Background Few longitudinal studies have investigated the extended long-term impact of the Covid-19 pandemic for children's and adolescents' mental health, and a lack of uniform findings suggest ...heterogeneity in the impact of the pandemic. Methods This study investigated child and adolescent mental health symptoms across four occasions (pre-pandemic, initial lockdown, second lockdown, and society post reopening) using data from the Dynamics of Family Conflict study. Child and adolescent depressive vulnerability, age, and sex were explored as trajectory moderators. Children and adolescents (N = 381, M.sub.age = 13.65, SD = 1.74) self-reported their anxiety, depression, and externalizing symptoms. Mixed effects analyses were performed to investigate trajectories across measurement occasions and interaction terms between occasion and moderator variables were included to better understand the heterogeneity in the impact of the pandemic. Results Children and adolescents reported increases in anxiety symptoms at the second lockdown (t(523) = -3.66, p < .01) and when society had reopened (t(522) = -4.90, p < .001). An increase in depression symptoms was seen when society had reopened relative to the three previous measurement occasions (ps < 0.01). Depressive vulnerability moderated the trajectory for anxiety symptoms (F(3,498) = 3.05, p = .028), while age moderated the trajectory for depression symptoms (F(3,532) = 2.97, p = .031). Conclusion The delayed and negative impact on children's and adolescents' mental health underscores the need for continued monitoring, and implementation of support systems to help and mitigate further deterioration. Keywords: Covid-19, Anxiety and depression, Externalizing difficulties, Children and adolescents, Vulnerability, Longitudinal study
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK, VSZLJ
While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted ...in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charité University Medicine Berlin and Cerrahpaşa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event “intra-familial conflicts” and the use of “low-risk methods” for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
(1) Background: Discrepancies between children’s self-reports and their parents’ reports on mental health indicators are associated with measurement errors or informant bias. However, they are a ...valuable tool in understanding the course of child psychopathology. This study aims to determine the level of discrepancies between parents’ perceptions and children’s self-reports in mental health indicators in Northern Chile. (2) Methods: A System of Evaluation of Children and Adolescents self-report (Sistema de Evaluación de Niños y Adolescentes, SENA) was responded to by 408 students between 8 and 13 years old and their parents. (3) Results: Children reported a significantly higher frequency of emotional problems, defiant behavior, and executive functions as compared to their parents’ responses. (4) Conclusions: There is a disjunction between the report of parents and children, which could originate in poor family communication.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Electroconvulsive therapy (ECT) is a well-established treatment for adults with mood disorders. However, its use in child and adolescent populations is less common. At the same time, approximately ...60% of child and adolescent patients do not respond satisfactorily to first-line treatments for mood disorders. Given the need for effective treatments for severe mood disorders in adolescents and the low use rate of ECT, this systematic review examines the existing literature on the effectiveness and adverse effect profile of ECT when used for treatment-resistant mood disorders in children and adolescents. Searches were conducted in Medline, Embase, and PsycInfo using search terms related to (1) children and adolescents, (2) mood disorders, and (3) ECT. Searches identified 1715 unique articles. The full text of 71 selected articles were reviewed, leading to 41 studies included in the study. A standardized data extraction tool was used to collect key information from each study (i.e. author and publication year, objectives, participants and setting, design, measures, clinical outcomes, and side effects). As most of the studies found were case series, the Joanna Briggs Institute Case Series Critical Appraisal tool was used to assess quality. Studies were summarized qualitatively by comparing findings across key study parameters. Our review identified 41 studies for inclusion. Twenty were case series, two were case–control studies, and nineteen were case reports. Overall treatment response rates ranged from 51 to 92%, with patients receiving an average of 12 treatments. Among studies with n > 30, response rates were largely 70–82% for depression and 87–90% for mania. Seven studies used the Mini-Mental State Exam and found no evidence of significant post-treatment cognitive impairment. The majority of side effects were minor and transient. Tardive seizure was reported in 4 (0.6%) patients. ECT was discontinued early due to side effects in 11 (1.5%) cases. No fatalities were reported. Our data suggest that ECT is safe and effective for the treatment of mood disorders in child and adolescent populations, and should be considered in severe and treatment-refractory cases. Controlled studies with objective measures and long-term follow-up are needed to advance the evidence base.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
ABSTRACT
Objectives:
The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases. ...Here, an updated and expanded evidence‐based guideline is presented.
Methods:
Literature databases and other sources of information were searched for studies that could inform on 10 formulated questions on symptoms, serology, human leukocyte antigen genetics, and histopathology. Eligible articles were assessed using QUADAS2. GRADE provided a basis for statements and recommendations.
Results:
Various symptoms are suggested for case finding, with limited contribution to diagnostic accuracy. If CD is suspected, measurement of total serum IgA and IgA‐antibodies against transglutaminase 2 (TGA‐IgA) is superior to other combinations. We recommend against deamidated gliadin peptide antibodies (DGP‐IgG/IgA) for initial testing. Only if total IgA is low/undetectable, an IgG‐based test is indicated. Patients with positive results should be referred to a paediatric gastroenterologist/specialist. If TGA‐IgA is ≥10 times the upper limit of normal (10× ULN) and the family agrees, the no‐biopsy diagnosis may be applied, provided endomysial antibodies (EMA‐IgA) will test positive in a second blood sample. Human leukocyte antigen DQ2‐/DQ8 determination and symptoms are not obligatory criteria. In children with positive TGA‐IgA <10× ULN at least 4 biopsies from the distal duodenum and at least 1 from the bulb should be taken. Discordant results between TGA‐IgA and histopathology may require re‐evaluation of biopsies. Patients with no/mild histological changes (Marsh 0/I) but confirmed autoimmunity (TGA‐IgA/EMA‐IgA+) should be followed closely.
Conclusions:
CD diagnosis can be accurately established with or without duodenal biopsies if given recommendations are followed.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The existence of depression among children or adolescents can trigger a sequence of burdens on themselves, their families and even the whole society, which cause both physical and economic impacts. ...Our network meta-analysis (NMA) was aimed at comparing them with each other for evaluating the optimal psychosocial therapy to help children and adolescents with depression to improve their mental health. Based on several biomedical databases, a system of search strategies was conducted for searching randomized controlled trials (RCTs) which published from their inception on October, 1st 2018 without language restriction. We carried out an expression analysis for comparing the efficacy of various psychosocial therapies using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. Only 32 of RCTs which involved 2677 participants were eventually included in our analyses from the 19,176 of initial citation screening. In addition, in terms of various valid assessment instruments, interpersonal psychotherapy standard mean difference (SMD) = −1.38, Credible interval (CrI) − 2.5, − 0.20), computer cognitive–behavioral therapy (SMD = −1.36, CrI − 2.59, − 0.14), cognitive–behavioral therapy (SMD = −1.16, CrI − 2.15, − 0.18), had significantly better effects than the named control group. All together, these results suggest that interpersonal psychotherapy might be the best approach to improve the depressive state among children and adolescents. This study may provide an excellent resource for future endeavors to utilize psychosocial interventions and may also serve as a springboard for creative undertakings as yet unknown.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This study systematically reviewed the clinical practice guidelines (CPGs) for depression in children and adolescents and assessed the quality and recommendation consistency of those CPGs. Evidence ...mapping was presented to illustrate the research trends and identify gaps to guide future research. Literature on CPGs for depression was systematically collected from PubMed, Embase, Web of Science, guideline databases, and psychiatric association/ society websites. The basic information, recommendations, methodological quality, and reporting quality of CPGs were extracted, and the supporting evidence strength for the included CPGs was analyzed in Excel. Four appraisers independently assessed the eligible CPGs using AGREE II instrument and the RIGHT checklist. All recommendations from the CPGs were summarized and analyzed, and the evidence mapping bubble charts were plotted in Excel. After excluding 15,184 records, 12 depression CPGs were eventually proved eligible, six of which were of high quality and six medium quality. A total of 39 major recommendations were summarized, 35 of which were supported by high-quality CPGs. Although direct comparisons are challenging due to differences in grading schemes and research quality, most CPGs share many pivotal recommendations that can help guide clinical practice. However, the evidence for some clinical problems is still lacking. Thus, more research is necessary on the screening and treatment of children and adolescents to put forward more evidence-based and high-quality recommendations.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The right middle frontal gyrus (MFG) has been proposed as a convergence site for the dorsal attention network (DAN) and ventral attention network (VAN), regulating both networks and enabling flexible ...modulation of attention. However, it is unclear whether the connections between the right MFG and these networks can predict changes in attention-deficit/hyperactivity disorder (ADHD) symptoms.
This study used data from the Children School Functions and Brain Development project (N = 713, 56.2% boys). Resting-state functional magnetic resonance imaging was employed to analyze the connections of the right MFG with the DAN/VAN; connectome-based predictive modeling was applied for longitudinal prediction, and ADHD polygenic risk scores were used for genetic analysis.
ADHD symptoms were associated with the connections between the right MFG and DAN subregion, including the frontal eye field, as well as the VAN subregions, namely the inferior parietal lobule and inferior frontal gyrus. Furthermore, these connections of the right MFG with the frontal eye field, the inferior parietal lobule, and the inferior frontal gyrus could significantly predict changes in ADHD symptoms over 1 year and mediate the prediction of ADHD symptom changes by polygenic risk scores for ADHD. Finally, the validation samples confirmed that the functional connectivity between the right MFG and the frontal eye field/inferior parietal lobule in patients with ADHD was significantly weaker than that in typically developing control participants, and this difference disappeared after medication.
The connection of the right MFG with the DAN and VAN can serve as a predictive indicator for changes in ADHD symptoms over the following year, while also mediating the prediction of ADHD symptom changes by a polygenic risk score for ADHD. These findings hold promise as potential biomarkers for early identification of children who are at risk of developing ADHD.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
To assess the effectiveness and safety of repeated low-level red light (RLRL), which is a newly available treatment for myopia control in children and adolescents with high myopia.
Multicenter, ...randomized, parallel-group, single-blind clinical trial (randomized controlled trial; NCT05184621).
Between February 2021 and April 2022, 192 children aged 6 to 16 years were enrolled. Each child had at least 1 eye with myopia of cycloplegic spherical equivalent refraction (SER) at least –4.0 diopters (D), astigmatism of ≤2.0 D, anisometropia of ≤3.0 D, and best-corrected visual acuity (BCVA) of 0.2 logarithm of the minimum angle of resolution or better. Follow-up was completed by April 2023.
Participants were randomly assigned at a 1:1 ratio to intervention (RLRL treatment plus single-vision spectacles) or control (single-vision spectacles) groups. The RLRL treatment was administered for 3 minutes per session, twice daily with a minimum interval of 4 hours, 7 days per week.
The primary outcome and key secondary outcome were changes in axial length (AL) and cycloplegic SER measured at baseline and the 12-month follow-up visit. Participants who had at least 1 postrandomization follow-up visit were analyzed for treatment efficacy.
Among 192 randomized participants, 188 (97.91%) were included in the analyses (96 in the RLRL group and 92 in the control group). After 12 months, the adjusted mean change in AL was –0.06 mm (95% confidence interval CI, –0.10 to –0.02 mm) and 0.34 mm (95% CI, 0.30 to 0.39 mm) in the intervention and control groups, respectively. A total of 48 participants (53.3%) in the intervention group were still experiencing axial shortening >0.05 mm at the 12-month follow-up. The mean SER change after 12 months was 0.11 D (95% CI, 0.02to 0.19 D) and –0.75 D (95% CI, –0.88 to –0.62 D) in the intervention and control groups, respectively.
Repeated low-level red light demonstrates stronger treatment efficacy among those with high myopia, with 53.3% experiencing substantial axial shortening. Repeated low-level red light provides an excellent solution for the management of high myopia progression, a significant challenge in ophthalmology practice.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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