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
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 Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications...BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.展开更多
Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the...Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the diagnose of CRVDs.The purpose of this study was to determine the utility of objective infrared eye tracking in identifying CRVDs among adolescents experiencing persisting post-concussive symptoms(PPCS)more than 28 days after injury.Methods:This was a prospective study of adolescents with PPCS evaluated with visio-vestibular examination(VVE),comprehensive vision examination,and an eye tracking device.Results:Of the 108 adolescents enrolled,67(62%)were diagnosed with a CRVD by comprehensive vision examination.On VVE,the near point of convergence break(5.5±3.2 cm vs.3.9±1.7 cm(mean±SD),p<0.001)and recovery(8.1±3.3 cm vs.6.8±2.3 cm,p=0.02)distinguished between those with and without CRVD.Concussion symptom provocation on VVE with horizontal saccades(35(52%)vs.12(29%),p=0.02)and horizontal vestibulo-ocular reflex testing(37(55%)vs.14(34%),p=0.03),and sway on tandem gait under the forward eyes closed condition(25(37%)vs.6(15%),p=0.01)also identified those with CRVD.From the eye tracking device,the BOX score(8.1±5.8 vs.5.2±4.1,p=0.007)and a metric of the left eye tracking along the bottom of the visual target(0.094±0.500 vs.-0.124±0.410,p=0.02)identified those with CRVD,with a multivariable receiver operating characteristic curve analysis,including the BOX score,achieving an area under the receiver operating characteristic curve of 0.7637.Conclusion:CRVDs are common in those with PPCS,with impact on recovery after concussion.Novel eye-tracking metrics can serve as an aid in the identification of those with CRVDs who would benefit from referral for comprehensive diagnosis and treatment.展开更多
Adolescent depression is increasingly recognized as a serious mental health disorder with distinct clinical and molecular features.Using single-nucleus RNA sequencing,we identified cell-specific transcriptomic changes...Adolescent depression is increasingly recognized as a serious mental health disorder with distinct clinical and molecular features.Using single-nucleus RNA sequencing,we identified cell-specific transcriptomic changes in the nucleus accumbens(NAc),particularly in astrocytes,of adolescent macaques exhibiting depressive-like behaviors.The level of diacylglycerol kinase beta was significantly reduced in neurons and glial cells of depressed macaques,while FKBP5 levels increased in glial cells.Disruption of GABAergic synapses and disruption of D-glutamine and D-glutamate metabolism were linked to depressive phenotypes in medium spiny neurons(MSNs)and subtypes of astrocytes.Communication pathways between astrocytes and D1/D2-MSNs were also disrupted,involving factors like bone morphogenetic protein-6 and Erb-B2 receptor tyrosine kinase-4.Bulk transcriptomic and proteomic analyses corroborated these findings,and FKBP5 upregulation was confirmed by qRT-PCR,western blotting,and immunofluorescence in the NAc of rats and macaques with chronic unpredictable mild stress.Our results highlight the specific roles of different cell types in adolescent depression in the NAc,offering potential targets for new antidepressant therapies.展开更多
Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of a...Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.展开更多
Objective:This study aimed to examine the association between parent-child relationships and physically aggressive behavior among adolescents.Methods:This is a cross-sectional study that uses secondary data from the 2...Objective:This study aimed to examine the association between parent-child relationships and physically aggressive behavior among adolescents.Methods:This is a cross-sectional study that uses secondary data from the 2015 Indonesia Global School-Based Health Survey(IGSHS).Health surveys were conducted in 75 schools representing three regions(Sumatra,Java-Bali;Outer Sumatra;and Java-Bali)in 26 provinces and 68 districts/cities in Indonesia(N=10,139 students).Students who participated were aged 12-19 years,were enrolled in public schools in the junior and high school levels.Results:It has been seen that for most middle-aged adolescents(58.7%),their parents(25%-29%)pay less attention to academic assignments(homework),problems,and use of free time.The most significant factors that influence adolescents to commit violence are smoking and consuming alcohol.Adolescents who smoke are twice as likely to commit physical violence compared with adolescents who do not smoke(OR=2.005;95%CI=1.7062-2.396).Meanwhile,adolescents who consume alcohol are 1.8 times more likely to commit physical violence compared with adolescents who do not consume alcohol(OR=1.807;95%CI=1.421-2.298).Conclusions:Through educational activities and consultations,this study’s findings are valuable for establishing parenting programs among those concerned about their children’s aggressive behavior.Meanwhile,counseling programs can be started in schools by conducting self-detection of negative adolescent behavior,such as screening for smoking,alcohol consumption,sleep issues,and attempted suicide.展开更多
Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resu...Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.展开更多
BACKGROUND The impact of mental health,including anxiety,on academic performance has been studied in several countries,but few data exist for Sudan.AIM To investigate the correlation between anxiety scores and academi...BACKGROUND The impact of mental health,including anxiety,on academic performance has been studied in several countries,but few data exist for Sudan.AIM To investigate the correlation between anxiety scores and academic performance among adolescent schoolchildren in Northern Sudan.METHODS This cross-sectional study was carried out during the 2021–2022 academic year among schoolchildren from randomly selected schools in Almatamah locality,River Nile State,Northern Sudan.A questionnaire was used to collect the parti-cipants’sociodemographic data.Anxiety levels were assessed using the ques-tionnaire tools of the General Anxiety Disorder 7-item scale.Students’academic performance scores were obtained from school records.Multivariate linear regression was performed.RESULTS A total of 328 students participated in this study,comprising 156 boys(47.6%)and 172 girls(52.4%).The median[interquartile range(IQR)]age of the students was 14.9 years(13.9–15.6 years).The median(IQR)of the students’academic scores was 27.6%(22.2%–48.1%).The median(IQR)of the students’anxiety scores was 0(0–3).In univariate linear analysis,anxiety scores were positively associated with academic performance scores(coefficient=1.19,P value<0.001).In multivariate linear analysis,after controlling for age,sex,parental education,occupation,and body mass index-Z-score,anxiety scores were positively associated with academic performance scores(coefficient=0.60,P value<0.001).CONCLUSION The current study revealed a positive correlation between anxiety scores and students’academic performance scores.However,the association between mental health disorders,including anxiety,and academic performance is a complex issue.Therefore,further studies are recommended.展开更多
Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As su...Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As such,we aim to provide theoretical foundations for early identification and intervention.Methods:This cross-sectional study enrolled 90 hospitalized adolescents with depression(case group)and 91 healthy adolescents(control group).Childhood Trauma Questionnaire(CTQ),Adolescent Self-Rating Life Events Checklist(ASLEC),and Children’s Depression Inventory(CDI)were administered to assess trauma history,life event stressors,and depressive symptoms.Statistical analyses included independent samples t-tests,chi-square tests,and Pearson correlation analysis.Results:The case group demonstrated a significantly higher proportion of only-child families(28.9%).ASLEC and CDI scores were significantly elevated in the case group compared to the control group(P<0.05).In comparison,CTQ scores were lower in the case group(P=0.025).Positive correlations were identified between CDI scores and both CTQ(r=0.261)and ASLEC(r=0.218)in the case group.Conclusion:Child-hood trauma and recent life event stressors demonstrate significant associations with adolescent depressive symp-toms,potentially mediated through emotional dysregulation and negative cognitive bias.Implementation of early trauma screening protocols combined with stress management interventions(e.g.,cognitive behavioral therapy)and family system optimization strategies may effectively mitigate depression risk in this population.展开更多
Adolescent depressive symptoms represent a significant public health concern,with negative life events and dysfunctional attitudes playing pivotal roles in theirdevelopment.A cross-sectional study by Yu et al assessed...Adolescent depressive symptoms represent a significant public health concern,with negative life events and dysfunctional attitudes playing pivotal roles in theirdevelopment.A cross-sectional study by Yu et al assessed the interplay betweendysfunctional attitudes,social support,and depressive symptoms in 795 Chineseadolescents(49.9%male,mean age 15.2±1.8 years,age range 11-18 years)fromfive middle schools in Shandong Province.Using the Dysfunctional AttitudesScale,Adolescent Life Events Scale,Beck Depression Inventory,and SocialSupport Rating Scale,the study identified that dysfunctional attitudes,particularlyover-autonomy and over-perfectionism,mediate the relationship betweennegative life events and depressive symptoms.Social support moderated thisrelationship,significantly reducing depressive symptoms.These findingsunderscore the need for preventive and therapeutic strategies targeting dysfunctionalattitudes and enhancing social support to address adolescent depressivesymptoms.In this article,we extend their findings to highlight the significance ofculturally tailored interventions that incorporate familial and communitydynamics in mitigating depressive symptoms,particularly in collectivist societies.展开更多
Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly ...Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.展开更多
Objective: The purpose of this study was to evaluate health education using videos and leaflets for preconception care (PCC) awareness among adolescent females up to six months after the health education. Methods: The...Objective: The purpose of this study was to evaluate health education using videos and leaflets for preconception care (PCC) awareness among adolescent females up to six months after the health education. Methods: The subjects were female university students living in the Kinki area. A longitudinal survey was conducted on 67 members in the intervention group, who received the health education, and 52 members in the control group, who did not receive the health education. The primary outcome measures were knowledge of PCC and the subscales of the Health Promotion Lifestyle Profile. Surveys were conducted before, after, and six months after the intervention in the intervention group, and an initial survey and survey six months later were conducted in the control group. Cochran’s Q test, Bonferroni’s multiple comparison test, and McNemar’s test were used to analyze the knowledge of PCC data. The Health Awareness, Nutrition, and Stress Management subscales of the Health Promotion Lifestyle Profile were analyzed by paired t-test, and comparisons between the intervention and control groups were performed using the two-way repeated measures analysis of variance. Results: In the intervention group of 67 people, the number of subjects who answered “correct” for five of the nine items concerning knowledge of PCC increased immediately after the health education (P = 0.006) but decreased for five items from immediately after the health education to six months later (P = 0.043). In addition, the number of respondents who answered “correct” for “low birth weight infants and future lifestyle-related diseases” (P = 0.016) increased after six months compared with before the health education. For the 52 subjects in the control group, there was no change in the number of subjects who answered “correct” for eight out of the nine items after six months. There was also no increase in scores for the Health Promotion Lifestyle Profile after six months for either the intervention or control group. Conclusion: Providing health education about PCC using videos and leaflets to adolescent females was shown to enhance the knowledge of PCC immediately after the education.展开更多
BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which...BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which may mimic malignancy.Here,we describe a case of adenomyosis-associated uterine rupture(secondary to hemorrhagic necrosis)and concurrent pulmonary endometriosis in a 16-year-old girl initially suspected of having advanced uterine cancer.CASE SUMMARY A 16-year-old girl presented with acute abdominal pain and oliguria.Imaging studies revealed a 15-cm ruptured uterine mass accompanied by hemoperitoneum and multiple pulmonary nodules suggestive of metastatic disease.Laboratory tests demonstrated severe anemia and markedly elevated tumor markers[cancer antigen(CA)-125:1063 U/mL;CA-19-9:1347 U/mL].Emergency laparotomy revealed adenomyosis-associated uterine rupture secondary to hemorrhagic necrosis,with no macroscopic abnormalities in other organs.A total abdominal hysterectomy was performed.Histopathological analysis confirmed uterine adenomyosis with hemorrhagic necrosis.Subsequent thoracoscopic wedge resections of the pulmonary lesions demonstrated histologically confirmed endometriosis.The patient has remained disease-free under treatment with oral dienogest.CONCLUSION This case of an adolescent patient highlights how benign gynecological conditions can mimic malignancy,necessitating broad differential diagnoses despite alarming presentations.展开更多
Background Adolescents’subjective well-being(SWB)is strongly linked to mental health,academic achievement,social relationships,and quality of life,and is a key predictor of life outcomes in adulthood.Mental health an...Background Adolescents’subjective well-being(SWB)is strongly linked to mental health,academic achievement,social relationships,and quality of life,and is a key predictor of life outcomes in adulthood.Mental health and addictive behaviors are the two main factors influencing SWB.This study aimed to identify key mental health and addictive behavior factors associated with adolescent SWB through machine learning models.Methods The data for this study comes from the Health Behaviour in School-aged Children(HBSC)survey 2017/18.The study data contains health data from 60,450 adolescents aged 10–16 years.The study used the XGBoost machine learning model to analyze the impact of mental health and addictive behaviors on adolescent SWB.Gain was used to analyze the significance of the variables.The direction of action of the variables and the interaction between the variables were analyzed using the SHapley Additive exPlanations(SHAP)method.Results The model in this study has an accuracy of 86.7%and an AUC value of 0.85,showing its good predictive performance.Six key variables were filtered through Gain analysis.Feeling low and health as the two most important factors affecting SWB,with these two variables contributing 51.38%and 19.65%,respectively.Friends and thinking body as major factors influencing SWB in mental health.Smoking lifetime and sweets as major factors influencing SWB in addictive behaviors.The interactions and characteristic dependencies between these variables were further analyzed.The results showed that feeling low,friends,and sweets had a positive effect on SWB,while health and smoking lifetime showed a negative effect.In addition,a moderate thinking body contributes to SWB,whereas being too fat and too thin are both associated with decreased levels of SWB.Conclusion Mental health and addictive behavioral factors such as feeling low,friends,sweets,and smoking lifetime were significant factors influencing SWB.This provides a scientific basis for the development of public health policies and interventions aimed at enhancing adolescent well-being.展开更多
Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the pr...Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the prevalence and profile of pregnant women, and to assess the maternal and perinatal prognosis of adolescent childbirth in Kisangani. Methods: This was a prospective, multicenter, case-control observational study conducted over a seven-month period, from February 1 to August 31, 2024, in primiparous adolescent gestational carriers (cases) and primiparous gestational carriers aged 20 to 34 years (controls) who delivered in five health facilities in the city of Kisangani, Democratic Republic of Congo. Results: The prevalence of teenage childbirth was 13.8%. Adolescents were more likely than controls to be in secondary education and to be unemployed. Compared with controls, pregnant adolescents were more likely to have poor ANC attendance. There was a statistical difference between the two groups in relation to pelvic anomaly, rupture of membranes on admission, hypertensive disorders, vicious presentation, caesarean section, episiotomy, postpartum anaemia and puerperal psychosis. In fact, these morbidities were more common in adolescent girls than in controls. Compared with controls, neonatal depression, prematurity, low birth weight and perinatal death were more prevalent in the newborns of teenage mothers. Conclusion: The prevalence of teenage childbirth is high in Kisangani;there is an association between unmarried status, lack of employment, low socio-economic status, poor ANC follow-up and teenage childbirth in Kisangani. The latter is also associated with high maternal and perinatal morbidity and mortality.展开更多
Background:Understanding the factors that influence adolescent psychological resilience is critical for promoting mental health.This study explores the impact and mechanism of labor values on adolescent psychological ...Background:Understanding the factors that influence adolescent psychological resilience is critical for promoting mental health.This study explores the impact and mechanism of labor values on adolescent psychological resilience from the perspective of emotion regulation theory.Methods:This study conducted an in-depth analysis using the Labor Value Scale on 2691 elementary school upper-grade students,middle school students,and high school students.Results:The results show that:(1)labor values can positively predict adolescents’mental resilience;(2)cognitive reappraisal and expression inhibition play a partial mediating role in the relationship between labor values and adolescents’psychological resilience.Among them,labor values can positively predict adolescents’mental resilience through positive cognitive reappraisal,and labor values can also predict adolescents’mental resilience through expression inhibition.Conclusion:Based on the theory of emotion regulation,this study explores the direct effect of labor values on mental resilience and the mediating effect of different strategies of emotion regulation.The results of this study provide a theoretical basis for improving the mental resilience of adolescents.展开更多
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 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 National Natural Science Foundation of China,No.82105018 and No.81903950.
文摘BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.
基金supported by funding from the National Institution of Neurological Disorders and Stroke(1R41NS103698-01A1 to CLM)。
文摘Background:Early identification of concussion-related vision disorders(CRVDs)may improve outcomes by enabling earlier management,referral,and treatment.Objective eye tracking may provide additional data to support the diagnose of CRVDs.The purpose of this study was to determine the utility of objective infrared eye tracking in identifying CRVDs among adolescents experiencing persisting post-concussive symptoms(PPCS)more than 28 days after injury.Methods:This was a prospective study of adolescents with PPCS evaluated with visio-vestibular examination(VVE),comprehensive vision examination,and an eye tracking device.Results:Of the 108 adolescents enrolled,67(62%)were diagnosed with a CRVD by comprehensive vision examination.On VVE,the near point of convergence break(5.5±3.2 cm vs.3.9±1.7 cm(mean±SD),p<0.001)and recovery(8.1±3.3 cm vs.6.8±2.3 cm,p=0.02)distinguished between those with and without CRVD.Concussion symptom provocation on VVE with horizontal saccades(35(52%)vs.12(29%),p=0.02)and horizontal vestibulo-ocular reflex testing(37(55%)vs.14(34%),p=0.03),and sway on tandem gait under the forward eyes closed condition(25(37%)vs.6(15%),p=0.01)also identified those with CRVD.From the eye tracking device,the BOX score(8.1±5.8 vs.5.2±4.1,p=0.007)and a metric of the left eye tracking along the bottom of the visual target(0.094±0.500 vs.-0.124±0.410,p=0.02)identified those with CRVD,with a multivariable receiver operating characteristic curve analysis,including the BOX score,achieving an area under the receiver operating characteristic curve of 0.7637.Conclusion:CRVDs are common in those with PPCS,with impact on recovery after concussion.Novel eye-tracking metrics can serve as an aid in the identification of those with CRVDs who would benefit from referral for comprehensive diagnosis and treatment.
基金supported by STI2030-Major Projects(2022ZD0212900)the Joint Project of Chongqing Municipal Science and Technology Bureau and Chongqing Health Commission(2023CCXM003)+4 种基金the National Key Research and Development Program of China(2017YFA0505700)the National Natural Science Foundation of China(82271565 and 82301714)the China Postdoctoral Science Foundation(2023TQ0398,GZB20230916,2023MD734124)the Natural Science Foundation of Chongqing,China(CSTB2023NSCQ-BHX0106)the Postdoctoral Innovation Talents Support Program of Chongqing,China(2208013341918508).
文摘Adolescent depression is increasingly recognized as a serious mental health disorder with distinct clinical and molecular features.Using single-nucleus RNA sequencing,we identified cell-specific transcriptomic changes in the nucleus accumbens(NAc),particularly in astrocytes,of adolescent macaques exhibiting depressive-like behaviors.The level of diacylglycerol kinase beta was significantly reduced in neurons and glial cells of depressed macaques,while FKBP5 levels increased in glial cells.Disruption of GABAergic synapses and disruption of D-glutamine and D-glutamate metabolism were linked to depressive phenotypes in medium spiny neurons(MSNs)and subtypes of astrocytes.Communication pathways between astrocytes and D1/D2-MSNs were also disrupted,involving factors like bone morphogenetic protein-6 and Erb-B2 receptor tyrosine kinase-4.Bulk transcriptomic and proteomic analyses corroborated these findings,and FKBP5 upregulation was confirmed by qRT-PCR,western blotting,and immunofluorescence in the NAc of rats and macaques with chronic unpredictable mild stress.Our results highlight the specific roles of different cell types in adolescent depression in the NAc,offering potential targets for new antidepressant therapies.
基金supported in part by the Higher Education Sprout Project,Ministry of Education,to the Headquarters of University Advancement at National Cheng Kung University(NCKU).
文摘Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.
文摘Objective:This study aimed to examine the association between parent-child relationships and physically aggressive behavior among adolescents.Methods:This is a cross-sectional study that uses secondary data from the 2015 Indonesia Global School-Based Health Survey(IGSHS).Health surveys were conducted in 75 schools representing three regions(Sumatra,Java-Bali;Outer Sumatra;and Java-Bali)in 26 provinces and 68 districts/cities in Indonesia(N=10,139 students).Students who participated were aged 12-19 years,were enrolled in public schools in the junior and high school levels.Results:It has been seen that for most middle-aged adolescents(58.7%),their parents(25%-29%)pay less attention to academic assignments(homework),problems,and use of free time.The most significant factors that influence adolescents to commit violence are smoking and consuming alcohol.Adolescents who smoke are twice as likely to commit physical violence compared with adolescents who do not smoke(OR=2.005;95%CI=1.7062-2.396).Meanwhile,adolescents who consume alcohol are 1.8 times more likely to commit physical violence compared with adolescents who do not consume alcohol(OR=1.807;95%CI=1.421-2.298).Conclusions:Through educational activities and consultations,this study’s findings are valuable for establishing parenting programs among those concerned about their children’s aggressive behavior.Meanwhile,counseling programs can be started in schools by conducting self-detection of negative adolescent behavior,such as screening for smoking,alcohol consumption,sleep issues,and attempted suicide.
基金supported by Seoul National University of Science and Technology.
文摘Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.
文摘BACKGROUND The impact of mental health,including anxiety,on academic performance has been studied in several countries,but few data exist for Sudan.AIM To investigate the correlation between anxiety scores and academic performance among adolescent schoolchildren in Northern Sudan.METHODS This cross-sectional study was carried out during the 2021–2022 academic year among schoolchildren from randomly selected schools in Almatamah locality,River Nile State,Northern Sudan.A questionnaire was used to collect the parti-cipants’sociodemographic data.Anxiety levels were assessed using the ques-tionnaire tools of the General Anxiety Disorder 7-item scale.Students’academic performance scores were obtained from school records.Multivariate linear regression was performed.RESULTS A total of 328 students participated in this study,comprising 156 boys(47.6%)and 172 girls(52.4%).The median[interquartile range(IQR)]age of the students was 14.9 years(13.9–15.6 years).The median(IQR)of the students’academic scores was 27.6%(22.2%–48.1%).The median(IQR)of the students’anxiety scores was 0(0–3).In univariate linear analysis,anxiety scores were positively associated with academic performance scores(coefficient=1.19,P value<0.001).In multivariate linear analysis,after controlling for age,sex,parental education,occupation,and body mass index-Z-score,anxiety scores were positively associated with academic performance scores(coefficient=0.60,P value<0.001).CONCLUSION The current study revealed a positive correlation between anxiety scores and students’academic performance scores.However,the association between mental health disorders,including anxiety,and academic performance is a complex issue.Therefore,further studies are recommended.
基金Research Project of Yunnan Provincial Psychiatric Hospital(SJKY-2023-10).
文摘Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As such,we aim to provide theoretical foundations for early identification and intervention.Methods:This cross-sectional study enrolled 90 hospitalized adolescents with depression(case group)and 91 healthy adolescents(control group).Childhood Trauma Questionnaire(CTQ),Adolescent Self-Rating Life Events Checklist(ASLEC),and Children’s Depression Inventory(CDI)were administered to assess trauma history,life event stressors,and depressive symptoms.Statistical analyses included independent samples t-tests,chi-square tests,and Pearson correlation analysis.Results:The case group demonstrated a significantly higher proportion of only-child families(28.9%).ASLEC and CDI scores were significantly elevated in the case group compared to the control group(P<0.05).In comparison,CTQ scores were lower in the case group(P=0.025).Positive correlations were identified between CDI scores and both CTQ(r=0.261)and ASLEC(r=0.218)in the case group.Conclusion:Child-hood trauma and recent life event stressors demonstrate significant associations with adolescent depressive symp-toms,potentially mediated through emotional dysregulation and negative cognitive bias.Implementation of early trauma screening protocols combined with stress management interventions(e.g.,cognitive behavioral therapy)and family system optimization strategies may effectively mitigate depression risk in this population.
基金Supported by National High Level Hospital Clinical Research Funding Project,No.BJ-2023-206.
文摘Adolescent depressive symptoms represent a significant public health concern,with negative life events and dysfunctional attitudes playing pivotal roles in theirdevelopment.A cross-sectional study by Yu et al assessed the interplay betweendysfunctional attitudes,social support,and depressive symptoms in 795 Chineseadolescents(49.9%male,mean age 15.2±1.8 years,age range 11-18 years)fromfive middle schools in Shandong Province.Using the Dysfunctional AttitudesScale,Adolescent Life Events Scale,Beck Depression Inventory,and SocialSupport Rating Scale,the study identified that dysfunctional attitudes,particularlyover-autonomy and over-perfectionism,mediate the relationship betweennegative life events and depressive symptoms.Social support moderated thisrelationship,significantly reducing depressive symptoms.These findingsunderscore the need for preventive and therapeutic strategies targeting dysfunctionalattitudes and enhancing social support to address adolescent depressivesymptoms.In this article,we extend their findings to highlight the significance ofculturally tailored interventions that incorporate familial and communitydynamics in mitigating depressive symptoms,particularly in collectivist societies.
基金the Global WACh Rising Star Seed Award by the Department of Global Health,University of Washington,Seattle,USA(Grant No:UW/GWACh/RSA/2023-01)。
文摘Background Globally,suicide is the third leading cause of death among girls aged 15-19 years.However,there is a growing concern that suicide research has paid lttle attention to pregnant adolescent girls,particularly in lowincome and middle-income countries,including Ghana,where nearly one in seven adolescents experiences(unwanted)pregnancy.Aims To assess the prevalence and correlates of suicidal ideation and suicide attempt and the self-reported reasons for attempted suicide among pregnant adolescent girls in Ghana.Methods We collected cross-sectional data(between August 2022 and December 2023)using structured anonymous questionnaires from a sample of 449 pregnant adolescent girls(aged 14-19 years)drawn from the three geographical zones of Ghana.We applied bivariable and multivariable analysis techniques to the data.Results Overall,28.51%(95%confidence interval(Cl)24.37%to 32.93%)reported suicidal ideation,and 18.04%(95%Cl 14.59%to 21.91%)reported suicide attempt during the current pregnancy.Participants who reported attempted suicide endorsed more interpersonal reasons(eg,to communicate distress,to seek help or to influence others)than intrapersonal reasons for their attempted suicide.In the final adjusted logistic regression models,food insecurity(adjusted odds ratio(aOR)=2.69;95%Cl 1.34 to 5.41;p=0.005)was uniquely associated with increased odds of suicidal ideation.Adverse childhood experiences(a0R=3.04;95%CI 1.33 to 6.97;p=0.008),history of attempted suicide before current pregnancy(a0R=3.47;95%CI 1.27 to 9.47;p=0.015)and depression(measured by the 5-item World Health Organization Well-Being Index;aOR=0.31;95%CI 0.12 to 0.77;p=0.012)were uniquely associated with increased odds of suicide attempt.Five variables were commonly associated with increased odds of both suicidal ideation and suicide attempt:conflict with parents,alcohol use,pregnancy-related anxiety,history of attempted suicide and intimate partner violence.While being in junior high school was uniquely associated with reduced odds of suicidal ideation,intimate partner's acceptance of paternity was commonly associated with reduced odds of both suicidal ideation and suicide attempt.Conclusions Although the prevalence estimates of suicidal ideation and suicide attempt in this study are comparable with known rates among non-pregnant adolescent girls in Ghana,additional research is needed to nuance our understanding of the correlates identified in this study.The evidence aiso highlights a need for both routine antepartum primary care mental health screening for suicidality and related risks and targeted prevention and intervention programmes.
文摘Objective: The purpose of this study was to evaluate health education using videos and leaflets for preconception care (PCC) awareness among adolescent females up to six months after the health education. Methods: The subjects were female university students living in the Kinki area. A longitudinal survey was conducted on 67 members in the intervention group, who received the health education, and 52 members in the control group, who did not receive the health education. The primary outcome measures were knowledge of PCC and the subscales of the Health Promotion Lifestyle Profile. Surveys were conducted before, after, and six months after the intervention in the intervention group, and an initial survey and survey six months later were conducted in the control group. Cochran’s Q test, Bonferroni’s multiple comparison test, and McNemar’s test were used to analyze the knowledge of PCC data. The Health Awareness, Nutrition, and Stress Management subscales of the Health Promotion Lifestyle Profile were analyzed by paired t-test, and comparisons between the intervention and control groups were performed using the two-way repeated measures analysis of variance. Results: In the intervention group of 67 people, the number of subjects who answered “correct” for five of the nine items concerning knowledge of PCC increased immediately after the health education (P = 0.006) but decreased for five items from immediately after the health education to six months later (P = 0.043). In addition, the number of respondents who answered “correct” for “low birth weight infants and future lifestyle-related diseases” (P = 0.016) increased after six months compared with before the health education. For the 52 subjects in the control group, there was no change in the number of subjects who answered “correct” for eight out of the nine items after six months. There was also no increase in scores for the Health Promotion Lifestyle Profile after six months for either the intervention or control group. Conclusion: Providing health education about PCC using videos and leaflets to adolescent females was shown to enhance the knowledge of PCC immediately after the education.
文摘BACKGROUND Uterine adenomyosis and pulmonary endometriosis are exceptionally rare in adolescents and can pose significant diagnostic challenges due to their nonspecific clinical presentation and imaging features,which may mimic malignancy.Here,we describe a case of adenomyosis-associated uterine rupture(secondary to hemorrhagic necrosis)and concurrent pulmonary endometriosis in a 16-year-old girl initially suspected of having advanced uterine cancer.CASE SUMMARY A 16-year-old girl presented with acute abdominal pain and oliguria.Imaging studies revealed a 15-cm ruptured uterine mass accompanied by hemoperitoneum and multiple pulmonary nodules suggestive of metastatic disease.Laboratory tests demonstrated severe anemia and markedly elevated tumor markers[cancer antigen(CA)-125:1063 U/mL;CA-19-9:1347 U/mL].Emergency laparotomy revealed adenomyosis-associated uterine rupture secondary to hemorrhagic necrosis,with no macroscopic abnormalities in other organs.A total abdominal hysterectomy was performed.Histopathological analysis confirmed uterine adenomyosis with hemorrhagic necrosis.Subsequent thoracoscopic wedge resections of the pulmonary lesions demonstrated histologically confirmed endometriosis.The patient has remained disease-free under treatment with oral dienogest.CONCLUSION This case of an adolescent patient highlights how benign gynecological conditions can mimic malignancy,necessitating broad differential diagnoses despite alarming presentations.
基金funded by the National Social Science Fund of China(GrantNo.24CTJ019).
文摘Background Adolescents’subjective well-being(SWB)is strongly linked to mental health,academic achievement,social relationships,and quality of life,and is a key predictor of life outcomes in adulthood.Mental health and addictive behaviors are the two main factors influencing SWB.This study aimed to identify key mental health and addictive behavior factors associated with adolescent SWB through machine learning models.Methods The data for this study comes from the Health Behaviour in School-aged Children(HBSC)survey 2017/18.The study data contains health data from 60,450 adolescents aged 10–16 years.The study used the XGBoost machine learning model to analyze the impact of mental health and addictive behaviors on adolescent SWB.Gain was used to analyze the significance of the variables.The direction of action of the variables and the interaction between the variables were analyzed using the SHapley Additive exPlanations(SHAP)method.Results The model in this study has an accuracy of 86.7%and an AUC value of 0.85,showing its good predictive performance.Six key variables were filtered through Gain analysis.Feeling low and health as the two most important factors affecting SWB,with these two variables contributing 51.38%and 19.65%,respectively.Friends and thinking body as major factors influencing SWB in mental health.Smoking lifetime and sweets as major factors influencing SWB in addictive behaviors.The interactions and characteristic dependencies between these variables were further analyzed.The results showed that feeling low,friends,and sweets had a positive effect on SWB,while health and smoking lifetime showed a negative effect.In addition,a moderate thinking body contributes to SWB,whereas being too fat and too thin are both associated with decreased levels of SWB.Conclusion Mental health and addictive behavioral factors such as feeling low,friends,sweets,and smoking lifetime were significant factors influencing SWB.This provides a scientific basis for the development of public health policies and interventions aimed at enhancing adolescent well-being.
文摘Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the prevalence and profile of pregnant women, and to assess the maternal and perinatal prognosis of adolescent childbirth in Kisangani. Methods: This was a prospective, multicenter, case-control observational study conducted over a seven-month period, from February 1 to August 31, 2024, in primiparous adolescent gestational carriers (cases) and primiparous gestational carriers aged 20 to 34 years (controls) who delivered in five health facilities in the city of Kisangani, Democratic Republic of Congo. Results: The prevalence of teenage childbirth was 13.8%. Adolescents were more likely than controls to be in secondary education and to be unemployed. Compared with controls, pregnant adolescents were more likely to have poor ANC attendance. There was a statistical difference between the two groups in relation to pelvic anomaly, rupture of membranes on admission, hypertensive disorders, vicious presentation, caesarean section, episiotomy, postpartum anaemia and puerperal psychosis. In fact, these morbidities were more common in adolescent girls than in controls. Compared with controls, neonatal depression, prematurity, low birth weight and perinatal death were more prevalent in the newborns of teenage mothers. Conclusion: The prevalence of teenage childbirth is high in Kisangani;there is an association between unmarried status, lack of employment, low socio-economic status, poor ANC follow-up and teenage childbirth in Kisangani. The latter is also associated with high maternal and perinatal morbidity and mortality.
基金supported by Scientific Research Fund of Hunan Provincial EducationDepartment(23B1133):How Labor Affects Moral Development:Based on the perspective of mixed research methods.
文摘Background:Understanding the factors that influence adolescent psychological resilience is critical for promoting mental health.This study explores the impact and mechanism of labor values on adolescent psychological resilience from the perspective of emotion regulation theory.Methods:This study conducted an in-depth analysis using the Labor Value Scale on 2691 elementary school upper-grade students,middle school students,and high school students.Results:The results show that:(1)labor values can positively predict adolescents’mental resilience;(2)cognitive reappraisal and expression inhibition play a partial mediating role in the relationship between labor values and adolescents’psychological resilience.Among them,labor values can positively predict adolescents’mental resilience through positive cognitive reappraisal,and labor values can also predict adolescents’mental resilience through expression inhibition.Conclusion:Based on the theory of emotion regulation,this study explores the direct effect of labor values on mental resilience and the mediating effect of different strategies of emotion regulation.The results of this study provide a theoretical basis for improving the mental resilience of adolescents.
