Adolescent Mental Health Disorders Research Articles

Project ECHO: An Evidence-Based Pathway to Build Child and Adolescent Mental Health Workforce in Pakistan

ABSTRACT Most mental health disorders present by age 14 years but less than fifty percent youth receive any treatment. Most present to non-mental health disciplines secondary to mental health workforce deficits. Mental health access is lower in developing countries like Pakistan and worse in the rural areas of the country which houses majority of the population. The growing need to manage child and adolescent mental health disorders in a timely manner necessitates use of innovative professional training approaches to increase mental health workforce. Project ECHO is a hub-and-spoke model that uses videoconferencing to connect general providers (“spokes”) with specialists (the “hub”) overcoming the site and location specific barriers which often impede access. Our 12 month curriculum was developed to expand child and adolescent mental health workforce using ECHO platform. Participants (n = 227) completed surveys;78.3% were from healthcare sector including pediatrics, family community medicine and behavioral health specialties and the rest represented school counselors and community organizations. Interestingly, patients with anxiety disorders were most commonly seeking care from family/community medicine (p = .040) while mood and autism from pediatricians and psychiatrists. Knowledge and confidence of participants improved significantly after sessions (p = <.001). Most expressed satisfaction with the ECHO sessions (93.8%). Main barriers to implementing the evidence-based recommendations included time, clinic support and patient compliance. Results support interprofessional training to increase child and adolescent mental health workforce and reflect benefit of brief tele mentoring to improve training beyond profession specific competencies. Future studies should explore clinical and provider level outcomes with similar professional education approaches.

The Global Burden of Disease Epidemiology—When Big Data Impute the Nonexistent

This Viewpoint discusses concerns about the data quality of the Global Burden of Disease study with respect to incidence estimates of child and adolescent mental health disorders, such as autism and attention-deficit/hyperactivity disorder, in low- and middle-income countries.

Bentuk dan Faktor Gangguan Kesehatan Mental pada Remaja

Adolescence is a period of adjustment to a new life because it is faced with new developmental tasks, so it is not uncommon for someone to experience obstacles in carrying it out. These obstacles include being faced with mental health disorders. Mental health is psychological or mental well-being. However, teenagers experience problems in this regard. In this research, the systematic literature review (SLR) method is used, which is an analysis of articles related to the topic discussed. Six articles were obtained from the Sage and Science Direct databases, with topics discussing forms and factors of mental health disorders in adolescents. The selection of articles is adjusted to the inclusion criteria that have been previously determined. Based on the results of the review, it can be understood that the forms of mental health disorders that are often encountered in adolescents are anxiety, depression and stress. Meanwhile, factors for mental health disorders in adolescents are economic, environmental and knowledge related to mental health itself.

Influence of Social Media and Family Environment on Adolescent Anxiety Disorder

Adolescent anxiety disorder is a prevalent psychological disorder that has a substantial impact on the mental health and total development of adolescents. This study reviews and investigates the definition, characteristics, and the two essential etiological components of anxiety disorders in adolescents, namely social media and home environment. This is achieved by describing and analyzing prior research pertaining to anxiety disorders and adolescent mental health. The paper begins by defining adolescent anxiety disorder, noting that it is primarily characterized by excessive concern and tension, which is frequently accompanied by physical discomfort and emotional distress. Adolescents may exhibit social distress, avoidance behaviors, and academic difficulties that impair their daily functioning and learning. As a significant aspect of adolescents' existence, social media has a significant effect on their anxiety levels. Social anxiety, body image anxiety, and other stressors brought on by social media may aggravate anxiety symptoms. Moreover, online violence and negative remarks may have a negative effect on adolescents' mental health. Another crucial etiologic factor is the family environment. Instability, conflict, and tension in the home may increase the risk of adolescents developing anxiety disorders. Anxiety disorders have also been linked to parental styles and economic circumstances. Although numerous scientific studies have been conducted on adolescents and anxiety disorders, additional research is required to shed light on the progression of mental health disorders in adolescents and bring them to the attention of society.

Common adolescent mental health disorders seen in Family Medicine Clinics in Ghana and Nigeria.

Mental health disorders among adolescents is on the rise globally. Patients seldom present to mental health physicians, for fear of stigmatization, and due to the dearth of mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to identify the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana, who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help to reduce stigmatization and improve the management of the disease thus, reducing the burden.

Burden of mental health disorders and synthesis of community-based mental health intervention measures among adolescents during COVID-19 pandemic in low middle-income countries: A systematic review and meta-analysis.

COVID-19 pandemic and the resultant lockdown could have negatively impacted adolescent mental health. The synthesised burden of mental health illness among adolescents during or after the pandemic is unknown in Low Middle-Income Countries (LMICs). The objective was to ascertain the pooled prevalence of mental health disorders among adolescents aged 10 - 19 years and to systematically review & conduct a descriptive synthesis of community-based mental health intervention measures in addressing adolescent mental health disorders during the COVID-19 pandemic in LMICs. The literature was searched in Embase, PubMed, and Scopus and selected the relevant studies. The data was extracted from the selected studies, and its quality was assessed using adapted Newcastle-Ottawa Quality Assessment Scales. Meta-analysis was performed using random effects model to pool the prevalence of mental health disorders. Statistical heterogeneity was evaluated through Cochran's Q test & I2 statistic. Thirty-five studies were selected out of 7955 identified studies. Most of the studies (n=7, each) were from India and Iran. The majority of research works were community-based (n=18), conducted in 2020 (23 articles), and participant interviews were conducted through online mode (n=21). Varied instruments were used to measure the burden of mental health in different settings. Pooled prevalence (95% confidence intervals) of anxiety, depression and stress was found to be 43.69 (18.58-68.80)%, 47.02 (31.72-62.32)% and 39.97 (30.53-49.40)%, respectively, with high heterogeneity between the studies. No studies reported community-based mental health interventions. There has been a higher prevalence of anxiety, depression, stress, and other mental health illnesses, among adolescents in LMICs during the COVID-19 pandemic. It is important to note that no existing literature directly addresses community-based interventions for these common mental health illnesses. It is imperative to prepare the health system for early identification and management of common mental health illness among the adolescent age group in the event of any future disaster.

Effects of Childhood Trauma on Adolescent Mental Health

Adolescent mental health issues are being increasingly acknowledged, yet the bulk of adolescent psychological issues may be traced back to childhood. This literature review provides a comprehensive analysis of the association between childhood trauma and mental health disorders in adolescents. A systematic search of relevant terms including emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, non-suicidal self-injury, suicide, aggressive behavior, Internet addiction, post-traumatic stress disorder, depression, and cognition was conducted. This review meticulously catalogs and discusses psychological disorders based on their specific classifications, resulting harms, association with childhood trauma, mediating mechanisms, and coping techniques. The findings from numerous pertinent journals and literature highlight a significant correlation between childhood abuse and neglect and various aspects of adolescent behavior, mood, and cognition. By a variety of intermediary systems, this association may be indirectly related. Treatment enables intervention and prevention of adolescent mental health issues. Several articles have demonstrated that childhood trauma has negative consequences on adolescent mental health. Unfortunately, there are research in this sector, and the majority of them is cross-sectional or has restrictions. Therefore, the contribution of this paper is to inspire readers or future researchers to further explore the effects of childhood trauma on adolescent psychology.

Racial and Gender Disparities in Suicide and Mental Health Care Utilization in a Pediatric Primary Care Setting

PurposeWe examined racial and gender disparities in the underrecognition of mental health disorders in adolescents and young adults as defined by a suicide-related diagnosis without a previous mental or behavioral health diagnosis. MethodsWe employed a series of adjusted mixed multilevel logistic regression models to determine the odds of specific mental health diagnoses (anxiety, depression, and suicide-related) in a large, U.S. pediatric ambulatory care group (ages 8–20 years) using Electronic Medical Record Data. ResultsUsing the reference group of White males, White females had 17% increased odds of having a suicide-related diagnosis (odds ratio (OR) 1.17, 95% confidence intervals (CI) 1.03, 1.34) and Black females had 48% increased odds of suicide-related diagnosis (OR 1.48, 95% CI 1.28, 1.71). Conversely, White females had 75% increased odds of recorded anxiety (OR 1.75, 95% CI 1.62, 1.89), Black males had 62% decreased odds of anxiety (OR 0.38, 95% CI 0.33, 0.42), and Black females had 33% decreased odds of anxiety (OR 0.67, 95% CI 0.60, 0.74). White females had 81% increased odds of having recorded depression (OR 1.81, 95% CI 1.62, 2.04) and Black females had 80% increased odds of underrecognized need for mental or behavioral health diagnosis services (OR 1.80, 95% CI 1.53, 2.13) as defined by a suicide-related diagnosis without a previous mental health diagnosis. DiscussionBlack adolescents and young adult patients are either not accessing or identified as needing mental health services at the same rates as their White peers, and Black females are experiencing the most underrecognition of need for mental health services.

Effect of multi-level interventions on mental health outcomes among adolescents in sub-Saharan Africa: a systematic review

ObjectiveIn sub-Saharan Africa (SSA), multiple factors contribute to the considerable burden of mental health disorders among adolescents, highlighting the need for interventions that address underlying risks at multiple levels. We...

Genetic Factors in Mental Health Disorders in adolescents in West Java: Experiencing it with Genomics

Genetic Factors in Mental Health Disorders in adolescents in West Java: Experiencing it with Genomics

4 Adolescents Identifying their Barriers to Access Mental Health and Addiction Services in a Small Rural Canadian Town

Abstract Background Mental health illnesses or disorders and addictions are common in the Canadian population. Despite the huge burden associated with child and adolescent mental health disorders around the world, in Canada and in our local communities there are gaps in the provision of care for this population. Teenagers are particularly vulnerable to the inadequate provision of care, as services have been traditionally conceptualized to serve the needs of children and adults. The gap between need and access to mental health and addiction services has been identified by: parents, teachers, and health care providers, albeit mostly studied in large urban populations. Objectives The purpose of the study was to identify the adolescent-perceived barriers to accessing mental health services in the community. Methods We conducted a cross-sectional study in a small rural town through online questionnaires, asking local high school students to report their perceived personal and community level barriers to accessing services. The sample included 244 high school students answering the questionnaire, which included sections on perception of individual level barriers and perception of community level barriers. We also captured respondent characteristics, including demographics, attempts to access mental health services in the past, and awareness of resources. Results Respondents’ top perceived barriers were the lack of awareness regarding available resources, lack of proper education regarding mental health issues, and uncertainty of what the treatment would entail. Students who had previously accessed services identified the lack of qualified mental health professionals, frequent change of mental health professionals, and lack of collaboration and communication among service providers as their top barriers, whereas students who had not accessed services reported the uncertainty of the treatment, fear of social stigma, and exclusion as primary barriers. Conclusion The study findings strongly support the need for promoting better mental health literacy in the school and in the community as well as improving the services available. A critical look at the mental health curriculum components across the grades is urgently needed. Planning mental health services addressing these perceived barriers might improve teenagers’ access to services, allowing those in need to seek help and receive effective treatment before they are in crisis. Potential competing interests Received funding from MicroResearch and Saint Martha's Foundation

Effects of Client Confidentiality on Adolescents’ Willingness to Attend Therapy

Adolescent mental health disorders are very prevalent and have a direct impact on their daily lives. Previous research has identified the importance of client confidentiality and adolescents’ lack of willingness to attend therapy, but they have not been directly compared. This absence of this correlation led this research to question: To what extent does the lack of client confidentiality lead high school students to abstain from receiving necessary psychotherapy treatment? In conducting this research, a survey was sent to high schoolers and an interview with a practicing therapist was conducted. The information gathered was then analyzed using the correlational and descriptive methods. It was established that there was a positive correlation between the two variables and that an increase in the promise of client confidentiality for high schoolers would lead to an increased willingness to attend therapy. The results of this study could be applied by therapists to make therapy more appealing and welcoming to adolescents, allowing them to have an outlet to share their struggles and receive professional help.

Association of cannabis, cannabidiol and synthetic cannabinoid use with mental health in UK adolescents.

Cannabis has been associated with poorer mental health, but little is known of the effect of synthetic cannabinoids or cannabidiol (often referred to as CBD). To investigate associations of cannabis, synthetic cannabinoids and cannabidiol with mental health in adolescence. We conducted a cross-sectional analysis with 13- to 14-year-old adolescents across England and Wales in 2019-2020. Multilevel logistic regression was used to examine the association of lifetime use of cannabis, synthetic cannabinoids and cannabidiol with self-reported symptoms of probable depression, anxiety, conduct disorder and auditory hallucinations. Of the 6672 adolescents who participated, 5.2% reported using of cannabis, 1.9% reported using cannabidiol and 0.6% reported using synthetic cannabinoids. After correction for multiple testing, adolescents who had used these substances were significantly more likely to report a probable depressive, anxiety or conduct disorder, as well as auditory hallucinations, than those who had not. Adjustment for socioeconomic disadvantage had little effect on associations, but weekly tobacco use resulted in marked attenuation of associations. The association of cannabis use with probable anxiety and depressive disorders was weaker in those who reported using cannabidiol than those who did not. There was little evidence of an interaction between synthetic cannabinoids and cannabidiol. To our knowledge, this study provides the first general population evidence that synthetic cannabinoids and cannabidiol are associated with probable mental health disorders in adolescence. These associations require replication, ideally with prospective cohorts and stronger study designs.

Association between childhood trauma and mental health disorders in adolescents during the second pandemic wave of COVID-19, Chiclayo-Peru.

The COVID-19 pandemic has significantly affected mental health, with children and adolescents being particularly vulnerable. Evidence on the association between childhood trauma and mental health outcomes in schoolchildren during the pandemic is limited. This study aimed to evaluate this relationship in Chiclayo city, northern Peru, during the second wave of COVID-19. A cross-sectional secondary data study was conducted, measuring childhood trauma using the Marshall's Trauma Scale, depressive symptomatology (PHQ-9), and anxiety symptomatology (GAD-7). Additional variables assessed were alcohol use (AUDIT), resilience (abbreviated CD-RISC), and socio-educational data. Prevalence ratios were estimated using generalized linear models. Among 456 participants, 88.2% were female, with a mean age of 14.5 years (SD: 1.33). Depressive symptomatology prevalence was 76.3% (95%CI: 72.14-80.15) and increased by 23% in schoolchildren with childhood trauma (PR: 1.23; 95%CI: 1.10-1.37). Factors positively associated with depressive symptomatology included increasing age, seeking mental health help during the pandemic, and severe family dysfunction. Anxiety symptomatology prevalence was 62.3% (95%CI: 57.65-66.75) and increased by 55% in schoolchildren with childhood trauma (PR: 1.55; 95%CI: 1.31-1.85). Anxiety symptomatology was positively associated with mild, moderate, and severe family dysfunction. Schoolchildren exposed to childhood trauma are at increased risk for depressive and anxiety symptoms. Monitoring the impact of the COVID-19 pandemic on adolescent mental health is vital. These findings can assist schools in establishing effective measures to prevent mental health outcomes.

Examining associations between obesity and mental health disorders from childhood to adolescence: A case-control prospective study

Childhood obesity and mental disorders often co-exist. To date, most of the studies are cross-sectional, involve the assessment of a specific disorder, and rely on self-report questionnaires. This study aimed to provide a comprehensive psychological assessment to examine the concurrent and prospective association between childhood obesity and mental health problems. We compared 34 children with obesity with 37 children with normal weight at baseline, and at a five-year follow-up, to examine the development of mental health disorders from childhood (8–12 years) to adolescence (13–18 years). Both assessments included a clinical interview and self-reported measures of psychosocial and family markers. Findings showed that the obesity group had a higher prevalence of mental disorders, and psychological comorbidity increased in five years. Prospectively, childhood obesity was associated with a psychological diagnosis in adolescence. Moreover, the obesity group displayed higher severity of symptoms at both times. Finally, body esteem contributed to predicting mental health disorders in adolescence regardless of weight status, while eating symptomatology was a specific marker for the obesity group. Therefore, in the management of childhood obesity is suggested to address also psychosocial variables such as weight-related teasing and body esteem, to prevent the onset or development of mental health problems.

The impact of facilitators and rural immersion on medical student engagement during a child and adolescent mental health videoconference workshop.

Child and adolescent mental health (CAMH) disorders are a major public health problem in Australia, especially outside metropolitan areas. The issue is compounded by a shortage of child and adolescent psychiatrists (CAPs). CAMH receives minimal coverage in health professional training, training opportunities are scarce, and support for generalist health professionals, who treat most cases, is lacking. Novel approaches to early medical education and teaching are required to strengthen the available skilled workforce in rural and remote settings. This qualitative study explored the factors influencing medical student engagement in a CAMH videoconferencing workshop as part of the Rural Clinical School of WA. Our results confirm the priority of personal characteristics of medical educators, over clinical and subject matter expertise, on student learning. This research affirms that general practitioners are well-placed to facilitate recognition of learning experiences, especially given that students may not readily recognise exposure to CAMH cases. Our findings support the effectiveness, efficiencies, and benefits of utilising general medical educators in supporting child and adolescent psychiatry expertise in delivering subspecialty training within medical school curricula.

The effects of exposure to high temperatures during pregnancy on adolescent mental health: Evidence from China

This paper provides the first study to explore the relationship between exposure to ambient temperatures during pregnancy and adolescent mental health in China. The results show that experiencing one more hot day relative to local historical contemporaneous average values during pregnancy significantly increases the likelihood of mental health disorders in adolescence. The impact is larger in the first and second trimesters. Individuals born in the northern region and whose mothers work in agriculture are more vulnerable to high temperatures. Prenatal exposure to hot days is more harmful to the mental health of older adolescents. Additionally, the adverse effects are similar for both men and women and individuals with rural and urban hukou. Biological effects, income effects, and human capital accumulation might be three operative channels of the impact. These findings add to the evidence on the lasting health effects of early life exposure to climatic shocks and call for policy interventions during pregnancy.

Ability and Preparedness of Family Physicians to Recognise and Treat Adolescent Mental Health Disorders in Nigeria and Ghana.

Management of mental health disorders has not been fully integrated into primary care despite been advocated by the World Health Organisation (WHO) and the World Organisation of Family Doctors (WONCA). This study therefore seeks to assess the ability and preparedness of Family Physicians to recognise and treat mental health disorders in adolescents. A descriptive cross-sectional study of 233 randomly selected Physicians Practicing in Family Medicine Clinics in Nigeria and Ghana was conducted using a semi structured self-administered questionnaire that was developed by the researchers and validated with a Cronbach's alpha coefficient of .85. Data analysis was done with the Statistical Package for Social Sciences™ (IBM Corp, Armonk, NY, USA) version 22.0. Respondents had a mean age of 43 ± 8 years, were mostly males 130 (55.79%), practised in Nigeria 168 (72.10%) and have been in practice for over 10 years 149 (63.95%). Majority of respondents 153 (65.67%) received at least one Medical Education sessions in mental health in the preceding 12 months of the study. Out of these, 146 (95.42%) said the sessions enhanced their knowledge of mental health, and 121 (79.08%) said the sessions enhanced their abilities and preparedness to attend to patients with mental disorders. Barriers included stigmatisation 156 (66.95%), poor facilities 136 (58.37%), non-conducive environment 135 (57.94%) and non-cooperation from patients 133 (57.08%). This study showed that a lot of family physicians in Ghana and Nigeria are able and prepared to manage adolescent mental health disorders. They however cited stigmatisation, poor facilities and non-conducive environment as barriers to management of adolescent mental health disorders in primary care. Considering the severity of the disorder, there is a need to increase the training of Family Physicians in the management of adolescent mental health.

Nurse Education and Hospital Readmissions for Children With and Without a Mental Health Condition.

In adults, receiving care in a hospital with more baccalaureate-prepared nurses improves outcomes. This relationship is magnified in adults with serious mental illness or cognitive impairment. Whether the same is true in children with and without a mental health condition is unknown. The study purposes were to determine 1) whether the proportion of baccalaureate-prepared nurses affected the odds of readmission in children; and 2) whether this relationship differed for children with a mental health condition. We linked cross-sectional data from the 2016 Healthcare Cost and Utilization Project State Inpatient Databases, the RN4CAST-US nurse survey in Florida, and the American Hospital Association. Inclusion criteria were ages 3 to 21 years. Mental health conditions were defined as psychiatric or developmental/behavioral diagnoses. These were identified using the Child and Adolescent Mental Health Disorders Classification System. We used multivariable, hierarchical logistic regression models to assess the relationship between nurse training and readmissions. In 35 081 patients admitted to 122 hospitals with 4440 nurses, 21.0% of patients had a mental health condition and 4.2% had a 7-day readmission. For individuals without a mental health condition, each 10% increase in the proportion of baccalaureate-prepared nurses was associated with 8.0% lower odds of readmission (odds ratio = 0.92, 95% confidence interval = 0.87-0.97). For those with a mental health condition, each 10% increase in the proportion of baccalaureate-prepared nurses was associated with 16.0% lower odds of readmission (odds ratio = 0.84, 95% confidence interval = 0.78-0.91). A higher proportion of baccalaureate-educated nurses is associated with lower odds of readmission for pediatric patients. This association has a larger magnitude in patients with a mental health condition.

Analysis of Adolescent Depression Risk Factors During the Third Year of COVID-19 Pandemic in Surabaya

Background: The COVID-19 pandemic has caused changes such as isolation and contact restrictions. Adolescents are vulnerable to these changes because social contact is very important for their development. Research is needed on risk factors for adolescent mental health disorders especially depression during a pandemic to help deal with psychological conditions during and after an outbreak. Objective: To analyse the relationship between risk factors and adolescent depression during the third year of COVID-19 pandemic in Surabaya. Methods: This study used an observational analytic cross-sectional study design with an accidental sampling technique. The sample population is students of a junior high school in Surabaya grade 7 and 8. Depression is the dependent variable measured using the DASS-42 score using only the depression item. The independent variables consist of risk factors which are measured using a questionnaire. Statistical data were analysed using the Chi-square test. Result: Total respondents in this study is 121 students. A total of 22.3% students experienced depression. There was a correlation between gender (p=0.009), family history of COVID-19 infection (p=0.041), and parental education (p=0.055) on depression in adolescents. Conclusion: Gender, family history of COVID-19 infection, and parental education have a relationship with depression in adolescents during the COVID-19 pandemic in Surabaya.