research must prioritise co-design with youth, parents, and stakeholders as a critical next step in developing more effective paediatric ED interventions. Digital tools may offer promise for delivering interventions in the ED but should complement face-to-face professional contact.

Young people who self-harm are at an increased risk of suicide. Furthering our understanding of the risk factors for self-harm is essential for identifying high-risk groups, which can be used to inform the design of preventative interventions. This study used the Avon Longitudinal Study of Parents and Children (ALSPAC) and applied latent class analysis to the risk factors for self-harm at ages 13 and 17. Longitudinal associations between the latent classes and self-harm at ages 17 and 20 were examined. Cross-cohort comparisons were conducted between this study and a previous study using Irish data. At age 13 there was a low risk group, a peer problems group, and substance use group, similar for the two cohort studies, and a family conflict group, which was the least similar group to its matching group in the Irish study. All of these age 13 high-risk groups had approximately twice the relative risk (between 1.3 and 2.5) for self-harm at age 17 compared to the low risk group. The age 17 models were very similar across the two cohorts, each with a low risk group, a depression and high substance use group, a depression and low substance use group, and a substance use group. The relative risk of self-harm at age 20 for these high-risk groups compared the low risk group ranged from 3.6 to 8.0. These groups could help identify those at risk of self-harm and inform the design of prevention programmes to reduce self-harm behaviour in young people.

Pediatric major depressive disorder (MDD) often leads to recurrent depression in adulthood. The efficacy, safety and dose dependency of pharmacological effect is unclear. We conducted a systematic review and dose-response meta-analysis comprising of 22 double-blind randomized controlled trials, the majority of which had short trial durations ranging from 6 to 12 weeks. Studies were identified from PubMed, Ovid Embase, Ovid Medline, Ovid PsycInfo, Wanfang, ClinicalTrial.gov and CENTRAL until July 31, 2023. Doses of all antidepressants were converted to fluoxetine equivalents. Outcomes including treatment response, remission, suicidality, tolerability and acceptability were assessed. Sensitivity analysis, funnel plot and the trim-and fill method are used to assess and adjust for publication bias. Findings revealed that antidepressants were marginally more effective than placebos in terms of treatment response, but significantly increased the risk of adverse effects. No significant differences were observed in remission, suicidality, or overall dropout rates. Dose-response analysis indicated a relatively flat increase in response probability with higher fluoxetine equivalent doses, but also a sharp increase risk of discontinuation due to side effects. This study suggests that antidepressants for pediatric MDD may be less effective in adults, emphasizing the need to balance treatment benefits with potential adverse effects when considering interventions for this population.

Home Treatment (HT) in child and adolescent psychiatry is an increasingly important topic in the current context of global crises and strained mental health systems. We implemented a HT program provided by a multiprofessional treatment team and compared long-term outcomes of 27 patients (48% female, Ø15.15 ± 2.77 years) with those of 48 patients (69% female, Ø16.35 ± 2.87 years) who received inpatient treatment as usual (I-TAU). Psychopathology was assessed using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA[-SR]) and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF) at admission, discharge, and 18-24 months after discharge. Treatment outcomes were analyzed using mixed models. The results showed that patients in the HT arm had significantly lower HoNOSCA scores at follow-up (β = -4.25 [95%CI: -7.64 to -0.86], SE = 1.73, p = 0.014) and higher GAF scores (β = 12.09 [95%CI: 4.48 to 19.70], SE = 3.88, p = 0.002) compared to those in the I-TAU arm. No significant differences were observed in HoNOSCA-SR scores (β = -2.46 [95%CI: -9.16 to 4.30], SE = 3.43, p = 0.48) and readmission rates (OR = 1.23 [95%CI = 0.47 to 3.20], p = 0.67). These results highlight the potential of HT in improving long-term functional and psychopathological outcomes in youth mental health. HT may be an equally effective and even more sustainable type of treatment for child and adolescent mental disorders. The trial was preregistered at the German Clinical Trials Register (DRKS00025424, 05/27/2021).

This study explores the roles of the precuneus and posterior cingulate cortex (pCunPCC) in the relationship between premonitory urge (PU) and tic severity in Tourette syndrome (TS). We recruited 58 children diagnosed with TS (age mean ± SD = 11.12 ± 2.56, F/M = 11/47). Tic and PU severity were measured using the Yale Global Tic Severity Scale (YGTSS) and the Premonitory Urge for Tics Scale (PUTS), respectively. We constructed brain functional networks for each subject based on resting-state fMRI and further calculated the degree centrality (DC), global efficiency (GE), and local efficiency (LE) of each pCunPCC region. A significant positive correlation was found between PUTS and YGTSS scores (t = 4.75, p < 0.001). The DC and GE of the right pCunPCC ROI 3 (Schaefer Atlas) showed significant negative correlations with YGTSS (t = -2.63, FDR-corrected p = 0.03 for DC; t = -2.85, FDR-corrected p = 0.04 for GE) and PUTS scores (t = -3.35, FDR-corrected p = 0.01 for DC; t = -2.95, FDR-corrected p = 0.03 for GE). Moderation analysis indicated that higher DC in the right pCunPCC ROI 3 reduced the effect of PU on tic severity. These moderation effects were also observed with PU and vocal tics, but not motor tics. The right pCunPCC serves as critical moderator in the relationship between PU and tic severity. This study highlighted the potential neural mechanisms underlying the relationship between PU and tic severity, providing potential targets for future intervention and treatment of TS.

Infants frequently experience sleep problems in early childhood. Poor infant sleep can impact not only infants' cognitive development but also maternal sleep and maternal mental health. Studies have reported associations between infant sleep and maternal sleep and between infant sleep and maternal depression. However, methods utilized in these studies are unable to disentangle the directionality of these relationships. The purpose of this study was to assess the bi-directional relationships between child sleep, maternal sleep, and maternal depression in the first two years of life in a multi-ethnic Asian cohort. Data were drawn from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Child nighttime sleep duration, maternal sleep (PSQI), and maternal depression scores (BDI) were assessed at 26 weeks gestational age, and when the child was 3, 12, and 24 months old in 1,131 children. We used autoregressive latent trajectory modeling with structured residuals (ALT-SR) to assess associations. Higher maternal depression scores at 3 months were predictive of longer nighttime sleep duration when the child was 12 months (BDI → ChildSleep:Ѱ = 0.04, p = .01), but at other timepoints this cross-lagged relationship was not significant, (BDI → ChildSleep: Ѱ = 0.02, p = .49; BDI → ChildSleep: Ѱ = 0.03, p = .07). In addition, better maternal sleep at 3 months predicted longer nighttime child sleep duration at 12 months (PSQI → ChildSleep: Ѱ = - 0.08, p = 0.01), but not at other timepoints (PSQI → BISQ: Ѱ = -0.06, p = .29; PSQI → ChildSleep: Ѱ = -0.05, p = 0.18). When using methods that properly differentiate between-person and within-person effects, we found that higher maternal depression scores were protective of infant sleep, but infant sleep did not affect maternal sleep or depression scores.

Sanfilippo syndrome (MPS III) is one of the types of mucopolysaccharidoses (MPS), a group of inherited metabolic diseases in which the accumulation of glycosaminoglycans (GAGs) results from deficiency of different lysosomal enzymes. The hallmarks of MPS III are relatively minor somatic abnormalities with severe and progressive central nervous system (CNS) symptoms. An analysis of the literature showed that the biggest problems for carers of people with MPS III are behavioural disorders and sleep disorders. Despite extensive discussions on improving the quality of life of patients, little attention was paid to the families/carers of patients. The families/carers are providing appropriate medical and palliative care to the patient every day due to their loss of mobility, self-care skills, tube feeding, airway clearance and other supports continue to have an adverse effect on the quality of life of families/carers. However, a literature review of possible solutions showed that effective methods (both pharmacological and non-pharmacological) exist. The needs of carers of MPS III patients should receive as much attention as the search for new treatments. There are many options for dealing with such problems. The key issue is to identify the source of the problem and choose the most effective therapy. Alleviating behavioural disorders, pain complaints and sleep problems will have a positive impact not only on the quality of life of carers/families, but also on the patients themselves.

The STADIA trial aimed to assess the effectiveness of a standardised diagnostic assessment tool (Development and Wellbeing Assessment, DAWBA) in aiding clinician-made diagnosis decisions in Child and Adolescent Mental Health Services (CAMHS). This study reports the qualitative process evaluation of the STADIA trial, which aimed to identify barriers and facilitators to using the online-completed DAWBA in CAMHS. Qualitative data were collected through 109 semi-structured interviews with young people, parents/carers, healthcare professionals and service commissioners/funders in 8 CAMHS sites across England. Deductive thematic analysis was guided by the domains of the Consolidated Framework for Implementation Research. Young people and parents/carers showed high levels of engagement with the DAWBA. They perceived a validation of symptoms from the generated DAWBA report, which they actively used as 'evidence' when seeking help from other services. Clinicians involved in determining referral acceptance/rejection decisions were positive about its use and saw benefits in aiding decision-making. In contrast, however, barriers to clinicians engaging with the DAWBA report during the assessment stage arose from limited awareness and accessibility to the report, a context of high workload and pressure, and general concerns about the value of a diagnosis. The DAWBA was not widely used by clinicians in the expected way to aid diagnostic decision-making. However, it may offer children and young people much-needed engagement during long waiting times for initial assessment in CAMHS. The DAWBA may be more acceptable to clinical teams in triaging referrals to help with timely decisions about the most suitable services.Trial registration ISRCTN15748675 (29/05/2019).

The prefrontal-hippocampal pathways are integral to memory suppression, facilitating positive and adaptative responses following traumatic events. However, the role of these circuits in promoting resilience among adolescents remains largely unknown. This study used structural similarity analysis of MRI-based gray matter volume (GMV) to map connectivity networks centered on the hippocampus, investigating whether structural similarity between prefrontal regions and hippocampus were related to resilience in a cohort of 145 adolescents. Additionally, spatial correlation analyses of resilience-related structural similarity network and neurotransmitter distribution maps were conducted to identify molecular adaptations within prefrontal-hippocampal circuits associated with resilience. The results showed that higher resilience levels were correlated with stronger structural similarity between the prefrontal areas (i.e., middle frontal gyrus and orbitofrontal cortex) and hippocampus. Furthermore, the serotonergic neurotransmitter system, which modulates neural oscillations in prefrontal-hippocampal pathways, appears to be associated with resilience. The current findings suggest that structural and molecular adaptations within prefrontal-hippocampal circuits, which are implicated in the suppression of intrusive, unwanted memories, may foster resilience in young people. These insights advance our knowledge of the neurobiological markers of resilience, paving the way for more targeted and effective therapeutic interventions to bolster resilience and mitigate adverse outcomes in developmental populations.

Adolescent loneliness is prevalent and poses a significant risk for youth mental health. This study aimed to estimate the global prevalence and distribution of frequent perceived loneliness in adolescents and its associations with suicidal ideation, planning, and attempts. We analyzed data from the Global School-based Student Health Survey (GSHS) across 93 countries/territories (2003-2021) for adolescents aged 11-18. Weighted prevalence of frequent perceived loneliness was estimated for each country/territory, with pooled prevalence calculated by sex, age, WHO regions, and economic groups. Binary logistic regressions were employed to assess the associations between loneliness perception and suicidal behaviors in each country/territory, with overall estimates derived by random-effects meta-analysis. Among 388,093 adolescents included, 13.2% (95% CI 12.2-14.3%) reported frequent perceived loneliness, with the lowest observed in Europe (North Macedonia and Tajikistan) at 4.6% (95% CI 1.1-8.1%) and the highest in the Eastern Mediterranean at 16.1% (95% CI 14.7-17.6%). Girls and older adolescents had higher prevalence of frequent perceived loneliness. Frequent perceived loneliness was significantly associated with increased odds of suicidal ideation (overall OR: 2.41, 95% CI 2.25-2.58), planning (overall OR: 2.06, 95% CI 1.92-2.21), and attempts (overall OR: 2.08, 95% CI 1.95-2.20). These associations were consistent across most countries/territories, sexes, age, regions, and economic groups. These findings highlight frequent perceived loneliness in adolescents as a global public health concern strongly linked to suicidal behaviors, underscoring the urgent need for targeted interventions to address loneliness and its mental health consequences.

Social skills training (SST) is a widely proposed intervention to address social impairments in autism spectrum disorder (ASD). SST employs a series of activities aiming to enhance pro-social behaviors. A promising approach to evaluate SST's effects lays on social responsiveness (SR) indicators, which are related to the capacity to respond appropriately to social stimuli. Despite the widespread use of SST, there are no integrative studies evaluating its effects on the SR of ASD people. We performed a systematic review with meta-analysis investigating the effects of SSTs in SR indicators of individuals with ASD. PRISMA guidelines were considered to search through EMBASE, PubMed, PsycINFO, and Scopus without timeframes or language restrictions. Randomized controlled trials (RCTs) were included only. Jamovi (version 1.6) was used to perform the meta-analysis with the standardized mean difference (SMD) between pre and post-intervention scores (∆) as the outcome measure. Twenty-seven papers composed the review and 25 the meta-analysis. The population was predominantly male (80%), with a mean age of 13.03 years. Interventions were mostly conducted in group settings. Meta-analysis indicated the set of interventions as capable of improving SR indicators of ASD people (SMD = 0.57 (CI 95% 0.46-0.67; p < 0.0001). Although our findings cannot support PEERS program as quantitatively superior to other programs, its methodological consistency, treatment adherence and involvement of parents are noteworthy. SST appears to be a viable, versatile, and easily implementable intervention to improve SR of individuals with ASD.

Folate and vitamin B are associated with neurodevelopment and neurotransmitter synthesis and insufficiencies of these nutrients could be linked to psychiatric disorders in children and adolescents. To assess serum levels of folate and B in child and adolescent psychiatric inpatients and examine possible links between these levels and different psychiatric disorders. Child and adolescent psychiatric inpatients admitted in a general hospital during a 3-year period were included for analysis. Folate and B levels were measured when the subjects were admitted. Psychiatric diagnoses were made following DSM-5 criteria and grouped into categories. Logistic regression analysis was used to study the effects of socio-demographic variables as well as folate and B levels, insufficiencies and deficits as possible predictors of outcome (psychiatric diagnostic category). 729 inpatients (60.6% female, mean age: 15.1 ± 2 years) were included. A total of 42.9% presented insufficient folate levels and 19.4% insufficient B levels. Insufficient B levels were associated with depressive disorders in the multivariate model (OR = 0.82, p = 0.002) as was female sex (OR = 1.65, p = 0.007). Moreover, low vitamin B levels were linked to schizophrenia spectrum disorders (SSD, OR = 0.9982, p = 0.024). In contrast, higher folate (OR = 1.15, p < 0.001) and vitamin B levels (1.0024, p = 0.002) as well as female sex (OR = 7.86, p < 0.001) were associated with eating disorders. Insufficient or low B levels could help predict depressive and SSD respectively in child and adolescent psychiatric inpatients. Further study could help us better understand the impact of this insufficiency during the neurodevelopmental period and the potential benefits of nutritional interventions.

CSA (Childhood Sexual Abuse) represents a major health issue, however its detection in daily psychiatric practice is remains challenging. In adolescents, CSA often takes a back seat to diagnostic and behavioral issues such as suicide attempts and BPD (Borderline Personality Disorder), with which it is frequently associated. Additionally, confusion persists between the perspective of complex trauma and conventional psychiatric diagnoses. This study aimed to compare clinical features of hospitalized adolescents with a history of CSA, to a control group, in order to identify clinical predictors of CSA and of suicidal attempts. The secondary objective was to describe the overlap between PTSD (Post Traumatic Stress Disorder) and BPD, according to cumulative adversity. This study included 425 adolescents aged 13 to 19 years, who were hospitalized in a psychiatric unit. Among these adolescents, 107 had a history of CSA. The findings indicate that CSA plays a significant role in the psychopathology of adolescents. CSA was found to be associated with PTSD, BPD (OR = 1.9, p < 0.01), self-harm (OR = 1.8, p < 0.05), addictive disorders (OR = 1.87, p < 0.05), and parental neglect (p < 0,001). Suicide attempts were also significantly correlated with sexual abuse (OR = 1.78, p < 0.05). Moreover, the combination of factors such as female gender, the presence of BPD, and substance dependence was found to increase the likelihood of a history of sexual abuse in these adolescents by 14.8 times. These findings contribute to the early detection of sexual violence and its consequences, providing valuable insights for healthcare professionals. Additionally, they support the reinforcement of preventive initiatives.

Childhood and adolescence are pivotal periods for mental health. The hypothalamic-pituitary-adrenal axis is the primary stress system and its chronic activation is measurable via hair cortisol concentration (HCC), indicating long-term stress exposure. While HCC is linked to adult mental health, this relationship remains unclear among youth. Although a bidirectional relationship is possible, the impact of mental health problems on HCC in youths has been comparatively underexplored. This study aimed to assess the association between symptoms of mental health problems in childhood and adolescence and HCC levels at age 15 in a Brazilian population-based cohort. We analyzed data from the 2004 Pelotas Birth Cohort, which includes 4,231 children followed from birth. At ages 6, 11 and 15 years, mental health symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). At age 15, HCC was measured from 3 cm hair samples, quantified through the enzyme-linked immunosorbent assay. To evaluate the cumulative impact of mental health symptoms from childhood to adolescence, group-based trajectory analysis was conducted. Subsequently, linear regression models were used to estimate associations between mental health scores and HCC, with adjustment for relevant covariates. Regression coefficients were exponentiated to improve interpretability. SDQ total difficulties (β = 1.004 [1.000;1.008]) and conduct problems (β = 1.017 [1.004;1.030]) at age 6 were associated with HCC at age 15 in adjusted models. Hyperactivity/inattention symptoms at ages 6 (β = 1.009 [1.001;1.018]) and 11 (β = 1.013 [1.004;1.022]) were associated with HCC in adjusted models. At age 15, hyperactivity/inattention symptoms and HCC was associated with HCC in the partially adjusted model (β = 1.009 [1.000;1.017]). Trajectories of chronic conduct problems and hyperactivity between ages 6 and 15 were also associated with elevated HCC, although for hyperactivity/inattention symptoms the association was not significant. These associations emphasize the links between mental health and chronic stress over time, especially between both conduct problems and hyperactivity/inattention symptoms in relation to higher concentrations of HCC.

This study sought to identify factors associated with parenting across Western Europe, Eastern Europe and China countries, and determine whether the associations between parental attitudes and child's mental health differ across countries. This cross-sectional study included mothers and their children. European data were drawn from the School Child Mental Health in Europe study, conducted in the Netherlands, Germany, Lithuania, Bulgaria and Romania, including 4104 dyads. Chinese data were collected from the Dongli District of Tianjin, including 1000 dyads. Parental attitudes were auto reported using Parenting Scale and Parent Behavior and Attitude Questionnaire. Children's mental health was auto reported using the Dominic Interactive. Parenting vary across cultures and impact children's mental health differently. Whatever the parental attitudes, the main determinants were related to family configuration, parental well-being and place of residence. Some associations were culture-specific: parent's distress associated with laxness, over-reactivity and low autonomy-promoting attitudes in Europe. Single parenting correlated with low autonomy-promoting attitudes in China but low caring in Western Europe. Urban parents exhibited less laxness and low caring in Eastern Europe. The impact on children's mental health also varied: over-reactivity was linked to internalized and externalized disorders in Western Europe, verbosity associated with internalized and externalized disorders in China, and low caring was linked to externalized disorders in Eastern Europe. Parental diverse attitudes are associated with different children mental health problems; these associations are not identical in the different regions emphasizing the need to tailor existing supporting parental interventions with a culturally sensitive approach.

Do the shortened Positive and Negative Syndrome Scale (PANSS) (Kay et al., J Clin Psychiatry 58:538-546, 1987) versions recently developed from a National Institute of Mental Health (NIMH) pediatric dataset continue to perform well in a third independent randomized double-blind clinical trial of adolescents with schizophrenia? Secondary analysis of the double-blind, placebo-controlled aripiprazole pivotal trial data (N = 302) found that the 10-item (and 20-item) PANSS versions on which we have previously reported (Findling et al., J Am Acad Child Adolesc Psychiatry, https://doi.org/10.1016/j.jaac.2022.07.864 , 2023) continued to provide high reliability, strong convergent correlation with expected measures, and treatment effects that equaled those found in the 30-item adult PANSS. Our shortened PANSS, derived originally from the randomized non-placebo controlled NIMH Treatment of Early Onset Schizophrenia Spectrum study (TEOSS) (Sikich et al., Am J Psychiatry 165(11):1420-1431, 2008), and independently replicated in both the placebo-controlled paliperidone pivotal trial for adolescents with schizophrenia (Youngstrom et al., PsyArxiv, https://doi.org/10.31234/osf.io/zb695 , 2023), and now the placebo-controlled aripiprazole pivotal trial for adolescents with schizophrenia, has again performed as well as the full 30 item adult-patient derived PANSS. The findings suggest it is possible to reduce the PANSS interview by 2 thirds, thus reducing burden on families and pediatric patients as well as administration and training costs, while maintaining high reliability, validity, and sensitivity to treatment equal to that of the 30-item version.

Exercise interventions targeting Fundamental Movement Skills (FMS) represent a critical approach for mitigating functional impairments in children with autism spectrum disorder (ASD). This study, for the first time, based on motor development theory, employed a Network Meta-analysis (NMA) to examine the effects of four types of exercise interventions-Isolation of Fundamental Movement Skills (FMS-I), Combination of Fundamental Movement Skills (FMS-C), Fine Motor Movement (FMM), and Specialized Movement Skills (SMS)-on the core symptoms of ASD in children aged 3-12, including social communication deficits and stereotyped and repetitive behaviors. Five electronic databases were systematically searched up to May 22, 2024. Included studies compared exercise interventions with control groups and assessed at least one core symptom of ASD. Study quality and evidence certainty were evaluated using the Risk of Bias tools (RoB 2.0, ROBINS-I) and the Confidence in Network Meta-Analysis (CINeMA) framework. Data analysis was performed via Stata 17.0 software. The systematic review included 26 studies encompassing 878 children, with 19 studies eligible for NMA. Ranking probabilities indicated that FMS-I emerged as the most promising intervention for addressing social communication deficits (SMD: -0.99, 95%CI: -1.46 to -0.52; SUCRA: 86.9%) and stereotyped and repetitive behaviors (SMD: -2.73, 95% CI: -3.76 to -1.70; SUCRA: 100%). The FMS-C showed potential for enhancing overall features (SMD: -0.90; 95%CI: -1.32 to -0.49; SUCRA: 74.7%). To conclude, exercise interventions should be grounded in FMS, transitioning from isolated movements to integrated actions, to enhance the overall behavior of children with ASD.

Previous longitudinal studies have explored the developmental mechanisms of non-suicidal self-injury (NSSI) and suicidal ideation (SI) in adolescents and primarily focused on variable levels rather than trajectories (e.g., intercepts and slopes). The present study aimed to explore the developmental trajectories of NSSI and SI among Chinese adolescents, emphasizing the predictive roles of fear of negative evaluations (FNE) and thwarted belongingness (TB) on these trajectories from an interpersonal perspective. The latent growth model was incorporated to construct a mediation model of FNE, TB, NSSI, and SI. A total of 515 adolescents (M = 12.309, SD = 0.807; 49.3% girls) completed questionnaires on 4 waves, 6 months apart. The results showed that: (1) FNE showed a curvilinear growth trajectory, with a progressively smaller growth rate; TB, NSSI, and SI all showed a linearly decreasing trajectory; (2) in the relationship between FNE and NSSI, TB's intercept mediated the relationship from FNE's intercept to NSSI's; (3) in the relationship between FNE and SI, TB's intercept mediated the relationship from FNE's intercept to SI's intercept, as well as to SI's slope. Meanwhile, TB's slope mediated the relationship from FNE's slope to SI's. This study reveals the dynamic developmental trajectories of FNE, TB, NSSI, and SI in Chinese adolescents. Notably, TB plays a different mediating role between FNE, NSSI, and SI, highlighting its critical role in the development of these behaviors. Early interventions targeting FNE and enhanced belongingness may help prevent or reduce NSSI and SI in adolescents.

Little research has examined early life risk for symptoms of cognitive disengagement syndrome (CDS) despite a well-established literature regarding co-occurring outcomes (e.g., attention-deficit/hyperactivity disorder). The current study estimated bivariate associations between early life risk factors and CDS in a large and representative sample of U.S. children. We conducted secondary analyses of baseline data from the Adolescent Brain Cognitive Development (ABCD) study (N = 8,096 children, 9-10 years old). Birthing parents reported early life risk factors on a developmental history questionnaire, including parental, prenatal, delivery and birth, and developmental milestone information. They also completed the Child Behavior Checklist, which includes a CDS subscale that was dichotomized to estimate the odds of elevated CDS symptoms (i.e., T-score > 70) in children related to risk indices. We observed significantly elevated odds of CDS related to parental risk factors (i.e., unplanned pregnancy, pregnancy awareness after 6 weeks, teenage parenthood), birthing parent illnesses in pregnancy (i.e., severe nausea, proteinuria, pre-eclampsia/toxemia, severe anemia, urinary tract infection), pregnancy complications (i.e., bleeding), prenatal substance exposures (i.e., prescription medication, tobacco, illicit drugs), delivery and birth risk factors (i.e., child blue at delivery, child not breathing, jaundice, incubation after delivery), and late motor and speech milestones in children. Several early-life risk factors were associated with elevated odds of CDS at ages 9-10 years; study design prevents the determination of causality. Further investigation is warranted regarding early life origins of CDS with priority given to risk indices that have upstream commonalities (i.e., that restrict fetal growth, nutrients, and oxygen).

Adolescent sexual violence is a serious public health concern that may have lasting impacts on the survivor, yet limited longitudinal research on the behavioural and mental health outcomes following sexual victimization exists. To describe the long-term behavioural and mental health outcomes associated with sexual victimization at 14 years of age, and whether these outcomes differed by sex, sexual orientation, and ethnic minority status. This prospective study used data from the Millennium Cohort Study, a nationally representative, longitudinal cohort study of children born in the United Kingdom between 2000 and 2002. Sexual victimization was self-reported when cohort members were 14 years of age, and outcomes (self-harm, suicide attempt, distress, alcohol use, binge drinking, smoking, vaping, and illicit substance consumption) were measured at age 17. Sexual victimization at age 14 was associated with poorer mental health, binge drinking, smoking regularly, vaping, and illicit drug use at age 17. Mental health outcomes differed by sex and these associations were stronger for males than females (self-harm: males RR = 2.4,95%CI: 1.55-3.79, females RR = 1.3,95%CI: 1.10-1.63; distress: males RR = 3.3,95%CI: 1.73-6.24, females RR = 1.4,95%CI: 1.08-1.75). Compared to non-victimized heterosexual adolescents, victimized heterosexual adolescents had nearly twice the risk of self-harm (RR = 1.87,95%CI: 1.40-2.46) and distress (RR = 2.09,95%CI: 1.46-2.96). Victimized adolescents belonging to an ethnic minority group showed three times the risk of distress (RR = 3.35,95%CI: 1.70-6.61) and non-ethnic minorities were more likely to vape (RR = 1.56, 95%CI:1.08-2.25). Adolescents who experience sexual victimization are at increased risk of poorer mental health later in adolescence.