搜索结果：European child & adolescent psychiatry

BACKGROUND: WHO recommend that children and adolescents attend scheduled well-care visits for health promotion, prevention, early detection, identification and management of disability and disease. Children born to adolescent mothers experience a disproportionate burden of poor health outcomes, but their well-care attendance is under-researched. METHODS: Cross-sectional data were used from a cohort of adolescent and young mothers (10–24 years; n = 1040) and their children (n = 1145) recruited through purposive, convenience-based sampling across healthcare facilities and community-based settings in Eastern Cape, South Africa (2017–2019). Quantitative data on visit attendance up to 18 months were analysed using descriptive statistics for children of adolescent mothers (10–19 years) aged ≥ 19 months at data collection, to allow complete observation of visits. In 2022, semi-structured interviews (n = 16) were conducted until saturation, to explore factors influencing attendance. Themes were developed and matched to the capability, opportunity and motivation model of behaviour (COM-B) and Theoretical Domains Framework using a realist thematic template analysis approach. RESULTS: Records were available for 415/482 eligible children. Attendance declined from 85.1% (95%CI: 81.3–88.4) at 6 weeks to 49.7% (95%CI: 46.6–56.5%) at 18 months, with higher attendance during visits coinciding with the childhood immunisation schedule. Attendance and qualitative findings were similar by maternal HIV status. Themes were matched to the COM-B. Capability: mothers’ organisational and financial acumen facilitated their child’s attendance; mothers persisted in attending despite harsh attitudes from healthcare workers. Opportunity: financial and kinship support and information in the child health booklet facilitated visit attendance; lack of childcare support, poor weather, cost and distance to clinic interfered with attendance. Motivation: mothers were motivated to attend visits to gain knowledge and fulfil their parental role. CONCLUSION: This study identified missed opportunities for promoting life-course health and well-being among children and their adolescent mothers, and theory-informed opportunities to support well-care visit attendance. Findings challenge deficit-based narratives highlighting mothers’ motivations and strategies for ensuring attendance. Enhancing the quality of nurse-adolescent mother interactions may increase the perceived and actual value of visits and support attendance. Further research is needed on interventions to promote consistent attendance, address barriers to access and identify opportunities to strengthen integration of well-care and HIV-related services.

As many as half of all psychotic disorders diagnosed by age 28 in the population emerge in individuals who attended child and adolescent psychiatry services, highlighting important opportunities for psychosis prediction and prevention. An important next step is to identify prognostic factors for later psychotic disorders within this clinical population. We assessed a large number of potential prognostic factors for adult-onset psychosis within adolescent psychiatry services. Linked population-wide register data for all individuals born in Finland 1987-1992. Using survival analyses, we assessed a range of clinical, service use, and sociodemographic characteristics in adolescent psychiatry patients (ie, individuals who were diagnosed with a mental disorder in specialist-level services in adolescence [ages 13-17 years]) as prognostic factors for adult-onset psychotic disorders (ages 18-30 years; individuals diagnosed with psychosis before age 18 [n = 2276] were excluded). Among adolescent psychiatry patients (n = 27 626), cumulative risk of psychosis between ages 18 and 30 was 8.5%. Within-service significant prognostic factors for psychosis included: total number of mental disorder diagnoses received in adolescence, young maternal age, premature birth, older age at first adolescent psychiatry contact, history of child psychiatry contact, psychiatric inpatient admission in adolescence, parental history of psychosis, and parental history of inpatient psychiatric admission. Our findings demonstrate that a number of clinical, service use, and sociodemographic factors have prognostic significance for the development of adulthood psychosis among adolescent psychiatry patients.

Appropriately designed, conducted, and reported randomised controlled trials (RCTs) in children and adolescents inform treatment and health-care decisions made by young people, families, researchers, clinicians, regulators, funders, policy makers, and other interest holders. To critically evaluate, interpret, and apply trial results, readers require access to a complete and transparent report of what was planned, done, and found, taking unique considerations specific to children and adolescents into account. Harmonised guidance based on evidence and consensus is needed to optimise standardised reporting and reduce research waste in paediatric RCTs. As an extension to the Consolidated Standards of Reporting Trials (CONSORT) 2025 statement, the CONSORT-Children and Adolescents (CONSORT-C) 2026 reporting guideline aims to improve the quality and completeness of reporting of paediatric RCTs that involve participants aged 0-19 years. The Enhancing the Quality of Transparency of Health Research (EQUATOR) Network's published framework primarily informed the development of CONSORT-C 2026. A literature review was conducted to generate a list of candidate reporting items. To obtain direct input from young people and family caregivers throughout the project, a Youth Advisory Group and a Family Caregiver Advisory Group were formed. An international Delphi study with a priori consensus thresholds, consensus meeting, group writing of the explanation and elaboration paper, and pilot testing were conducted. CONSORT-C 2026 consists of a checklist with 13 new reporting items, including one youth-generated and six youth-endorsed items; the accompanying explanation and elaboration paper explains all items and offers examples of good reporting. CONSORT-C 2026 can be considered a minimum set of reporting items applicable to paediatric RCT reports reflecting the priorities of clinicians, researchers, young people, family caregivers, and other interest holders. Widespread implementation and uptake of CONSORT-C 2026 should optimise the usability of trial results for these populations, improve the reproducibility of trial results, and reduce research waste.

Studies that jointly examine the specific symptoms of problematic gaming and problematic social media use with comparable conceptualizations and link them to adolescent psychological well-being remain scarce. This study addresses this gap with an effective representative sample of n = 33,586 adolescents aged 11-15 years across 10 European countries, collected in the 2021-22 Health Behaviour in School-aged Children (HBSC) survey. A network approach was applied to data about problematic media use (i.e., Internet Gaming Disorder Scale, Social Media Disorder Scale) and psychological well-being (i.e., WHO-5 Well-being Index, Multiple Health Complaints Scale, and Loneliness). In gaming and social media, either separately or together, escapism was both the most common and the key bridge symptom: it was connected to loneliness in both genders and to overall well-being and nervousness in girls. Behavioral symptoms that reflect negative consequences of use (i.e., conflict, deception, and problems with others) were strongly related across gaming and social media, suggesting that they reflect a general condition rather than a behavior linked to a specific media use. The findings highlight the central role of escapism in the interplay between adolescent problematic media use and psychological well-being, with some gender-specific differences. Symptom-level focus can guide prevention and intervention strategies. It can also prompt further research to move beyond aggregated symptom scores to better capture the heterogeneity of problematic media use as well as how specifically relevant the symptoms are for the two problematic behaviors in relation to psychological well-being.

Evidence-based parenting programmes are widely used to prevent violence against children and improve parenting and mental health. Despite hundreds of randomised trials, little is known about their outcomes when delivered at scale within routine delivery. This study assesses the WHO-endorsed and UNICEF-endorsed Parenting for Lifelong Health programme for caregivers and adolescents, delivered through non-governmental organisation and government in Botswana, the Democratic Republic of the Congo, Eswatini, South Africa, South Sudan, Tanzania, Zambia and Zimbabwe, with support from the President's Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID) and the European Union. Pre-post surveys for caregivers and adolescents were integrated into service data collection between 2016 and 2022. Abbreviated standardised measures of physical abuse, emotional abuse, approval of corporal punishment, positive involved parenting, monitoring/supervision, caregiver depressive symptoms, parenting stress and adolescent depressive symptoms and externalising behaviour were used. Individual country scores were analysed separately for caregivers and adolescents using generalised linear mixed-effects models, and cross-country data were combined using a random-effects meta-analytic model. 123 050 participants were included (93% retention, 57 908 adolescents (96% female), 56 423 caregivers at follow-up). In all-country meta-analyses, estimates showed reduced physical abuse (-65%; 95% CI 51% to 74%), emotional abuse (-59%; 95% CI 48% to 68%) and approval of corporal punishment (-55%; 95% CI 48% to 60%). Positive involved parenting increased (+52%; 95% CI 24% to 87%) and poor supervision/monitoring decreased (-48%; 95% CI 34% to 58%). Caregiver depressive symptoms (-25%; 95% CI 8% to 48%), parenting stress (-46%; 95% CI 41% to 52%), adolescent depressive symptoms (-22%; 95% CI 1% to 38%) and adolescent externalising behaviour problems (-43%; 95% CI 29% to 54%) all declined. There was heterogeneity in pre-intervention scores and extent of change between humanitarian and development settings, and between different target groups, but strong consistency across caregiver and adolescent reports. In eight African countries, including humanitarian and pandemic-affected contexts, an evidence-based parenting programme showed consistent associations with reduced violence against adolescent girls and improved parenting and mental health.

The theme of the 21st International Congress of the European Society for Child and Adolescent Psychiatry, "Beyond Nature and Nurture," focused on issues surrounding the future of child and adolescent psychiatry. In particular, it focused on how the role of family involvement is evolving in child and adolescent psychiatry. Many mental health disorders affecting young people require a focus on the context and environment of the youth. The "Maisons des Adolescents" take into account the complexity of disorders that emerge during adolescence and their multifactorial causes. Psychological suffering can lead to major health risks, and these disorders often require family involvement. In our symposium, we described different forms of care involving parents in a research and a clinical setting. We looked at the management of suicidal crises in a day-hospital setting and the therapeutic education program for bulimia and binge eating disorder.

Randomised controlled trial (RCT) protocols contain essential details needed to understand and evaluate the trial's planned aims, design, data collection methods, monitoring, data analysis, and participants' safety. However, key information is often omitted from paediatric RCT protocols, including details on dose adjustments of interventions based on age, body surface area, or weight; developmental appropriateness of trial outcome measures and processes; or strategies to minimise participants' anxiety and pain. These deficiencies impair the planning and implementation of potentially impactful trials for children and adolescents. Appropriate guidance is needed to support harmonised, comprehensive reporting of paediatric RCT protocols involving participants aged 0-19 years. The methodological framework for developing reporting guidelines published by the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network was implemented to develop a paediatric extension to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2025 guidelines, called SPIRIT-Children and Adolescents (SPIRIT-C) 2026. A list of candidate reporting items was generated from the literature, and a Youth Advisory Group and a Family Caregiver Advisory Group contributed essential input throughout the project. An international Delphi study with a priori consensus thresholds, a consensus meeting, group writing of the explanation and elaboration paper, and pilot testing of the draft guideline were conducted. SPIRIT-C 2026 consists of a checklist with 17 new reporting items for reporting paediatric RCT protocols; four items are youth generated and six youth endorsed. SPIRIT-C 2026 can be considered a minimum set of reporting items pertinent to paediatric RCT protocols that are relevant to various interest holders, including young people, family caregivers, researchers, paediatric trialists, ethics committees, regulators, funders, and journal editors. The accompanying explanation and elaboration paper explains all items and offers examples of good reporting. Widespread implementation and uptake of SPIRIT-C 2026 should enhance the quality and usefulness of protocols for RCTs that involve participants from birth through adolescence, and ultimately foster high-quality paediatric trials.

Paternal mental health (PMH) has been shown to associate with child development as early as infancy. However, the moderating effects of certain contextual factors remain poorly understood. Using data from the French SEPAGES cohort, an outcome-wide analytic approach was used to investigate the relationship between PMH during pregnancy (n = 166), 0-12 months postnatally (n = 117), and 12-24 months postnatally (n = 207) with child socioemotional, behavioral and cognitive outcomes at two and three years. Mother's mental health, child sex and parent's professional class were then tested as potential moderators. Findings revealed no significant associations between paternal depression or anxiety with any measure of child development. However, mother's professional class and maternal prenatal depression moderated the association between paternal anxiety and several areas of child development, with children of lower maternal professional classes showing poorer cognitive outcomes but improved social perception when exposed to paternal anxiety. Children exposed to paternal anxiety showed worse working memory outcomes and future-oriented tasks and organization when also exposed to maternal depression. While our findings contrast with current research, showing no relationship between PMH and child development, they highlight the importance of considering family socioeconomic position when studying the relationship between PMH and child development.

The EORTC QLQ-C30 (QLQ-C30) is the most widely used cancer-specific patient-reported outcome questionnaire in adult clinical trials, but its suitability for adolescents who have distinct developmental needs is unclear. Adolescents with cancer are often underrepresented in clinical trials, and efforts are underway to improve their participation by lowering the age of entry. This study evaluated the QLQ-C30's acceptability, reliability, validity and delivery preferences in adolescents with cancer across different languages and cultural backgrounds. Adolescents aged 12-17 years, undergoing or having completed cancer treatment for curative or palliative intent, completed the QLQ-C30 alongside the PedsQL Cancer Teen questionnaire and shared their feedback on relevance, ease of completion and preferred mode of administration (paper or electronic). Socio-demographic and clinical data were recorded. Two hundred adolescents (mean age 14.5 years, standard deviation (SD) 1.6 years; 51.5% male) representing different cultures participated. The QLQ-C30 required a mean 12 min to complete and was described as acceptable and easy to complete. Psychometric testing confirmed the QLQ-C30 subscale structure with acceptable-to-good internal consistency (Cronbach's α 0.70-0.84), as well as good convergent and discriminant validity with PedsQL subscales. Comparisons of scores according to treatment intent and performance status demonstrated some support for known-group validity. Over half (57%) adolescents preferred paper completion of questionnaires. This study is the first to systematically evaluate the QLQ-C30 in adolescents and establishes its acceptability and validity in this population, confirming it as a measure of choice for clinical trials involving adolescents and enabling robust life course-based outcome assessment.

Environmental factors such as temperature may influence how much time adolescents spend being active, but evidence remains limited. We aimed to evaluate the relationship between same-day temperature exposure and accelerometer-measured time spent in physical activity at different intensities in adolescents in two European cohorts. We used data from 1316 Dutch adolescents (mean age [standard deviation]: 12.7 [1.5] years, Generation R Study, 2015-2018) and 531 Spanish adolescents (13.6 [2.3] years, INMA Project, 2017-2022). Ambient residential-level daily temperature at 100 × 100-m resolution was estimated using the UrbClim model. Daily light, moderate, and vigorous physical activity duration was measured with wrist-worn accelerometers up to nine consecutive days. Cohort-specific distributed lag mixed-effect models assessed same-day temperature effects on physical activity, adjusting for temperatures in the two previous days. Adolescents spend more time in light and moderate physical activity on warmer days. In Generation R, light activity increased by up to 10.9 (95% confidence interval = 4.7, 17.0) minutes and moderate activity by 4.8 (1.2; 8.4) minutes at the 95th versus 5th percentile (21.5 vs. 2.3ºC). In INMA, increases were 16.3 (3.8, 28.9) and 14.2 (6.1, 22.4) minutes, respectively (25.1 vs. 7.7ºC). No associations were observed for vigorous activity. Warmer temperatures were associated with more time spent in light and moderate, but not vigorous, physical activity in Dutch and Spanish adolescents. These findings highlight the importance of considering ambient temperature when designing activity interventions, particularly in the context of climate change.

Autism Spectrum Disorder (ASD) is associated with altered attentional function. This has been associated with enhanced visual search performance. Addressing a gap in the literature, we investigate the longitudinal development of visual search alongside ASD symptoms. Using eye-tracking, we studied performance in a single-feature visual search task with visual search accuracy and time to target. We investigated preschoolers with ASD (n = 60, age = 47 months) and a cohort of developmental age-matched typically developing (TD) children (n = 50, age = 35 months) at baseline and after approximately 3 years. We further explored associations of visual search performance with parent-reported ASD symptom domains. Both groups showed similar visual search accuracy and time to target at baseline. At the 3-year follow-up, the ASD group showed significantly lower visual search accuracy and shorter time to target than the TD group. Within the ASD cohort, higher accuracy and shorter time to target were associated with higher social communication impairments. The often-reported ASD advantage in visual search may not be as pronounced as assumed to differentiate between ASD and neurotypical development. It may also be dependent on the measure reported. More accurate and faster search may be associated with certain symptom severity profiles of ASD, supporting broad heterogeneity in the autism spectrum. Children with autism spectrum disorder (ASD) have been reported to show better performance in visual search tasks than typically developing (TD) children without ASD. Using eye‐tracking at two time points over 3 years, we found a more complex pattern. While children with ASD and TD children show similar performance at preschool age, children with ASD show lower visual search accuracy but faster time to target after 3 years. Also, our findings support an association of enhanced visual search and ASD symptomatology within neurodiversity.

Pre- and postpartum environments and genetic effects influence childhood internalising problems, which increase depression risk. DNA methylation (DNAm) may capture some of these effects. We therefore investigated associations between child blood DNAm and internalising problems. We meta-analysed probe and region-level epigenome-wide association studies using data from 3 European birth cohorts (ALSPAC, MoBa, Generation R; analytic N = 1,121-3,011) from the Pregnancy And Childhood Epigenetics (PACE) Consortium. DNAm was assessed at birth (cord blood) and age 6 years (peripheral blood). Internalising problems (ages 3 and 6) were reported by mothers using the Child Behaviour Checklist or Strengths and Difficulties Questionnaire. Models were adjusted for age at DNAm assessment, 20 surrogate variables, estimated cell proportions, maternal education, age, smoking and, in secondary analysis, maternal anxiety and depression. Public databases were searched for mental health associations with top CpG sites and regions. No significant probe-level associations were found between cord- or peripheral-blood DNAm and internalising problems. In region-level analyses, two differentially methylated regions (DMRs) in cord blood were associated with internalising problems at age 3 (annotated to STK32C, MIR886) and one at age 6 (PFKFB2). At age 6, peripheral-blood analyses identified two DMRs (C10orf26 (WBP1L), FAM125A). Several genes showed prior associations with psychiatric phenotypes, including depression. The higher-powered regional-level analyses revealed more associations than probe-level. Among others, we identified a region annotated to STK32C that has previously been linked to adolescent depression. Larger samples and refined phenotyping are needed to clarify the role of DNAm in internalising problems.

Infant regulatory problems (RP), such as sleeping disturbances, feeding difficulties and excessive crying, affect a significant number of families and can persist beyond typical developmental stages, leading to distress for both the child and parents. These challenges disrupt the co-regulatory bond between parent and infant, often resulting in mutual dysregulation, parental burnout, and strained family relationships. Sociocultural values in Western societies, combined with conflicting role expectations, can contribute to heightened parental stress. Despite growing recognition of infant mental health (IMH), families' lived experiences dealing with persistent and severe RP remain underexplored. This study addresses the existing gap by employing an Interpretative Phenomenological Approach (IPA), specifically the Multi Family Member Interview Analysis (MFMIA), to explore the nuanced and shared experiences of families in crisis. Interviews were conducted with six father-mother dyads who had received specialised tertiary IMH treatment due to persistent and severe RP in their child. Analysis revealed four phenomenological themes. First, families experienced more than stress or fatigue; RP represented an existential rupture that dismantled the predictability of everyday life (Disrupted lives). Second, traditional gender roles shaped coping strategies: fathers often sought refuge in work while mothers remained confined to relentless caregiving, creating a painful asymmetry that intensified exhaustion (A gendered struggle for balance). Third, social isolation emerged through external minimisation and internal reluctance to show vulnerability, leaving families increasingly disconnected (Alone on an island: trapped in a vicious cycle of isolation). Finally, the crisis extended beyond its acute phase, with participants describing a prolonged period characterised by significant differences between families, where persistent vulnerability intertwined with varying degrees of resilience (The past shapes the present). These results reveal a bidirectional dynamic, i.e., a spiralling mutual influence, operating between the infant and the parents, as well as within the co-parenting dyad. In this cycle, the challenges of raising a child with RP and the disruptions within the parent-child and parenting subsystems mutually reinforce each other, eroding identity, straining relationships, and fostering isolation. This study highlights the critical importance of societal recognition, accessible social support, and responsive government policies for families facing infant RP.

Internalizing disorders such as anxiety and depression can be especially severe during adolescence, presenting significant challenges for affected individuals. While cognitive-behavioural therapy (CBT) has shown promise as an effective treatment for these conditions, a significant proportion of youth do not benefit sufficiently from CBT. One critical factor that may influence the effectiveness of CBT is adherence to therapy homework, with evidence suggesting a relationship between homework completion and therapy outcomes, including symptom reduction. In this context, smartphone apps have emerged as a potentially helpful tool to enhance adherence by providing engaging ways for adolescents to complete their therapy homework. However, in Germany, there is currently a lack of evaluated smartphone apps that can be deployed as adjuncts to CBT for adolescents. This study is designed as a randomized controlled trial (RCT). It will evaluate the effects of the JAY smartphone app on therapy homework adherence during CBT for adolescents with internalizing disorders (n = 35) compared to CBT with standard paper-and-pencil homework (n = 35). The findings of the JAY trial may contribute to the understanding of how smartphone apps can be integrated into CBT for adolescents to enhance therapy homework adherence and ultimately treatment outcomes. German Clinical Trials Register (DRKS) DRKS00026623. Registered on 13th October 2023, https://drks.de/search/de/trial/DRKS00026623/details .

Genetic differences are robustly associated with educational outcomes, but how they become linked is poorly understood. A plausible hypothesis, yet to be thoroughly empirically tested, is that the school environment mediates the association. Using structural equation models, we tested whether the student-teacher relationship at age 5 (teacher-reported Student-Teacher Relationship Scale) mediated the association between children's education-linked genetic propensities (PGSedu) and mother-rated reading and math performance at ages 6-8. We performed these analyses in 63,032 children from the Norwegian Mother, Father and Child Cohort Study, a longitudinal, population-based, pregnancy cohort. Higher PGSedu were significantly associated with lower student-teacher conflict (&#x3b2;&#x2009;=&#x2009;-0.08, p&#x2009;<&#x2009;.001) and positive teacher responses (&#x3b2;&#x2009;=&#x2009;0.07, p&#x2009;=&#x2009;.001), but not student-teacher closeness (&#x3b2;&#x2009;=&#x2009;0.01, p&#x2009;=&#x2009;.616). Associations between PGSedu and educational performance were significantly partially mediated via conflict (&#x3b2;&#x2009;=&#x2009;0.01, p&#x2009;<&#x2009;.001) and positive teacher responses (&#x3b2;&#x2009;=&#x2009;0.01, p&#x2009;=&#x2009;.019) but not closeness (&#x3b2;&#x2009;=&#x2009;1&#x2009;&#xd7;&#x2009;10-3, p&#x2009;=&#x2009;.619). Student-teacher conflict and positive teacher responses may be mechanisms involved in the cascade of pathways linking children's genetics to their educational outcomes.

Repetitive head impacts (RHIs) are associated with later-life neurodegeneration. Because soccer is the most widely played sport among youth worldwide, identifying early changes associated with RHI is important. To determine whether participation in 1 season of youth soccer is associated with changes in cognition, behavior, balance, brain structure or function, or blood biomarkers compared with noncontact sports. Prospective longitudinal cohort study at European centers (Munich, Germany; Leuven, Belgium; and Oslo, Norway). Male adolescent soccer players and noncontact athletes were each studied across a single competitive season with assessments at preseason, postseason, and 2 months later. Data were analyzed from January 2023 to March 2025. Soccer players were compared with noncontact athletes. In addition, self-reported heading of a soccer ball was assessed among soccer players as a measure of RHI. Cognition, behavior, balance, magnetic resonance imaging (brain structure, function, and biochemistry), and plasma biomarkers. Male adolescent soccer players (n&#x2009;=&#x2009;82; mean [SD] age, 14.8 [0.6] years) did not differ from noncontact sport athletes (n&#x2009;=&#x2009;47; mean [SD] age, 14.7 [0.7] years) in cognition, behavior, balance, cortical thickness, brain volumes, white-matter microstructure, or functional connectivity. At preseason, soccer players had higher total N-acetylaspartate (tNAA; &#x3b2;, -0.379 [95% CI, -0.627 to -0.131]; P&#x2009;=&#x2009;.003), glial fibrillary acidic protein (GFAP; &#x3b2;, -0.055 [95% CI, -0.103 to -0.006]; P&#x2009;=&#x2009;.03), and neurofilament light chain (NfL; &#x3b2;, -0.071 [95% CI, -0.122 to -0.020]; P&#x2009;=&#x2009;.01) than noncontact sport controls. Across the season, tNAA (&#x3b2;, 0.047 [95% CI, 0.020-0.074]; P&#x2009;=&#x2009;.001) declined in soccer players and increased in controls, converging by postseason. Group trajectories of GFAP and NfL did not differ between groups. Within soccer players, heading exposure was not significantly associated with changes in any outcome. In this cohort study of adolescent males, no statistically significant differences were detected over 1 season between soccer players and noncontact sport athletes in cognition, behavior, or brain structure and function. Group differences in GFAP and NfL may represent early signs of exposure, but lack of association with heading exposure warrants further investigation. These results highlight the need for large, multiyear studies to inform health policy.

Childbirth-related post-traumatic stress disorder (CB-PTSD) is an important international health concern. Despite increasing recognition of the public health burden of CB-PTSD, little is known about how CB-PTSD symptoms present across different countries. This study examined cross-national differences in CB-PTSD symptom severity and presentation to inform culturally sensitive screening and intervention strategies. Data were drawn from the International Survey of Childbirth-Related Trauma (INTERSECT) cross-sectional survey of 11,302 women 6-12&#xa0;weeks postpartum in 31 countries using a standard protocol. CB-PTSD symptoms were assessed using the City Birth Trauma Scale, measuring DSM-5 symptom components (re-experiencing, avoidance, negative cognitions and mood, hyperarousal). Participants were mostly married, aged 30-34&#xa0;years, with average household income, and higher education. CB-PTSD symptom severity varied substantially across countries, with the highest mean scores in Pakistan (M&#xa0;=&#xa0;23.49, SD&#xa0;=&#xa0;13.23) and lowest in Nigeria (M&#xa0;=&#xa0;1.89, SD&#xa0;=&#xa0;3.66). Despite these differences, symptom patterns were largely consistent across countries, with avoidance symptoms lowest and hyperarousal symptoms highest. Exceptions were observed in countries with particularly high symptom levels. Decision tree analysis identified avoidance symptoms (>3.1) as the strongest discriminator of CB-PTSD cases vs non-cases (F(1,11,204)&#xa0;=&#xa0;4820.54, p&#xa0;=&#xa0;.000), followed by negative cognitions and mood (>10; F(1,716)&#xa0;=&#xa0;143.69, p&#xa0;=&#xa0;.000). While CB-PTSD severity varies internationally, symptom presentation is largely consistent, supporting its relevance as an international construct. Avoidance symptoms were the least commonly endorsed yet the most discriminative for identifying CB-PTSD in decision tree analyses, suggesting they may serve as a useful clinical flag for women who warrant more detailed assessment. Variations in symptom expression in countries with high levels of symptoms highlight the importance of culturally sensitive approaches to screening and assessment.

Personal and family mental health histories of youth with functional tic-like behaviours (FTLB) and/or tics (TS) were compared. This is a cross-sectional study with between-group analysis of 127 patients aged 4-17 years referred to a tic service between 2019 and 2022 who were diagnosed with FTLB, TS, or co-occurring FTLB and TS. Co-occurring psychiatric and neurodevelopmental conditions in the personal and family history of cases collected prospectively were recorded as per standard care. Post-hoc analysis was undertaken to explore findings of interest. Later tic onset (13 years vs. 5 years) and increased comorbid psychiatric disorders (>&#x2009;78% vs. 51%) in the FTLB versus TS groups, support the European Society for the Study of Tourette Syndrome (ESSTS) criteria for clinical diagnosis of FTLBs. Anxiety, depression and autism were more prominent in FTLB groups. 35% of the FTLB group had an ADHD diagnosis. Family history of tics is significantly more likely in the TS groups, while family history of anxiety was most prominent in the TS+FTLB group. Post hoc analysis indicated that in FTLB with co-occurring ADHD, the majority of ADHD (56%) was picked up following FTLB presentation, with missed ADHD diagnoses mainly in girls. Patterns of difference in mental health and family mental health exist between TS and FTLB supporting ESSTS diagnostic criterion for FTLB. FTLB is associated with anxiety, depression and autism. ADHD is present in 35% of FTLB even without TS, and if this is a replicable finding, suggests a treatable vulnerability factor in FTLB.

Using data from the EU-GEI Work Package 2 (EU-GEI WP2) programme, we sought to test several hypotheses related to gaps in our knowledge of associations between childhood adversities and psychosis. EU-GEI WP2 comprises incidence and case-control studies of first-episode psychosis conducted in 17 sites in 6 countries. In each site, over 2-year periods, we identified and collected relevant data from individuals aged 18-64 with a first-episode psychosis and with no history of psychosis. Missing data were imputed. We used multi-level logistic regression to test our hypotheses. In total, 1071 cases and 1497 controls were included. We found variations in the prevalence and the magnitude of associations between any adversity and psychosis by place (eg, odds ratios ranged from 0.4 [Cuenca, Spain] to 12.1 [Madrid, Spain]). The weighted percentages reporting adversities in control samples were associated with site incidence rates (eg, 3+ adversities: Spearman's rho 0.56, P .025). We found variations in the magnitude of associations by sex (eg, effect of physical and sexual abuse stronger among women), by age of exposure, and by severity and frequency of adversities (eg, largest odds ratios for adversities involving hostility, threat, and violence). Variations across populations in prevalence and effects of adversities may contribute to variations in rates of psychosis. Variations in effects by sex and age of onset may point to sex-specific mechanisms and to developmentally sensitive periods. Adversities involving severe threat, hostility, and violence may have the largest effects on risk of psychosis.