Adolescent Mental Health Disorders Research Articles

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.

Early life exposure to high fructose diet induces metabolic dysregulation associated with sex-specific cognitive impairment in adolescent rats

The incidence of adolescent mental health disorders is on the rise. Epidemiological studies suggest that poor nutrition is a significant contributor to this public health crisis, specifically through exposure to high level of dietary sugar, including fructose, during critical periods of development. Previous studies have shown that elevated fructose exposure during adolescence disrupts mental health. Despite these data, it is currently unknown how fructose exposure, specifically during infancy, may impact adolescent mental health. We developed a rat experimental protocol to investigate the effects of fructose exposure during infancy on behavioral, cognitive and metabolic endpoints in adolescence. We found that exposing rats to high fructose from birth to weaning resulted in higher circulating glucose, insulin and leptin levels in adolescence. High fructose during infancy also increased bodyweight, disrupted metabolic homeostasis in the basolateral amygdala (BLA) as indicated by decreased activity of the cellular energy sensor AMPK, and impaired attention and impulsivity in a male-specific manner. This impaired attention observed in adolescent male rats following neonatal fructose exposure was partially rescued by viral-mediated, in vivo expression of a constitutively active form of AMPK in principal neurons of the BLA. Our results suggest that exposure to high level of fructose during infancy may impact adolescent mental health in a male-specific manner and that manipulation of AMPK activity may mitigate this impact.

Attitudes and perceptions of teachers toward mental health literacy: A case of Odzi High School, Mutare District, Zimbabwe.

In dealing with adolescent mental health, teachers and school institutions have a critical role in minimizing the challenges of mental health. However, the success of such a measure is dependent on teachers' attitudes and perceptions of mental health literacy. Adolescent mental health disorders have become a major global concern with heightened increases and prevalence in secondary schools. In Zimbabwe, a dearth of knowledge exists in understanding the perceptions and attitudes of teachers in maximizing student mental health and positive educational outcomes. The aim of the research was to understand the attitudes and perceptions of teachers toward mental health literacy. Using a qualitative approach to understanding attitudes and perceptions, a case study was carried out at Odzi High School. A total of 12 teachers were purposively sampled for data generation on knowledge, attitudes, perceptions, and strategies that can be used to inform adolescent mental health. Data were collected using semi-structured interview(s). Emergent themes of the study were knowledge, stigma, training, and development. Using thematic analysis, the data showed that there was generalized knowledge of mental health and there were disparities in effective and efficient responses to gender sensitivity issues. Additionally, this knowledge was not put into practice because of attitudes and perceptions toward mental health. Recommendations from the study include developing of mental health training for teachers, equipping teachers with skills in psychosocial support in schools' mental health, and enabling teachers to be able to link adolescents to appropriate care within the school and community-based settings. Teachers have the responsibility of promoting the wellbeing of the students, thus minimizing the adverse effects. Outcomes for positive mental health may be the result of teachers' informed perceptions and positive attitudes on mental health literacy.

3.5 Circadian Rhythms Sleep Disorders

Circadian rhythm sleep wake disorders (CRSWD), defined as inappropriately timed sleep due to misalignment between the internal rhythm and the required timing of the patient’s school or social activities, are common in adolescents with mental health disorders. Interventions that target circadian disruptions improve the mental health of patients with mental health disorders and increase the effectiveness of psychiatric interventions. The objectives of the presentation are to: 1) define CRSWD and characterize their comorbidity with mental health disorders in adolescents; 2) briefly explain the key processes related to circadian rhythms in sleep and wakefulness; and 3) review methods for diagnosing and treating CRSWD.

EARLY DETECTION OF ADOLESCENT MENTAL HEALTH DURING THE COVID-19 PANDEMIC AT SMA NEGERI 1 PEMATANG RAYA SIMALUNGUN REGENCY

The Covid-19 pandemic has caused the Indonesian government to issue a PSBB (Large-Scale Social Restriction) policy. The implementation of this policy has the risk of causing mental health disorders in adolescents, especially middle teens who like to be in groups with their peers. Therefore, early detection of adolescent mental health during the Covid-19 pandemic needs to be done to prevent and deal with disorders that can occur in adolescent growth and development. This study aims to identify the mental health of adolescents during the Covid-19 pandemic at SMA Negeri 1 Pematang Raya, Simalungun Regency. The population of this study were all students of SMA Negeri 1 Pematang Raya, totaling 1024 with a total sample of 288 people. The sample was determined by simple random sampling technique. The research instrument used was a modified Strength and Dificulties Questionnaire (SDQ). The results of this study indicate that in the weakness domain which consists of 4 subdomains namely emotional problems, behavior problems, hyperactivity, and relationship problems with peers, as many as 124 adolescents (43.1%) are at risk for experiencing relationship problems with peers during the pandemic.

175 National Trends in Chemical Restraint for Pediatric Behavioral Health Patients in the Emergency Department

175 National Trends in Chemical Restraint for Pediatric Behavioral Health Patients in the Emergency Department

Hubungan Antara Pola Asuh Orangtua, Teman Sebaya, Lingkungan Tempat Tinggal dan Sosial Ekonomi Dengan Kesehatan Mental Remaja

Introduction: Adolescence is a dynamic phase of development and undergoes many changes, these changes include physical, mental, social, and emotional changes. It is estimated that 10-20% of adolescents globally have mental health conditions, but these are still underdiagnosed and treated. In Indonesia, it is known that the estimated number of people with mental disorders worldwide is around 450 million, including schizophrenia (WHO, 2017). With Disability Adjusted Life Years (DALYs) is 4.5% and the cause of disability (YLDs) is greater than other diseases, namely 13.4%. Riskesdas (2018) results show that depressive disorders have started to occur since the adolescent age range (15-24 years), with a prevalence of 6.2%. The available data shows that there are not a few people with mental health disorders in adolescents. Factors that influence mental health problems in adolescents are the family environment, peers, school environment, community environment and social media. The family environment referred to here is parenting style, uncomfortable place to live, and lower socioeconomic status of parents. Objective: This study aims to determine the relationship between parenting patterns and adolescent mental health, the relationship between peers and adolescent mental health, the relationship between living environment and adolescent mental health, and the relationship between socioeconomic status and adolescent mental health. Methods: This type of research uses a quantitative approach with a descriptive type. The design of this study used a cross-sectional study method. The sampling technique used is the Non Probability Sampling technique, namely Purposive Sampling. The sample used was 121 students of SMKN 62 South Jakarta. The instruments used are the Self Reporting Questionnaire (SRQ) the and Parental Authority Questionnaire (PAQ). Used as 121 students at SMKN 62 South Jakarta. Results: The p-value between parenting and adolescent mental health is 0,029 < 0,05. The results of the p-value of peers with adolescent mental health are 0,006 < 0,05. The result of the p-value between the neighborhood and the mental health of adolescents is 0,042 < 0,05. And the results of the p-value between the socio-economic and mental health of adolescents are 0,044 <0,05. Conclusion: Of all the variables (parental parenting, peers, living environment, and socio-economic) that exist, the results show that all variables have a relationship with adolescent mental health.

Association between maternal depression and emotion and behavior regulation in Peruvian children: A population-based study

Depression is more frequent in women, affecting the early stages of child development. This study aimed to determine the association between maternal depression and self-regulation of emotions and behaviors in Peruvian children under five years. A cross-sectional analytical study of data collected by the 2019 Demographic and Family Health Survey (ENDES) was conducted. The outcome variable was emotion and behavior regulation in children aged 24 to 59 months, and exposure was the presence of depression in women aged 15 to 49 years during the 14 days prior to the survey using the Patient Health Questionnaire (PHQ-9). A generalized linear model of the binomial family was used for reporting crude prevalence ratios and adjusted. The overall prevalence of children who did not self-regulate their emotions and behaviors was 68.8%, while 3.8% of the mothers had moderate depressive symptoms and 2.2% severe symptoms. Regarding the association of interest, moderate and severe depressive symptoms of mothers decreased the probability of children regulating emotions and behaviors in the first model, whereas in the second model, an association was only found with severe depressive symptoms. In conclusion, children of mothers with moderate and severe depressive symptoms had a lower probability of self-regulating their emotions and behaviors. Therefore, it is necessary to develop maternal education, nutritional and social support programs and mental health strategies from the first level of care aimed at reducing social, economic and child factors to reduce the risk of depression in mothers and low early childhood development, which could reduce the risk of developing mental health disorders in adolescence and adulthood.

In utero exposure to dietary emulsifier alters the behavioral activity in offspring

ObjectivePediatric mental health disorder is a combination of neuroinflammatory conditions with unknown etiology and currently, there are less awareness on the impacts of food additives on pediatric neuroinflammatory conditions and adolescent mental health disorders. Food additives such as dietary emulsifier (DE) (polysorbate 80, carrageenan and maltodextrin) are added to a variety of processed foods, and their consumption has increased dramatically worldwide which could be a risk factor for pediatric mental health disorders. Therefore, there is a critical need to understand the impact of maternal exposure to food additives associated pediatric mental health and the underlying mechanism.Materials and MethodsBehavioral testing such as tail flick assay, radial arm, rotarod and hot plate assay was done on the offspring from both control and DE exposed mice for the impaired motor activity, pain sensitivity and cognitive behavior. Colonic microbial composition was determined through 16sRNA pyrosequencing of fecal DNA samples from control and in utero DE‐exposed offspring. Level of pro inflammatory cytokines in the colon tissue as well as the serum sample was measured using Multianalyte cytokine assay kit from Qiagen.Summary of ResultsOur results show that in utero exposure to DE leads to decreased brain sizes and impaired motor learning in the offspring. Additionally, in utero exposure to DE leads to decreased pain sensitivity as a sign of stress in offspring. In utero exposure to DE shows on onset of cognitive impairment in offspring. In utero exposure to DE leads to an elevated M1 macrophage cytokine profile and CLGI symptoms in the gastrointestinal tract of offspring. In utero exposure to DE leads to gut dysbiosis in offspring. Among the DE‐exposed adolescents, the male offspring had significantly higher impact on these parameters compared to the DE‐exposed female offspring. In utero exposure to DE leads to imbalance in serum levels of dihydrotestosterone (DHT) and estradiol (E2) in the Offspring.ConclusionOur data suggest that maternal exposure to food additive is associated with the male biased cognitive impairment and neurobehavioral changes in the offspring. In future, we will determine the specific mechanism responsible for the sex specific alternation in offspring born to DE exposed mother to develop a preventative and therapeutic strategies.

Epidemic Rates of Child and Adolescent Mental Health Disorders Require an Urgent Response

A new Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC) documents the high prevalence of mental health disorders among America's children even before the pandemic.1 Pandemic era reports recently led the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children's Hospital Association (CHA) to issue a joint declaration of a national emergency in child and adolescent mental health.2 This new MMWR represents remarkable work compiling diverse information from nine nationally-representative data sets. Findings indicate high rates of mental health disorders among US children and youth, including evidence that even very young children experience mental health conditions. Twenty percent of all children have an identified mental health condition annually while forty percent of all children will meet criteria by age 18. MMWR findings show that children living in poverty and minoritized children fare worse than their peers in access to care, identifiable risk factors, and prevalence of certain mental health conditions. Despite high rates of mental health conditions, the MMWR documents low rates of treatment (about 11.4% annually for White, 9.8% for Black, and 8.7% for LatinX children).

Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature.

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in puberty, affects 1–4% of adolescents, and disproportionately affects young women. Our aim was to comprehensively examine the association between AIS and risk for depression, anxiety, eating disorders, psychotic disorders, and personality dysfunctional mechanisms. Methods: Literature review of related articles published in PubMed, Google Scholar, and Scopus up to 15 July 2021. Results: A total of 30 studies were deemed eligible, examining the effects of AIS upon mental health, and using appropriate psychometric inventories. Studies highlighted the association of brace treatment with elevated anxiety. In addition, mental health conditions and traits (e.g., anxiety and depressive symptoms, neuroticism) were detected more frequently amongst AIS patients compared to healthy controls. Conclusions: AIS represents a risk factor for mental health disorders. More longitudinal studies, utilizing accurate psychometric instruments, are warranted, to reveal the current impact of AIS on the mental health of youngsters, along with the tailoring of well-targeted interventions to reduce the burden of mental health issues in adulthood.

High Prevalence of Mental Health Disorders in Adolescents and Youth Living with HIV: An Observational Study from Eight Health Services in Sofala Province, Mozambique.

Adolescent mental health (MH) is a significant global health concern, which is extremely relevant when referring to adolescents and youth living with HIV (AYHIV). In Mozambique, ∼52% of the population is <18 years and the country has the world's eighth highest HIV prevalence (insert citation). We performed an observational study to evaluate anxiety, depression, post-traumatic stress disorder (PTSD) and alcohol-drug abuse in adolescents and youth assessing health services in Sofala Province, Mozambique. From November 20, 2019, to November 20, 2021, all adolescents and youth (10-24 years) accessing one of the psychological services offered at 8 Servicios Amigos dos Adolescentes (SAAJ) of the Sofala Province were screened by a psychologist using the following standardized tools: Generalized Anxiety Disorder-7 (GAD-7) for anxiety, Patient Health Questionnaire-9 (PHQ-9) for depression, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) for PTSD, and Cut down, Annoyed, Guilty, and Eye-opener Adapted to Include Drugs (CAGE-AID) for alcohol-drug abuse. Overall, 2108 adolescents and youth were included in the study (63% female, median age: 19 years). Of them, 1096 (52%) were HIV positive. AYHIV had higher scores at the four tools tested and for concomitant MH disorders (GAD-7, PHQ-9, PTSD-5, and CAGE). The multivariable logistic regressions showed a greater probability to be GAD-7 > 10 for women, [adjusting odds ratio (AOR): 1.46, 95% confidence interval (CI): 1.01-2.10], for workers (AOR: 2.18, 95% CI: 1.12-4.23) and people living with HIV (AOR: 1.78, 95% CI: 1.25-2.54). Higher values of CAGE (≥2) and PTSD (≥3) seemed to be associated only with HIV-positive status (AOR: 4.87, 95% CI: 3.72-6.38 and AOR: 1.73, 95% CI: 1.28-237). These data further reinforce the urgent need for a global health policy action with focused intervention on MH in AYHIV patients.

Hubungan Gaya Hidup dengan Kesehatan Mental Remaja di Indonesia (Analisis Data Global School-Based Student Health Survey Indonesia 2015)

Background: Mental health disorders are one of the main risk factors for causing pain and death in adolescents. Symptoms of mental health disorders can be anxiety, depression, sleep disorders, suicidal or self-harm ideas and attempted suicide. Poor mental health is a severe health problem, especially in adolescents. Mental health is affected by multiple factors, including daily behavior and individual lifestyle.Methods: This study aimed to find out the relationship between lifestyle and mental health of adolescent in Indonesia. This study used secondary data of Indonesia's Global School-Based Student Health Survey in 2015. The population of this study was 9.628 students aged 11-18 years in Indonesia. This research sample was obtained by total sampling method. This study used multivariate analysis of cox regression and large associations expressed with Prevalence Ratio (PR) with 95% Confidence Interval.Result: The prevalence of adolescents in Indonesia with mental health disorders is 9,4%. Multivariate analysis test results showed there was a significant relationship between lifestyle and adolescent mental health in Indonesia (PR= 1,47, 95% CI: 1,31 – 1,65) after being controlled by gender, socioeconomic status, and bullying.Conclusion: The school and parents are advised to work together to prevent mental health disorders in adolescents.

Be The One

Be The One

Pengaruh Pembatasan Sosial sebagai Upaya Menekan Penularan Covid-19 terhadap Kondisi Kesehatan Mental Remaja: Literature Review

Background: At the end of April 2021, the occurrence of Covid-19 in Indonesia has reached 1.63 million cases and 44,172 deaths. The social restriction policy is an effort for the government to suppress the rate of transmission of Covid-19, although on the other hand, this policy also raises fear, anxiety, and worry for the community, including teenagers. The emotional development and behaviour of adolescents towards adulthood require social space, but are constrained by social restrictions. Objective: to determine the effect of social restrictions on adolescent mental health. Methods: This study uses a literature review method from 2019 to 2021 obtained from the Google Scholar, PubMed, and Science Direct databases using the keywords social restrictions, youth, mental health disorders, Youth and Children, Covid-19, Impact, and mental health. . The criteria for the selected articles were articles published in 2019-2021 nationally and internationally related to literature review research. Results: the impact of social restrictions on the mental health of adolescents is quite varied. The existence of limitations in socializing, boredom and the many tasks assigned to adolescents are the main factors for adolescents experiencing mental disorders such as stress, depression, and anxiety. Conclusion: social restrictions indirectly have an impact on the mental health of adolescents and even trigger mental health disorders in adolescents.

A homeschool-based cognitive behavioral program to improve adolescent mental health.

Anxiety and depression are prevalent in the adolescent population and can have significant consequences. Treatment recommendations are established but rates of utilization remain low, often due to a lack of access to mental health providers. Availability of mental health services in a school-based setting may increase access, but homeschooled children do not have access to these services. Additionally, the COVID-19 pandemic has increased the number of homeschooled children and compounded the problem of adolescent mental health disorders. This pilot evidence-based practice project aimed to increase access to cognitive behavioral therapy (CBT) in adolescents. Eight students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE) program. A Friedman test was used to evaluate median differences on anxiety and depression screening instruments at baseline, program completion, and 1 month after the program. Students also completed an adapted COPE program evaluation. Median scores on screening instruments decreased from pre-COPE to 1 month after, although results were not statistically significant. Students reported that the COPE program was helpful, and they learned new ways to deal with their thoughts, feelings, and behaviors. COPE is a feasible option to increase access to CBT in a homeschool setting.

Childhood poverty and mental health disorders in early adulthood: evidence from a Brazilian cohort study.

We examined the association between childhood poverty and mental health disorders (MHD) in childhood and early adulthood. We also investigated whether the association between poverty in childhood and MHD is mediated by exposure to stressful life events (SLE). We used data from a prospective community cohort of young people assessed at baseline (M = 9.7years, SD = 1.9), first (M = 13.5years, SD = 1.9), and second (M = 18.2years, SD = 2.0) follow-ups (N = 1,590) in Brazil. Poverty was assessed using a standardized classification. Exposure to 20 different SLE was measured using the Life History instrument. Psychiatric diagnoses were evaluated using the Development and Well-Being Assessment. Latent growth models investigated the association between poverty at baseline and the growth of any MHD, externalizing, and internalizing disorders. Mediation models evaluated whether the association between childhood poverty and MHD in early adulthood was mediated by exposure to SLE. Poverty affected 11.4% of the sample at baseline and was associated with an increased propensity for presenting externalizing disorders in adolescence or early adulthood (standardized estimate = 0.27, p = 0.016). This association was not significant for any disorder or internalizing disorders. Childhood poverty increased the likelihood of externalizing disorders in early adulthood through higher exposure to SLE (OR = 1.07, 95 CI% 1.01-1.14). Results were only replicated among females in stratified analyses. Childhood poverty had detrimental consequences on externalizing MHD in adolescence, especially among females. Poverty and SLE are preventable risk factors that need to be tackled to reduce the burden of externalizing disorders in young people.

Adolescent Mental Health Disorders and Upper Secondary School Completion – The Role of Family Resources

ABSTRACT This article investigates the role of socioeconomic family resources in modifying the relationships with upper secondary school completion (SSC) for three mental health dimensions, i.e., externalizing, internalizing and substance use disorders. Using data from administrative registers, we follow a cohort in Norway born in 1996 into early adulthood. We find that having a mental health disorder in adolescence was associated with 12–17 percentage points lower SSC rate after adjustment for demographic and household factors, comorbidity and educational performance. In girls, high family income attenuated the negative relationships between all three mental health dimensions and SSC, while in boys, this was true only for substance use disorders. The paper concludes that access to family socioeconomic resources “buffers” the negative impact of mental health disorders on SSC, but less so in boys, contributing to aggravate social and health-related inequalities in SSC.

28.12 Homicidal Ideation and Psychiatric Comorbidity in Inpatient Adolescents Aged 12 to 17 Years

Adolescents with homicidal tendencies are a serious growing concern in the United States. Research studies in the past have showcased the relationship between homicidal ideation (HI) and mental illnesses, but very limited information is available on the adolescent and inpatient population. We aim to evaluate the difference in the prevalence of demographic characteristics and mental health disorders in adolescents with and without HI. The adolescent population (ages 12-17 years) that admitted to the hospital with the diagnosis of HI was identified from the 2016 to 2018 National (Nationwide) Inpatient Sample dataset. Patients without HI were used as a control group. The prevalence of mental illness comorbidities between the group was compared using the Rao-Scott adjusted χ2 test. A total of 18,935 patients (mean age: 14.5 years) with HI diagnosis were identified in the study. The majority of the patients in the HI group were male compared to the control group (58.7% vs 41.2%; p < 0.001). Racially, it was more prevalent in the White race (56.0% vs 52.6%; p < 0.001) as well as the Black race (22.3% vs 17.8%; p < 0.001). It was less prevalent among the Hispanic race (14.9% vs 21.3%; p < 0.001). MDD prevalence was 48.2% in patients with HI and 22.3% in the control group. Bipolar disorders (17.7% vs 3.8%; p < 0.001), and anxiety disorders (49.5% vs 20.0%; p < 0.001) were highly prevalent among patients with HI. Suicidal ideation/attempt was prevalent in 66.9% of patients with HI. The study found a higher prevalence of mental illnesses such as depression, anxiety, and bipolar disorder in adolescents with HI. The White race was more prevalent in the homicidal group of the study. Further large-scale longitudinal research studies are warranted to establish the causal relationship between mental health disorders and HI among adolescents.