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Given the importance of the link between mental and other medical conditions, JCPP Advances organized a special issue on the topic; yet since then, very few papers have focused on this area. As such, this editorial perspective aims not only to highlight the link between mental and other medical conditions, but also to (1) explore the origins of the divide between mental and "physical" health, (2) provide evidence that this so-called divide does not exist in actuality, (3) highlight the harms of maintaining such a divide, and (4) discuss strategies to bridge this divide to address this monumental mistake, which has been perpetuated throughout medicine.
Numerous meta-analyses have established associations between child maltreatment (CM) and mental health difficulties (MH). However, variation exists between meta-analyses regarding the magnitude of these predictions. A systematic, quantitative umbrella synthesis (i.e., meta-analysis of meta-analyses) was undertaken to describe the associations between various types of CM and MH. Meta-analyses were included if they examined CM, including but not limited to retrospective reports in adulthood, and MH at any point. Included forms of CM were: physical abuse, emotional abuse, sexual abuse, neglect, and exposure to intimate partner violence. MH outcomes were: externalising problems, internalising problems, thought problems, suicidal distress, substance misuse, and other psychological difficulties. Searches were run in January 2024. Random effects models were created in R version 4.2.0. We analysed and combined effect sizes from 148 quantitative meta-analyses, including 668 effect sizes and over 9.5 million data points. CM was associated with all MH outcomes: (1) externalising problems (r = 0.21; 95% CI = 0.18-0.24; k = 32), (2) internalising problems (r = 0.22; 95% CI = 0.20-0.24; k = 46), (3) thought problems (r = 0.24; 95% CI = 0.21-0.27; k = 38), (4) suicidal distress (r = 0.23; 95% CI 0.18-0.28; k = 19), (5) substance misuse (r = 0.19; 95% CI = 0.13-0.26; k = 13), (6) other psychological difficulties (r = 0.24; 95% CI = 0.20-0.28; k = 50). Associations tend to be of similar magnitude for different forms of CM. CM is robustly associated with MH. A parsimonious explanation for these findings would be a common mechanism(s) or a general psychopathology factor conferring high-risk for different mental health difficulties following CM. The results possibly question the conventional wisdom that suggests some forms of maltreatment are intrinsically more harmful to mental health than others. However, further work is required to understand how potentially confounding factors (e.g., age, measurement of CM) influence these associations.
There is a critical lack of reliable, high-quality epidemiological data on mental health and/or social and emotional wellbeing (SEWB) outcomes for First Nations children, partly, due to the limited availability of culturally valid assessment tools. This review aims to assess the cultural validity of mental health and SEWB assessment tools used with First Nations children aged 4-12 years in Australia, and identify gaps, strengths, and opportunities for reform that enhance cultural safety, and self-determination in assessment practices. A systematic search of five electronic databases (Web of Science, PubMed, PsycINFO, Informit, and CINAHL) identified English-language studies (1980-2025) assessing mental health or SEWB in Aboriginal and/or Torres Strait Islander children aged 4-12 years. Data on assessment tools were extracted and their cultural validity analysed using the First Nations Cultural Validity Assessment Tool. Tools were classified, as bespoke, culturally adapted or generic, using the CBSPATSISP definitions. This review examined the cultural validity across 10 studies, including 11 unique tools and 16 assessments of cultural validity. Three tools were bespoke, eight culturally adapted, and five generic. Over three quarters of tools used to assess SEWB or mental health in First Nations children had poor or limited cultural validity. Two bespoke SEWB tools were identified, although none specifically targeted mental health. Culturally valid assessment tools for First Nations children remain limited, with research predominantly relying on inappropriate measures. Improving the measurement of mental health and SEWB outcomes requires a shift towards First Nations-led, co-designed tools grounded in Indigenous knowledges, strengths, and cultural frameworks. The evidence base was limited by reliance on published academic sources, which may have missed community-used assessment tools, a focus on cultural validity rather than broader study quality, and limited psychometric reporting for some First Nations-specific measures. PROSPERO (CRD42024542866). 13 May 2024. www.crd.york.ac.uk/PROSPERO/view/CRD42024542866.
Children who show difficult temperament are at risk of peer victimisation, which in turn associates with numerous negative outcomes later in life. We used network analysis to examine whether specific aspects of difficult temperament contributed to these associations, and whether the links were moderated by variations in genetic liability for ADHD, schizophrenia, and depression. In 3354 mother-child dyads (51.8% female), we examined in three steps: (i) the network structure of difficult temperament as indexed by adaptability, intensity, and mood (age 2), (ii) its item-level associations with peer victimisation (ages 8, 10, and 13), and (iii) moderation of these associations by polygenic risk scores (PRS) for ADHD, schizophrenia, and depression. Indicators of difficult temperament formed a coherent network that was associated with peer victimisation. Regarding PRS moderation, for those high in PRS (top 10%) for ADHD and schizophrenia, indicators of temperamental intensity and mood were associated with peer victimisation, respectively. For those high in PRS for depression, however, aspects of temperament were no longer associated with peer victimisation. Finally, the network results for those in the general population across all PRS (bottom 90%) largely resembled the model estimated using the full sample. The findings highlight specific temperamental behaviours as risk factors for peer victimisation; additionally, children high in PRS for neurodevelopmental disorders may be at especially high-risk for this outcome early in development.
Valstad et al. (2026) presented important methodological advances in the study of indirect genetic effects in developmental psychology and psychiatry. By combining genetically informative family designs with measured genetic data, they addressed how sibling interaction and genetic nurture may contribute to developmental outcomes such as attention-deficit/hyperactivity disorder (ADHD) and educational performance. Their work highlights the importance of disentangling direct genetic effects from indirect genetic effects that arise through family relationships and shared environments. We discuss the conceptual implications of these processes for developmental psychology and psychopathology, and emphasize the interpretational challenges associated with correlated genetic and environmental influences. We note that heterogeneity in developmental processes may complicate statistical modeling approaches designed to estimate indirect genetic effects.
Genetic epidemiological analyses of child and adolescent mental health often use data from prospective longitudinal cohorts. Missingness due to selective attrition is therefore an important potential source of bias in such analyses. Informatively reporting on missingness and taking appropriate steps to handle it in analyses can mitigate this potential bias. Here, we aim to systematically assess how researchers report and address missingness in genetic epidemiological studies of child and adolescent mental health-related outcomes using cohort data. We systematically searched the Ovid Medline database for studies published between August 2012 and August 2025, reporting polygenic score, genome-wide association, or Mendelian randomization analyses, of data on children or adolescents participating in cohort studies. We extracted information from eligible studies based on criteria adapted from the strengthening and reporting of observational studies in epidemiology (STROBE) guidelines. A total of 133 eligible studies were included, of which 125 (93.98%) reported the number of complete cases in all waves, while 84 (63.16%) detailed the amount of missingness on all key variables. Most studies used complete case analysis, while 39 studies explicitly reported applying other methods to handle missingness, with multiple imputation (n = 20, 15.04%) being the most common, followed by full information maximum likelihood 10 (8.1%). Only 18 studies (13.53%) reported an assumed missing mechanism along with the method used to address missingness. Full reporting of both the extent and handling of missingness at the item level was rare, occurring in only 5 (3.76%) and 15 (11.28%) studies, respectively, among the 123 studies that used multi-item instruments. Best practice recommendations for reporting on missing data handling emphasize the importance of detailing the proportion of missingness, types of mechanisms underpinning missingness, and details of approaches used. Based on this review, these recommendations for proper reporting of missing data are rarely followed in full.
Play provides an important foundation for a healthy childhood but longitudinal data exploring how play experiences relate to children's mental health over time is scarce. In this study, data on preschool-aged children's activities and mental health during Covid-19 related restrictions was used to explore how where (inside/outside) and with whom children played related to internalising and externalising problems over time. UK based parents/carers (n = 1028) of preschool-aged children (2-5 years) completed an online survey at four time points between April and July 2020. The survey asked how much time in the previous week their child had spent: Playing inside; Playing outside; Playing alone; Playing with a parent; Playing with another child in their household; and their child's mental health (Strengths and Difficulties Questionnaire internalising and externalising scales). Four hierarchical linear regression analyses were conducted to examine associations between where children play (inside/outside) and (1) internalising and (2) externalising symptoms, and with whom children play (with parent, other child, alone) and (3) internalising and (4) externalising symptoms. Effects of linear and quadratic time, and interactions between play and time were examined. Parent mental health, parent education, contact with nature and physical activity were included as covariates. Both inside and outside play was associated with less severe internalising problems (beta = -0.23 [SE = 0.10]; beta -0.54 [SE = 0.19]) and, in statistical interaction with time, less time playing inside was associated with a stronger improvement in externalising problems over time (beta = 0.77 [SE = 0.23]). Further, more time playing with other children was associated with less severe internalising problems (beta = -0.50 [SE = 0.13]) whereas playing alone was associated with more severe internalising problems (beta = 0.28 [SE = 0.10]). Varied play opportunities are related to young children's mental health. Even during a pandemic response, children should be given opportunity to play with other children and play outdoors wherever possible.
Multiple psychiatric disorders are associated with later dementia, but it remains unclear whether these associations reflect a shared liability toward all psychiatric conditions (general psychopathology factor) or diagnosis-specific effects (specific psychopathology factors). In this Swedish register-based cohort study, we investigated these questions while adjusting for familial confounding shared by siblings (N = 2 543 621 individuals, 1 485 880 full-sibling pairs). Exposures were (i) six psychiatric diagnoses recorded by age 35 and (ii) a latent bifactor model fit to these diagnoses that identified one general and three specific (internalizing, externalizing, and psychotic) psychopathology factors. Outcomes were all-cause dementia and Alzheimer's disease recorded after age 50. For observed psychiatric diagnoses, we estimated between-individual (HR) and within-sibling hazard ratios (HRwn) using Cox regression; for latent factors, we estimated between-individual (OR) and within-sibling odds ratios (ORwn) using exploratory structural equation modelling. All psychiatric diagnoses were significantly associated with increased risk of all-cause dementia (HR range 2.03-3.59; HRwn range 1.72-2.94) and Alzheimer's disease (HR range 1.89-3.47; HRwn range 1.77-3.22). These associations were largely attributable to the general psychopathology factor, even after adjusting for familial confounding (ORwn with 95% CI: 1.25 [1.17-1.32] for dementia; 1.24 [1.16-1.32] for Alzheimer's disease). After accounting for the general factor, only the psychotic-specific factor remained associated (ORwn with 95% CI: 1.20 [1.07-1.36] for dementia; 1.20 [1.06-1.37] for Alzheimer's disease). These results suggest that liability toward general psychopathology and, independently, psychotic conditions, by early adulthood might be early markers of increased dementia risk and targets for timely identification and prevention.
The Cyclothymic-Hypersensitive Temperament (CHT) is a multidimensional, transdiagnostic affective disposition characterized by mood instability, interpersonal sensitivity, heightened emotional reactivity and impulsive behaviors. The CHT Questionnaire (CHTQ) currently lacks of normative references and empirically derived thresholds. Study 1 established age- and sex-adjusted normative scores and derived percentiles, tolerance limits, and Equivalent Score (ES)-based risk categories. Study 2 tested the clinical relevance of these norms in 196 adolescents with bipolar spectrum disorders and propensity score-matched controls, examining group differences, ES-based risk distributions, and disorder-specific thresholds. In Study 1, regression analyses showed a significant age-by-sex interaction for Total and subscale scores. Age was positively associated with Total in females (R 2 = 0.029) and negatively in males (R 2 = 0.009). The same pattern emerged for Impulsiveness/Emotional Dysregulation (IED; females: R 2 = 0.029; males: ns) and Moodiness/Hypersensitivity (MHS; R 2 = 0.017 both sexes), supporting age- and sex-specific norms. Normative values and ES-based classifications enhanced score interpretability. Moderate- and high-risk thresholds were 15.32 and 17.24 for Total, 6.67 and 7.70 for IED, 9.80 and 10.87 for MHS. In Study 2, bipolar adolescents showed higher adjusted Total and IED than controls (Total: t = -3.33, p < 0.001, d = 0.34; IED: t = -4.42, p < 0.001, d = 0.45), with no MHS differences. Logistic regression showed Total (odds ratio [OR] = 1.08, p = 0.001) and IED (OR = 1.20, p < 0.001), but not MHS, predicted bipolar status. Receiver Operating Characteristic (ROC) analyses showed modest discrimination for Total (Area Under the Curve [AUC] = 0.61; cut-off = 13.50) and IED (AUC = 0.63; cut-off = 4.78), and chance-level performance for MHS. Integrating age- and sex-adjusted norms with risk categories and clinical thresholds, the CHTQ may support developmentally informed early risk stratification and longitudinal monitoring.
Early intervention in youth mental health has long been assumed to confer long-term benefits, altering developmental trajectories and reducing risk of later mental disorders. The 3-year follow-up of the Mind My Mind (MMM) trial challenges these assumptions. The MMM transdiagnostic cognitive behavioural therapy (CBT) intervention led to clinically meaningful improvements at the end of treatment and at short-term follow-up. Its superiority over management as usual, however, was not sustained at 3 years, and rates of subsequent specialist psychiatric diagnosis did not differ between the MMM and control groups. These findings highlight that effective psychological intervention in youth does not necessarily alter longer-term mental health trajectories. Prevention science in youth mental health must move beyond equating early treatment with durable change and instead clarify the mechanisms and targets required to alter developmental trajectories toward serious mental illness.
Sensory over-responsivity (SOR) is highly prevalent and impairing in autism spectrum disorder (ASD). SOR has been associated with sensory-limbic hyperresponsivity and reduced prefrontal top-down regulation during sensory stimulation. There are few evidence-based treatments for SOR, but cognitive reappraisal, an emotion regulation strategy, has been shown to reduce negative feelings through activation of frontal brain regions. The current study examined whether reappraisal changes neural reactivity to aversive sensory stimulation in autistic compared to typically developing (TD) children. Forty-seven ASD and 45 age/IQ-matched TD youth aged 8-15 years participated in fMRI while experiencing aversive tactile stimulation on their arm and alternately focused either on how the stimulus made them feel ('React'), or how they would describe the stimuli objectively ('Reappraise'). Aversiveness ratings were provided after each stimulus. Parents reported on participants' SOR severity. Autistic youth showed reduced activation in sensory cortical regions during Reappraisal compared to React. Reappraisal also resulted in increased dorsomedial prefrontal cortex activation, with a trend toward more increases in the TD group but no significant group differences. Despite these reappraisal-related neural changes across both groups, only TD youth showed a reduction in aversiveness ratings for Reappraisal compared to React. Among ASD youth, higher SOR was associated with fewer decreases in sensory cortices but greater increases in frontal regions during Reappraisal compared to React. Older ASD youth also showed increased activity in the ventral prefrontal cortex during Reappraisal. Results suggest that cognitive reappraisal modulates neural responses during sensory processing and, more specifically, may reduce hyperactivity in sensory cortical regions previously shown to be associated with SOR. However, individual differences such as age and SOR severity may affect the extent to which top-down cognitive processes are uniquely engaged during reappraisal.
Brief emotion-focused family therapy (EFFT) interventions have demonstrated numerous positive outcomes across the domains of child mental health and parent psychosocial well-being. However, there is limited research examining interpersonal processes at the family-level of analysis following 2-day EFFT programs. This study explored family functioning in the year following a virtual, parent-focused EFFT intervention (n = 159 caregivers, representing 124 families and 264 children). Caregivers completed the General Functioning subscale of the Family Assessment Device at 6 timepoints from baseline to 12-month post-intervention. Multilevel modeling was used to complete growth curve analysis, exploring post-intervention changes in family functioning over time. This allowed for the exploration of between versus within family differences pre- to post-intervention in the study sample. Variance in family functioning was attributable to stable differences between caregivers (level 2; 59%) and change over time (level 1; 41%), including measurement error. Growth curve analysis identified positive changes in family functioning post-intervention, with a cubic trajectory of improvement. Higher COVID-19 disruption, caregiver psychological distress, and parenting stress significantly predicted lower baseline family functioning, but did not significantly interact with change over time. These results suggest that there is a general pattern of non-linear change following EFFT workshops, specifically relating to family interpersonal dynamics. Overall, the study findings expand the evidence base for this promising, brief, relational intervention, now available in virtual formats, thereby increasing access for busy families.
When receiving an attention deficit hyperactivity disorder (ADHD) diagnosis, children and families/carers need clear and accurate information about the condition in a suitable format. However, many of the available resources are complex or provide content that is not evidence-based. Furthermore, there are limited studies that co-develop digital resources with and for children, particularly those with ADHD. This study describes a co-production approach with an under-represented group, children with ADHD (aged 7-11), and their families/carers, to develop an animated video that provides support and improves understanding of ADHD. The iterative co-design process involved a series of focus groups with children and families/carers at different stages of video animation development. The views of healthcare professionals were also obtained via online questionnaires and interviews. Key themes were identified through thematic analysis before more detailed discussions of content and a review of the animation storyboard. Eleven families (12 children, 11 parents/carers) were involved in focus groups and 23 health professionals responded to online questionnaires. The study resulted in the creation of a widely accessible evidence-based bilingual (English, Welsh) animated video for children aged 7-11, newly diagnosed with ADHD, and their families/carers. Preliminary feedback and evaluation from participants at the animation launch event showed that the animation has been well received. This study provides background around the development of a well-received digital resource for children with ADHD. It also outlines a framework for the co-production of further resources, especially as those involved agreed that a wider range of resources is needed for children and young people with ADHD.
Children and adolescents with attention-deficit hyperactivity disorder (ADHD) exhibit higher physical activity (PA) levels than peers without ADHD. It remains unclear how this association evolves across developmental stages and differs between sexes. This study explores associations between ADHD symptoms and PA levels in childhood and adolescence, focusing on sex differences. Data from the Millennium Cohort Study at ages 7 (n = 14,043), 11 (n = 13,469), 14 (n = 11,872) and 17 (n = 10,757) were included. Moderate-to-vigorous PA (MVPA) was objectively measured using accelerometers at ages 7 and 14, and PA by parent- and self-reporting at ages 7, 11 and 14. ADHD symptoms were assessed by the ADHD subscale of the Strengths and Difficulties Questionnaire (SDQ) at all ages. Multiple linear regressions and mixed-effects regression models estimated associations between PA and SDQ ADHD scores adjusting for confounders. MVPA was associated with higher SDQ ADHD scores at age 7 (b = 0.009, p < 0.001) and, to a lesser extent, age 14 (b = 0.004, p = 0.004). MVPA and SDQ ADHD scores were associated among males at ages 7 (b = 0.008, p = 0.001) and 14 (b = 0.004, p = 0.007), but among girls at age 7 only (b = 0.011, p < 0.001). Age 7 MVPA was associated with higher ADHD symptoms at ages 11 (b = 0.004, p = 0.003) and 17 (b = 0.004, p = 0.031), however age 14 MVPA was not associated with ADHD symptoms at age 17. Higher reported PA levels at ages 7, 11 and 14 were associated with lower SDQ ADHD scores. Young people with higher objectively-measured PA levels exhibited higher ADHD symptoms, although this association was stronger in males. By adolescence, PA and SDQ ADHD scores were less strongly associated, and no longer significantly associated among adolescent females. Subjectively-measured PA showed the inverse association with ADHD symptoms, emphasising the importance of mode of PA measurement.
Adolescent depression is heterogeneous, yet many studies rely on aggregate symptom scores that may obscure meaningful differences in symptom presentation. Latent class analysis (LCA) offers a person-centered approach for identifying symptom subgroups, but few studies have examined depressive symptom classes longitudinally with attention to social determinants of health (SDoH). This study identified depressive symptom classes among youth with depression and/or suicidality, examined demographic, clinical, and socio-ecological correlates of class membership, and evaluated changes in psychological outcomes over 6 months. Participants were 1,825 youth ages 8-20 years who screened positive for depression, endorsed suicidal thoughts or behaviors, or were receiving treatment for depression. Baseline Patient Health Questionnaire for Adolescents (PHQ-A) item responses were used to identify latent classes of depressive symptoms. Associations between class membership and sociodemographic characteristics, trauma exposure, health-related social needs, treatment barriers, anxiety, suicidality and resilience were examined using chi-square tests and analyses of variance. Mixed-effect models evaluated changes in clinical symptoms and resilience across 6 months of follow-up. A five-class solution was identified: Somatic Symptoms (15.6%), No Symptoms (12.4%), Mild Symptoms (20.5%), Moderate Symptoms (27.8%), and High Symptoms (23.5%). Classes differed significantly by sex, trauma exposure, interpersonal safety concerns, treatment barriers, anxiety severity, suicidality, and resilience. In contrast, household income and basic resource insecurities did not differ significantly across classes. Longitudinally, depressive symptoms, anxiety, and suicidality showed significant time-by-class interactions; however, within- and between-class effect sizes were generally small. Resilience did not exhibit differential changes across classes. Depressive symptom classes among youth with depression or suicidality demonstrate distinct clinical and socio-ecological profiles, highlighting meaningful heterogeneity beyond symptom severity alone. Person-centered approaches may improve characterization of adolescent depression and inform more tailored assessment and intervention strategies. Future longitudinal research should examine the stability of these classes and predictors of transitions between symptom classes.
Digital technologies are becoming an important part of health care, including for individuals with attention-deficit/hyperactivity disorder (ADHD). Digital health innovations present valuable opportunities to provide flexible and tailored support for their diverse needs, along with significant challenges. Attentional, organizational, and motivational characteristics associated with ADHD may affect how individuals engage with digital tools. Potential risks include additional access barriers, the exclusion of underserved groups, and diminished quality of care. To help reduce these risks, the development, evaluation, and implementation of digital tools must be person-centered and guided by a comprehensive understanding of the diverse needs of all stakeholders. To advance research in this area, a multidisciplinary panel of ADHD specialists, technology experts, and individuals with lived experience of ADHD was formed. The panel worked together to agree on key priorities and considerations for developing, evaluating, and implementing digital technologies for ADHD. The recommendations are designed to be shared with the wider research community and to guide innovations in ADHD digital health to improve care. A modified Delphi approach was used to develop consensus. Key statements were drafted, building on discussions held during the European Network for ADHD (EUNETHYDIS) Special Interest Group meeting in 2024. An expert panel that included additional key stakeholders was convened. Draft statements were shared with panel members via a 2-round Delphi survey and discussion meetings, with final statements coproduced by the panel. Insights from multiple perspectives were incorporated, and consensus agreement was sought. Refined statements were shared with EUNETHYDIS members for ratification. Panel members were invited to contribute as coauthors. An expert panel of 28 members (21 EUNETHYDIS Special Interest Group members, 7 invited experts) coproduced 30 consensus statements on ADHD and digital health. Agreement ranged from 78.6% (22/28) to 100% (28/28) for the first round (19 statements) and from 92.6% (25/27) to 100% (27/27) for the second round (30 statements). Final statements covered 4 topic areas: Opportunities and Aspirations, Development and Evaluation, Implementation, and Risks and Unintended Consequences. These were ratified in September 2025 by the EUNETHYDIS. This consensus process provides the first comprehensive set of key considerations for digital health care for people with ADHD and demonstrates the feasibility of achieving expert agreement on complex, rapidly evolving topics, such as digital health. Future work should focus on translating these considerations into more specific and practical implementation frameworks, identifying priorities, and connecting them to real-life stories and empirical evidence.
Depression is a highly heterogeneous condition. Depression with an onset in childhood and early adolescence has a worse clinical course, is more heritable, and shows a lower genetic correlation with other depression subtypes, than does later-onset depression. It is also more strongly associated with neurodevelopmental (ND) comorbidities and genetic liability to attention-deficit hyperactivity disorder. Thus, we hypothesised that early-onset depression represents a distinctive 'neurodevelopmental' depression subtype associated with an increased burden of rare copy number variants (CNVs) that are enriched in ND conditions. We tested this hypothesis using four population cohorts across the UK, Norway, and Sweden. Participants were ascertained from four population cohorts across the UK, Norway, and Sweden. Early-onset depression was defined as a score >11 on the self-reported Short Mood and Feelings Questionnaire between ages 10 and 14 years (cases n = 5994 vs. controls n = 26,388) and, for secondary analyses, using ICD-10 criteria for major depressive disorder (MDD) with onset  ≤ 14 years (cases n = 856 vs. controls n = 96,769). Carriers of large, rare (>500 kb, <1% frequency) CNVs and known ND CNVs were identified. Primary analyses tested associations between early-onset depression and (i) large, rare CNVs, and (ii) ND CNVs. Secondary analyses investigated parent-reported measures of early-onset depression. Meta-analysis did not identify any robust associations between early-onset depression (SMFQ-defined) and large, rare CNVs (OR = 0.92 [95% CI = 0.84-1.02], p = 0.12) or ND CNVs (OR = 1.06 [0.85-1.31], p = 0.60). No robust associations were observed between early-onset depression, defined using ICD-10 MDD criteria, and large rare CNVs (OR = 1.08 [0.86-1.36], p = 0.49) or ND CNVs (OR = 0.69 [0.34-1.39], p = 0.30). Our findings did not support the hypothesis that individuals with early-onset depression show enrichment for large, rare or known ND CNVs.
Adults formerly placed out-of-home (care leavers) often accumulate multiple psychosocial adversities that can lead to poor quality of life (QoL) and place them at high risk for developing mental disorders persisting into adulthood. This study examines the development of mental disorders among care leavers and their QoL, differentiating by disorder groups. The sample consisted of 119 young adults formerly placed out-of-home (Mage at baseline = 15.0 years; Mage at follow-up = 25.4 years). Mental disorders were assessed at baseline using the Kiddie Schedule for Affective Disorder and Schizophrenia-Present and Lifetime Version and at a 10-year follow-up with the Structured Clinical Interview for DSM-5 Disorders-Clinician Version. Personality disorders were evaluated at both time points using the Structured Clinical Interview for DSM-IV-TR Axis II. QoL was measured at follow-up using the World Health Organization QoL-BREF questionnaire. Four groups based on the presence or absence of mental disorders at baseline and follow-up were identified: resilient (n = 24, 20.2%), persistent (n = 56, 47.0%), remitted (n = 25, 21.0%), and newly occurring (n = 14, 11.8%). Regarding the mental disorder groups, internalizing disorders at baseline (β = -0.44, p < .05, 95% CI [-0.85, -0.04]) and internalizing (β = -0.78, p < .001, 95% CI [-1.14, -0.43]) and externalizing disorders (β = -0.50, p < .01, 95% CI [-0.86, -0.13]) at follow-up were negatively associated with QoL in young adulthood. Mental disorder trajectories from childhood to young adulthood can negatively impact care leavers' QoL. Prevention and early intervention, as well as addressing mental health during out-of-home placement and transition into young adulthood, are important to reduce the risk of persistent psychopathology and lower QoL.
Cognitive theories suggest that negative self-perception is central to the development and maintenance of depression. One way self-perception is represented is through mental imagery of the self. Despite its theoretical importance, the role of mental images of the self in depression has not been systematically examined. This study investigated cross-sectional and longitudinal associations between self-perception, mental images of the self, and depressive symptoms in young people. A total of 796 young people (aged 12-24) recruited from school and university populations completed surveys at two timepoints, 1 month apart. Measures included the Harter Self-perception Profile Global Self-Worth subscale, the Mental Imagery Questionnaire for Youths and the Revised Child Anxiety and Depression Scale-Short Version. Self-perception was negatively associated with depressive symptoms both cross-sectionally and longitudinally ( b  = -2.57, 95% CI [-2.87, -2.27]; b  = -0.83, 95% CI [-1.22, -0.45]). Positive and negative mental images of the self were associated with depressive symptoms (t = -5.61; t = 10.73). Frequency of positive and negative images of the self were associated with self-perception ( b  = -0.57, 95% CI [-0.76, -0.39]; b  = 0.38 95% CI [0.18, 0.58]) and depression ( b  = 0.12, 95% CI [0.09, 0.16]; b  = -0.10, 95% CI [-0.14, -0.06]), cross-sectionally. Positive imagery vividness was linked to self-perception in the full sample ( b  = 0.09, 95% CI [0.01, 0.16]) and school subgroup ( b  = 0.14, 95% CI [0.03, 0.24], but not in the university subgroup. Longitudinally, both frequency and vividness of positive imagery were associated with self-perception in the university subgroup only ( b  = 0.05, 95% CI [0.01, 0.10]; b  = 0.09, 95% CI [0.01, 0.16]). Young people's self-perceptions, whether expressed through evaluative thoughts or mental images, play a critical role in depressive symptoms. Findings support cognitive models of depression and highlight self-perception as a promising intervention target. The study also underscores limitations of current mental imagery measures and the need for more robust tools to clarify these relationships.
Accurate population prevalence estimates of eating difficulties in children and young people provide essential information for the design and implementation of prevention efforts. We aimed to (I) explore the proportion of students reporting eating difficulties in a large English secondary school sample, (II) analyse factors associated with increased odds of eating difficulties and (III) estimate a weighted prevalence of eating difficulties in England. 19,797 students in school years 7-11 (aged 11-16 years) and 3037 in school years 12-13 (aged 16-19 years) from the OxWell Student Survey completed questions from the Development and Well-Being Assessment. A further 2664 had answers imputed using multiple imputation by chained equations, resulting in n = 25,498 students. The survey happened during February and March 2023. Logistic regression models estimated associations between gender, year group, ethnic group and eating difficulties. For students in Years 7-11, we estimated the prevalence of eating difficulties weighted to England's population. The most endorsed difficulty was students thinking they were fat when others said they were very thin (47.3%; 11,277/23,837) and the least endorsed was self-induced vomiting (17.7%; 4203/23,748). Girls (aOR 3.1, 95% CI 2.9, 3.2) and gender diverse/gender non-disclosing young people (aOR 3.3, 95% CI 2.9, 3.9) had higher odds of having eating difficulties compared to boys, with increasing odds in older year groups. The weighted prevalence of eating difficulties in students in school years 7-11 was 62.5% (95% CI: 61.8, 63.3). The findings show that eating difficulties are common in secondary school students with more than half of our sample self-reporting at least one type of eating difficulty. These data provide insight for clinical services, and the high prevalence further suggests that early intervention in community settings may have a valuable role in reducing the demand on eating disorder services.