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Executive function (EF) impairments are heterogeneous in children with attention deficit/hyperactivity disorder (ADHD). Culture has a significant impact on EF development in typically developing (TD) children, yet its influence on EF impairments in those with ADHD remains understudied. This study aims to investigate the impact of cultural factors on EF impairments in children with ADHD through a cross-cultural comparison. To ensure a robust sample size, the study initially recruited a large participant pool of 690 children from China and Australia. We applied similar diagnostic criteria and used propensity score matching to align clinical representation. This approach resulted in a final sample of 198 children aged 7-12, including 102 children diagnosed with ADHD and 96 TD peers. The same neuropsychological testing battery was used to assess EF in terms of working memory (WM), inhibitory control (IC), and set shifting. Significant cultural effects were observed: Chinese children with ADHD showed lower performance in IC and WM compared to their TD peers, a pattern not seen in Australian children. A latent profile analysis revealed distinct EF profiles, highlighting a subgroup of Chinese children with severe EF impairments. This study advances cross-cultural ADHD research on EF by using a robust methodology, including consistent diagnostic and testing procedures, propensity score matching, and person-centered analysis. Our findings suggest that high-EF-expectation environments may have a negative effect on EF in children with ADHD, which provides insight into the underlying contributors to heterogeneous EF and underscores the need for culturally tailored ADHD interventions.

Across diverse populations, there is growing evidence that emotion regulation is central to healthy adaptation. Much is known about emotion regulation processes in typically developing populations, but comparatively very little is known about how these processes unfold in individuals with intellectual disability. This integrative review advances understanding of emotion regulation in intellectual disability within a clinical framework. We first synthesize research on affective and behavioral functioning across the heterogeneous intellectual disability population. We then apply the process model of emotion regulation to examine how differences in cognition, language, and executive functioning shape regulation capacities. Particular attention is given to the distinction between self-focused strategies used by individuals to regulate their own emotions, and other-focused, interpersonal strategies (i.e. caregiver-mediated support), which may play a particularly critical role for individuals with intellectual disability across the lifespan. Finally, we discuss implications for clinical practice, including interventions for promoting healthy emotion regulation in intellectual disability within the process model framework and recommendations for family-centered approaches. By integrating empirical evidence with a widely used theoretical model, this review establishes a foundation for conceptualizing emotion regulation in intellectual disability and for improving interventions that support emotional well-being in this underserved population.

Bidirectional and transactional models propose that parents and children have the potential to influence each other's mental health over time. While bidirectional associations have been widely studied, transactional processes involving parent internalising, offspring internalising, and offspring externalising symptoms remain underexplored. The COVID-19 pandemic was associated with marked changes in parent and offspring mental health, providing an enhanced opportunity to examine these dynamics across developmental stages and gender. We examined four waves of survey data from the UK-based longitudinal COVID-19: Supporting Parents, Adolescents and Children during Epidemics (Co-SPACE) study collected between May 2020 and May 2021. Data from 2349 parent-child dyads (4-16-year-old children) were analysed using multi-group (for age and gender) random intercept cross-lagged panel modelling. In the full sample, parent internalising symptoms significantly predicted increases in offspring internalising symptoms over time. Among primary school aged children (4-10 years), effects were parent-driven, with no evidence that changes in child symptoms predicted parent symptoms. In contrast, among secondary school aged children (11-16 years), we found bidirectional associations between parent internalising and offspring externalising symptoms, and some time-specific links with internalising symptoms. However, no sustained transactional loops (i.e., indirect effects forming a feedback cycle) were detected. Gender did not moderate any associations. These findings suggest that parent and offspring mental health symptoms may become more reciprocal as children grow older.

Postinfectious autoimmune processes are hypothesized to be causally implicated in tic disorders, including Tourette syndrome and chronic tic disorder. However, this hypothesis remains controversial. In this nationwide cohort study, we aimed to clarify the mechanisms underlying the association between proneness to infections and tic disorders. Using Swedish national registers, we identified 3,886,533 individuals (probands) born between 1970 and 2008 with available data on both biological parents. Probands were linked to six clusters of relatives: parents, full siblings, maternal half-siblings, paternal half-siblings, aunts/uncles, and cousins. Cox proportional hazards regression models were used to estimate the risk of tic disorders in probands exposed to infections and their relatives, compared with unexposed probands and their relatives. We also examined dose-response associations using logistic regression models. Probands exposed to infections had an increased risk of tic disorders (hazard ratio [HR], 1.46; 95% confidence interval [CI], 1.40-1.52), as did their relatives. The observed risks increased with the degree of genetic relatedness, from HR (95% CI) of 1.15 (1.12-1.19) in cousins to 1.31 (1.25-1.37) in first-degree relatives. There was a dose-response association between the number of infections in the probands and the odds for tic disorders in the probands and their relatives. Results remained consistent after adjustment for infections in relatives, tic disorders in probands, and autoimmune diseases in probands and relatives. Our results suggest an important role of shared genetic factors in the association between infections and tic disorders, potentially pointing to pleiotropic mechanisms.

Single-session interventions (SSIs) are emerging as one promising way to support one's mental health. Growth mindset refers to the beliefs about the malleability of traits and attributes. Building upon a feasibility study of a growth mindset single session intervention, this randomised controlled trial aimed to evaluate its efficacy when delivered online to young people. We recruited participants aged 14-18-year-olds via social media, schools, and charities in the UK. They were randomised to receive either an online video-based intervention or were placed on a waitlist control. They reported anxiety and depression symptoms, as well as personality mindset and psychological flexibility at baseline and at 1-month follow up. An intention-to-treat (ITT) analysis and a case completer analysis were conducted. In a sample of 104 participants (mean age = 16.3), an ITT analysis yielded negligible effects on anxiety and depression symptoms (d = 0.07, 95% CI: [-0.32, 0.47]) and psychological flexibility (d = -0.12, 95% CI: [-0.50, 0.25]) at 4-week follow-up. The personality mindset measure yielded a significant large effect relative to waitlist (d = -0.96, 95% CI: [-1.87, -0.04], p = 0.02), however it was statistically non-significant with Bonferroni correction. Case completer analysis resulted in similar observations. The intervention impacted personality mindset but had limited effect on anxiety and depression. Large sample sizes, improve retention rate, and a longer follow-up period are needed in future studies.

Children with conduct problems often present with a range of complex needs and many factors have the potential to complicate the delivery of evidence-based interventions for conduct problems. Little, however, is known about how to optimise the delivery of such interventions for complex cases, and there has been a lack of consensus regarding the features that reflect case complexity in treating child conduct problems. The aims of this study were to examine practitioner perceptions of the factors that contribute to case complexity in child conduct problems, and perceptions of the therapist competencies necessitated by distinct features of case complexity when delivering these interventions. Practitioners (n = 49) with expertise in evidence-based parenting interventions for conduct problems were recruited from nine countries. Using the Delphi method, participant consensus was established across multiple rounds of consultation and feedback with the expert panel. Experts reached consensus on a model comprising seven distinct drivers of case complexity among children with conduct problems, spanning child-related factors, caregiver-related factors, and broader ecological factors. Consensus was also reached regarding 16 therapist competencies of key importance to distinct drivers of case complexity, thereby validating the conceptualisation of these drivers. These findings represent a novel consensus-based practitioner perspective on the complex needs of children with conduct problems, and offer researchers and practitioners a common language for communicating information about case complexity. This perspective has the potential to inform clinical research, practice, and training, to better meet these complex client needs.

Hypochondriasis is a prevalent psychiatric condition associated with substantial individual suffering and healthcare utilization. Despite its clinical importance, little is known about its etiology, and the extent to which familial and genetic factors contribute to its development remains unclear. In this population-based cohort study, we identified 5,809,325 individuals born in Sweden between 1950 and 2008 with information on both biological parents, excluding those who emigrated or died before age 6 or before 1997. From this cohort, we identified clusters of full siblings, half siblings, and cousins. We compared the risk of hypochondriasis among relatives of individuals diagnosed with hypochondriasis to that of relatives of individuals without hypochondriasis. Previously validated ICD-10 diagnoses of hypochondriasis were identified through the Swedish National Patient Register (NPR). Cox regression models with time-varying exposures and attained age as the underlying time scale were used to estimate hazard ratios (HRs). A total of 3,202 individuals were diagnosed with hypochondriasis (57.1% women; median age at first diagnosis 32.1 years). Relatives of individuals with hypochondriasis had a higher risk of the disorder, compared with relatives of individuals without hypochondriasis, and the risk increased with the degree of genetic relatedness. The strongest association was observed in full siblings (HR, 9.5; 95% CI, 5.1-17.5), followed by half siblings (HR, 5.6; 95% CI, 2.1-14.9) and cousins (HR, 2.6; 95% CI, 1.4-4.9). Hypochondriasis is a familial and likely heritable disorder.

Umbrella reviews, or overviews of reviews, synthesize information using systematic reviews (SRs) as their unit of analysis. Although a formal guideline exists for reporting umbrella reviews of healthcare interventions (i.e. Preferred Reporting Items for Overviews of Reviews [PRIOR]), no formal guideline exists for conducting and/or reporting umbrella reviews of observational studies that examine epidemiological associations. To review the existing guidance on conducting and/or reporting umbrella reviews of observational studies on epidemiological associations, as part of the process of developing a formal reporting guideline. We reviewed the scoping review conducted in the context of PRIOR development and identified documents through forward citation search in PubMed, Scopus, and manual search in Google Scholar, Google Search up to December 22, 2024. Documents, regardless of format, were included if they provided guidance for conducting and/or reporting umbrella reviews of observational studies (including meta-research studies of their features). Title/abstract screening and data extraction were performed independently and in duplicate and summarized narratively by stages of the umbrella review process. The search retrieved 4491 unique records, with 96 full texts assessed and eight documents included. These documents, published between 2014 and 2023, offered guidance across seven topic areas, but overall guidance on conducting and/or reporting is limited. These areas include the answerable questions, prerequisite considerations, the scope of umbrella reviews, searching for SRs, primary data collection, analysis, presentation, and assessing the certainty/quality of the body of evidence. There is a need for dedicated, practical, and evidence-based formal reporting guidelines for umbrella reviews of observational studies on epidemiological associations. This review lays the groundwork for developing the PRIOR-extension for such studies: the Preferred Reporting Items for Umbrella Reviews of Cross-sectional, Case-control, and Cohort Studies.

Externalising behaviours are among the most common childhood mental health problems and have been linked to numerous adverse psychosocial outcomes including antisocial behaviour and depression. Parental negativity (PNeg) and child behaviours have been shown to mutually influence each other, leading to coercive cycles of negative behaviour over time. Interrupting these negative cycles is a common target for clinical intervention but little is known about what factors moderate these cycles over time in the general population. Using data on 9943 families from The Avon Longitudinal Study of Parents and Children across ages 4, 7 and 8, we explored the reciprocal associations between PNeg and externalising behaviour and tested whether they differed as a function of high versus low parent-reported interpersonal social support and neighbourhood social cohesion. Using random-intercept cross-lagged panel models, we found bidirectional associations between PNeg and child externalising behaviour across ages 7 to 8 (βs = 0.13-0.15) but not ages 4 to 7 (βs = 0.01-0.03). Moreover, we did not find evidence of moderation of any of the cross-lagged paths by social support or neighbourhood cohesion. Parent-reported interpersonal social support and neighbourhood social cohesion do not appear to play a role in interrupting negative parent-child interaction cycles in the general population.

This Swedish nationwide cohort study used large-scale data to investigate the associations between bipolar disorder and somatic disorders and whether these risks differ by subtype, sex, or exposure to compulsory care. 61,071 individuals diagnosed with bipolar disorder in inpatient (from 1973) or outpatient care (from 2001) care were compared with the general population without bipolar disorder. The cohort included individuals born in 1932 or later, with follow-up from 1973 to 2020. Cox regression models estimated associations with a range of somatic conditions, including cardiovascular, endocrine, neurological, and infectious diseases. Subtype-specific analyses were conducted in individuals with type 1 (n = 8,352) or type 2 (n = 9,674), and in those with a history of compulsory care (n = 6,748). Bipolar disorder was associated with significantly increased risks for most examined somatic conditions. The highest hazard ratios (HRs) were observed for sleep disorders (HR 3.79; 95% CI, 3.71-3.87) and dementias (HR 4.32; 95% CI, 3.82-4.79). Type 2 diabetes risk was elevated, while no association was found for type 1 diabetes. Most risks were comparable across bipolar subtypes, though certain conditions-such as migraine and fibromyalgia-were more strongly associated with type 2. Individuals with a history of compulsory psychiatric care showed elevated risks for several conditions. Regardless of sex or subtype, bipolar disorder is associated with substantially higher lifetime risks of a broad range of somatic conditions. Integrated psychiatric and somatic health care may help reduce morbidity and improve outcomes.

Adolescents who have had an acquired brain injury (ABI) commonly experience depression. Brief Behavioural Activation (Brief BA) is a successful, values-based intervention for managing depression in neurotypical adolescents. This study investigated the effectiveness of Brief BA, using a single-case experimental design, with adolescents experiencing depression following ABI. Five adolescents, one male and four female, aged 14-17 years and with ABI, completed a 6-week course of Brief BA. The primary outcome measures were mean daily activity scores out of 10 for 'achievement', 'closeness' and 'enjoyment' (mean achievement, closeness and enjoyment scores; MACES). MACES were collected daily for 9 weeks, comprising at least 2 weeks at baseline and at least 6 weeks during the intervention. Secondary outcome measures of depression, quality of life (QoL), and participation were collected once at baseline, immediately post-treatment, and at a 4-week follow-up. Two participants showed a significant increase in enjoyment scores and one participant showed a significant increase in closeness scores. No other significant differences were noted for MACES. All participants reported significant reliable improvement in depression scores at their follow-up sessions, with three showing clinically significant improvement. Three participants reported reliable improvement in QoL. All parents reported reliable improvement in participants' depression and QoL scores. No significant changes were noted for participation scores. The significant changes in closeness and enjoyment scores following intervention suggest Brief BA may encourage positive behavioural change for adolescents with depression following ABI. Discussions explore the potential role of insight through linking valued activities with mood and positive reinforcement, leading to an improvement on depression and QoL outcomes. Charities and services providing low-intensity interventions might want to consider trialling Brief BA for this population. Future research suggestions, such as investigating Brief BA for depression linked with more diverse neurological conditions, are discussed.

Physical activity is often associated with positive psychological wellbeing in adolescents, and there is evidence from randomised trials to support this. However, the effect sizes reported from intervention studies vary considerably. Moreover, physical activity is a 'complex intervention' and findings from trials may not generalise to naturalistic settings. Estimating causal effects from observational data is challenging, though provides an opportunity to add to the evidence base in this area. We used newer machine learning-based causal inference methods to estimate (i) the causal effect of physical activity on psychological distress in young people (ii) variations in effects across subgroups ('heterogeneous treatment effects'). Data from the Millennium Cohort Study were available for 9123 adolescents. Self-reported days of moderate/vigorous activity was recorded at ages 14 and 17. Psychological distress was measured at age 17 using the Kessler-6 scale. Directed acyclic graphs were co-produced with a youth advisory group and individuals with lived experience to identify confounders. Average and heterogeneous treatment effects of physical activity at age 14 on psychological distress at age 17, as well as concurrently at age 17, were estimated using causal machine learning methods (targeted learning, causal forests). We observed no overall impact of physical activity at age 14 on self-reported distress scores at age 17 (0.11 points, -0.09 to 0.31, p&#xa0;=&#xa0;.28), although there was a modest impact of physical activity at 17 on concurrent distress (-0.39, -0.61 to -0.18, p&#xa0;<&#xa0;.001). Meeting government guidelines on physical activity levels benefited boys more than girls, but had relatively less positive impact on young people with special educational needs. Whilst no overall impact of physical activity levels on youth distress was observed, boys may particularly benefit from targeted interventions in this regard. Causal machine learning is a promising approach to rapidly generating evidence from observational data.

The prevalence of self-harm is high across neurodivergence. Help-seeking is an important component of the management of mental health problems and self-harm, but it is low in adolescents who self-harm. Combined with a common neurodivergent challenge of encountering multiple barriers in accessing support, it is unclear whether and how neurodivergent adolescents who self-harm seek, receive, and perceive mental health support in comparison to their peers. Participants were 12,209 adolescents (aged 11-18&#xa0;years) from the OxWell 2023 Student Survey in English schools. Of these, 1001 (8.2%) self-identified as neurodivergent (dyslexic, dyspraxic, autistic, and/or have attention deficit hyperactivity disorder) and self-reported self-harm. We conducted three separate mixed-effect models to examine (1) help-seeking, (2) receipt, and (3) perceived helpfulness of the support. Proportionally more adolescents who reported both self-harm and self-identified neurodivergence sought help compared to their peers who reported no self-harm and/or no neurodivergence. In line with previous studies, all adolescents were more likely to seek support from informal than formal sources and least likely to seek support online. Yet, self-identified neurodivergent adolescents who self-harm were more likely to seek formal support than their peers. When support was sought, adolescents in all groups were likely to receive it. However, those who reported either self-harm or self-identified neurodivergence were less likely to perceive the support received as helpful, especially from formal services. Self-identified neurodivergent adolescents who self-harm report greater unmet need for mental health support, but not due to a lack of help-seeking. These findings, instead, point to potential issues with the acceptability of support received. This highlights the need to better understand which forms and locations of support are most acceptable to meet the specific needs of this population.

Exploring the similarities and differences of mental health-based service contact behaviours for children and young people (CYP) and associated characteristics will allow for distinct analysis of identified groups, and inform both current support pathways alongside more focussed targeted intervention strategies. Using data from the Mental Health of CYP in England Survey, 2017, we fitted latent class analysis models to identify classes of CYP based on the type of service contact they received. Analysis was stratified by educational stage (aged 5-10, 11-16 and 17-19&#xa0;years) owing to different help-seeking pathways. For each educational stage, the four-class model was the best fit. Latent classes for children aged 5-10&#xa0;years included, No Services, Community Services,&#xa0;Nonmedical Services, Contact all services. Children and young people&#xa0;reported&#xa0;different patterns of class membership by gender and ethnic group. Similar latent classes were identified for YP aged 11-16&#xa0;years including: No Services, Nonmedical Services, Community Services, and Contact all services, however, stronger patterns of contact were found for nonmedical compared to community services. For those aged 17-19&#xa0;years, classes included: No Services, Nonmedical Services, Specialised Services and Community and Health Services. Young people in the Specialist Service class had higher probabilities of being white/other compared to Black/Asian/Mixed/Other. CYP show different patterns of service contact across educational stages, with gender and ethnic disparities. Our findings could inform models of help, and support those designing and commissioning services to refocus and review where funding is best placed.

Recent developmental models posited that general tendencies to exhibit psychological problems are relatively stable, but specific problems change frequently. We need comprehensive descriptions of persistence and change in psychological problems before advancing such theories, however. Data from four annual assessments of 9806 children (ages 9-10&#xa0;years at baseline) in the Adolescent Behavior Cognitive Development Study&#x2122; were used to quantify persistence and change in each of 10 parent-rated specific psychological problems. Novel pairwise analyses revealed that the persistence of psychological problems over 1-3&#xa0;years was common, but behavior change in the sense that problem x 1 at baseline desisted and was replaced by a new problem y 2 at follow-up was uncommon. The only relatively common changes in behavior over time involved adding a new problem (i.e., x 1 at baseline followed by x 2&#xa0;+&#xa0;y 2 at follow-up) or subtracting a problem (i.e., x 1&#xa0;+&#xa0;y 1 at baseline followed by only y 2 at follow-up). If confirmed across other measures and developmental epochs, these findings challenge a key postulate of current theories that the developmental course of psychological problems involves frequent replacement of one problem by another.

This systematic review aimed to assess the current evidence on the efficacy and safety of Atomoxetine in common clinical attention-deficit hyperactivity disorder (ADHD) symptoms in the context of autism spectrum disorder (ASD) for children and adolescents. Some of these common clinical symptoms of ADHD in the context of ASD include core symptoms of ASD, ADHD, depression, anxiety, mood instability/irritability, and cognitive symptoms. Major medical literature were searched for randomized controlled trials (RCTs), open-label trials, and other relevant studies or clinical trials reporting on pediatric (age <18&#xa0;years) patients with ASD treated with Atomoxetine for any reason. Databases were searched January of 2024 and include PubMed, Google Scholar, Web of Science, Scopus, PsycINFO, and Embase. Exclusion criteria were unpublished data and multiple reports from the same data set. A total of 100 abstracts were screened, and 16 clinical trials were selected for inclusion. Out of these 16 clinical trials there were two RCTs (n&#xa0;=&#xa0;128 and 97), four open-label trials (n&#xa0;=&#xa0;24, 12, 12, and 16), eight extension studies (n&#xa0;=&#xa0;128, 97, 88, 97, 97, 117, 128, and 94), one observational study (n&#xa0;=&#xa0;4), and one crossover study (n&#xa0;=&#xa0;16). Meta-analysis was not performed due to a lack of homogeneity in the two RCTs. There were limited studies available with a need for more high-power studies. In the current studies, most suggested that Atomoxetine was well tolerated and safe in pediatric patients with ASD. In fact, Atomoxetine response rates were found to be similar to those of methylphenidate in ASD studies, while inducing fewer adverse events and tolerated better. Further trials are warranted to make conclusive recommendations on Atomoxetine for improvement of common clinical symptoms of ADHD in the ASD pediatric population. Given limited approved therapies for common clinical symptoms of ASD in children and adolescents, Atomoxetine could be used as a safe off-label option due to a favorable tolerability profile and minimal adverse effects.

Pregnancy complications have been associated with offspring autism spectrum disorders (ASD). There has also been increasing evidence for multigenerational risk factors of ASD. In a multigenerational California birth cohort of 1,740,379 mother-child pairs, we investigated pregnancy complications when the grandmother was pregnant with the mother's generation and their associations with ASD in grandchildren. We estimated odds ratios (ORs) and 95% CIs using logistic regression. The odds of ASD in grandchildren were higher among grandmothers who experienced pregnancy hypertensive disorders (OR, 1.23; 95% CI, 1.12-1.36) or infections (OR, 1.14; 95% CI, 1.01-1.28) compared to grandmothers who did not have the respective condition in pregnancy. The odds of ASD in grandchildren were also higher among mothers born prematurely (OR, 1.06; 95% CI, 1.02-1.11) compared to mothers born at term and elevated among mothers born with low birth weight (OR, 1.05; 95% CI, 1.00-1.11) compared to mothers with normal birth weight. ASD risk in grandchildren is higher among grandmothers who experienced hypertensive disorders or infections when pregnant with their daughters. Future studies are needed to explore the biologic underpinnings of possible multigenerational mechanisms.

Differences in tactile reactivity are observed in autism and to some extent in children with other developmental concerns. However, it is unknown whether differences in responding to touch may serve as a diagnostic marker of autism in children referred for developmental evaluation. This study examined the utility of a tactile reactivity assessment in differentiating autistic children from those with other neurodevelopmental concerns and the association between tactile responsivity, autism symptomatology, developmental level, and adaptive skills. Children (108 autism [mean age 31&#xa0;months], 43 non-autism [mean age 29&#xa0;months]) were administered the tactile portion of the Sensory Processing Assessment along with assessments of autism symptoms, developmental level, and adaptive behavior. Autistic children showed decreased orienting to both social and non-social touches compared to children in the non-autism group. The social touch responsivity had a sensitivity of 0.62 and a specificity of 0.76. The non-social touch responsivity had a sensitivity of 0.21 and a specificity of 0.93. The sensitivity for overall responsivity was 0.14 and the specificity was 1. For all children, reduced tactile responsivity was associated with greater autism symptomatology, adaptive functioning difficulties and lower developmental levels. Autistic children who engaged in seeking behaviors while playing with distractor toys showed reduced orienting to novel touches. Autistic children showed reduced orienting to novel touches compared to children with other developmental concerns. Children who did not respond to both social and non-social touches were more likely to be diagnosed with autism. Reduced orienting to tactile stimuli was associated with higher autism symptomatology, and lower verbal/non-verbal, and adaptive skills in all children. Tendencies of seeking behaviors impacted orienting to touch within the autism group. The findings suggest that tactile reactivity may be a promising indicator of autism diagnosis in young children and that examining this behavior could be a valuable addition to existing standardized protocols.

Health anxiety (HA) is characterized by impairing worry about being or becoming seriously ill. This cross-sectional study aimed to explore psychological and&#xa0;behavioral correlates of HA compared to other anxiety phenomena in adolescents, that is, with respect to depression, physical symptoms, bodily dissatisfaction, health-related quality of life (HRQoL) and healthcare utilization. This study was pre-registered at https://doi.org/10.17605/OSF.IO/YNBJG. We employed data from the 16/17-year follow-up (N&#xa0;=&#xa0;2438, 16/17&#xa0;years old) from the general population-based Copenhagen Child Cohort 2000. Health anxiety, anxiety, depression, physical symptoms, bodily dissatisfaction, and HRQoL were assessed using self-report questionnaires, and linked to register data on healthcare utilization. Latent profile and latent class analyses were applied to explore if specific HA related profiles/classes could be detected. These analyses did not support the idea of HA being independent of other anxieties. Instead, four groups were created based on levels of HA and anxiety symptoms. Differences between the four groups regarding the various health-related aspects were examined using relevant statistics. The four groups were: no anxieties (N&#xa0;=&#xa0;1822; 74.7%), high other anxiety (N&#xa0;=&#xa0;364; 14.9%), high HA (N&#xa0;=&#xa0;111; 4.6%), and both high HA and other anxiety (N&#xa0;=&#xa0;141; 5.8%). The high HA group reported fewer depressive symptoms, more physical symptoms, and higher healthcare utilization than those with high other anxiety. Compared to those without anxieties, both HA groups had worse scores on all psychological and behavioral correlates. Adolescents with both high HA and other anxiety symptoms reported most depressive and physical symptoms, highest bodily dissatisfaction, the lowest HRQoL and the highest healthcare utilization. HA symptoms often co-occur with additional anxiety symptoms but is specifically associated with significantly higher healthcare utilization, highlighting the importance of early recognition and intervention in youth to reduce its clinical impact.