Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,an...Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.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 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
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:Adolescent suicide remains a pressing public health concern in South Korea and worldwide,ranking as one of the leading causes of death among youth.Identifying modifiable risk and protective factors is criti...Background:Adolescent suicide remains a pressing public health concern in South Korea and worldwide,ranking as one of the leading causes of death among youth.Identifying modifiable risk and protective factors is critical for prevention strategies.Physical activity has been suggested as one such factor due to its potential mental health benefits.This study aimed to examine whether associations between physical activity and suicidality differ by activity type and by stage of suicidal behavior,distinguishing suicidal ideation,planning,and attempts among Korean adolescents.Methods:This cross-sectional secondary analysis used data from the 20th Korea Youth Risk Behavior Web-based Survey(KYRBS)conducted in 2024,a nationally representative survey of Korean adolescents.The study included 54,653 middle and high school students with complete data on physical activity,suicidal ideation,planning,and attempts.Three types of physical activity(vigorous activity,muscle-strengthening activity,and≥60 min of daily physical activity)were examined.Associations with suicidal behaviors were analyzed using multivariable logistic regression models,adjusting for psychological,behavioral,and sociodemographic covariates.Results:In this nationally representative sample of Korean adolescents,engaging in at least 60 min of daily physical activity was significantly associated with lower odds of suicide planning,but not ideation or attempts.In contrast,muscle-strengthening activity was linked to increased odds of both suicide planning and attempts,whereas vigorous activity showed no significant associations.Psychological factors,including generalized anxiety,sadness,stress,and loneliness,showed strong associations with suicidal behaviors and were included as covariates in the adjusted models.Female students,low academic performance,and unstable residential status were also associated with higher odds of suicidal behaviors.Conclusion:The associations between physical activity and suicidality differed by activity type and suicidal outcome;muscle-strengthening activity was positively associated with suicide planning and attempts in adjusted models.展开更多
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
Background:The management of renal neoplasms in adolescent patients poses unique clinical challenges due to their transitional position between paediatric and adult populations.This age group exhibits marked heterogen...Background:The management of renal neoplasms in adolescent patients poses unique clinical challenges due to their transitional position between paediatric and adult populations.This age group exhibits marked heterogeneity in tumour histology,ranging from entities commonly observed in paediatric oncology to tumours typical of adult age,as well as rare histological subtypes that exceptionally affect the kidney.Given the substantial differences in clinical protocols between paediatric and adult populations,rigorous multidisciplinary evaluation is essential to determine optimal diagnostic and therapeutic strategies for adolescent patients.Case Description:We present four cases from our tertiary referral centre that illustrate the variability in radiological and histopathological presentations and clinical outcomes in this population,underscoring the critical importance of a multidisciplinary approach.Case 1 demonstrates the typical management of Wilms’tumour in an older paediatric patient.Case 2 exemplifies the diagnostic challenge of distinguishing between Wilms’tumour and renal cell carcinoma at the upper end of the adolescent spectrum.Case 3 revealed the unexpected diagnosis of renal Ewing sarcoma in a 13-year-old female.Case 4 highlights the potential for severe perioperative complications,including life-threatening thromboembolic events,in a patient with Wilms’tumour.Conclusions:The variability in tumour types,biological behaviour,and potential for severe complications underscores the necessity of comprehensive multidisciplinary management in specialized hospital settings.An integrated approach ensures accurate diagnosis,individualized treatment planning,and effective management of complications,ultimately optimizing outcomes for adolescent patients with renal neoplasms.展开更多
Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has b...Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.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
Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against d...Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.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
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
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention...Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.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
BACKGROUND Currently,adolescent depression is one of the most significant public health concerns,markedly influencing emotional,cognitive,and social maturation.Despite advancements in distinguish the neurobiological s...BACKGROUND Currently,adolescent depression is one of the most significant public health concerns,markedly influencing emotional,cognitive,and social maturation.Despite advancements in distinguish the neurobiological substrates underlying depression,the intricate patterns of disrupted brain network connectivity in adolescents warrant further exploration.AIM To elucidate the neural correlates of adolescent depression by examining brain network connectivity using resting-state functional magnetic resonance imaging(rs-fMRI).METHODS The study cohort comprised 74 depressed adolescents and 59 healthy controls aged 12 to 17 years.Participants underwent rs-fMRI to evaluate functional connectivity within and across critical brain networks,including the visual,default mode network(DMN),dorsal attention,salience,somatomotor,and frontoparietal control networks.RESULTS Analyses revealed pronounced functional disparities within key neural circuits among adolescents with depression.The results demonstrated existence of hemispheric asymmetries characterized by enhanced activity in the left visual network,which contrasted the diminished activity in the right hemisphere.The DMN facilitated increased activity within the left prefrontal cortex and reduced engagement in the right hemisphere,implicating disrupted self-referential and emotional processing mechanisms.Additionally,an overactive right dorsal attention network and a hypoactive salience network were identified,underscoring significant abnormalities in attentional and emotional regulation in adolescent depression.CONCLUSION The findings from this study underscore distinct neural connectivity disruptions in adolescent depression,underscoring the critical role of specific neurobiological markers for precise early diagnosis of adolescent depression.The observed functional asymmetries and network-specific deviations elucidate the complex neurobiological architecture of adolescent depression,supporting the development of targeted therapeutic strategies.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
文摘Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.
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.
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 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.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(RS-2023-NR076968)the Chung-Ang University Graduate Research Scholarship in 2024.
文摘Background:Adolescent suicide remains a pressing public health concern in South Korea and worldwide,ranking as one of the leading causes of death among youth.Identifying modifiable risk and protective factors is critical for prevention strategies.Physical activity has been suggested as one such factor due to its potential mental health benefits.This study aimed to examine whether associations between physical activity and suicidality differ by activity type and by stage of suicidal behavior,distinguishing suicidal ideation,planning,and attempts among Korean adolescents.Methods:This cross-sectional secondary analysis used data from the 20th Korea Youth Risk Behavior Web-based Survey(KYRBS)conducted in 2024,a nationally representative survey of Korean adolescents.The study included 54,653 middle and high school students with complete data on physical activity,suicidal ideation,planning,and attempts.Three types of physical activity(vigorous activity,muscle-strengthening activity,and≥60 min of daily physical activity)were examined.Associations with suicidal behaviors were analyzed using multivariable logistic regression models,adjusting for psychological,behavioral,and sociodemographic covariates.Results:In this nationally representative sample of Korean adolescents,engaging in at least 60 min of daily physical activity was significantly associated with lower odds of suicide planning,but not ideation or attempts.In contrast,muscle-strengthening activity was linked to increased odds of both suicide planning and attempts,whereas vigorous activity showed no significant associations.Psychological factors,including generalized anxiety,sadness,stress,and loneliness,showed strong associations with suicidal behaviors and were included as covariates in the adjusted models.Female students,low academic performance,and unstable residential status were also associated with higher odds of suicidal behaviors.Conclusion:The associations between physical activity and suicidality differed by activity type and suicidal outcome;muscle-strengthening activity was positively associated with suicide planning and attempts in adjusted models.
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.
文摘Background:The management of renal neoplasms in adolescent patients poses unique clinical challenges due to their transitional position between paediatric and adult populations.This age group exhibits marked heterogeneity in tumour histology,ranging from entities commonly observed in paediatric oncology to tumours typical of adult age,as well as rare histological subtypes that exceptionally affect the kidney.Given the substantial differences in clinical protocols between paediatric and adult populations,rigorous multidisciplinary evaluation is essential to determine optimal diagnostic and therapeutic strategies for adolescent patients.Case Description:We present four cases from our tertiary referral centre that illustrate the variability in radiological and histopathological presentations and clinical outcomes in this population,underscoring the critical importance of a multidisciplinary approach.Case 1 demonstrates the typical management of Wilms’tumour in an older paediatric patient.Case 2 exemplifies the diagnostic challenge of distinguishing between Wilms’tumour and renal cell carcinoma at the upper end of the adolescent spectrum.Case 3 revealed the unexpected diagnosis of renal Ewing sarcoma in a 13-year-old female.Case 4 highlights the potential for severe perioperative complications,including life-threatening thromboembolic events,in a patient with Wilms’tumour.Conclusions:The variability in tumour types,biological behaviour,and potential for severe complications underscores the necessity of comprehensive multidisciplinary management in specialized hospital settings.An integrated approach ensures accurate diagnosis,individualized treatment planning,and effective management of complications,ultimately optimizing outcomes for adolescent patients with renal neoplasms.
基金supported by grants from the National Natural Science Foundation of China(G.F.Wang,grant number 82204071)(P.Y.Su,grant numbers 81874268 and 82473655)the Research Funds of the Center for Big Data and Population Health of IHM(P.Y.Su,No.JKS2023016)Anhui Provincial Health Commission Scientific Research Project(Y.Zhou,No.AHWJ2023A30027)。
文摘Vitamin D deficiency(VDD)represents a significant nutritional concern among children and adolescents.The estimated prevalence of VDD in China is 46.8%in this population^([1]).VDD during childhood and adolescence has been associated with the onset of various conditions,including acute respiratory infections,asthma,atopic dermatitis,and food allergies^([2]).Multiple factors,including age,sun exposure,adiposity,and genetics,influence vitamin D levels^([2,3]).Increasing attention has been directed toward understanding the environmental determinants that may influence vitamin D status.Given the potential of metallic pollutants to disrupt endocrine function and their ubiquity in the environment,investigating the effects of metal exposure on human vitamin D status,particularly in vulnerable populations,is imperative.
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Background:Depression is a growing public health concern among Chinese children and adolescents,with substantial healthcare costs.Physical activity(PA)and organized sport are modifiable behaviours protective against depression.This study,therefore,estimated the healthcare costs of depression attributable to insufficient PA and organized sport participation.Methods:A cost-of-illness approach with population attributable fraction(PAF)was applied.Relative risks were derived from longitudinal evidence,prevalence estimates from national Chinese surveys,and depression case numbers from the Global Burden of Disease 2021.Direct healthcare costs were extrapolated from European Union estimates,adjusted to 2024 US dollars(USD),and Chinese expenditure.Sex-stratified analyses were conducted.Results:Estimated depression-related healthcare costs attributable to insufficient PA were approximately 81 million USD,compared with around 84 million USD attributable to insufficient organized sport participation.At the population level,the economic burden attributable to insufficient PA and organized sport was of a similar order of magnitude.Among boys,costs attributable to insufficient organized sport participation(approximately 57 million USD)exceeded those attributable to insufficient PA(around 39 million USD),whereas among girls,costs attributable to insufficient PA(approximately 42 million USD)were higher than those related to organized sport(around 27 million USD).These sex-specific patterns were consistent across sensitivity analyses examining uncertainty in key model parameters.Conclusions:Both insufficient PA and organized sport contribute substantially to depression-related healthcare costs,with sex-specific differences.Policies should prioritise promoting overall PA in girls and organized sport in boys to reduce depression burden and associated expenditures.The magnitude of these attributable costs indicates an economically meaningful burden that is potentially modifiable through behavioural interventions.
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.
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Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
文摘Objectives:Childhood and adolescent obesity are an increasing global health concern.This study aimed to evaluate the effectiveness of digital components and interaction types in counseling interventions for prevention and treatment.Methods:All studies were searched in online databases and grey literature,including PubMed(Medline),Web of Science,CINAHL,Scopus,IEEE Xplore Digital Library,Journal of Medical Internet Research(JMIR),MedNar,EBSco Open Dissertations.The search period is from inception to June 2023,and the languages are Finnish,English and Swedish.The research quality was evaluated using the web-based data management system Covidence for prevalence studies.The study protocol was registered with PROSPERO(registration number:CRD42021247595).Results:In this review,4,407 studies were screened,and 22 were included.These involved 3,433 participants and 264 child-parent pairs.The digital approaches included multicomponent elements like internet platforms,text messaging,video conferencing,online communities,wearable technology,and mobile apps,allowing one-way,two-way,and face-to-face interactions.Two studies showed statistically significant effects of treatment on BMI and waist-to-hip ratio.Most interventions reported positive outcomes,with no significant differences between groups,and none showed null effects during followup.Conclusions:Digital multicomponents like mobile apps and wearables can help obese children and adolescents adopt healthier lifestyles.While these interventions show promise for obesity management,further research is needed to assess their effectiveness,particularly regarding nurses'perspectives.
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 Medical Research Project of the Chongqing Municipal Health Commission,No.2024WSJK110.
文摘BACKGROUND Currently,adolescent depression is one of the most significant public health concerns,markedly influencing emotional,cognitive,and social maturation.Despite advancements in distinguish the neurobiological substrates underlying depression,the intricate patterns of disrupted brain network connectivity in adolescents warrant further exploration.AIM To elucidate the neural correlates of adolescent depression by examining brain network connectivity using resting-state functional magnetic resonance imaging(rs-fMRI).METHODS The study cohort comprised 74 depressed adolescents and 59 healthy controls aged 12 to 17 years.Participants underwent rs-fMRI to evaluate functional connectivity within and across critical brain networks,including the visual,default mode network(DMN),dorsal attention,salience,somatomotor,and frontoparietal control networks.RESULTS Analyses revealed pronounced functional disparities within key neural circuits among adolescents with depression.The results demonstrated existence of hemispheric asymmetries characterized by enhanced activity in the left visual network,which contrasted the diminished activity in the right hemisphere.The DMN facilitated increased activity within the left prefrontal cortex and reduced engagement in the right hemisphere,implicating disrupted self-referential and emotional processing mechanisms.Additionally,an overactive right dorsal attention network and a hypoactive salience network were identified,underscoring significant abnormalities in attentional and emotional regulation in adolescent depression.CONCLUSION The findings from this study underscore distinct neural connectivity disruptions in adolescent depression,underscoring the critical role of specific neurobiological markers for precise early diagnosis of adolescent depression.The observed functional asymmetries and network-specific deviations elucidate the complex neurobiological architecture of adolescent depression,supporting the development of targeted therapeutic strategies.
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.
