Health Conditions In Adolescents Research Articles

Terapi Mindfulness terhadap Kesehatan Mental Remaja

This study aims to identify the effectiveness of mindfulness interventions on mental health conditions in adolescents. The method used is a systematic literature review with seven national and international research articles reviewed utilizing the search engines PubMed, Scopus, Science Direct, and Google Scholar within the last six years. The research results from the identification of 7 research articles found significant effects of mindfulness interventions on adolescent mental health conditions, such as increasing the ability to regulate emotions, resilience, and reducing stress, depression, and anxiety. The conclusion of this literature review strengthens the effectiveness of mindfulness in improving adolescent mental health in a more positive direction.
 
 Keywords: Mental Health, Mindfulness, Adolescents

Mental Health Education for Adolescents at Junior High School 21 Tanjung Jabung Timur District, Jambi

Adolescence is a stage of life marked by important developments, namely physical, psychological, emotional, and social aspects. In recent years, adolescent mental health has received increasing attention from experts. This is because the early age of the first episode of mental disorders occurs at the age before 14 years. Adolescents at SMPN 21 Tanjung Jabung Timur do not know about mental health in adolescents. This community service activity aims to help increase the knowledge of young people at SMPN 21 Tanjung Jabung Timur about mental health and how to handle it early if mental health problems occur in friends at school. This community service activity was carried out at SMP Negeri 21 East Tanjung Jabung Regency as a health partner. The methods used are lectures, discussions, pre-test and post-test measurements of mental health conditions in adolescents. The results of the activity showed an increase in adolescent knowledge about mental health after being given mental health education by 74.4%. Mental health education is important to do as an effort to prevent mental health problems in adolescents.

Examining the associations between attention-deficit/hyperactivity disorder, sleep problems, and other mental health conditions in adolescents.

Adolescents with attention-deficit/hyperactivity disorder (ADHD) often experience greater sleep difficulties compared to those without. However, findings are mixed, and other mental health conditions are often overlooked. This study aimed to examine the relationship between sleep problems, ADHD, and other mental health conditions in a sample of adolescents. Data from 373 adolescents aged 10-19 years was used as part of the wider 'Healthy Brain Network' study, which targets children and adolescents experiencing mental health and neurodevelopmental difficulties. Mental health conditions were assessed via a comprehensive assessment. Sleep was measured by self- and parent-report, as well as via up to a month of actigraphy data. Actigraphy data were analysed using mixed-methods modelling, while subjectivesleep data were analysed using multiple regression. Subjectively-reported sleep was generally worse in adolescents who had ADHD and other mental health conditions compared to those with ADHD but no other conditions. There were no associations between ADHD status and objective sleep measures or self-reported measures, but a significant association was found between ADHD status and parent-reported sleep difficulties, even when accounting for other conditions. Parent-reported sleep problems were associated not only with ADHD, but also with anxiety, depression, and externalising disorders. The strength of association between ADHD and sleep problems is potentially not as strong as previously thought when considering the role of other mental health conditions. Clinicians should consider the role of other mental health conditions when sleep problems are present, and vice versa. The study also highlights the importance of comprehensive, multi-informant assessment of mental health conditions, including sleep.

Chronic diseases and health conditions in adolescents: Sex inequalities

To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Doenças crônicas e problemas de saúde de adolescentes: desigualdades segundo sexo

ABSTRACT Objective: To estimate the prevalence of chronic diseases and health conditions in adolescents from Campinas (São Paulo), investigating sex differences according to age group. Methods: This population-based study analyzed data from the ISACamp 2014/15 health survey, with a total of 1,022 adolescents interviewed. The interviewees consisted of 517 boys and 505 girls; 492 of them in the ten to 14 age group and 530 in the 15 to 19 age group. We verified the associations using the χ2 test with Rao Scott adjustment and estimated prevalence ratios (PR) with multiple Poisson regression adjusted for age. Analyses were also stratified by age group. Results: Respiratory diseases, such as rhinitis (25.3%), sinusitis (15.7%), and asthma (10.9%), were the most prevalent among adolescents. Health complaints were high, especially headaches (39.5%), emotional conditions (34.5%), allergies (27.5%), and back pain (21.3%). More than 22.0% of adolescents reported having three or more health conditions. Girls declared a higher number of health conditions (three or more) than boys (PR=2.27). Conclusion: The study showed that adolescents presented a significant number of health conditions, particularly regarding complaints, indicating the need for clinical care and public policies aimed at controlling and preventing these diseases in this age group.

Association of Oral Health Conditions in Adolescents with Social Factors and Obesity.

This study aimed to investigate associations between psychosocial factors, obesity, and oral health in a study population of 10- to 18-year-old adolescents who participated in the LIFE Child study. Psychosocial information (socioeconomic status (SES) based on parents’ education, occupation and household income, Strengths and Difficulties Questionnaire (SDQ), health-related quality of life) and physical activity behavior were obtained. Nutritional status was classified based on age- and sex-adjusted body mass index into underweight, overweight, normal weight and obese. Clinical dental examinations were performed and scored with respect to caries experience (CE), oral hygiene (OH), and periodontal status (periodontal health score: PERIO-S). Age-adjusted regression analysis under the assumption of a double Poisson distribution was performed with and without adjusting for SES (α = 5%). A total of 1158 study participants (590 girls, 568 boys; mean age 13.2 ± 2.3 years) were included (17.2% were classified as obese). CE was 20% higher for moderate and 60% higher for low SES compared to high SES (p < 0.05). PERIO-S was 10% higher for moderate and 30% higher for low compared to high SES (p < 0.05). Poor OH was associated with higher CE (Ratio R = 2.3, p < 0.0001) and PERIO-S (R = 3.1, p < 0.0001). Physical activity in a sports club was associated with lower CE-S and PERIO-S (R = 0.85, p < 0.001). Obesity was associated with increased CE (R = 1.3, p < 0.001) compared to normal weight. For low but not high SES, more reported difficulties were associated with higher CE. In conclusion, low SES, poor OH, and obesity are associated with unfavorable oral health conditions, whereas physical activity and high SES are potentially protective.

Association of Treatable Health Conditions During Adolescence With Accelerated Aging at Midlife

Biological aging is a distinct construct from health; however, people who age quickly are more likely to experience poor health. Identifying pediatric health conditions associated with accelerated aging could help develop treatment approaches to slow midlife aging and prevent poor health in later life. To examine the association between 4 treatable health conditions in adolescence and accelerated aging at midlife. This cohort study analyzed data from participants in the Dunedin Study, a longitudinal investigation of health and behavior among a birth cohort born between April 1, 1972, and March 31, 1973, in Dunedin, New Zealand, and followed up until age 45 years. Participants underwent an assessment at age 45 years and had data for at least 1 adolescent health condition (asthma, smoking, obesity, and psychological disorders) and outcome measure (pace of aging, gait speed, brain age, and facial age). Data analysis was performed from February 11 to September 27, 2021. Asthma, cigarette smoking, obesity, and psychological disorders were assessed at age 11, 13, and 15 years. The outcome was a midlife aging factor composite score comprising 4 measures of biological aging: pace of aging, gait speed, brain age (specifically, BrainAGE score), and facial age. A total of 910 participants (459 men [50.4%]) met the inclusion criteria, including an assessment at age 45 years. Participants who had smoked daily (0.61 [95% CI, 0.43-0.79] SD units), had obesity (0.82 [95% CI, 0.59-1.06] SD units), or had a psychological disorder diagnosis (0.43 [95% CI, 0.29-0.56] SD units) during adolescence were biologically older at midlife compared with participants without these conditions. Participants with asthma were not biologically older at midlife (0.02 [95% CI, -0.14 to 0.19] SD units) compared with those without asthma. These results remained unchanged after adjusting for childhood risk factors such as poor health, socioeconomic disadvantage, and adverse experiences. This study found that adolescent smoking, obesity, and psychological disorder diagnoses were associated with older biological age at midlife. These health conditions could be treated during adolescence to reduce the risk of accelerated biological aging later in life.

Meta Analysis: The Effect of Bullying on Adolescents on Mental Health and Depression

Background: Bullying is an act of aggression that is intentional and repeated physically, psychologically, verbally, and cyber which can cause various health problems. Bullying is one of the causes of poor mental health conditions in adolescents whose impact can continue into adulthood. This study was aimed to assess the magnitude of the effect of bullying on mental health and depression based on the scores obtained from several previous similar studies. Subjects and Method : The design of this research study was a systematic review and meta-analysis. The primary articles used were obtained from online databases (PubMed, Google Scholar, ResearchGate, and Springer Link) published in 2012-2022. Population: teenagers. Intervention: bullying. Comparison: not experiencing bullying. Outcomes: mental health and depression. The keywords used in the primary article search were “Bullying” AND “Mental Health Problem” OR “Psychological Disorder” OR “Psychological Distress” AND “Depression” OR “Depressive Disorder” AND “Adolescent” OR “Teenager”. This study uses full-text articles with a cross-sectional design and contains an aOR (adjusted Odds Ratio) value. The selection of articles was carried out using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application. Results: There are 7 articles from Saudi Arabia, Taiwan, Italy, Morocco, Sweden, Australia, and Ethiopia on bullying and adolescent mental health, as well as 8 articles from Saudi Arabia, US, Italy, China, Brazil, Canada, Australia, and Malaysia on bullying and depression in adolescents. The results of the meta-analysis showed that bullying was statistically significant in increasing the occurrence of mental health disorders (aOR= 2.48; 95%CI= 1.64 to 3.74; p&lt; 0.001) and depression (aOR= 2.74; 95%CI= 2.29 to 3.28; p&lt; 0.0001) in teenagers. Conclusion: The experience of bullying can increase the risk of mental health disorders and depression in adolescents. Keywords: Bullying, mental health, depression, youth. Correspondence: Riya Ulin Nuha. Faculty of Health Science, Universitas ‘Aisyiyah Yogyakarta. Jl. Ring Road Barat 63 Mlangi Nogotirto Gamping, Sleman 55292, Yogyakarta, Indonesia. Email: ulin514@gmail.com . Mobile: 081238710748. Journal of Epidemiology and Public Health (2022), 07(01): 104-119 https://doi.org/10.26911/jepublichealth.2022.07.01.09

Adolescent and Adult Correlates of Prescription Opioid Use and Misuse in Adulthood: Associations Across Domains of Despair

Objective: Given continued increases in “deaths of despair”, there is a need to examine associations of factors across multiple domains of despair (i.e. cognitive, emotional, behavioral, biological) with opioid-related behaviors. An understanding of current and early life correlates of prescription opioid behaviors can help inform clinical care, public health interventions, and future life course research. Methods: Using data from Waves I (1994–1995; participants ages 12–18 years) and V (2016–2018; participants ages 34–42 years) of the National Longitudinal Study of Adolescent to Adult Health (N = 10,685), we examined adolescent and adult demographic, mental and physical health, substance use, and behavioral characteristics associated with past 30-day prescription opioid use only, misuse only, and both use and misuse to no recent use or misuse in adulthood. Results: Overall, 2.3% of adult participants reported past 30-day prescription opioid use only, 6.3% reported past 30-day misuse only, and 1.3% reported both prescribed use and misuse in the past 30 days. Physical health conditions in adolescence and adulthood were most common among those reporting use only and both use and misuse. Mental health conditions, other substance use, and delinquent behaviors in adolescence and adulthood were most common among those reporting misuse only and both use and misuse. Conclusions: Results from this nationally representative sample highlight the prevalence of specific prescription opioid behaviors and underscore the importance of targeting underlying drivers of prescription opioid use and misuse early in the life course. Continued implementation individual- and population-level approaches will be critical to addressing continued demand for opioids.

Relationship between Smoking, Physical Activity, Screen Time, and Quality of Life among Adolescents.

Background: Quality of life (QOL) is a crucial part of evaluating health conditions IN adolescents. The purposes of this study were to (1) examine the relationship of QOL and smoking, physical activity (PA) and screen time (ST) among Chinese adolescents, (2) explore the relationship between PA-ST combination and QOL of adolescents, and (3) investigate the dose-response relationship between PA-ST and QOL. Methods: This study randomly selected 12,900 adolescents (11–18 years) from 13 administrative regions in Shandong Province, China. The data gathering tools for Smoking (tobacco), PA (PAQ-A) and ST (average daily time for ST) and QOL questionnaire (child and adolescent quality of life scale) were completed among all adolescents. Statistical analysis was performed by T test, chi-square test and multiple linear regression. Results: 12,641 adolescents (aged 12–18) completed the study. In multiple linear regression models, the result demonstrated that the adolescents from rural areas, with high ST, low PA, and smoking, with older age and low socioeconomic status, showed a lower QOL score. First-time smokers under 10 years revealed the lowest QOL, and PA > 30 min five days per week have the highest QOL. In addition, boys and girls with PA > 30 min three to four days per week in high ST group obtain the higher scores (boys β = 5.951, girls β = 3.699) than low PA-low ST groups. Conclusions: Adolescents from rural areas suffer from a relatively poorer QOL. More than 30 min of PA five or more days for boys and three or four days per week for girls could decrease negative effects of ST and improve QOL.

Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence.

IntroductionAs adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health‐related risk behaviours. For adolescents living with HIV (ALHIV), these risks may be even more pronounced. Research shows that this population may face additional mental health challenges related to the biological impact of the disease and its treatment, the psychosocial burdens of living with HIV and HIV‐related social and environmental stressors.DiscussionPsychosocial interventions delivered to adolescents can promote positive mental health, prevent mental health problems and strengthen young people’s capacity to navigate challenges and protect themselves from risk. It is likely that these interventions can also benefit at‐risk populations, such as ALHIV, yet there is little research on this. There is an urgent need for more research evaluating the effects of interventions designed to improve the mental health of ALHIV. We highlight four priorities moving forward. These include: generating more evidence about preventive mental health interventions for ALHIV; including mental health outcomes in research on psychosocial interventions for ALHIV; conducting intervention research that is sensitive to differences among ALHIV populations and involving adolescents in intervention design and testing.ConclusionsMore robust research on promotive and preventive mental health interventions is needed for ALHIV. Programmes should be informed by adolescent priorities and preferences and responsive to the specific needs of these groups.

Linking adolescent future expectations to health in adulthood: Evidence and mechanisms

Previous studies have suggested that the expectations adolescents have about their future are related to health behaviors and, consequently, to health conditions in adolescence and adulthood. However, few studies have addressed whether observed associations reflect unobserved family background. Moreover, relatively little attention has been paid to how adolescents' future expectations influence health in adulthood. This study investigated whether the association between future expectations (on future survival and college attainment) during adolescence and health in adulthood is spurious owing to family background. This study also explored the mechanisms that undergird the relationship between adolescents' future expectations and physical health. Participants were drawn from nearly 3,500 family samples of the National Longitudinal Study of Adolescent to Adult Health. This study used sibling fixed-effect approach to take into account genetic factors, family environment, as well as childhood social context such as school and neighborhood effects. Sibling fixed-effect estimates revealed that survival expectations are associated with adult physical health (Framingham Risk Score for 30-year cardiovascular risk), net of unobserved background characteristics shared by siblings. The association between college expectations and adult physical health, however, was confounded by family background characteristics. In contrast to physical health, the influence of both survival and college expectations on psychological health in adulthood was robust to adjustment for sibling fixed effects. Regarding mediating pathways that connect future expectations to physical health, Sobel-Goodman mediation tests showed that binge drinking and unhealthy dietary habits explain about 38 percent of the relationship between survival expectations and physical health. Adolescents' future expectations are positively associated with health and well-being in adulthood net of unobserved family background characteristics. Substance use and dietary habits are relevant mediating pathways that link future expectations (particularly about survival) to physical health. Improving adolescents' future orientations about their life chances may improve adult health.

Prevalence of Depression and Generalized Anxiety Disorder Among Mexican Indigenous Adolescents and Young Adults: Challenges for Healthcare.

Providing evidence on mental disorders in indigenous adolescents is critical to achieving universal health coverage (UHC). The prevalence of symptoms of depression and generalized anxiety disorder symptoms were estimated for 2082 adolescents aged 14-20years in Chiapas, Mexico. Mental disorders were assessed using the 9-item Patient-Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale. Among the adolescents evaluated, 35.8% suffered from depression or generalized anxiety disorder. Of those, 6.1% reported a previous diagnosis. 32.1% of adolescents with both mental disorders reported having attempted suicide. Gender, substance use, adverse living experiences and living conditions were correlated to the presence of depression and/or generalized anxiety disorder. It is mandatory for Mexican health authorities to develop effective instruments aiming to screen and diagnose mental health conditions in adolescents, as well as to provide timely treatment in primary health-care units.

E-cigarette Risk Factors and Effects on Adolescent Health in the United States

Despite their adverse health effects, e-cigarette use has increased considerably among adolescents (people aged 10-19 years) in the United States. This is due to a number of factors including peer pressure, the availability of a variety of e-liquid flavors, the targeted marketing of these products to adolescents, and the belief by adolescents that e-cigarettes are less harmful to health than tobacco products. Just as traditional tobacco products, e-cigarettes have been found to be harmful to health and responsible for multiple adverse health conditions in adolescents, including inhibited growth and development, poor mental health, certain cancers, lung damage, nicotine dependency, future drug use, and social stigmatization. While the United States government realizes the harmful effects of e-cigarettes on adolescents, and although it has put in place certain policies to regulate the issue, e-cigarette use continues to be a public health problem among adolescents. This article discusses e-cigarettes, their use, risk factors, and health effects on adolescents in the US. It also proposes strategies for safeguarding adolescent health.

Autoestima y consumo de alcohol en adolescentes de secundaria de Ciudad del Carmen, Campeche

Introducción: Los adolescentes transitan por una etapa de cambios biológicos, psicológicos y sociales que pudieran ser factores condicionantes en la adquisición de conductas nocivas como el uso y/o abuso de alcohol. Objetivo: Establecer la asociación entre autoestima y el consumo de alcohol de los adolescentes. Metodología: Estudio descriptivo correlacional llevado a cabo en 191 adolescentes de Educación Secundaria de Ciudad del Carmen Campeche, México. Se utilizó la Prueba de Identificación de Desórdenes por Uso de Alcohol (AUDIT) y la Escala de Autoestima de Rosenberg. Resultados: Predomina el tipo de consumo de dependiente (35.4%) seguido del sensato (34.1%), por sexo en los varones predomina un consumo dependiente (39.4%) y en las mujeres un consumo sensato (38.8%). Se estableció una relación negativa entre el autoestima y consumo de alcohol de acuerdo a la puntuación AUDIT (r= -.425, p=.042). Conclusión: La ingesta de bebidas alcohólicas representa un problema creciente de salud que pudiera ocasionar múltiples daños a la salud de los adolescentes, además de estar asociado a variables psicológicas como la autoestima, que juega un papel primordial en la adquisición o modificación de hábitos saludables o no, y por lo tanto constituye un factor protector ante el consumo de alcohol.

Mindfulness-based interventions for adolescent health.

Mindfulness, the practice of paying attention to the present moment, purposefully and nonjudgmentally, has been gaining popularity as adjunct treatment for adolescents with a range of physical and mental health problems. Research conducted in adults and emerging research conducted in adolescents has shown that mindfulness-based interventions can improve outcomes in several areas. The purpose of this review is to discuss recent research on the effects of mindfulness and suggest exercises that primary care clinicians can offer to their adolescent patients. Research has shown positive effects of mindfulness across several health conditions commonly encountered during adolescence. Mindfulness-based Interventions can reduce symptoms of anxiety and depression. The application of mindfulness can help with the prevention and treatment of binge eating, over-eating, and restrictive eating disorders. In the treatment of substance use disorders, mindfulness can improve emotion regulation and reduce symptoms of withdrawal and craving. Mindfulness can also lead to improvement in overall quality of life for patients suffering from chronic pain. Lastly, mindfulness can be useful for adolescents with ADHD, sleep problems, chronic illness, and stress related to performance sports. Although research in adolescents remains limited, mindfulness holds promise in the treatment of a range of health conditions in adolescents.

Mindfulness-Based Interventions for Adolescents with Mental Health Conditions: A Systematic Review of the Research Literature

Although research investigating Mindfulness-based interventions (MBIs) for adults has increased exponentially, the evidence of the effects of MBIs on adolescents with mental health problems is only beginning to emerge. Our aim is to systematically review the current state of the MBI research literature across the range of mental health conditions in adolescents, and to identify some key research questions yet unanswered. MEDLINE, CINAHL, PsycINFO and Scopus were searched, as well as the references of retrieved articles. Of 754 articles, 17 met the inclusion criteria. Of these, only a few studies implemented a manualized intervention for adolescents, five featured interventions adapted from the classical Mindfulness models (MBSR and MBCT), while the remaining studies used a combination between these models while incorporating also other components. In terms of research design, only three of the studies were RCTs, seven pilot studies, five design studies and the rest were feasibility studies. Moreover, only three of the seventeen studies used validated measures of mindfulness in gauging the impact of the interventions. We identified the following four categories of mental health conditions in studies of MBIs among adolescents: Neurodevelopmental and Behavioral Disorders; Mood and Anxiety Disorders; Substance Abuse Disorders, and Heterogeneous Disorders. The evidence so far suggests that MBIs are both feasible and well accepted, although study populations and methods varied so much that precise estimates of impact on clinical outcomes needs further research. Guided by our systematic review, we summarize ways to adapt MBIs for adolescents with mental health problems.

Sex- and Age-Dependent Differences in Autonomic Nervous System Functioning in Adolescents

PurposeWe assessed sex- and age-dependent differences in a cross-sectional analysis of cardiac autonomic nervous system (ANS) regulation during sleep in adolescents. MethodsNocturnal heart rate (HR) and heart rate variability (HRV) metrics, reflecting ANS functioning, were analyzed across the night and within undisturbed rapid eye movement (REM) and non-REM sleep in 149 healthy adolescents (12–22 years; 67 female) from the National Consortium on Alcohol and Neurodevelopment in Adolescence. ResultsNocturnal HR was slower in older, more pubertally advanced boys than in younger boys. In girls, HR did not vary according to age or maturity, although overall HRV and vagal modulation declined with age. Although younger boys and girls had similar HR, the male-female HR difference increased by ~2.4 bpm every year (p < .01, higher in older girls). Boys and girls showed expected increases in total HRV across the night but this within-night “recovery” was blunted in girls compared with boys (p < .05). Also, the non-REM and REM difference in HR was greater in girls (p < .01). Models exploring a role of covariates (sleep, mood, reproductive hormones, activity) in influencing HR and HRV showed few significant effects, apart from sedentary activity (higher in older girls), which partially mediated the sex × age interaction in HR. ConclusionsSex-related differences in cardiac ANS function emerge during adolescence. The extent to which sex-age divergences in ANS function are adaptive or reflect underlying sex-specific vulnerability for the development of psychopathology and other health conditions in adolescence needs to be determined.

General and diabetes-specific stress in adolescents with type 1 diabetes.

Type 1 diabetes (T1D) is one of the most common chronic health conditions in adolescents in the United States. Adherence to the recommended treatment regimen has been reported as a source of stress for adolescents. The purpose of this study was to examine the associations among general and diabetes-specific stress and glycemic control (HbA1c), self-management, and diabetes-specific quality of life (QOL) in adolescents with T1D. A secondary analysis of baseline data (N=320) from a randomized controlled trial was conducted. Adolescents completed validated measures of general and diabetes-specific stress, self-management, and diabetes-specific QOL. HbA1c levels were obtained from medical records. Over 50% of the sample scored at or above criteria for high general and diabetes-specific stress. Higher general and diabetes-specific stress was significantly associated with higher HbA1c, poorer self-management activities, and lower diabetes-specific QOL. Diabetes-specific stress accounted for a significant proportion of the variance in HbA1c, while general stress did not. General and diabetes-specific stress accounted for 40% of the variance in diabetes-specific QOL. General and diabetes-specific stress are common in adolescents with T1D. Healthcare providers must be mindful of the sources of stress that adolescents with T1D face on a daily basis. General stress and diabetes-specific stress should be differentiated and may require different interventions to improve coping and outcomes.

Trajectory of achievement in primary school and development of mental health conditions in adolescence: a cohort study using linked health and education data

BackgroundLittle is known about how mental health in primary school affects subsequent adolescent mental health. This study examined the effect of education in primary school on development of mental health conditions. MethodsThis cohort study of all children in Wales between 1999 and 2014 used routine data from general practice and hospital data linked with education records held in the Secure Anonymised Information Linkage (SAIL) databank. Cox regression was used, controlling for sex, deprivation, conduct disorder, attention deficit hyperactivity disorder, and learning difficulty. FindingsHealth records of 652 903 children (319 839 boys, 307 584 girls) were linked with educational records: between the ages of 12 and 21 years, 33 498 children (5·1%) developed depression, 15 946 (2·4%) self-harmed, and 2183 (0·3%) had eating disorders. 10 458 boys (3·2%) and 23 040 girls (7·5%) had diagnosed depression during their childhood, and 10 550 boys (3·3%) and 21 278 girls (6·9%) were given an antidepressant. Children who developed depression were more likely than those not developing depression to have passed key stage 1 (age 7 years) (adjusted hazard ratio [HR] 1·19, 95% CI 1·08–1·30) but not key stage 2 (age 11) (0·76, 0·69–0·83), indicating that they were declining in primary school education. Conversely those who self-harmed (4736 boys [1·5%], 11 210 girls [3·6%]) were achieving as well as those who did not self-harm (1·02, 0·92–1·12). In children with an eating disorder, only female sex was associated with development of the disorder (10·5, 7·55–14·5), and educational achievement was not significantly different from those without the disorder (1·16, 0·82–1·63). However, at key stage 3 (age 14) children with eating disorders achieved well in secondary school (1·42, 1·2–1·7). InterpretationThe trajectory of achievement in primary school is very different for children who develop depression, self-harm, or eating disorders. Those who developed depression were deprived children declining in primary school education; those who self-harmed were deprived children improving in primary educational achievement. However, eating disorders were not associated with education or deprivation in primary school but associated with high achievement in secondary school. FundingNational Centre for Population Health and Wellbeing Research.