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 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
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 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: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
BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated...BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.展开更多
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
BACKGROUND 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 Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than...Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.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
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.
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.
文摘Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.
基金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.
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BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.
文摘Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
基金Supported by the 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 The Netherlands Organization for Scientific Research VIDI(grant number:198.007).
文摘Background Conditional relative survival(CRS),the probability of survival given that an individual has already survived a certain period post-diagnosis,is a more clinically relevant measure for long-term survival than standard relative survival(RS).This study aims to evaluate the 5-year CRS among adolescent and young adult(AYA)breast cancer patients by age,tumor stage,and receptor subtype to guide disclosure periods for insurance.Methods Data of all females aged 18–39 years and diagnosed with invasive breast cancer between 2003 and 2021(n=13,075)were obtained from The Netherlands Cancer Registry(NCR).The five-year CRS was calculated annually up to 10 years post-diagnosis using a hybrid analysis approach.Results For the total AYA breast cancer study population the 5-year CRS exceeded 90%from diagnosis and increased beyond 95%7 years post-diagnosis.Patients aged 18–24 reached 95%9 years post-diagnosis,those aged 25–29 after 5 years,and those aged 30–34 and 35–39 after 8 years.For stage I,the 5-year CRS reached 95%from diagnosis,for stage II after 6 years,while the 5-year CRS for stages III and IV did not reach the 95%threshold during the 10-year follow-up.Triple-negative tumors exceeded 95%after 4 years,human epidermal growth factor receptor 2(HER2)positive tumors after 6 years,while hormone receptor(HR)positive tumors did not reach 95%.Conclusion Excess mortality among AYA breast cancer patients tends to be little(CRS 90%–95%)from diagnosis and becomes minimal(CRS>95%)over time compared to the general population.These results can enhance expectation management and inform policymakers,suggesting a shorter disclosure period.
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.
