Epidemiology and Psychiatric Sciences最新文献

{"title":"Modelling the impact on a local mental health system of previously implemented care programs: the experience of assertive outreach teams in Bizkaia (Spain).","authors":"N Almeda, D Diaz-Milanes, H Killaspy, L Salvador-Carulla, J J Uriarte-Uriarte, C R García Alonso","doi":"10.1017/S2045796025000125","DOIUrl":"10.1017/S2045796025000125","url":null,"abstract":"<p><strong>Aims: </strong>The study assessed the interactions and the impact of specialist mobile community care teams (assertive outreach teams or AOTs) implemented in the mental health (MH) system of Bizkaia (Spain) using a methodology derived from an ecosystem perspective.</p><p><strong>Methods: </strong>First, the experts assessed the system's services and codified them according to an international classification system. Second, following an iterative methodology for expert-knowledge elicitation, a clients' flow diagram showing the inter-dependencies of the system's components was developed. It included variables and their relationships represented in a causal model. Third, the system elements where the AOTs had a major impact (stress nodes) were identified. Fourth, three scenarios (variable combinations representing the 'stress points' of the system) were modelled to assess its relative technical efficiency (technical performance indicator).</p><p><strong>Results: </strong>The classification system identified the lack of fidelity of the AOTs to the original assertive community treatment model, categorizing them as non-acute low-intensity mobile care. The causal model identified the following elements of the system as 'stress nodes' in relation to AOT: users' families; social services (outside of the healthcare system); acute hospitals; non-acute residential facilities and, to a lesser extent, acute hospital day care services. When the stress nodes inside the healthcare system were modelled separately, acute and non-acute hospital care services resulted in a large deterioration in the system performance, while acute day hospital care had only a small impact.</p><p><strong>Conclusions: </strong>The development of the expert-knowledge-based causal model from an ecosystem perspective was helpful in combining information from different levels, from nano to macro, to identify the components in the system likely to be most affected by a potential policy intervention, such as the closure of AOTs. It was also able to illustrate the interaction between the MH system components over time and the impact of the potential changes on the technical performance of the system. Such approaches have potential future application in assisting with service planning and decision-making in other health systems and socio-economic contexts.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e20"},"PeriodicalIF":5.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the effect of community treatment orders on aggression or criminal behaviour in people with a mental illness - CORRIGENDUM.","authors":"S Kisely, C Bull, N Gill","doi":"10.1017/S2045796025000149","DOIUrl":"10.1017/S2045796025000149","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e18"},"PeriodicalIF":5.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A population-based cohort study of perinatal mental illness following traumatic brain injury.","authors":"Hilary K Brown, Kinwah Fung, Andrea Mataruga, Rachel Strauss, Vincy Chan, Natalie Urbach, Tatyana Mollayeva, Angela Colantonio, Eyal Cohen, Cindy-Lee Dennis, Joel G Ray, Natasha R Saunders, Simone N Vigod","doi":"10.1017/S2045796025000150","DOIUrl":"10.1017/S2045796025000150","url":null,"abstract":"<p><strong>Aims: </strong>To examine the risk of perinatal mental illness, including new diagnoses and recurrent use of mental healthcare, comparing women with and without traumatic brain injury (TBI), and to identify injury-related factors associated with these outcomes among women with TBI.</p><p><strong>Methods: </strong>We conducted a population-based cohort study in Ontario, Canada, of all obstetrical deliveries to women in 2012-2021, excluding those with mental healthcare use in the year before conception. The cohort was stratified into women with no remote mental illness history (to identify new mental illness diagnoses between conception and 365 days postpartum) and those with a remote mental illness history (to identify recurrent illnesses). Modified Poisson regression generated adjusted relative risks (aRRs) (1) comparing women with and without TBI and (2) according to injury-related variables (i.e., number, severity, timing, mechanism and intent) among women with TBI.</p><p><strong>Results: </strong>There were <i>n</i> = 12,724 women with a history of TBI (mean age: 27.6 years [SD, 5.5]) and <i>n</i> = 786,317 without a history of TBI (mean age: 30.6 years [SD, 5.0]). Women with TBI were at elevated risk of a new mental illness diagnosis in the perinatal period compared to women without TBI (18.5% vs. 12.7%; aRR: 1.31, 95% confidence interval [CI]: 1.24-1.39), including mood and anxiety disorders. Women with a TBI were also at elevated risk for recurrent use of mental healthcare perinatally (35.5% vs. 27.8%; aRR: 1.18, 95% CI: 1.14-1.22), including mood and anxiety, psychotic, substance use and other mental health disorders. Among women with a history of TBI, the number of TBI-related healthcare encounters was positively associated with an elevated risk of new-onset mental illness.</p><p><strong>Conclusions: </strong>These findings demonstrate the need for providers to be attentive to the risk for perinatal mental illness in women with a TBI. This population may benefit from screening and tailored mental health supports and treatment options.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e19"},"PeriodicalIF":5.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-country comparison of temporal change in adolescent mental health problems in the UK and Brazil.","authors":"J M Armitage, E Viegas da Silva, F Tseliou, L Riglin, G Hammerton, S Collishaw, I S Santos, L Tovo-Rodrigues, A M B Menezes, C F Wehrmeister, H Gonçalves, A Matijasevich, J Murray","doi":"10.1017/S2045796025000137","DOIUrl":"10.1017/S2045796025000137","url":null,"abstract":"<p><strong>Aims: </strong>Epidemiological evidence shows a concerning rise in youth mental health difficulties over the past three decades. Most evidence, however, comes from countries in Europe or North America, with far less known about changes in other global regions. This study aimed to compare adolescent mental health across two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil.</p><p><strong>Methods: </strong>Four population-based cohorts with identical mental health measures were compared. In Brazil, these included the 1993 Pelotas Birth Cohort and the 2004 Pelotas Birth Cohort. In the UK, cohorts included the Avon Longitudinal Study of Parents and Children, and the Millennium Cohort Study. Mental health was measured in all cohorts using identical, parent-rated scores from the Strengths and Difficulties Questionnaire (SDQ). This was assessed in both countries over approximately the same time periods, when adolescents were aged 11 (2004 vs 2015 in Brazil, and 2003 vs 2012 in the UK), with follow-up analyses focused on outcomes in later adolescence.</p><p><strong>Results: </strong>Mental health problems were higher in the UK for adolescents born in the early 2000s compared to those born in the early 1990s. In Pelotas, the opposite was found, whereby problems were lower for adolescents born in the early 2000s compared to those born in the early 1990s. Despite these promising reductions in mental health problems in Pelotas over time, SDQ scores remained higher in Pelotas compared to the UK.</p><p><strong>Conclusions: </strong>Our study represents the first to compare two population-based cohorts in the UK, and two population-based cohorts in Pelotas, Brazil, to understand how mental health problems have changed over time across the two settings. Our findings provide the most up-to-date insight into population-level rates of youth mental health problems in Pelotas, and shed novel insight into how these have changed over the last two decades in comparison to the UK. In doing so, our study provides a tentative first step towards understanding youth mental health over time at a more global scale, and presents a valuable opportunity to examine putative contributors to differences across time.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e17"},"PeriodicalIF":5.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complete mental health of Australia's adolescents and emerging adults: distress and wellbeing across 3 nationally representative community samples.","authors":"Dimity Crisp, Debra Rickwood, Richard Burns, Emily Bariola","doi":"10.1017/S2045796025000083","DOIUrl":"10.1017/S2045796025000083","url":null,"abstract":"<p><strong>Aims: </strong>The high level of psychological distress in young people is a growing concern. However, there are few national surveys that describe the trajectories of mental health and wellbeing through adolescence into early adulthood. Further, existing research has largely focused exclusively on mental ill-health, with little focus on positive mental health. This study provides the first national profile of the mental health and wellbeing of Australians aged 12-25 years.</p><p><strong>Methods: </strong>Participants completed the National Youth Mental Health survey in 2018 (n₁ = 3832), 2020 (n₂ = 974) or 2022 (n₃ = 961). We applied Keyes' Complete Mental Health (CMH) framework to derive categories of mental health and wellbeing, and examine rates of CMH over time, by age and gender.</p><p><strong>Results: </strong>While approximately half of those surveyed reported flourishing (high wellbeing without mental illness), rates of flourishing declined between 2018 and 2022. Rates of flourishing generally decreased with age, and flourishing was more prevalent amongst males than females.</p><p><strong>Conclusions: </strong>The findings provide a unique contrast of youth mental health pre-, during and post- the COVID-19 pandemic. While rates of psychological distress are consistently high, the proportion of youth reporting flourishing highlights the need to consider all aspects of psychological functioning to accurately understand and respond to the mental health needs of young people.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e16"},"PeriodicalIF":5.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reports vs clinician ratings of efficacies of psychotherapies for depression: a meta-analysis of randomized trials.","authors":"Clara Miguel, Mathias Harrer, Eirini Karyotaki, Constantin Yves Plessen, Marketa Ciharova, Toshi A Furukawa, Ioana A Cristea, Pim Cuijpers","doi":"10.1017/S2045796025000095","DOIUrl":"10.1017/S2045796025000095","url":null,"abstract":"<p><strong>Aims: </strong>The comparability between self-reports and clinician-rated scales for measuring depression following treatment has been a long-standing debate, with studies finding mixed results. While the use of self-reports in psychotherapy trials is very common, it has been widely assumed that these tools pose a validity threat when masking of participants is not possible. We conducted a meta-analysis across randomized controlled trials (RCTs) of psychotherapy for depression to examine if treatment effect estimates obtained via self-reports differ from clinician-rated outcomes.</p><p><strong>Methods: </strong>We identified studies from a living database of psychotherapies for depression (updated to 1 January 2023). We included RCTs measuring depression at post-treatment with both a self-report and a clinician-rated scale. As our main model, we ran a multilevel hierarchical meta-analysis, resulting in a pooled differential effect size (Δ<i>g</i>) between self-reports and clinician ratings. Moderators of this difference were explored through multimodel inference analyses.</p><p><strong>Results: </strong>A total of 91 trials (283 effect sizes) were included. In our main model, we found that self-reports produced smaller effect size estimates compared to clinician-rated instruments (Δ<i>g</i><i>=</i> 0.12; 95% CI: 0.03-0.21). This difference was very similar when only including trials with masked clinicians (Δ<i>g</i><i>=</i> 0.10; 95% CI: 0.00-0.20). However, it was more pronounced for unmasked clinical ratings (Δ<i>g</i><i>=</i> 0.20; 95% CI: -0.03 to 0.43) and when trials targeted specific population groups (e.g., perinatal depression) (Δ<i>g</i><i>=</i> 0.20; 95% CI: 0.08-0.32). Effect sizes between self-reports and clinicians were identical in trials targeting general adults (Δ<i>g</i><i>=</i> 0.00; 95% CI: -0.14 to 0.14).</p><p><strong>Conclusions: </strong>Self-report instruments did not overestimate the effects of psychotherapy for depression and were generally more conservative than clinician assessments. Patients' perception of improvement should not be considered less valid by default, despite the inherent challenge of masking in psychotherapy.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e15"},"PeriodicalIF":5.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of suicide among patients with social anxiety disorder.","authors":"Han-Ting Wei, Shih-Jen Tsai, Chih-Ming Cheng, Wen-Han Chang, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Mu-Hong Chen","doi":"10.1017/S204579602500006X","DOIUrl":"10.1017/S204579602500006X","url":null,"abstract":"<p><strong>Aims: </strong>Increasing evidence has established a strong association between social anxiety disorder and suicidal behaviours, including suicidal ideation and suicide attempts. However, the association between social anxiety disorder and suicide mortality remains unclear.</p><p><strong>Methods: </strong>This study analysed data from 15,776 patients with social anxiety disorder, extracted from a nationwide Taiwanese cohort between 2003 and 2017. Two unexposed groups without social anxiety disorder, matched by birth year and sex in 1:4 and 1:10 ratios, respectively, were used for comparison. Suicide deaths during the same period were examined. Psychiatric comorbidities commonly associated with social anxiety disorder, including schizophrenia, bipolar disorder, major depression, alcohol use disorder (AUD), substance use disorder (SUD), obsessive-compulsive disorder, autism, and attention deficit hyperactivity disorder, were identified.</p><p><strong>Results: </strong>Time-dependent Cox regression models, adjusted for demographic factors and psychiatric comorbidities, revealed that individuals with social anxiety disorder had an increased risk of suicide (hazard ratio: 3.49 in the 1:4 matched analysis and 2.84 in the 1:10 matched analysis) compared with those without the disorder. Comorbidities such as schizophrenia, bipolar disorder, major depression, AUD, and SUD further increased the risk of suicide in patients with social anxiety disorder.</p><p><strong>Conclusion: </strong>Social anxiety disorder is an independent risk factor for suicide death. Additional psychiatric comorbidities, including schizophrenia, major affective disorders, and AUD, further increased social anxiety disorder-related suicide risk. Therefore, mental health officers and clinicians should develop targeted suicide prevention strategies for individuals with social anxiety disorder.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e14"},"PeriodicalIF":5.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards person-centered care in global mental health: implications for meta-analyses and clinical trials.","authors":"Davide Papola, Vikram Patel","doi":"10.1017/S2045796025000071","DOIUrl":"10.1017/S2045796025000071","url":null,"abstract":"","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e13"},"PeriodicalIF":5.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the effect of community treatment orders on aggression or criminal behaviour in people with a mental illness.","authors":"S Kisely, C Bull, N Gill","doi":"10.1017/S2045796025000058","DOIUrl":"10.1017/S2045796025000058","url":null,"abstract":"<p><strong>Aims: </strong>There has been concern about violent acts and other criminal behaviour by people with a possible history of mental health problems. We therefore assessed the effects of community treatment orders (CTOs) on self-, third-party-, and agency-reported criminal behaviour when compared to voluntary treatment.</p><p><strong>Methods: </strong>A systematic search of PubMed/Medline, Embase, PsycINFO and criminal justice bibliographic databases for observational or randomised controlled trials (RCTs) comparing CTO cases with controls receiving voluntary psychiatric treatment. Relevant outcomes were reports of violence and aggression or contacts with the criminal justice system such as arrests and court appearances.</p><p><strong>Results: </strong>Thirteen papers from 11 studies met inclusion criteria. Nine papers came from the United States and four from Australia. Two papers were of RCTs. Results for all outcomes were non-significant, the effect size declining as study design improved from non-randomised data on self-reported criminal behaviour, through third party criminal justice records and finally to RCTs. Similarly, there was no significant finding in the subgroup analysis of serious criminal behaviour.</p><p><strong>Conclusions: </strong>On the limited available evidence, CTOs may not address aggression or criminal behaviour in people with mental illness. This is possibly because the risk of violence is increased by comorbid or nonclinical variables, which are beyond the scope of CTOs. These include substance use, a history of victimisation or maltreatment, and the wider environment. The management of risk should therefore focus on the whole person and their community through social and public health interventions, not solely legislative control.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e12"},"PeriodicalIF":5.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internet gaming disorder and depression mediated by impaired resilience and sleep distress: a three-wave longitudinal study among Chinese adolescents.","authors":"P Peng, Z M Chen, S L Ren, Y He, J G Li, A J Liao, L L Zhao, X Shao, S S Chen, R N He, Y D Liang, Y G Tan, X G Chen, Y H Liao, J S Tang","doi":"10.1017/S2045796025000046","DOIUrl":"10.1017/S2045796025000046","url":null,"abstract":"<p><strong>Aims: </strong>While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.</p><p><strong>Methods: </strong>A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.</p><p><strong>Results: </strong>(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79-5.98, <i>p</i> < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16-1.74, <i>p</i> < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01-1.53, <i>p</i> = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.</p><p><strong>Conclusions: </strong>IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e11"},"PeriodicalIF":5.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}