European Child & Adolescent Psychiatry最新文献

{"title":"Electrophysiological indices of reward anticipation as ADHD risk and prognostic biomarkers.","authors":"Nóra Bunford, Kristóf Ágrez, György Hámori, Júlia Koller, Attila Pulay, Zsófia Nemoda, János M Réthelyi","doi":"10.1007/s00787-024-02606-4","DOIUrl":"https://doi.org/10.1007/s00787-024-02606-4","url":null,"abstract":"<p><p>The attention-deficit/hyperactivity disorder (ADHD) clinical phenotype has limitations for deciphering ADHD etiology and predicting prognosis. Although relative to the clinical phenotype, intermediate phenotypes may have better explanatory and prognostic power, the extent to which ADHD intermediate phenotypes are associated with ADHD risk and prognosis is unknown. The aim of this study was to evaluate evidence for event-related potential (ERP) measures of reward anticipation as ADHD risk and prognostic biomarkers. We examined, whether (1) in a sample of adolescents (N = 304; M_age = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity and depression, ERPs are associated with ADHD polygenic risk scores (PRSs) (ADHD risk) and (2) in a sample of adolescents at-risk for ADHD (n = 99; M_age = 15.78 years, SD = 1.08; 39.5% female), accounting for the effects of age, sex, ADHD severity, depression, and baseline outcome values, ERPs are associated, prospectively, with alcohol misuse (ADHD prognosis). In adolescents, greater ADHD PRSs were associated with lower electrophysiological anticipatory attention to motivationally relevant feedback (b = -0.115, p = .046 95%CI [-0.228; -0.002]). The predictors accounted for 5% of the variance in the outcome. In adolescents at-risk for ADHD, at 18-month follow-up, lower electrophysiological anticipatory attention to motivationally relevant feedback was associated with greater alcohol consumption (b = -7.454, p = .007, 95%CI [-12.873; -2.034]). The predictors accounted for 31% of the variance in this outcome. These findings were replicated in sensitivity analyses with behavioral performance variables added as covariates. The current findings support the hypothesis that ERP amplitudes of reward anticipation may be ADHD risk and prognostic biomarkers and suggest that intermediate phenotypes may confer advantages over the ADHD clinical phenotype in delineating etiology and predicting prognosis.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroanatomical basis of language ability in an autism subgroup with moderate language deficits.","authors":"Yaqiong Xiao, Ningxuan Zhang, Kaiyu Huang, Shuiqun Zhang, Jin Xin, Qingshan Huang, Aiwen Yi","doi":"10.1007/s00787-024-02605-5","DOIUrl":"https://doi.org/10.1007/s00787-024-02605-5","url":null,"abstract":"<p><p>Children with autism spectrum disorder (ASD) are highly heterogenous in their language abilities. A number of studies have shown neural correlates of language deficits in children with ASD, but the underlying neuroanatomical foundation of early language deficits in ASD remains largely elusive. In this study, we analyzed MRI data from a cohort of Chinese children with ASD (n = 67) and typical development (TD, n = 37) aged 1.5 to 6.5 years. The ASD sample was classified into two subgroups based on the median of the language scores: ASD with moderate language deficits (ASD_moderate, n = 34) and ASD with severe language deficits (ASD_severe, n = 34). We tested the group differences in the brain volumes between TD and two ASD subgroups, and also examined the associations between cortical grey matter volume and language abilities in TD and ASD subgroups, separately. We observed significant group differences in grey matter and white matter volume, with post-hoc analyses specifically indicating significant differences between TD and ASD_moderate subgroup. Significant correlations between grey matter volume and language scores were observed exclusively within the ASD_moderate subgroup, including positive associations in the bilateral superior temporal gyrus, hippocampus, and left inferior parietal lobe, and negative correlations in the bilateral precuneus. These findings provide novel evidence for the neuroanatomical basis related to language ability in an ASD subgroup with moderate language deficits, and offer new insights into the heterogeneity of language deficits in children with ASD.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency psychiatric care for children and adolescents: factors associated with multiple visits and hospital admissions.","authors":"Berta Ezquerra, Inmaculada Peñuelas-Calvo, Ines Marti-Estevez, Maria Taracena-Cuerda, Enrique Baca-García, Alejandro Porras-Segovia","doi":"10.1007/s00787-024-02594-5","DOIUrl":"https://doi.org/10.1007/s00787-024-02594-5","url":null,"abstract":"<p><p>Given the increased demand for mental health resources in the child and adolescent population, this study aims to describe the emergency psychiatric care of the children and adolescents and to explore factors associated with multiple visits and hospital admissions. All patients < 18 years of age who visited the psychiatric ED(ED) of a University Hospital in Madrid, Spain, during 2022 were included. Data were collected by the attending psychiatrist upon first 2022 ED visit (index visit) and during any ED revisit. Electronic health records of all included patients were revised to contrast information and complete missing data. Logistic regressions and correlation analyses were used to explore factors associated with multiple ED visits and hospitalisations. N = 397 patients were included. Factors associated with multiple ED visits were: being LGTBQ+, having eating problems, substance use, consulting for psychosis upon first visit, having a history of suicidal behaviour, previous mental health service use or previous hospitalisations, having two or more psychiatric diagnoses, and being diagnosed of eating disorders or depression. Factors associated with hospitalisation include female gender, older age, LGTBQ+, family conflicts, first or second-generation migrants, history of abuse, eating problems, drug use, history of suicidal behaviour, previous mental health service use or previous hospitalisations, psychiatric comorbidity, and eating disorders diagnosis. Identifying predictors that lead to different clinical pathways and use of mental health services can improve clinical outcomes and resource use.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prospective relationship between anxiety symptoms and eating disorder symptoms among adolescents: a systematic review and meta-analysis of a bi-directional relationship.","authors":"Nora Trompeter, Ștefana Dârvariu, Anna V Brieva-Toloza, Marie-Christine Opitz, Francisco Diego Rabelo-da-Ponte, Helen Sharpe, Sylvane Desrivieres, Ulrike Schmidt, Nadia Micali","doi":"10.1007/s00787-024-02601-9","DOIUrl":"https://doi.org/10.1007/s00787-024-02601-9","url":null,"abstract":"<p><p>Anxiety symptoms and eating disorder symptoms commonly co-occur in adolescents. However, there is divergent evidence on the prospective relationship between the two factors. This systematic review and meta-analysis summarises the existing literature on the prospective and bi-directional relationship between anxiety symptoms and eating disorder symptoms in adolescence. A systematic search across six databases was conducted on the 11th June 2024. Studies were included if they assessed the prospective relationship between anxiety symptoms and eating disorder symptoms, or vice versa, in adolescence. 19,591 studies were screened, of which 54 studies met inclusion criteria and were included in the full review. Four meta-analyses were conducted. Anxiety symptoms were associated with subsequent eating disorder symptoms, increases in eating disorder symptoms, and higher odds of eating disorders, including their onset. Conversely, eating disorder symptoms were associated with subsequent anxiety symptoms, increases in anxiety symptoms, and higher odds of subsequent anxiety disorders. Current evidence suggests that anxiety symptoms and eating disorder symptoms do not merely co-occur during adolescence, but are prospectively and bi-directionally linked. Further research is needed to understand the underlying mechanisms of this relationship, as well as individual differences in symptom trajectories.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive dysfunction in adolescents with recent onset major depressive disorder: a cross-sectional comparative study.","authors":"Olga Bienek, Kelly Allott, Linda Antonucci, Alessandro Bertolino, Carolina Bonivento, Stephan Borgwardt, Paolo Brambilla, Katharine Chisholm, Udo Dannlowski, Theresa K Lichtenstein, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Nikolaos Koutsouleris, Rebekka Lencer, Siân Lowri Griffiths, Eleonora Maggioni, Eva Meisenzahl, Christos Pantelis, Marlene Rosen, Stephan Ruhrmann, Raimo K R Salokangas, Alexandra Stainton, Marian Surmann, Rachel Upthegrove, Julian Wenzel, Stephen J Wood, Georg Romer, Jörg Michael Müller","doi":"10.1007/s00787-024-02599-0","DOIUrl":"https://doi.org/10.1007/s00787-024-02599-0","url":null,"abstract":"<p><p>The aim of this study was to examine the neurocognitive deficits associated with the first episode of major depressive disorder (recent onset depression, ROD) in adolescents as compared to adult patients. Cross-sectional neurocognitive data from the baseline assessments of the PRONIA study with N = 650 (55.31% females) were analyzed. Based on a principal component analysis of eleven neurocognitive tests, we constructed an overall neurocognitive performance (NP) score. We examined mean score differences in NP between the groups of healthy controls (HC) and ROD and between adolescents (15-21 years) and adults (22-40 years) within a GLM approach. This accounts for unbalanced data with focus on interaction effects while controlling for effects of medication and educational years. Our results show lower NP for the ROD as compared to the HC group (d = - 0.29, p = .046) and lower NP for the adolescent group as compared to the adult group (d = - 0.29; p < .039). There was no interaction between these two group effects (F = 1.11; p = .29). Our findings suggest that the detrimental effect of ROD on neurocognitive functioning is comparable in adolescent and adult patients, since lower scores in adolescent patients are explained by effects of age and education. Neurocognitive impairment is an under addressed issue in clinical treatment guidelines for adolescent MDD. We suggest efficient monitoring in clinical practice by using an aggregate of the Digit Symbol Substitution Test and the Trail Making Test B, which highly correlated with the overall score of NP (r = 0.82).</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediation of DNA methylation (cg04622888 and cg05037505) in the association between childhood maltreatment and non-suicidal self-injury in early adolescents.","authors":"Yanqi Li, Shuangshuang Guo, Xinyi Xie, Yi Zhang, Ting Jiao, Yibo Wu, Ying Ma, Runsen Chen, Ruoling Chen, Yizhen Yu, Jie Tang","doi":"10.1007/s00787-024-02600-w","DOIUrl":"10.1007/s00787-024-02600-w","url":null,"abstract":"<p><p>It is unclear whether DNA methylation underlies the association between childhood maltreatment (CM) and non-suicidal self-injury (NSSI) in early adolescents. We aim to explore the mediation of specific DNA methylation sites in the associations of CM and its subtypes with NSSI, following investigation on the association between specific DNA methylation sites and NSSI. A case-control study was conducted to examine 155 adolescents aged 12-14 years who were identified to have engaged in NSSI and 201 controls. CM and its subtypes were evaluated by using the Childhood Trauma Questionnaire. The EPIC 850 k Bead Chip was used to discover differential methylation sites (DMSs) in the peripheral blood between 10 NSSI cases and 10 controls. Targeted pyrosequencing was employed to detect the levels of specific DMSs among the total study population, which were selected based on bioinformatics analyses and literature review. We discovered 456 DMSs between NSSI cases and controls, 219 were hypermethylated and 237 were hypomethylated. After controlling for potential confounders, CM or its subtypes, and the methylation of cg04622888 and cg05037505 were all significantly associated with NSSI (all P < 0.05). The total association of CM and its subtypes with NSSI were all significantly (all P < 0.05), with the standardized coefficient (β) ranged from 0.12 for physical neglect to 0.24 for emotional neglect and CM. Significant indirect association of physical neglect with NSSI through methylation of cg04622888 was observed and the mediating proportion was 0.14 (95%CI 0.06-0.23). Significant indirect associations of emotional abuse, emotional neglect, and physical neglect with NSSI through methylation of cg05037505 were also observed, and the mediating proportions were 0.09 (95%CI 0.04-0.14), 0.08 (95%CI, 0.03-0.14) and 0.19 (95%CI 0.07-0.32), respectively. Data of this study suggested that methylation of cg04622888 and cg05037505 were independently associated with NSSI among early adolescents, and they partially mediated the associations of emotional abuse, emotional neglect, and physical abuse with NSSI.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features.","authors":"Iselin Solerød Dibaj, Anita Johanna Tørmoen, Ole Klungsøyr, Katharina Teresa Enehaug Morken, Egil Haga, Kine Johansen Dymbe, Lars Mehlum","doi":"10.1007/s00787-024-02602-8","DOIUrl":"https://doi.org/10.1007/s00787-024-02602-8","url":null,"abstract":"<p><p>Emotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: \"Treatment for Adolescents with Deliberate Self-harm\"; http://ClinicalTrials.gov/;NCT00675129.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult mental health outcomes of adolescent depression and co-occurring alcohol use disorder: a longitudinal cohort study.","authors":"Hannes Bohman, Sara Brolin Låftman, Iman Alaie, Richard Ssegonja, Ulf Jonsson","doi":"10.1007/s00787-024-02596-3","DOIUrl":"https://doi.org/10.1007/s00787-024-02596-3","url":null,"abstract":"<p><p>Depression and alcohol use disorder (AUD) are frequently co-occurring in adolescence, which often goes undetected in routine care. While this may potentially compromise treatment effectiveness and lead to a less favourable long-term prognosis, few longitudinal studies have followed this group into adulthood. The aim of this study was to explore the risk for adult depression, anxiety disorders, suicidality, and AUD in adolescents with concurrent depression and AUD. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study. Diagnostic interviews were conducted in adolescence (age 16-17) and adulthood (around age 30). Adolescents with concurrent depression and AUD (n = 38) were compared with peers having only depression (n = 189) or neither of the conditions (n = 144). Logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adolescents with concurrent depression and AUD were more likely than their non-affected peers to experience adult depressive episodes (aOR, 5.33; 95% CI, 2.22-12.83), anxiety disorders (4.05; 1.77-9.27), suicidality (5.37; 2.28-12.66), and AUD (7.68; 2.59-22.81). Notably, 34% of adolescents with both depression and AUD subsequently experienced both these conditions as adults, compared to 7% of adolescents with only depression. Adolescents suffering only from depression were less likely than those with both conditions to experience suicidality (0.44; 0.21-0.95) and AUD in adulthood (0.18; 0.07-0.44). These findings underscore the clinical imperative to identify adolescents with this comorbidity. Recognition of the poor long-term prognosis can inform targeted interventions for this vulnerable group, ultimately improving health and well-being throughout the life course.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and protective factors for mental health problems in children and adolescents during the COVID-19 pandemic: results of the longitudinal COPSY study.","authors":"F Zoellner, M Erhart, A-K Napp, F Reiss, J Devine, A Kaman, U Ravens-Sieberer","doi":"10.1007/s00787-024-02604-6","DOIUrl":"https://doi.org/10.1007/s00787-024-02604-6","url":null,"abstract":"<p><p>The COVID-19 pandemic has had profound effects on the mental health of children and adolescents worldwide, exacerbating existing challenges and introducing new stressors. This paper explores the impact of risk and protective factors on the mental well-being of young individuals during the pandemic. Using data from the German nationwide, population-based, longitudinal COPSY study (n = 2,471, girls: 50.0%, age 7-17 years) spanning nearly three years, this study investigates how factors such as gender, age, parental education, parental depressive symptoms, family cohesion, and social support influence mental health. Mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Latent growth analysis and structural equation modeling were employed to analyze cross-sectional and longitudinal data collected at five measurement points (initial response rate: 46.8%). Findings revealed that boys and younger children are at a higher risk for mental health problems. Additionally, low parental education, single parenthood, parental burden due to the pandemic and parental depressive symptoms were significantly linked with mental health problems in children. Conversely, personal resources, family cohesion, and social support were associated with less symptoms. Family cohesion additionally buffered against the negative impact of parental depressive symptoms. The study underscores the importance of multi-level interventions that consider individual, familial, and societal factors in promoting positive mental health outcomes among children and adolescents during challenging times. Continued research and collaborative efforts are needed to develop evidence-based strategies for supporting the resilience of young individuals in the face of future adversities.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018.","authors":"Björn Högberg, Mattias Strandh, Solveig Petersen, Karina Nilsson","doi":"10.1007/s00787-024-02597-2","DOIUrl":"10.1007/s00787-024-02597-2","url":null,"abstract":"<p><strong>Background: </strong>Rising rates of internalizing disorders and rising rates of school failure among adolescents are growing concerns. Despite the strong association between academic achievement and internalizing disorders, possible links between these two trends have not been investigated. Thus, the aim of this study was to investigate the development of the cross-sectional associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018.</p><p><strong>Methods: </strong>Register data on specialist psychiatric care and prescriptions of psycholeptic and psychotropic drugs were linked to data on students' school grades in the last year of compulsory school. The total sample size was 3,089,674 students. Logistic regression models with internalizing disorders as the dependent variable, and graduation year and academic achievement as independent variables, were estimated.</p><p><strong>Results: </strong>Throughout the period, there was a strong negative association between academic achievement and internalizing disorders. Low-achieving students had by far the highest risks of internalizing disorders. In absolute terms, the increase in internalizing disorders was clearly largest for low-achieving students. The relative risks for low-achieving compared to higher achieving students increased between 1990 and 2010 and declined after 2010.</p><p><strong>Conclusions: </strong>This study found consistently large, and at least until 2010 growing, achievement-related inequalities in internalizing disorders among Swedish adolescents between 1990 and 2018, with the lowest achieving students having disproportionally high risks. The increasingly pronounced concentration of internalizing disorders in the lowest rungs of the achievement distribution suggests that preventive interventions should focus on supporting this doubly disadvantaged group of students.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}