Children's Depression Inventory Research Articles

Alexithymia in primary ciliary dyskinesia.

Recent evidence suggests that alexithymic deficits in emotional processing may also affect physical health, and alexithymia may also be associated with organic disorders. The emotional well-being of patients with primary ciliary dyskinesia (PCD) is often negatively affected by uncertainty about the prognosis, lack of ongoing medical care, and lack of symptom control. This study aims to evaluate the frequency of alexithymia and its possible impact on the management of childhood PCD. Subjects were recruited from patients with PCD and healthy volunteers aged 8-18 years. The questionnaire included sociodemographic characteristics and self-report scales. Data were compared between patient and control groups. In the >14 years of age group, the total Toronto Alexithymia Scale (TAS-20) score was significantly higher in the patients (56.60 ± 13.01) compared to the control group (46.47 ± 7.50) (p = .007). There were 6 (30) patients with a TAS-20 score ≥61. There was a significant correlation between TAS-20 and Pediatric Quality of Life (PedsQL) score (child), but no correlation between TAS-20 and Kovacs Children Depression Inventory (CDI) and PedsQL score (parents). The TAS-20 score was significantly higher in patients with bronchiectasis (p = .035), nasal polyps (p = .045), and siblings with PCD (p = .001). Furthermore, the TAS-20 score had a significant negative correlation with pulmonary function tests. Although this study is based on limited data from a single center and cannot be generalized to all PCD patient communities, our results show that PCD patients are more likely to have alexithymia compared to healthy controls and highlight the need to evaluate for alexithymia in patients with PCD. It is important for pediatric pulmonologists to have a thorough knowledge of the alexithymic features associated with PCD and to refer patients to pediatric psychiatry when necessary, especially in patients who are noncompliant with treatment protocols.

Relationship Between Childhood Maltreatment With Levels of Depression On Street Children in Surabaya

Introductions: Childhood maltreatment is any form of violence or neglect that occurs against children under the age of 18. Street children are a group that is vulnerable to violence because their activities, for which they spend a lot of time on the streets, make it easier for them to experience violence from both adults and fellow students. One of the impacts can cause mental health disorders, one of which is depression. Objective: Analyze the relationship between childhood maltreatment and levels of depression in street children in Surabaya. Methods: A cross-sectional analytical study was conducted on 43 street children from Surabaya City, East Java, Indonesia. Subjects were selected through two stages, namely using the Children’s Depression Inventory (CDI) and the International Child Abuse Screening Tool for Children (ICAST-C) to assess depression and childhood maltreatment. Data analysis using chi-square. Results: The results of the study showed that of the 43 respondents, 18 children experienced childhood maltreatment and 31 children experienced moderate depression. The results of the analysis of the relationship between childhood maltreatment and depression levels showed a p-value of 0.481. Conclusion: Childhood maltreatment is not related to the level of depression in street children in Surabaya.

Longitudinal Associations Between Physical Activity and Depressive Symptoms in Chinese Children: Evidence from the Tongji Mental Health Cohort Study.

We aimed to examine the associations between depressive symptoms and physical activity parameters (e.g., intensity, frequency, and duration) among Chinese school-aged children. Participants in this study were extracted from the Tongji Mental Health Cohort Study. The baseline survey was conducted in June 2020 involving 2588 school-aged children from two primary schools in Hubei Province, China. A total of 2435 children were followed up successfully in December 2020. The Children's Depression Inventory Short Form (CDI-S) was applied to evaluate depressive symptoms among school-aged children. The Physical Activity Rating Scale-3 (PARS-3) was adopted to estimate children's physical activity parameters including the intensity, frequency, and duration. Generalized estimation equation models were used to explore the longitudinal associations between physical activity and depressive symptoms among school-aged children. Engaging in moderate levels of physical activity (OR, 0.800; 95%CI, 0.692-0.924) or high levels of physical activity (OR, 0.808; 95%CI, 0.689-0.947) in the baseline survey was associated with a reduced risk of developing depressive symptoms in the follow-up survey compared with children engaging in low levels of physical activity. Stratified analyses revealed that the associations between physical activity and depressive symptoms exhibited a significant correlation among boys and children in the older age group (11-12years). Our findings showed that engaging in physical activity more than once a week, with each session lasting 20min or longer, was related to significant reductions in depressive symptoms by 43.8% and 22.3%, respectively. Self-reported physical activity is positively associated with improved mental health among Chinese school-aged children, especially when considering parameters such as frequency and duration. The association between vigorous-intensity physical activity and depressive symptoms in children should be cautiously interpreted. Future research should continue to explore the effects of vigorous-intensity physical activity on depressive symptoms in children.

Using machine learning to develop a five-item short form of the children’s depression inventory

BackgroundMany adolescents experience depression that often goes undetected and untreated. Identifying children and adolescents at a high risk of depression in a timely manner is an urgent concern. While the Children’s Depression Inventory (CDI) is widely utilized in China, it lacks a localized revision or simplified version. With its 27 items requiring professional administration, the original CDI proves to be a time-consuming method for predicting children and adolescents with high depression risk. Hence, this study aimed to develop a shortened version of the CDI to predict high depression risk, thereby enhancing the efficiency of prediction and intervention.MethodsInitially, backward elimination is conducted to identify various version of the short-form scales (e.g., three-item and five-item versions). Subsequently, the performance of five machine learning (ML) algorithms on these versions is evaluated using the area under the ROC curve (AUC) to determine the best algorithm. The chosen algorithm is then utilized to model the short-form scales, facilitating the identification of the optimal short-form scale based on predefined evaluation metrics. Following this, evaluation metrics are computed for all potential decision thresholds of the optimal short-form scale, and the threshold value is determined. Finally, the reliability and validity of the optimal short-form scale are assessed using a new sample.ResultsThe study identified a five-item short-form CDI with a decision threshold of 4 as the most appropriate scale considering all assessment indicators. The scale had 81.48% fewer items than the original version, indicating good predictive performance (AUC = 0.81, Accuracy = 0.83, Recall = 0.76, Precision = 0.71). Based on the test of 315 middle school students, the results showed that the five-item CDI had good measurement indexes (Cronbach’s alpha = 0.72, criterion-related validity = 0.77).ConclusionsThis five-item short-form CDI is the first shortened and revised version of the CDI in China based on large local data samples.

Effect of virtual exercise program on depression level and family’s perception during COVID-19 pandemic in child cancer survivor: a case report

This study aimed to investigated the effect of a virtual exercise program on depression level during the COVID-19 pandemic in a patient who survived childhood cancer. An 8-year-old boy who was diagnosed with Acute Lymphoblastic Leukemia (ALL) about 4 years ago and survived after the treatment underwent a virtual aerobic exercise program tailered to face-to-face evaluations covering the lower and upper extremities and trunk under 5-week supervision. At the end of 5 weeks, his depression level did not decrease according to the Children's Depression Inventory (CDI), but the family was asked verbal questions about the effectiveness of this program. The family reported that despite the quarantine period during the COVID-19 pandemic, this exercise program increased the activity level of their children and that the program had positive effects on their children's emotional state. For future studies, inventories containing more detailed questions that measure parameters such as pain and depression level after aerobic exercises applied in surviving children are needed.

The Juvenile Arthritis Quality of Life Questionnaire in patients with juvenile idiopathic arthritis: Turkish version, validity, and reliability study.

This study aimed to assess the cultural adaptation, validity, and reliability of the Turkish version of the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) in patients with juvenile idiopathic arthritis (JIA). A total of 100 JIA patients (64% female), aged 9 to 18years, participated in the study conducted at a tertiary care university hospital. The JAQQ was culturally adapted through a rigorous translation process and administered alongside established measures, including the Childhood Health Assessment Questionnaire (CHAQ), Juvenile Arthritis Biopsychosocial Questionnaire (JABQ), and Children's Depression Inventory (CDI). Validity and reliability were evaluated using Spearman's correlation coefficients, Cronbach's alpha, intraclass correlation coefficient (ICC), standard error of the mean (SEM), and minimal detectable change (MDC). The Turkish version of JAQQ exhibited high convergent validity, correlating significantly with CHAQ, JABQ, and CDI. No floor or ceiling effects were observed in the total JAQQ score, indicating a balanced assessment. Internal consistency was excellent (Cronbach's α = 0.948), and test-retest reliability was satisfactory (ICC = 0.913). SEM and MDC95 values were 0.357 and 0.99, respectively. The Turkish adaptation of JAQQ emerges as a valid and reliable instrument for comprehensively assessing the health-related quality of life in children and adolescents diagnosed with JIA. The questionnaire's robust psychometric properties, coupled with distinctive features like individualized assessment, highlight its potential as a valuable tool for both clinical assessment and scientific research in the field of pediatric rheumatology. Key Points • The Juvenile Arthritis Quality of Life Questionnaire (JAQQ) is an important scale that evaluates the quality of life of children with Juvenile Idiopathic Arthritis (JIA). • JAQQ is known and used in the field of pediatric rheumatology in Turkey, but its Turkish adaptation has not been made before. • Our study includes 100 JIA patients aged between 9 and 18 years and shows that the Turkish version of JAQQ is valid and reliable in measuring the quality of life of these children. • This research contributes to the accurate assessment of the quality of life in Turkish children diagnosed with JIA, providing valuable insights for both clinical and scientific studies.

Validity and reliability of the Difficulties in Emotion Regulation Scale Short Form in Indonesian non-clinical population.

Emotion dysregulation is a transdiagnostic marker for vulnerability and has high comorbidity rates across various range of disorders among adolescents and young adults, highlighting the crucial need for precise assessment tools to recognize its significant impact on well-being. The Difficulties in Emotion Regulation Scale Short Form (DERS-SF) is a comprehensive instrument designed to measure the ability to regulate emotion. This study aimed to investigate the psychometric properties of DERS-SF among the non-clinical population, particularly high school and university students in Indonesia. A total of 738 senior high school and university students completed the Indonesian version of DERS-SF and standard questionnaires to assess its validity, consisting of the Depression Anxiety Stress Scale (DASS), the Beck Depression Inventory-II (BDI-II) for young adults and the Children Depression Inventory (CDI) for adolescents. Three models were examined in factorial validity tests using confirmatory factor analysis. The results showed that DERS-SF had an overall good internal consistency with Cronbach's alpha coefficient of.89 for the 18-item version,.90 for the 17-item version, and.91 for the 15-item version. Test-retest reliability was moderate with a value of.67. In addition, it had good satisfactory content as shown by item content validity index (I-CVI) = .96 and scale content validity index (S-CVI) = .83, as well as convergent validity. All subscales scores showed a positive and strong correlation with DASS, BDI-II, and CDI except awareness. Based on confirmatory factor analysis (CFA), the correlated 6-factor model excluding item number 6, and the 5-factor model excluding awareness were suitable to use in non-clinical populations. This study established the removal of the awareness subscale in the DERS-SF Indonesian version, resulting in better reliability and validity than the original version with complete subscales.

Early Predictors and Concurrent Correlates of Tonic and Phasic Irritability in Adolescence.

Irritability is a common presenting problem in youth mental health settings that is thought to include two components: tonic (e.g., irritable, touchy mood) and phasic (e.g., temper outbursts), each with unique correlates and outcomes, including later internalizing and externalizing problems, respectively. However, we are unaware of any studies of early predictors of tonic and phasic irritability. We utilized data from a longitudinal study of a community sample of 3-year-old children followed to age 15 (n = 444). We conducted confirmatory factor analysis (CFA) of items from several self-report irritability measures at age 15, including the Affective Reactivity Index, the International Personality Item Pool, the Schedule for Non-Adaptive and Adaptive Personality Youth Version, and the Child Depression Inventory, and examined their early childhood predictors. The CFA identified dimensions consistent with tonic and phasic irritability. Tonic irritability at age 15 was uniquely associated with concurrent internalizing disorders and suicidal behavior while phasic irritability was uniquely associated with concurrent externalizing disorders. When adolescent tonic and phasic irritability were examined together, female sex and parental depressive and substance use disorders at age 3 uniquely predicted adolescent tonic irritability. Additionally, male sex, less parental education, greater laboratory-observed anger and impulsivity, ODD symptoms, higher irritability, and no parental substance use history at age 3 uniquely predicted adolescent phasic irritability. Youth-reported tonic and phasic irritability at age 15 appear to be distinguishable constructs with distinct concurrent correlates and early antecedents. Findings have important implications for research on the etiology of irritability and developing effective treatments.

Level of Depression by Sex Among High School Students in Three Municipalities of Antioquia, Colombia

Introduction: The mental health of school-going adolescents is an issue of concern for some administrators in health and education fields at some municipalities in the department of Antioquia. Development: The aim was to determine the distribution of depression levels among high, mild, and none levels according to the gender of adolescents attending school in three municipalities of Antioquia. In each population, a random sample was obtained, designed with a 95 % confidence level for the presence of depression in students aged 11 to 19 years, with an-error ranging between 3 and 5 %. The research group measured the presence of depression with the Children's Depression Inventory (CDI). Municipal authorities provided the permission and the consent of parents, teachers, and students. The group analyzed simple correspondence using the statistical software SPSS and RStudio. Results: At the highest level of depression are mainly women from Marinilla and Carmen de Viboral; at the mild level are women from the two areas in Medellín; at the no depression level are men from Carmen de Viboral and the two areas in Medellín. Conclusions: depression is a public health problem, and when it occurs, it is more likely in women than in men; in some municipalities, there is no difference between men and women, and the whole population should be intervened to remedy the situation.

Adherence to medical treatment for Wilson’s disease in children and adolescents: a cohort study from Turkey

BackgroundThis study aimed to assess medication adherence and demographic, clinical, and psychopathological parameters such as quality of life, depression, and anxiety levels that can affect pediatrics with Wilson’s Disease (WD).MethodsA prospective cohort study was conducted at an outpatient clinic in Turkey among pediatric patients (2 to 18 years) with WD between November 2022 and April 2023. The Medication Adherence Report Scale (MARS-5) as a subjective and Medication Possession Ratio (MPR) as an objective assessment were scored. Physical, genetic and biochemical parameters, the Pediatric Quality of Life Inventory (PedsQL) for both parents and patients, Childhood Depression Inventory, State Trait Anxiety Inventory were also administered.ResultsA total of 30 pediatric outpatients who were prescribed D-penicillamine (n = 27) or trientine (n = 3) as chelators and zinc (n = 29) and pyridoxine (n = 19) as supplements were included. Proteinuria (n = 3), skin rash (n = 2), and gastrointestinal upset (n = 2) were observed. When the correlation between MARS-5 and duration of follow-up was examined, a significant negative correlation was found (p = 0.014). According to MPRs, non-adherence rates (missed doses ≥ 20%) were 29.6%, 17.2% and 5.3% for D-penicillamine, zinc and pyridoxine, respectively. PedsQL scores were higher than those of parents, with a positive correlation between them (p < 0.001). Also, there was a significant positive correlation between PedsQL and State Anxiety Inventory (p < 0.001). Comparing the change in urinary copper levels between different levels of treatment knowledge, significant differences were observed between high- and low levels (p = 0.043).ConclusionsOverall, nonadherence rates were 23.3% based on MARS-5 and 5.3–29.6% based on MPR. It is essential to consider factors such as the duration of follow-up, biochemical parameters, treatment knowledge, quality of life and anxiety as potential influencers of medication adherence.

Cognitive functioning of adolescents using Methamphetamine: The impact of inflammatory and oxidative processes.

Methamphetamine is a substance that causes neurotoxicity and its use is increasing in recent years. Literature highlights cognitive impairment resulting from Methamphetamine use. The aim of the present study is to evaluate the relationship between cognitive impairment and inflammatory processes in adolescents with Methamphetamine use disorder. The study included 69 adolescents aged 15-19 years, comprising 37 participants with Methamphetamine Use Disorder and 32 healthy controls. Central Nervous System Vital Signs was used to detect cognitive impairment. Childhood Trauma Questionnaire-33 and The Children's Depression Inventory scales were used. In addition, venous blood was collected from the volunteers. Biochemical parameters (IL-1beta, IL-6, TNF-a, BDNF, FAM19A5, TAS, TOS) were analyzed. Our study showed that (I) IL-6 and TNF-a levels of Methamphetamine users were lower than the healthy group; (II) BDNF levels of Methamphetamine users were higher than the healthy group; (III) mean Neurocognitive Index in cognitive tests of Methamphetamine using adolescents was negatively correlated with duration of Methamphetamine use and BDNF levels. Our study suggests that Methamphetamine use may have a negative effect on cognitive functions.

Contribution of caregiver and child anxiety and depressive symptoms to child asthma-related quality of life

BackgroundDepression and anxiety negatively affect asthma-related quality of life (QoL). Yet, little is known regarding mood and asthma-related factors that best uniquely explain asthma-related QoL in children. ObjectiveThis cross-sectional study evaluated the unique variance explained by caregiver and child depressive and anxiety symptom severity in child asthma-related QoL, apart from that explained by demographics and asthma control. MethodsChildren aged 7 to 17 years with asthma (n = 205) and their caregivers with major depressive disorder were included. A 3-stage hierarchical linear regression analysis was conducted with the Pediatric Asthma Quality of Life Questionnaire total scores considered as the outcome. Predictors included demographic characteristics (stage 1); asthma control assessed by the Asthma Control Test (stage 2); and caregiver depression and anxiety (Hamilton Rating Scale for Depression and the Spielberger State/Trait Anxiety Scale) and child depression and anxiety (Children's Depression Inventory and the Screen for Child Anxiety-Related Disorders) (stage 3). ResultsDemographic characteristics accounted for only 5.5% of the Pediatric Asthma Quality of Life Questionnaire scores. Asthma control significantly increased variance explained in QoL to 32.6%, whereas caregiver and child depression and anxiety symptoms significantly increased variance explained to 42.6%. Child anxiety was found to uniquely explain the largest proportion of variance in QoL (rs2 = 0.584). ConclusionAfter adjusting variance in QoL for demographic characteristics and asthma control, caregiver and child depression and anxiety measures significantly increased the proportion of variance explained in a child's asthma-related QoL. In addition to better asthma control, child and caregiver depression and anxiety should be addressed to increase child asthma-related QoL. Trial RegistrationClinicalTrials.gov Identifier: NCT02809677.

Depression, anxiety, and hopelessness in a sample of Egyptian children diagnosed with cystic fibrosis

BackgroundEven though current therapeutic approaches have significantly increased the longevity and standard of living for children suffering from cystic fibrosis (CF), the crucial psychological components of this illness have not received the same level of attention as other chronic illnesses. The aim of the research was to assess depression, anxiety, and hopelessness in cystic fibrosis-affected children and their relation to the duration of illness. In this study, we compared 40 healthy control children between the ages of 7 and 12 with 40 cystic fibrosis children who were matched for age and sex. All patients had detailed clinical and psychometric evaluations using the Children’s Depression Inventory (CDI), the Anxiety Scale for Children (ASC), and the Hopelessness Scale for Children (HSC).ResultsThe CDI, ASC, and HSC revealed a significant difference between both groups. Positive correlations between depression, anxiety, and hopelessness and disease duration were found.ConclusionsPatients with CF experienced significantly increased depression, anxiety, and hopelessness, and there is an association between these symptoms and the duration of the illness. We advise making psychiatric screening a standard part of evaluating and monitoring CF patients.

Self-compassion moderates the relationship between neuroticism and depression in junior high school students.

Neuroticism, an emotion-related personality trait, is often associated with a greater susceptibility to depression. On the other hand, self-compassion involves treating oneself in a peaceful, mindful, and friendly manner, particularly in the face of failure or frustration. The study investigated the relationship between neuroticism and depression in junior high school students, as well as the moderating role of self-compassion. A total of 757 junior high school students participated in the survey, which included the Children's Depression Inventory, the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, and the Chinese version of the Self-Compassion Scale. The results revealed that neuroticism positively predicted depression, while self-compassion had a significant moderating effect on the relationship between neuroticism and depression. Specifically, higher levels of self-compassion were associated with a weaker link between neuroticism and depression. These findings suggest that interventions promoting self-compassion may be beneficial for students exhibiting neurotic tendencies.

Diminished hedonic capacity in social activities as a mediator of the link between dysfunctional behavioral activation system and depressive symptoms.

Adolescence is a crucial period for the development of depression, and previous studies have suggested that the Behavioral Activation System (BAS) plays a significant role. However, little is known about the underlying mechanisms. This study aimed to explore the mediating role of anhedonia in the relationship between BAS and depressive symptoms among Chinese adolescents. A total of 1,023 high-school students aged 15-18 years participated in the study, with 916 continuing their participation three months later. All participants completed the Behavioral Inhibition System/Activation System (BIS/BAS) scale, Dimensional Anhedonia Rating Scale (DARS), Children's Depression Inventory (CDI), and the State-Trait Anxiety Inventory (STAI-S/T). Pathway model analysis was performed to examine the concurrent and prospective mediating effects of anhedonia and the potential moderating effect of sex. Anhedonia in the domains of social activities, hobbies and sensory experiences significantly mediated the cross-sectional relationship between BAS and depressive level three months later. Furthermore, the beta-value of the mediating effect of social activities was significantly higher than that of the other domains of hedonic capacity cross-sectionally and longitudinally. However, sex showed no significant moderating effect. Our findings underscore the importance of hedonic capacity, especially within the social domain, in the development of depressive symptoms. These findings contribute to the early diagnosis and prevention of depressive disorders.

Psychosocial conditions of children after liver transplant: Post-traumatic stress, depression, and anxiety

AimThis study aimed to determine psychosocial conditions, post-traumatic stress, depression, and anxiety of children who underwent a liver transplant. MethodThis is a relational descriptive study, which was conducted between March 2019 and December 2020 in the Inonu University Liver Transplantation Institute Pediatric Liver Transplant Clinic. The “Child Information Form,” “Child Post-Traumatic Stress Reaction Index,” “State-Trait Anxiety Inventory for Children-Trait Form,” and “Children's Depression Inventory” were used to collect data. The study was conducted with 71 children who had a previous liver transplant. ResultsOf the participating children, 56.3% were girls, 63.4% continued their primary school education after the transplant, 32.5% were diagnosed with cirrhosis, 39.4% received the transplant in 2017, 32.4% received it from the mother, and 25.4% received it from a cadaveric donor. Although it had been at least 3 years since the transplant, 47.9% exhibited moderate and 43.7% severe post-traumatic stress responses. There was a significant negative relationship between the age of children with a liver transplant and trait anxiety and post-traumatic stress responses (path coefficients β = −0.268, p = 0.002; β = −0.166, p = 0.023, respectively). There was a significant positive relationship between anxiety and post-traumatic stress responses of the children after the transplant and there was a statistically significant relationship between the path coefficients (β = 0.750; p < 0.001). ConclusionChildren who underwent a liver transplant had post-traumatic stress disorder, depression, and trait anxiety.

Depressive disorders in children with chronic kidney disease treated conservatively.

Children with chronic kidney disease (CKD) experience a lot of mental and emotional stress, which can lead to the development of depressive disorders. The prevalence of depressive disorders in CKD children is estimated to be between 7% and 35%. The aim of our study was to analyze the prevalence and characteristics of depression and depressive symptoms in children and adolescents with CKD treated conservatively. The cross-sectional, multicenter study was conducted in 73 CKD children aged 8-18 and in 92 of their parents. To assess the mental wellbeing of CKD children, Kovacs's Children's Depression Inventory 2 (CDI2) was used as CDI2: Self-Report and CDI2: Parent Form. The majority of CKD children acquired medium scores in CDI2, 11% of participants reported symptoms suggesting depressive disorder, and among them 8.2% met the criteria for depression. A significant relationship was found between age and interpersonal problems, age at CKD diagnosis, and total score and ineffectiveness, CKD duration and total score/emotional problems. Depressive symptoms were associated with the stage of CKD, and they differed significantly between stages III and IV. We noticed the child-parent disagreement on reported depressive symptoms. Parents perceive their children's mental state as worse than the children themselves. There is a problem of depression in children with CKD treated conservatively. Variables associated with depressive symptoms in CKD children treated conservatively require further study. Key factors predisposing to the development of depression seem to be age at the time of diagnosis, disease duration, and progression of CKD from stage III to IV. Disparities between depressive symptoms self-reported by CKD children and their parents' assessment require further analysis. However, these disparaties indicate that the final diagnosis of the occurrence of depressive disorders should be based on a multidimensional assessment of the patient's situation.

Unveiling a novel clinical risk assessment model for identifying non-suicidal self-injury risks in depressed Chinese adolescents amidst the COVID-19 pandemic: insights from low self-esteem, internet use, and sleep disturbance.

Non-suicidal self-injury (NSSI) is a highly prevalent behavioral problem among depression adolescent patients that can result in numerous adverse outcomes. This study endeavors to bridge this knowledge gap by creating a comprehensive model that incorporates multiple aspects of NSSI to accurately evaluate its risk in adolescents with depression, thereby enhancing our ability to prevent and address this challenging issue. Using a cross-sectional design, we recruited 302 adolescents with depressive disorders who visited or were hospitalized at Shandong Mental Health Center from December 2021 to June 2022. The participants completed several self-report questionnaires, including the Chinese version of the Internet Addiction Test, the Pittsburgh Sleep Quality Index questionnaire, the Defeat Scale, the Social Avoidance and Distress Scale and the Children's Depression Inventory. Logistic regression analysis was performed to identify the diagnostic factors, which were further used to establish clinical risk assessment models. A receiver operating characteristic curve (ROC) to identify the best model. An external validating team was introduced to verify the assessing efficiency. Based on a logistic regression analysis, three variables have been identified as significant risk factors. Specifically, adolescents with depression who experience low self-esteem, internet use, or suffer from sleep disturbance face an increased risk of NSSI. An integrated risk index for NSSI exhibits excellent accuracy in identifying depressed adolescents at risk of NSSI (area under the curve = 0.86, sensitivity = 0.88, specificity = 0.69). In the validation cohort, the identification performance remains strong (area under the curve = 0.84, sensitivity = 0.72, specificity = 0.81). This study highlighted the role of self-esteem, internet use and sleep disturbance in the development of NSSI. The risk index diagnosing NSSI onset may help to guide the design and application of novel interventions to minimize this risky behavior in future depressed adolescents.

Problematic video gaming is negatively associated with bone mineral density in adolescents.

Adolescent bone health may be negatively impacted by problematic video gaming (PVG) due to factors such as prolonged screen time, poor sleep quality, and increased depression. Although sedentary behaviors have been linked to decreased bone mass, there is limited research on how PVG impacts bone health. We aimed to evaluate the association between PVG and bone mineral density (BMD) in adolescents by comparing the BMD z-scores of adolescents with and without PVG and by identifying PVG-related risk factors that may affect low BMD scores. This cross-sectional study took place between May 2019 and August 2021 with 110 adolescents who played video games for at least two hours per day. Data on screen time, game genre, tobacco, alcohol, caffeine consumption, and vigorous physical activity status were recorded. PVG was assessed using the Internet Gaming Disorder-Short Form (IGDS9-SF), with scores ≤ 16 comprising the control group and > 16 the PVG group. Sleep quality was assessed by Pittsburgh Sleep Quality Index, and depression was evaluated by Children's Depression Inventory. Dual-energy X-ray absorptiometry measurements of femoral neck and lumbar spine BMD were compared between the two groups. The mean age of the participants was 14.2 ± 1.8years, and 86.4% were males. The PVG group exhibited lower femoral neck z-scores (p = 0.013) and a higher proportion of adolescents with low femoral neck BMD risk (27.8% vs 9.7%, p = 0.041). Lumber spine z-scores did not differ (p = 0.271). Despite poorer depressive symptoms and sleep quality in the PVG group, they were not associated with low BMD risk (OR 1.02, 95% CI 0.97-1.08, p = 0.398 and OR 1.00, 95% CI 0.87-1.18, p = 0.972, respectively). Among all PVG-related risk factors, video game time (aOR = 1.22, 95% CI = 1.06-1.41, p = 0.006) and vigorous physical activity amount (aOR = 2.86, 95% CI = 0.93-8.76, p = 0.080) showed the strongest associations with femoral neck z-scores. Conclusion: The results of this study, showing a negative association between PVG and femoral neck BMD in adolescents, underscore the importance evaluating, monitoring, and supporting lower extremity bone health in adolescents with PVG. What is Known: • Adolescents with problematic video gaming are at risk for depression, impaired sleep; sedentary lifestyle; consumption of tobacco, alcohol, and drugs; and high caffeine intake. • These risk factors might lead to compromised bone health. What is New: • Problematic video gaming is associated with the low femoral neck bone mineral density risk in adolescents. • Extended video game time and reduced physical activity are found to be the primary risk factors.

Depressive symptoms and oral mucositis in children with oncological diseases: a cross-sectional study.

The aim of this study was to investigate the correlation between depressive symptoms and the occurrence of oral mucositis in children with oncological diseases treated at a reference hospital. This was a cross-sectional study conducted with individuals aged 4 to 18 years, diagnosed with primary neoplasms. Data was collected by using a questionnaire that assessed the degree of oral mucositis according to the World Health Organization index, the risk of oral mucositis according to the Child's International Mucositis Evaluation Scale, and depressive symptoms using the Children's Depression Inventory. The data were analyzed and subjected to Spearman's correlation, chi-square test, and Fisher's exact test, considering p<0.05. A statistically significant correlation was observed between depressive symptoms and the degree of oral mucositis (p = 0.044), and also between the "pain" variable within the risk of oral mucositis and depressive symptoms (p = 0.021). Based on the findings, it can be inferred that oral mucositis may be associated with the development of depressive symptoms and may be influenced by the individual's hospitalization, thereby affecting the quality of life of pediatric patients.