Common Mental Disorders In Adolescents Research Articles

The intertwined effect of lack of emotional warmth and child abuse and neglect on common mental disorders in adolescence.

Adolescence is a vulnerable period for mental health problems. Although child abuse and neglect (CAN) are known risk factors for some of them, it is not clear if the negative consequences on mental health also occur in families where CAN and a warm parent-child relationship coexist. The aim of this study is to explore this gap and investigate the effects of different types of CAN according to levels of warmth in the parent-child relationship on common mental disorders (CMD) in adolescence. This is a cross-sectional study encompassing 487 adolescents attending the ninth grade at 2 public and 4 private schools in Rio de Janeiro, Brazil. CAN was measured by the Child Trauma Questionnaire (CTQ), CMD by the General Health Questionnaire (GHQ-12) and the level of warmth in the parent-child relationship were recalled using short Egna Minnen Betraffände Uppfostran (s-EMBU-23). The adjusted separate effects of different types of CAN and a low level of warmth in the parent-child relationship, and both in tandem, were estimated using multivariate linear regression models. Results indicated that emotional abuse and neglect, physical abuse and neglect, and a low level of warmth in the parent-child relationship are important risk factors for CMD in adolescence. Nevertheless, in families where CAN coexist with a warm and affectionate parent-child relationship, the negative effects of CAN on mental health are attenuated. Evidence indicates that actions to prevent or interrupt CAN and improving parental practices could be effective strategies to reduce CMD in adolescence.

Common mental disorders in adolescents with and without type 1 diabetes: Reported occurrence from a countrywide survey

AimsThe aim of this study was to evaluate the frequency of common mental disorders symptoms in adolescents with type 1 diabetes in comparison to a population-based sample of adolescents in Brazil. MethodsWe compared characteristics of 116 youth with type 1 diabetes and 73,508 youth without type 1 diabetes from the same population-based sample of adolescents aged 12–17years, taken from the Brazilian Study of Cardiovascular Risk in Adolescents (ERICA). We evaluated the 12-item General Health Questionnaire (GHQ) score, which is a self-administered screening survey for detecting mental health symptoms. Scores ≥3 were used to determine common mental disorder. ResultsAdolescents with and without type 1 diabetes were comparable with respect to age and race/ethnicity distributions. Youth with type 1 diabetes did not report higher scores on the weighted GHQ analyses in comparison to youth without type 1 diabetes (3.16, SE 0.76 vs. 2.10, SE 0.03, respectively; P = .167). No differences were found regarding the odds of having a GHQ score ≥3 (OR 1.48, 95% CI 0.72–3.08). However, analyses of mental health symptoms separately consistently showed that youth with type 1 diabetes more frequently endorsed mental health barriers in comparison to youth without type 1 diabetes. ConclusionsMental health symptoms seem to be more frequent than diagnosis of common mental disorders in adolescents with type 1 diabetes, which may also interfere in glycemic control. Our findings highlight the need for appropriate mental health assessment in diabetes care in order to prevent glycemic control deterioration.

Adolescent mental health and behavioural predictors of being NEET: a prospective study of young adults not in employment, education, or training.

Young adults who are not in employment, education, or training (NEET) are at risk of long-term economic disadvantage and social exclusion. Knowledge about risk factors for being NEET largely comes from cross-sectional studies of vulnerable individuals. Using data collected over a 10-year period, we examined adolescent predictors of being NEET in young adulthood. We used data on 1938 participants from the Victorian Adolescent Health Cohort Study, a community-based longitudinal study of adolescents in Victoria, Australia. Associations between common mental disorders, disruptive behaviour, cannabis use and drinking behaviour in adolescence, and NEET status at two waves of follow-up in young adulthood (mean ages of 20.7 and 24.1 years) were investigated using logistic regression, with generalised estimating equations used to account for the repeated outcome measure. Overall, 8.5% of the participants were NEET at age 20.7 years and 8.2% at 24.1 years. After adjusting for potential confounders, we found evidence of increased risk of being NEET among frequent adolescent cannabis users [adjusted odds ratio (ORadj) = 1.74; 95% confidence interval (CI) 1.10-2.75] and those who reported repeated disruptive behaviours (ORadj = 1.71; 95% CI 1.15-2.55) or persistent common mental disorders in adolescence (ORadj = 1.60; 95% CI 1.07-2.40). Similar associations were present when participants with children were included in the same category as those in employment, education, or training. Young people with an early onset of mental health and behavioural problems are at risk of failing to make the transition from school to employment. This finding reinforces the importance of integrated employment and mental health support programmes.

Psychometric properties of the Youth Anxiety Measure for DSM-5, Part I (YAM-5-I) in a community sample of Spanish-speaking adolescents

BackgroundAnxiety disorders are among the most common mental disorders in adolescence. There is a need for brief screening tools to identify adolescents at risk for anxiety disorders. The Youth Anxiety Measure for DSM-5 has been recently developed to assess youths’ anxiety symptoms in terms of the current classification system. The goal of this study is to provide a first test of its psychometric properties in a community sample of adolescents in Spain. MethodsThe sample consisted of 505 13- to 17-year-old adolescents who completed Part I of the YAM-5 (YAM-5-I), which measures symptoms of the major anxiety disorders. ResultsData indicated that the YAM-5-I displays appropriate internal consistency reliability. In addition, support was also found for the construct validity of the measure: most items loaded on a factor that represented the hypothesized anxiety syndromes, although it should also be noted that some items exhibited issues and therefore had to be discarded. LimitationsCross-cultural and trans-national studies are needed to determine psychometric properties of scale across languages and cultures. ConclusionsOur findings suggest that the YAM-5-I has satisfactory psychometric properties, which indicates that it can be used as a screening tool in Spanish-speaking adolescents from the general population.

Validation and Diagnostic Efficiency of the Mini-SPIN in Spanish-Speaking Adolescents.

ObjectivesSocial Anxiety Disorder (SAD) is one of the most common mental disorders in adolescence. Many validated psychometric tools are available to diagnose individuals with SAD efficaciously. However, there is a demand for shortened self-report instruments that identify adolescents at risk of developing SAD. We validate the Mini-SPIN and its diagnostic efficiency in overcoming this problem in Spanish-speaking adolescents in Spain.MethodsThe psychometric properties of the 3-item Mini-SPIN scale for adolescents were assessed in a community (study 1) and clinical sample (study 2).ResultsStudy 1 consisted of 573 adolescents, and found the Mini-SPIN to have appropriate internal consistency and high construct validity. Study 2 consisted of 354 adolescents (147 participants diagnosed with SAD and 207 healthy controls). Data revealed that the Mini-SPIN has good internal consistency, high construct validity and adequate diagnostic efficiency.ConclusionsOur findings suggest that the Mini-SPIN has good psychometric properties on clinical and healthy control adolescents and general population, which indicates that it can be used as a screening tool in Spanish-speaking adolescents. Cut-off scores are provided.

Anxiety and Depression: Adolescence to Adulthood

Source: Patton GC, Coffey C, Romaniuk H, et al. The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. Lancet. 2014; 383(9926): 1404– 1411; doi: 10.1016/S0140-6736(13)62116-9Investigators at multiple sites in Australia and the United Kingdom followed a cohort of adolescents with anxiety or depression to ascertain predictors of their persistence into adulthood. Participants were identified by random sampling of members of a large cohort of adolescents from 44 secondary schools in Victoria, Australia. They were observed prospectively from 1992 to 2008 and were assessed for anxiety and depression at 5 different times as adolescents and 3 different times as adults. An anxiety/depression episode was defined in adolescents by a score of ≥12 on the Revised Clinical Interview Schedule (CIS-R), a psychiatric interview designed to assess symptoms of depression and anxiety in non-clinical populations. This cutoff score was deemed to be the score at which clinical intervention would be appropriate. In adults, an anxiety/depression episode was defined as a score >2 on the General Health Questionnaire and through symptom information obtained on the Composite International Diagnostic Interview. In addition to basic demographic information, data on other covariates, including parental separation or divorce, antisocial behavior, daily smoking, high-risk alcohol use, and frequent use of cannabis, were collected. Investigators estimated rates of anxiety/depression episodes in adolescence by gender, explored the persistence of episodes across study time points, and assessed the predictive associations of demographics and risk behavior covariates with this persistence.From an original sample of 2,032 cohort members, 1,943 participated at least once during the first 6 adolescent time points with 1,761 members participating at least once in the young adult phase. The final analysis included 1,750 members. Observations began and terminated at a mean age of 15.5 and 29.1 years, respectively. There were 236/821 males (29%) and 498/929 females (54%) who had at least 1 anxiety/ depression episode during adolescence. Among these, 109 (47%) males and 323 (65%) females had at least 1 further episode in young adulthood. Having prolonged initial episodes during adolescence (persisting through 2 or more time points) was the clearest predictor of persistence into adulthood (OR=3.15; 95% CI, 1.86–5.37). Additionally, female gender (OR=2.12; 95% CI, 1.29–3.48) and parental separation or divorce (OR=1.62; 95% CI, 1.03–2.53) independently predicted persistence of anxiety/depression into adulthood. Surprisingly, high-risk adolescent behaviors were not associated with persistence of anxiety/depression into adulthood.The authors conclude that nearly half of young adults with anxiety/ depression have no further episodes after adolescence, suggesting that these common mental health disorders often resolve during the transition into adulthood.Dr Wardrop has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.Adolescence marks a tumultuous period emotionally and physically for many and the resultant anxiety and depression in this age group is a clinical reality for patients, families, and physicians alike.1 In the present study, depression and anxiety were seen frequently; ~41% of participants experienced at least 1 episode of these common mental health disorders as adolescents. Also notable was that ~59% of study participants with anxiety or depression in adolescence had persistence into young adulthood.What was unclear prior to this study were the factors that predicted the persistence of symptoms into young adulthood and which patients might be at most risk for this continuation of the disorder. Interestingly, cohort members who had a longer duration of initial symptoms, those of female gender, and those with a social history significant for parental divorce or separation had the greatest odds of persistence of a mental health disorder. This insight should assist clinicians in targeting their own adolescent patients with anxiety or depression for prompt treatment, in order to appropriately counsel and limit the severity and length of symptoms.Reassuringly, this study confirmed previous findings of a decrease in the prevalence of common mental disorders through young adulthood.2 While these results are compelling, their full clinical implications need further follow-up and study. Such work would lend insight into the longer-term health consequences of depression and anxiety experienced in adolescents and the outcomes of focused early interventions designed to shorten the duration of symptoms in these patients.3

Common adolescent mental disorders: transition to adulthood

Mental disorders are common, although reported rates differ according to developmental stage. 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar The prevalence of common mental disorders such as depression increases in adolescence, 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar , 2 Kim-Cohen J Caspi A Moffitt TE Harrington H Milne BJ Poulton R Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry. 2003; 60: 709-717 Crossref PubMed Scopus (1476) Google Scholar and many people will experience such a disorder by young adulthood. 3 Copeland W Shanahan L Costello EJ Angold A Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the Great Smoky Mountains Study. J Am Acad Child Adolesc Psychiatry. 2011; 50: 252-261 Summary Full Text Full Text PDF PubMed Scopus (198) Google Scholar Mental disorder in adolescence increases the risk of later adult disorder, 4 Clark C Rodgers B Caldwell T Power C Stansfeld S Childhood and adulthood psychological ill health as predictors of midlife affective and anxiety disorders. Arch Gen Psychiatry. 2007; 64: 668-678 Crossref PubMed Scopus (129) Google Scholar , 5 Fergusson DM Boden JM Horwood LJ Recurrence of major depression in adolescence and early adulthood, and later mental health, educational and economic outcomes. Br J Psychiatry. 2007; 191: 335-342 Crossref PubMed Scopus (201) Google Scholar , 6 Pine DS Cohen P Gurley D Brook J Ma J The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry. 1998; 55: 56-64 Crossref PubMed Scopus (1316) Google Scholar and adults with mental disorder often have their first episode in adolescence. 1 Costello EJ Copeland W Angold A Trends in psychopathology across the adolescent years: what changes when children become adolescents, and when adolescents become adults?. J Child Psychol Psychiatry. 2011; 52: 1015-1025 Crossref PubMed Scopus (484) Google Scholar , 7 Newman DL Moffitt TE Caspi A Magdol L Silva PA Stanton WR Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21. J Consult Clin Psychol. 1996; 64: 552-562 Crossref PubMed Scopus (492) Google Scholar Therefore, adolescence is potentially an important time for mental health interventions to reduce both present and long-term impairment. However, there is little detailed knowledge about the prognosis of common adolescent mental disorders during the transition to adulthood. A greater understanding of the course and prognosis of adolescent-onset common mental disorders is needed to identify those at highest risk of later problems, to inform decisions about when to intervene, and to help allocate clinical resources efficiently. The prognosis of common mental disorders in adolescents: a 14-year prospective cohort studyEpisodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life. Full-Text PDF

The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study

Most adults with common mental disorders report their first symptoms before 24 years of age. Although adolescent anxiety and depression are frequent, little clarity exists about which syndromes persist into adulthood or resolve before then. In this report, we aim to describe the patterns and predictors of persistence into adulthood. We recruited a stratified, random sample of 1943 adolescents from 44 secondary schools across the state of Victoria, Australia. Between August, 1992, and January, 2008, we assessed common mental disorder at five points in adolescence and three in young adulthood, commencing at a mean age of 15.5 years and ending at a mean age of 29.1 years. Adolescent disorders were defined on the Revised Clinical Interview Schedule (CIS-R) at five adolescent measurement points, with a primary cutoff score of 12 or higher representing a level at which a family doctor would be concerned. Secondary analyses addressed more severe disorders at a cutoff of 18 or higher. 236 of 821 (29%; 95% CI 25-32) male participants and 498 of 929 (54%; 51-57) female participants reported high symptoms on the CIS-R (≥12) at least once during adolescence. Almost 60% (434/734) went on to report a further episode as a young adult. However, for adolescents with one episode of less than 6 months duration, just over half had no further common mental health disorder as a young adult. Longer duration of mental health disorders in adolescence was the strongest predictor of clear-cut young adult disorder (odds ratio [OR] for persistent young adult disorder vs none 3.16, 95% CI 1.86-5.37). Girls (2.12, 1.29-3.48) and adolescents with a background of parental separation or divorce (1.62, 1.03-2.53) also had a greater likelihood of having ongoing disorder into young adulthood than did those without such a background. Rates of adolescent onset disorder dropped sharply by the late 20s (0.57, 0.45-0.73), suggesting a further resolution for many patients whose symptoms had persisted into the early 20s. Episodes of adolescent mental disorder often precede mental disorders in young adults. However, many such disorders, especially when brief in duration, are limited to the teenage years, with further symptom remission common in the late 20s. The resolution of many adolescent disorders gives reason for optimism that interventions that shorten the duration of episodes could prevent much morbidity later in life. Australia's National Health and Medical Research Council.

Dysfunktionale Emotionsregulation als grundlegendes Merkmal von Jugendlichen mit Angst- und depressiven Störungen

Depression and anxiety disorders are among the most common mental disorders in adolescents and show high comorbidity. The aim of the current study was to investigate emotion regulation as a conjoint as well as restricting factor. Matched samples of depressive and anxious adolescents and a control group (12-16 years; n = 60) were compared for their emotion regulation. Analyses of variance and t-tests were used to analyse group differences in emotion regulation. Individual differences in regulation strategies between the two types of disorders were analysed exploratorily. Results indicate more dysfunctional emotion regulation in anxious and depressive adolescents compared to a control group. Neither dysfunctional emotion regulation in sum, nor single strategies differentiated between the two disorder groups. Identification and modification of dysfunctional emotion regulation in anxious and depressive adolescents can support future prevention and intervention.

Brief Form of the Social Phobia and Anxiety Inventory (SPAI-B) for Adolescents

Although social phobia is one of the most common mental disorders in adolescents, there are few reliable and valid assessment instruments for this age group. This study examined the factor structure and psychometric properties of a brief version of the Social Phobia and Anxiety Inventory (SPAI; Turner, Beidel, Dancu, & Stanley, 1989 ) in a sample of adolescents. Although the original 45-item SPAI has excellent psychometric properties, its utility is limited by its length. We developed and piloted a brief, 16-item version of the SPAI that has good psychometric properties, assesses cognitive, behavioral, and somatic symptoms, consistent with the original scale, which may be particularly useful as a screening measure. Limitations and suggestions for future research are discussed.

EXPLORING THE RELEVANCE OF GENDER AND AGE DIFFERENCES IN THE ASSESSMENT OF SOCIAL FEARS IN ADOLESCENCE

Although social phobia is one of the most common mental disorders in adolescents, information on the need for normative data is missing. For this reason, this cross-sectional study was aimed at determining if there is a need to have normative data according to age and gender in socially anxious adolescents. Furthermore, we analyzed whether or not boys and girls differ in the nature of their social fears. The study population comprised 2,543 Spanish-speaking adolescents randomly recruited from 10 schools. The results indicate that there is no need for different normative data based on age and gender. Moreover, our data also indicate that even though there are quantitative differences between boys and girls, i.e., girls report a higher percentage, a qualitative analysis revealed that boys and girls experience the same social fears and, therefore, the nature of the social-anxiety provoking situations is the same across gender. Implications for developmental theories and assessment are discussed as well.

Common mental disorders in adolescents: a population based cross-sectional study

To assess the prevalence and the factors associated with common mental disorders among adolescents in Pelotas, a southern Brazilian city. A population based cross-sectional study was carried out in the urban area of Pelotas. Multi-stage sampling was used to obtain a sample of adolescents aged between 15 and 18 years. Adolescents were interviewed using a self-report confidential questionnaire. The presence of common mental disorders was assessed using the Self-Reporting Questionnaire 20 (SRQ-20). Multivariate analysis was carried out using the Poisson regression with a robust adjustment of variance and control for design effect. Nine hundred and sixty adolescents were interviewed. The prevalence of common mental disorders was 28.8%. Adolescents aged 17 years showed prevalence of 1.37 (95% CI 1.06-1.78) times greater than the 15 year olds. Adolescents whose mothers had between 5 and 8 years of schooling had a prevalence 1.42 (95% CI 1.01-1.51) times greater than those whose mothers had more than 8 years of schooling. Smoking and sedentary behavior were also associated with an increased prevalence of common mental disorders. Those who were dissatisfied with their body image showed a prevalence of 1.47 (95% CI 1.07-2.02). Maternal schooling, tobacco smoking, sedentary behavior and body image dissatisfaction were factors associated with the presence of common mental disorders.

The epidemiology of common mental disorders in adolescents: The Epirus school project

The epidemiology of common mental disorders in adolescents: The Epirus school project

Childhood maltreatment and the risk of substance problems in later life

This paper examines the risk of developing problems in adolescence and adulthood, particularly those associated with substance use, as a consequence of experiencing physical or sexual abuse during childhood. We review both retrospective and prospective research, conducted with both adolescent and adult respondents. Although there are some marked discrepancies in the findings from retrospective and prospective studies, these are probably due to differences in methodology, particularly between using official records and self-report to identify cases of abuse. Despite the wide range of methodologies and samples used in these studies, most indicate that the experience of childhood abuse is a risk factor for a number of common mental disorders in adolescence and adulthood, including alcohol and drug-related problems. In many cases, the experience of abuse appears to lead in later life to increased feelings of depression and anxiety which, while not sufficient to result in the diagnosis of a mental health disorder, place the victims at greater risk of developing substance problems. Multivariate studies indicate that this positive association remains even when controlling for important variables such as the presence of parental alcohol problems. The paper concludes with a number of recommendations for future research, so that it can be established whether the risk arises specifically from child abuse or neglect, or from the more general impact on child development of adverse family relationships.