Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of th...Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.展开更多
Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients...Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.展开更多
BACKGROUND Non-suicidal self-injury(NSSI)is common among adolescents with depressive disorders and poses a major public health challenge.Rumination,a key cognitive feature of depression,includes different subtypes tha...BACKGROUND Non-suicidal self-injury(NSSI)is common among adolescents with depressive disorders and poses a major public health challenge.Rumination,a key cognitive feature of depression,includes different subtypes that may relate to NSSI through distinct psychological mechanisms.However,how these subtypes interact with specific NSSI behaviors remains unclear.AIM To examine associations between rumination subtypes and specific NSSI behaviors in adolescents.METHODS We conducted a cross-sectional study with 305 hospitalized adolescents diagnosed with depressive disorders.The subjects ranged from 12-18 years in age.Rumi-nation subtypes were assessed using the Ruminative Response Scale,and 12 NSSI behaviors were evaluated using a validated questionnaire.Network analysis was applied to explore symptom-level associations and identify central symptoms.RESULTS The network analysis revealed close connections between rumination subtypes and NSSI behaviors.Brooding was linked to behaviors such as hitting objects and burning.Scratching emerged as the most influential NSSI symptom.Symptomfocused rumination served as a key bridge connecting rumination and NSSI.CONCLUSION Symptom-focused rumination and scratching were identified as potential intervention targets.These findings highlight the psychological significance of specific cognitive-behavioral links in adolescent depression and suggest directions for tailored prevention and treatment.However,the cross-sectional,single-site design limits causal inference and generalizability.Future longitudinal and multi-center studies are needed to confirm causal pathways and verify the generalizability of the findings to broader adolescent populations.展开更多
BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an e...BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.展开更多
1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconn...1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.展开更多
This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized ex...This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized exercise programs for this population.Based on the Arksey and O’Malley framework for scoping reviews,the following databases were systematically searched:PubMed,Web of Science,Cochrane Library,Embase,EBSCO,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biomedical Literature Database.Based on the inclusion and exclusion criteria,the original studies applying exercise intervention in adolescents with depression were screened.A total of 9 papers were included,including 7 randomized controlled trials,1 quasi-experimental study,and 1 mixed study.The types of exercise interventions included aerobic exercise,resistance training,anti-gravity exercise,and stretching.The frequency of exercise was 30–60 min,3–5 times per week in most studies,with most intensities being moderate to high.Exercise intervention is feasible and effective in adolescents with depression.Nursing staff play a crucial role in implementing and supervising these interventions,from initial assessment to continuous monitoring of motivation and safety.In future studies,healthcare professionals should focus on assessing the condition and physical functional status of adolescents with depression and improving the specific content of exercise intervention to develop a scientific and standardized exercise training program for adolescents with depression.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
This study examines the mediating role of positive psychological capital and the moderating role of ethnicity in the relationship between mindfulness and internalizing/externalizing problems among adolescents.The stud...This study examines the mediating role of positive psychological capital and the moderating role of ethnicity in the relationship between mindfulness and internalizing/externalizing problems among adolescents.The study sample comprized Chinese adolescents(N=637 ethnic minority;females=40.97%,meam age=12.68,SD=0.49 years;N=636 Han;females=49.06%,mean age=12.71,SD=0.47 years).The participants completed the Child and Adolescent Mindfulness Measure,the Positive Psycap Questionnaire,and the Youth Self-Report.Results from the moderated mediation analysis showed mindfulness was negatively associated with both internalizing and externalizing problems.Ethnicity moderated the relationship between mindfulness and internalizing problems to be stronger for Han adolescents compared to ethnic minority adolescents.Psychological capital mediated the relationship between mindfulness and internalizing problems in both groups,with a negative direction.Findings support the Conservation of Resources theory and highlight mindfulness as a personal resource fostering adolescent well-being in multicultural contexts.展开更多
This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;...This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.展开更多
BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated...BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.展开更多
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,an...BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,and suicidal behavior.Given the increasing rate of depression in this age group,understanding the underlying biological mechanisms is essential for early detection and intervention.Recent studies have suggested that immune markers play a role in the pathophysiology of depression,prompting further investigation of their potential association with depressive symptoms in adolescents.AIM To investigate the relationship between immune markers(monocytes,lymphocytes,and direct bilirubin)and the incidence and severity of depression among adolescents.METHODS This cross-sectional study recruited 145 adolescent patients with depression[male(M)/female(F)=38/107]from Jiangbin Hospital in Guangxi,Zhuang and 163 healthy controls(M/F=77/86)from routine health check-ups.Blood samples were collected after an overnight fast.Depression severity was measured using the Zung Self-Rating Depression Scale.The inclusion criteria were age 12-24 years,diagnosis of depressive disorder(ICD-10),and no recent antidepressant use.The exclusion criteria included psychiatric comorbidities and serious somatic diseases.Key statistical methods included group comparisons and correlation analyses.RESULTS There was a higher prevalence of females in the depression group(P<0.001).Significant age differences were observed between the groups(Z=9.43,P<0.001).The depression group had higher monocyte(Z=3.43,P<0.001)and lymphocyte(t=2.29,P<0.05)counts,and higher serum direct bilirubin levels(Z=4.72,P<0.001).Monocyte count varied significantly according to depression severity,with lower counts in the mild group(Z=-2.90,P<0.05).A negative correlation between age and lymphocyte counts was observed(ρ=-0.22,P<0.01).Logistic regression analysis showed that serum direct bilirubin levels significantly predicted depression.CONCLUSION The potential role of elevated levels of immune markers in the early detection of depression in adolescents has been highlighted.Therefore,it is necessary to explore further the relationships between these immune markers and depression.展开更多
BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive sympt...BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive symptoms in teenagers with facial burns.METHODS We selected 50 young patients with facial burns who were treated at our hospital between October 2023 and October 2024.The Hamilton Anxiety Scale and Beck Depression Inventory were used to evaluate anxiety and depressive symptoms.Additionally,we evaluated patients'social support levels and self-esteem.Pearson's correlation analysis was used to evaluate factors related to depression and anxiety.RESULTS The overall average Hamilton Anxiety Scale score was 23.4±6.2,and 16(32%)and 34(68%)patients showed mild to moderate and moderate to severe anxiety,respectively.The overall average Beck Depression Inventory score was 18.7±7.5,and 23(46%)and 27(54%)patients had mild to moderate and moderate to severe depression,respectively.Furthermore,Pearson's correlation analysis showed a significant positive correlation between burn severity and anxiety(r=0.48,P<0.01)and depression(r=0.42,P<0.01)symptoms.Self-esteem scores and social support were significantly negatively correlated with anxiety(r=-0.55 and r=-0.40,respectively;P<0.01)and depression(r=-0.60 and r=-0.38,respectively;P<0.01 for both).CONCLUSION Adolescents with facial burns commonly experience anxiety and depressive symptoms,the severity of which is closely related to burn severity,social support,and self-esteem.展开更多
Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable becaus...Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable because,compared to their cisgender peers,trans adolescents experience greater health challenges and systemic barriers to being physically active.To date,no research has evaluated an evidence-based exercise service within specialist paediatric gender services in Australia.Methods:The study is a non-randomised type 2 effectivenessimplementation hybrid trial for adolescents engaged with Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital,Western Australia.The participant group will receive the intervention alongside standard care.The design of the program has incorporated input from the GENder idenTity Longitudinal Experience(GENTLE)Cohort Consumer Advisory group;trans young people,families,and health professionals;guidelines for commonmedical presentations within paediatric gender services and international physical activity guidelines for adolescents.Program implementation and feasibility(i.e.,participant engagement,perceptions and experiences of the intervention),as well as preliminary effectiveness of the targeted exercise programon health outcomes(i.e.,quality of life,wellbeing and markers of physical health),will be evaluated as part of a pilot trial.Discussion:This project addresses a significant gap in research and healthcare and aims to enhance service delivery by integrating exercise into standard care for specialist paediatric gender services in Australia.Anticipated impacts include shaping current and future practices by defining safe,effective exercise for trans adolescents while laying the groundwork for larger scale implementation and research on long-term health benefits.展开更多
BACKGROUND Hypertension(HTN)is a significant global health concern due to its rising prevalence and associated risks of cardiovascular disease,chronic kidney disease,and other comorbidities.The increasing rates of HTN...BACKGROUND Hypertension(HTN)is a significant global health concern due to its rising prevalence and associated risks of cardiovascular disease,chronic kidney disease,and other comorbidities.The increasing rates of HTN among youth have been partly attributed to the global rise in childhood obesity,lipid abnormalities,and sedentary lifestyles.AIM To investigate the independent associations of aerobic fitness(AF),the triglyceride-to-high-density lipoprotein cholesterol(TG/HDL-C)ratio,visceral adiposity index(VAI),and resting blood pressure(BP)in Nigerian adolescents.METHODS A multistage sampling technique was used to select 403 in-school adolescents aged 11-19 years in Kogi East,Nigeria.Participants were assessed for AF,TG/HDL-C ratio,VAI,systolic BP(SBP),and diastolic BP(DBP).The associations between the independent variables and the risk of systolic and diastolic HTN were examined using multivariate regression models,controlling for age and maturity status.Receiver operating characteristics curve(ROC)and area under the curve(AUC)were employed to determine the predictive capacities of the independent variables.RESULTS The overall prevalence of systolic HTN was 5.5%(girls:7%;boys:4%)while diastolic HTN was 12.7%(girls:16.9%;boys:8.4%).Among girls,all independent variables showed significant associations with SBP,including fitness(P<0.001),TG/HDL-C(P<0.001),and VAI(P<0.001),with VAI showing the strongest association.In boys,all independent variables except VAI(P=0.063)were significantly associated with SBP,with fitness showing the stronger predictive power(Fitness,P<0.001;TG/HDL-C,P=0.029).For DBP,all independent variables,except fitness in girls(P=0.099),were significantly associated(P<0.001)in both sexes.Unfit boys were 1.1 times more likely to develop systolic HTN(95%CI:1.01–1.15,P=0.018)and had 1.1 times higher odds of developing diastolic HTN(95%CI:1.03–1.13,P=0.001).Only the ROC for DBP turned up significant(P<0.001)AUCs for TG/HDL-C and VAI in girls only,with 0.6 and 1.0 thresholds respectively.CONCLUSION AF,dyslipidemia,and visceral adipose tissue dysfunction were independently associated with the risk of HTN in Nigerian adolescents.These findings highlight the importance of promoting a healthy diet and encouraging aerobic physical activity among adolescents to reduce the risk of HTN.展开更多
Background:Adolescent depression and school refusal(SR)are prevalent and important global concerns that need to be understood and addressed.Cross-sectional associations have been reported but prospective relationships...Background:Adolescent depression and school refusal(SR)are prevalent and important global concerns that need to be understood and addressed.Cross-sectional associations have been reported but prospective relationships between them remain unclear.This longitudinal study investigated the bidirectional relationships between these two problems among Chinese adolescents.Methods:A longitudinal study was conducted in Taizhou,China,surveying students of three junior high schools,three senior high schools,and one vocational high school.A total of 3882 students completed the questionnaire at baseline(T1);3167 of them completed an identical follow-up questionnaire after 6 months(T2).Depression was assessed via the Patient Health Questionnaire(PHQ-9)and SR via the modified Chinese version of The School Refusal Assessment Scale-Revised(SRAS-R).Cross-lagged panel modeling(CLPM)analysis was conducted to test the reciprocal relationships,adjusting for socio-demographic factors.Multiple group analysis was conducted to test whether the CLPM differed by gender and grade.Results:Statistically significant bidirectional relationships were found.A higher level of SR assessed at T1 is prospectively associated with a higher level of depression at T2(β=0.07,p=0.006);a higher level of depression at T1 also is prospectively associated with a higher level of SR at T2(β=0.14,p<0.001).Such models differed significantly by neither gender nor grade.Conclusion:SR and depression should be seen as each other’s mutually reinforcing association.The bidirectional relationships potentially result in a vicious cycle.Early interventions may target both problems concurrently.Future studies may involve more time points and test some mediators.展开更多
Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnorm...Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnormalities were selected for this experiment,and they were intervened with form and body training and form and body training+visceral body acupressure techniques,and the anxiety and depression scores,spinal Cobb angle,vertebral body rotation of the parietal vertebrae,and the treatment efficiency were compared between the groups after the clinical interventions.Results:The anxiety and depression scores of patients in the form group were significantly higher than those of the combined group,P<0.05;the improvement of the Cobb angle and vertebral rotation of the parietal vertebrae of patients in the combined group was better than that of the form group,P<0.05;and the total effective rate of the treatment of patients in the form group was significantly lower than that of the combined group,P<0.05.Conclusion:After intervening in adolescents’abnormalities of form,patients were treated with a combination of the internal organs and body acupressure techniques and form training methods,and the results were compared between groups.After the joint intervention of the visceral massage technique and physical training,the patients’scoliosis and other physical problems were positively improved,and the psychological status of the patients was relatively adjusted to ensure their physical and mental health.展开更多
BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health p...BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health problems is crucial for effective intervention.This study aims to examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.AIM To examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.METHODS A total of 1260 middle school students(54.6%male)participated in this study.Data were collected at two time points(time 1 and time 2)using self-report questionnaires to assess PBV,depression,anxiety,and aggression.Cross-lagged panel network analysis was applied to examine the bi-directional relationships between these variables over time.RESULTS Depression,particularly a“sad mood,”was the most significant predictor of both PBV and aggression.Cyberbullying victimization also emerged as a key factor influencing depression and anxiety.While anxiety had weaker and less consistent effects on PBV,aggression was predominantly influenced by depressive symptoms and sleep disturbances.The analysis also identified key symptoms,such as a“sad mood”and sleep disturbances,as crucial targets for intervention to mitigate the cycle of PBV,depression,anxiety,and aggression.CONCLUSION This study provides important insights for bullying victimization prevention and intervention strategies:(1)Early identification and intervention targeting depression,particularly a“sad mood,”and sleep disturbances;(2)The importance of addressing cyberbullying as a distinct factor influencing mental health;and(3)The need for comprehensive,longitudinal approaches to understanding and intervening in the interconnected mental health issues among adolescents.展开更多
BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-...BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.AIM To investigate structural network communication within large-scale brain networks in adolescents with depression.METHODS We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression.Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents,including 17 depressed adolescents without SA or NSSI(major depressive disorder group),27 depressed adolescents with NSSI but no SA(NSSI group),and 41 depressed adolescents with SA and NSSI(NSSI+SA group).RESULTS Significant differences in structural network communication were observed across the four groups,involving spatially widespread brain regions,particularly encompassing cortico-cortical connections(e.g.,dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus;connections based on precentral gyrus)and cortico-subcortical circuits(e.g.,the nucleus accumbens-frontal circuit).In addition,we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents.We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.CONCLUSION This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA,highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms.These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.展开更多
文摘Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.
基金funded by the National Key Research and Development Program of China(grant number 2022YFC2305204).
文摘Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.
基金Supported by Key Research and Development Program of Shaanxi Province,China,No.2024SF-YBXM-078.
文摘BACKGROUND Non-suicidal self-injury(NSSI)is common among adolescents with depressive disorders and poses a major public health challenge.Rumination,a key cognitive feature of depression,includes different subtypes that may relate to NSSI through distinct psychological mechanisms.However,how these subtypes interact with specific NSSI behaviors remains unclear.AIM To examine associations between rumination subtypes and specific NSSI behaviors in adolescents.METHODS We conducted a cross-sectional study with 305 hospitalized adolescents diagnosed with depressive disorders.The subjects ranged from 12-18 years in age.Rumi-nation subtypes were assessed using the Ruminative Response Scale,and 12 NSSI behaviors were evaluated using a validated questionnaire.Network analysis was applied to explore symptom-level associations and identify central symptoms.RESULTS The network analysis revealed close connections between rumination subtypes and NSSI behaviors.Brooding was linked to behaviors such as hitting objects and burning.Scratching emerged as the most influential NSSI symptom.Symptomfocused rumination served as a key bridge connecting rumination and NSSI.CONCLUSION Symptom-focused rumination and scratching were identified as potential intervention targets.These findings highlight the psychological significance of specific cognitive-behavioral links in adolescent depression and suggest directions for tailored prevention and treatment.However,the cross-sectional,single-site design limits causal inference and generalizability.Future longitudinal and multi-center studies are needed to confirm causal pathways and verify the generalizability of the findings to broader adolescent populations.
基金Supported by Inter Disciplinary Direction Cultivation Project of Hunan University of Chinese Medicine,No.2025JC01032025 Hunan Province Science and Technology Innovation Plan Project,No.2025RC9012+2 种基金2022"Unveiling and Leading"Project of Discipline Construction at Hunan University of Chinese Medicine,No.22JBZ044Changsha Municipal Natural Science Foundation,No.kq2402174Hunan Provincial Science Popularization Fund Project,No.2025ZK4223.
文摘BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.
文摘1.Background The United Nations(UN)2030 Agenda for Sustainable Development,adopted in 2015,established the Sustainable Development Goals(SDGs)as a comprehensive framework to address global challenges through interconnected social,economic,and environmental targets.
文摘This scoping review aims to synthesize evidence on exercise interventions for adolescents with depression by examining their components and evaluating their effects,thereby informing the development of standardized exercise programs for this population.Based on the Arksey and O’Malley framework for scoping reviews,the following databases were systematically searched:PubMed,Web of Science,Cochrane Library,Embase,EBSCO,China National Knowledge Infrastructure,Wanfang Database,VIP Database,and China Biomedical Literature Database.Based on the inclusion and exclusion criteria,the original studies applying exercise intervention in adolescents with depression were screened.A total of 9 papers were included,including 7 randomized controlled trials,1 quasi-experimental study,and 1 mixed study.The types of exercise interventions included aerobic exercise,resistance training,anti-gravity exercise,and stretching.The frequency of exercise was 30–60 min,3–5 times per week in most studies,with most intensities being moderate to high.Exercise intervention is feasible and effective in adolescents with depression.Nursing staff play a crucial role in implementing and supervising these interventions,from initial assessment to continuous monitoring of motivation and safety.In future studies,healthcare professionals should focus on assessing the condition and physical functional status of adolescents with depression and improving the specific content of exercise intervention to develop a scientific and standardized exercise training program for adolescents with depression.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
基金supported by the Guizhou Provincial Science and Technology Projects[Basic Science of Guizhou-[2024]Youth 309,Guizhou Platform Talents[2021]1350-046]Zunyi Science and Technology Cooperation[HZ(2024)311]+3 种基金Funding of the Chinese Academy of Social Sciences(2024SYZH005)Peking University Longitudinal Scientific Research Technical Service Project(G-252)Guizhou Provincial Graduate Student Research Fund Project(2024YJSKYJJ339)Zunyi Medical University Graduate Research Fund Project(ZYK206).
文摘This study examines the mediating role of positive psychological capital and the moderating role of ethnicity in the relationship between mindfulness and internalizing/externalizing problems among adolescents.The study sample comprized Chinese adolescents(N=637 ethnic minority;females=40.97%,meam age=12.68,SD=0.49 years;N=636 Han;females=49.06%,mean age=12.71,SD=0.47 years).The participants completed the Child and Adolescent Mindfulness Measure,the Positive Psycap Questionnaire,and the Youth Self-Report.Results from the moderated mediation analysis showed mindfulness was negatively associated with both internalizing and externalizing problems.Ethnicity moderated the relationship between mindfulness and internalizing problems to be stronger for Han adolescents compared to ethnic minority adolescents.Psychological capital mediated the relationship between mindfulness and internalizing problems in both groups,with a negative direction.Findings support the Conservation of Resources theory and highlight mindfulness as a personal resource fostering adolescent well-being in multicultural contexts.
基金supported by the 2025 Fujian Provincial Social Science Foundation Project(FJ2025C074).
文摘This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.
文摘BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.
文摘Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
基金Supported by the Medical Discipline Construction Project of Pudong Health Committee of Shanghai,No.PWZzb2022-09Nanning City Science Research and Technology Development Program,No.ZC20233017and Guangxi Medical and Health Appropriate Technology Development and Promotion Project,No.S2021061.
文摘BACKGROUND Depression is a significant psychiatric disorder with particularly high prevalence among adolescents.This mental health condition can have severe consequences,including academic failure,social withdrawal,and suicidal behavior.Given the increasing rate of depression in this age group,understanding the underlying biological mechanisms is essential for early detection and intervention.Recent studies have suggested that immune markers play a role in the pathophysiology of depression,prompting further investigation of their potential association with depressive symptoms in adolescents.AIM To investigate the relationship between immune markers(monocytes,lymphocytes,and direct bilirubin)and the incidence and severity of depression among adolescents.METHODS This cross-sectional study recruited 145 adolescent patients with depression[male(M)/female(F)=38/107]from Jiangbin Hospital in Guangxi,Zhuang and 163 healthy controls(M/F=77/86)from routine health check-ups.Blood samples were collected after an overnight fast.Depression severity was measured using the Zung Self-Rating Depression Scale.The inclusion criteria were age 12-24 years,diagnosis of depressive disorder(ICD-10),and no recent antidepressant use.The exclusion criteria included psychiatric comorbidities and serious somatic diseases.Key statistical methods included group comparisons and correlation analyses.RESULTS There was a higher prevalence of females in the depression group(P<0.001).Significant age differences were observed between the groups(Z=9.43,P<0.001).The depression group had higher monocyte(Z=3.43,P<0.001)and lymphocyte(t=2.29,P<0.05)counts,and higher serum direct bilirubin levels(Z=4.72,P<0.001).Monocyte count varied significantly according to depression severity,with lower counts in the mild group(Z=-2.90,P<0.05).A negative correlation between age and lymphocyte counts was observed(ρ=-0.22,P<0.01).Logistic regression analysis showed that serum direct bilirubin levels significantly predicted depression.CONCLUSION The potential role of elevated levels of immune markers in the early detection of depression in adolescents has been highlighted.Therefore,it is necessary to explore further the relationships between these immune markers and depression.
文摘BACKGROUND Anxiety and depression are common psychological reactions in teenagers with facial burns and have a significant impact on their rehabilitation and quality of life.AIM To analyze anxiety and depressive symptoms in teenagers with facial burns.METHODS We selected 50 young patients with facial burns who were treated at our hospital between October 2023 and October 2024.The Hamilton Anxiety Scale and Beck Depression Inventory were used to evaluate anxiety and depressive symptoms.Additionally,we evaluated patients'social support levels and self-esteem.Pearson's correlation analysis was used to evaluate factors related to depression and anxiety.RESULTS The overall average Hamilton Anxiety Scale score was 23.4±6.2,and 16(32%)and 34(68%)patients showed mild to moderate and moderate to severe anxiety,respectively.The overall average Beck Depression Inventory score was 18.7±7.5,and 23(46%)and 27(54%)patients had mild to moderate and moderate to severe depression,respectively.Furthermore,Pearson's correlation analysis showed a significant positive correlation between burn severity and anxiety(r=0.48,P<0.01)and depression(r=0.42,P<0.01)symptoms.Self-esteem scores and social support were significantly negatively correlated with anxiety(r=-0.55 and r=-0.40,respectively;P<0.01)and depression(r=-0.60 and r=-0.38,respectively;P<0.01 for both).CONCLUSION Adolescents with facial burns commonly experience anxiety and depressive symptoms,the severity of which is closely related to burn severity,social support,and self-esteem.
基金funded by a NHMRC Investigator Grant(#2010063)the MRFF-funded Australian Research Consortium for Trans Youth and Children(ARCTYC,MRF2032119).
文摘Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable because,compared to their cisgender peers,trans adolescents experience greater health challenges and systemic barriers to being physically active.To date,no research has evaluated an evidence-based exercise service within specialist paediatric gender services in Australia.Methods:The study is a non-randomised type 2 effectivenessimplementation hybrid trial for adolescents engaged with Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital,Western Australia.The participant group will receive the intervention alongside standard care.The design of the program has incorporated input from the GENder idenTity Longitudinal Experience(GENTLE)Cohort Consumer Advisory group;trans young people,families,and health professionals;guidelines for commonmedical presentations within paediatric gender services and international physical activity guidelines for adolescents.Program implementation and feasibility(i.e.,participant engagement,perceptions and experiences of the intervention),as well as preliminary effectiveness of the targeted exercise programon health outcomes(i.e.,quality of life,wellbeing and markers of physical health),will be evaluated as part of a pilot trial.Discussion:This project addresses a significant gap in research and healthcare and aims to enhance service delivery by integrating exercise into standard care for specialist paediatric gender services in Australia.Anticipated impacts include shaping current and future practices by defining safe,effective exercise for trans adolescents while laying the groundwork for larger scale implementation and research on long-term health benefits.
文摘BACKGROUND Hypertension(HTN)is a significant global health concern due to its rising prevalence and associated risks of cardiovascular disease,chronic kidney disease,and other comorbidities.The increasing rates of HTN among youth have been partly attributed to the global rise in childhood obesity,lipid abnormalities,and sedentary lifestyles.AIM To investigate the independent associations of aerobic fitness(AF),the triglyceride-to-high-density lipoprotein cholesterol(TG/HDL-C)ratio,visceral adiposity index(VAI),and resting blood pressure(BP)in Nigerian adolescents.METHODS A multistage sampling technique was used to select 403 in-school adolescents aged 11-19 years in Kogi East,Nigeria.Participants were assessed for AF,TG/HDL-C ratio,VAI,systolic BP(SBP),and diastolic BP(DBP).The associations between the independent variables and the risk of systolic and diastolic HTN were examined using multivariate regression models,controlling for age and maturity status.Receiver operating characteristics curve(ROC)and area under the curve(AUC)were employed to determine the predictive capacities of the independent variables.RESULTS The overall prevalence of systolic HTN was 5.5%(girls:7%;boys:4%)while diastolic HTN was 12.7%(girls:16.9%;boys:8.4%).Among girls,all independent variables showed significant associations with SBP,including fitness(P<0.001),TG/HDL-C(P<0.001),and VAI(P<0.001),with VAI showing the strongest association.In boys,all independent variables except VAI(P=0.063)were significantly associated with SBP,with fitness showing the stronger predictive power(Fitness,P<0.001;TG/HDL-C,P=0.029).For DBP,all independent variables,except fitness in girls(P=0.099),were significantly associated(P<0.001)in both sexes.Unfit boys were 1.1 times more likely to develop systolic HTN(95%CI:1.01–1.15,P=0.018)and had 1.1 times higher odds of developing diastolic HTN(95%CI:1.03–1.13,P=0.001).Only the ROC for DBP turned up significant(P<0.001)AUCs for TG/HDL-C and VAI in girls only,with 0.6 and 1.0 thresholds respectively.CONCLUSION AF,dyslipidemia,and visceral adipose tissue dysfunction were independently associated with the risk of HTN in Nigerian adolescents.These findings highlight the importance of promoting a healthy diet and encouraging aerobic physical activity among adolescents to reduce the risk of HTN.
基金funded by Science and Technology Program of Wenzhou(Y20220843).
文摘Background:Adolescent depression and school refusal(SR)are prevalent and important global concerns that need to be understood and addressed.Cross-sectional associations have been reported but prospective relationships between them remain unclear.This longitudinal study investigated the bidirectional relationships between these two problems among Chinese adolescents.Methods:A longitudinal study was conducted in Taizhou,China,surveying students of three junior high schools,three senior high schools,and one vocational high school.A total of 3882 students completed the questionnaire at baseline(T1);3167 of them completed an identical follow-up questionnaire after 6 months(T2).Depression was assessed via the Patient Health Questionnaire(PHQ-9)and SR via the modified Chinese version of The School Refusal Assessment Scale-Revised(SRAS-R).Cross-lagged panel modeling(CLPM)analysis was conducted to test the reciprocal relationships,adjusting for socio-demographic factors.Multiple group analysis was conducted to test whether the CLPM differed by gender and grade.Results:Statistically significant bidirectional relationships were found.A higher level of SR assessed at T1 is prospectively associated with a higher level of depression at T2(β=0.07,p=0.006);a higher level of depression at T1 also is prospectively associated with a higher level of SR at T2(β=0.14,p<0.001).Such models differed significantly by neither gender nor grade.Conclusion:SR and depression should be seen as each other’s mutually reinforcing association.The bidirectional relationships potentially result in a vicious cycle.Early interventions may target both problems concurrently.Future studies may involve more time points and test some mediators.
文摘Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnormalities were selected for this experiment,and they were intervened with form and body training and form and body training+visceral body acupressure techniques,and the anxiety and depression scores,spinal Cobb angle,vertebral body rotation of the parietal vertebrae,and the treatment efficiency were compared between the groups after the clinical interventions.Results:The anxiety and depression scores of patients in the form group were significantly higher than those of the combined group,P<0.05;the improvement of the Cobb angle and vertebral rotation of the parietal vertebrae of patients in the combined group was better than that of the form group,P<0.05;and the total effective rate of the treatment of patients in the form group was significantly lower than that of the combined group,P<0.05.Conclusion:After intervening in adolescents’abnormalities of form,patients were treated with a combination of the internal organs and body acupressure techniques and form training methods,and the results were compared between groups.After the joint intervention of the visceral massage technique and physical training,the patients’scoliosis and other physical problems were positively improved,and the psychological status of the patients was relatively adjusted to ensure their physical and mental health.
基金Supported by the Humanities and Social Sciences Youth Foundation of Ministry of Education of China Project,No.22YJC190023.
文摘BACKGROUND Peer bullying victimization(PBV)is a significant public health issue that adolescents often face,with approximately one-third having experienced PBV.Understanding its interrelationships with mental health problems is crucial for effective intervention.This study aims to examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.AIM To examine the longitudinal relationships between internalizing problems(depression and anxiety),externalizing problems(aggression),and PBV among middle school students using cross-lagged panel network analysis.METHODS A total of 1260 middle school students(54.6%male)participated in this study.Data were collected at two time points(time 1 and time 2)using self-report questionnaires to assess PBV,depression,anxiety,and aggression.Cross-lagged panel network analysis was applied to examine the bi-directional relationships between these variables over time.RESULTS Depression,particularly a“sad mood,”was the most significant predictor of both PBV and aggression.Cyberbullying victimization also emerged as a key factor influencing depression and anxiety.While anxiety had weaker and less consistent effects on PBV,aggression was predominantly influenced by depressive symptoms and sleep disturbances.The analysis also identified key symptoms,such as a“sad mood”and sleep disturbances,as crucial targets for intervention to mitigate the cycle of PBV,depression,anxiety,and aggression.CONCLUSION This study provides important insights for bullying victimization prevention and intervention strategies:(1)Early identification and intervention targeting depression,particularly a“sad mood,”and sleep disturbances;(2)The importance of addressing cyberbullying as a distinct factor influencing mental health;and(3)The need for comprehensive,longitudinal approaches to understanding and intervening in the interconnected mental health issues among adolescents.
基金Supported by the National Natural Science Foundation of China,No.81871081 and No.62201265the Fundamental Research Funds for the Central Universities,No.NJ2024029-14the Talent Support Programs of Wuxi Health Commission,No.BJ2023085,No.FZXK2021012,and No.M202358.
文摘BACKGROUND Depression,non-suicidal self-injury(NSSI),and suicide attempts(SA)often co-occur during adolescence and are associated with long-term adverse health outcomes.Unfortunately,neural mechanisms underlying self-injury and SA are poorly understood in depressed adolescents but likely relate to the structural abnormalities in brain regions.AIM To investigate structural network communication within large-scale brain networks in adolescents with depression.METHODS We constructed five distinct network communication models to evaluate structural network efficiency at the whole-brain level in adolescents with depression.Diffusion magnetic resonance imaging data were acquired from 32 healthy controls and 85 depressed adolescents,including 17 depressed adolescents without SA or NSSI(major depressive disorder group),27 depressed adolescents with NSSI but no SA(NSSI group),and 41 depressed adolescents with SA and NSSI(NSSI+SA group).RESULTS Significant differences in structural network communication were observed across the four groups,involving spatially widespread brain regions,particularly encompassing cortico-cortical connections(e.g.,dorsal posterior cingulate gyrus and the right ventral posterior cingulate gyrus;connections based on precentral gyrus)and cortico-subcortical circuits(e.g.,the nucleus accumbens-frontal circuit).In addition,we examined whether compromised communication efficiency was linked to clinical symptoms in the depressed adolescents.We observed significant correlations between network communication efficiencies and clinical scale scores derived from depressed adolescents with NSSI and SA.CONCLUSION This study provides evidence of structural network communication differences in depressed adolescents with NSSI and SA,highlighting impaired neuroanatomical communication efficiency as a potential contributor to their symptoms.These findings offer new insights into the pathophysiological mechanisms underlying the comorbidity of NSSI and SA in adolescent depression.
