European Child & Adolescent Psychiatry最新文献

{"title":"Experience of compassionate care in mental health and community-based services for children and young people: facilitators of, and barriers to compassionate care- a systematic review.","authors":"Frane Vusio, Kathryn Odentz, Charlene Plunkett","doi":"10.1007/s00787-025-02711-y","DOIUrl":"10.1007/s00787-025-02711-y","url":null,"abstract":"<p><p>Compassion and compassionate care for children and young people (CYP) encompass a variety of emotions, including sympathy, empathy, and sadness for their suffering, alongside actions intended to alleviate their distress. While compassion is a well-recognised concept in health and social care, literature has identified various barriers and facilitators that affect the delivery of compassionate care. These include compassion fatigue, time limitations, organisational and clinical culture, insufficient resources or support, technological advancements, and burdensome administrative tasks. Despite being viewed as essential in health care, the concept of compassionate care remains poorly defined and expressed, particularly in the context of mental health services for CYP. This review explored the perspectives of CYPs, their parents, and staff regarding the compassionate care provided in community services. Additionally, it aimed to identify factors that facilitate or obstruct compassionate care for CYPs in both mental health and community settings services. From June to August 2024, a search was carried out for peer-reviewed articles and grey literature, with additional searches conducted in October 2024. The initial search produced 7,461 articles, with 23 selected for this review. A thematic synthesis organised the studies based on the main themes identified: 'Compassionate care is all about humanity' and 'the complex interplay of facilitators and barriers to compassionate care'. The identified articles highlighted the increasing need for compassionate care in community-based services for CYP, along with the range of facilitators and barriers to providing this care. Lastly, we propose an alternative definition of compassionate care tailored to these services.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2899-2916"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779380","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":"Association of low vitamin B₁₂ levels with depressive and schizophrenia spectrum disorders in child and adolescent psychiatric inpatients.","authors":"Gerard Anmella, Eva Varela, Nuria Prades, Anna Giménez-Palomo, Laura Espinosa, Clara de Castro, Ramon Deulofeu, Mireia Solerdelcoll, Ástrid Morer, Inmaculada Baeza","doi":"10.1007/s00787-025-02662-4","DOIUrl":"10.1007/s00787-025-02662-4","url":null,"abstract":"<p><p>Folate and vitamin B₁₂ are associated with neurodevelopment and neurotransmitter synthesis and insufficiencies of these nutrients could be linked to psychiatric disorders in children and adolescents. To assess serum levels of folate and B₁₂ in child and adolescent psychiatric inpatients and examine possible links between these levels and different psychiatric disorders. Child and adolescent psychiatric inpatients admitted in a general hospital during a 3-year period were included for analysis. Folate and B₁₂ levels were measured when the subjects were admitted. Psychiatric diagnoses were made following DSM-5 criteria and grouped into categories. Logistic regression analysis was used to study the effects of socio-demographic variables as well as folate and B₁₂ levels, insufficiencies and deficits as possible predictors of outcome (psychiatric diagnostic category). 729 inpatients (60.6% female, mean age: 15.1 ± 2 years) were included. A total of 42.9% presented insufficient folate levels and 19.4% insufficient B₁₂ levels. Insufficient B₁₂ levels were associated with depressive disorders in the multivariate model (OR = 0.82, p = 0.002) as was female sex (OR = 1.65, p = 0.007). Moreover, low vitamin B₁₂ levels were linked to schizophrenia spectrum disorders (SSD, OR = 0.9982, p = 0.024). In contrast, higher folate (OR = 1.15, p < 0.001) and vitamin B₁₂ levels (1.0024, p = 0.002) as well as female sex (OR = 7.86, p < 0.001) were associated with eating disorders. Insufficient or low B₁₂ levels could help predict depressive and SSD respectively in child and adolescent psychiatric inpatients. Further study could help us better understand the impact of this insufficiency during the neurodevelopmental period and the potential benefits of nutritional interventions.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2753-2762"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656567","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":"Prefrontal-hippocampal pathways underlying adolescent resilience.","authors":"Luqing Wei, Zhengdong Wu, Qi Xia, Chris Baeken, Guo-Rong Wu","doi":"10.1007/s00787-025-02704-x","DOIUrl":"10.1007/s00787-025-02704-x","url":null,"abstract":"<p><p>The prefrontal-hippocampal pathways are integral to memory suppression, facilitating positive and adaptative responses following traumatic events. However, the role of these circuits in promoting resilience among adolescents remains largely unknown. This study used structural similarity analysis of MRI-based gray matter volume (GMV) to map connectivity networks centered on the hippocampus, investigating whether structural similarity between prefrontal regions and hippocampus were related to resilience in a cohort of 145 adolescents. Additionally, spatial correlation analyses of resilience-related structural similarity network and neurotransmitter distribution maps were conducted to identify molecular adaptations within prefrontal-hippocampal circuits associated with resilience. The results showed that higher resilience levels were correlated with stronger structural similarity between the prefrontal areas (i.e., middle frontal gyrus and orbitofrontal cortex) and hippocampus. Furthermore, the serotonergic neurotransmitter system, which modulates neural oscillations in prefrontal-hippocampal pathways, appears to be associated with resilience. The current findings suggest that structural and molecular adaptations within prefrontal-hippocampal circuits, which are implicated in the suppression of intrusive, unwanted memories, may foster resilience in young people. These insights advance our knowledge of the neurobiological markers of resilience, paving the way for more targeted and effective therapeutic interventions to bolster resilience and mitigate adverse outcomes in developmental populations.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2815-2823"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735642","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":"From child sexual abuse to psychiatric diagnoses and complex trauma in adolescence.","authors":"Marine Rousset, Aziz Essadek, Maurice Corcos, Marion Robin","doi":"10.1007/s00787-025-02682-0","DOIUrl":"10.1007/s00787-025-02682-0","url":null,"abstract":"<p><p>CSA (Childhood Sexual Abuse) represents a major health issue, however its detection in daily psychiatric practice is remains challenging. In adolescents, CSA often takes a back seat to diagnostic and behavioral issues such as suicide attempts and BPD (Borderline Personality Disorder), with which it is frequently associated. Additionally, confusion persists between the perspective of complex trauma and conventional psychiatric diagnoses. This study aimed to compare clinical features of hospitalized adolescents with a history of CSA, to a control group, in order to identify clinical predictors of CSA and of suicidal attempts. The secondary objective was to describe the overlap between PTSD (Post Traumatic Stress Disorder) and BPD, according to cumulative adversity. This study included 425 adolescents aged 13 to 19 years, who were hospitalized in a psychiatric unit. Among these adolescents, 107 had a history of CSA. The findings indicate that CSA plays a significant role in the psychopathology of adolescents. CSA was found to be associated with PTSD, BPD (OR = 1.9, p < 0.01), self-harm (OR = 1.8, p < 0.05), addictive disorders (OR = 1.87, p < 0.05), and parental neglect (p < 0,001). Suicide attempts were also significantly correlated with sexual abuse (OR = 1.78, p < 0.05). Moreover, the combination of factors such as female gender, the presence of BPD, and substance dependence was found to increase the likelihood of a history of sexual abuse in these adolescents by 14.8 times. These findings contribute to the early detection of sexual violence and its consequences, providing valuable insights for healthcare professionals. Additionally, they support the reinforcement of preventive initiatives.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2805-2814"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735887","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":"Mental health changes during and after the COVID-19 pandemic in children and adolescents with mental disorders.","authors":"Josjan Zijlmans, Lotte van Rijn, Hekmat Alrouh, Emma Broek, Michiel Luijten, Jacintha Tieskens, Malindi van der Mheen, Hedy van Oers, Wiepke Cahn, Arnt Schellekens, Tinca J C Polderman, Janneke R Zinkstok","doi":"10.1007/s00787-025-02700-1","DOIUrl":"10.1007/s00787-025-02700-1","url":null,"abstract":"<p><p>The COVID-19 pandemic negatively affected child and adolescent mental health, but it is unclear which subgroups were affected most. We investigated to what extent severity and type of mental health problems during and after the pandemic were related to preexisting mental disorders in children in care at child and adolescent mental health services. We employed a repeated cross-sectional design involving data collection at seven time points (April 2020 to April 2023) in a total sample of 2,545 children (age 8-18 years). We grouped diagnostic classifications in four categories: Autism, ADHD, Anxious/Depressive disorders, and 'Other'. Mental health was assessed with parent-reported data on internalizing and externalizing problems and with self-reported data from the standardized PROMIS questionnaires 'Anxiety', 'Depressive symptoms', 'Sleep-related impairments', 'Anger', 'Global health', and 'Peer relations'. We tested for main effects between diagnostic categories and for different trajectories over time. We found that mental health outcomes varied substantially between diagnostic categories, with internalizing problems being largest in children with Anxious/Depressive disorders, and externalizing problems being largest in children with Autism and ADHD. However, we found no evidence for differences between diagnostic categories in trajectories in mental health outcomes during and after the COVID-19 pandemic. The results show that during the pandemic mental health outcomes worsened over time in children and adolescents in care, and that this negative effect on mental health did not differ between children with different diagnostic classifications. Regular high-quality monitoring is vital to recognize changing trajectories of youth mental health and to adapt to crisis situations.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2833-2842"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788169","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":"Universal school-based intervention: personal competence among public school children.","authors":"Elie G Karam, Josleen Al Barathie, Ingrid Kabalan, Youmna Cassir Haddad, Caroline Cordahi Tabet, Nadine Melhem","doi":"10.1007/s00787-025-02710-z","DOIUrl":"10.1007/s00787-025-02710-z","url":null,"abstract":"<p><p>Childhood adversities profoundly affect mental and physical well-being. Effective psychosocial interventions in schools are crucial for mitigating adversities' impacts. Despite availability, many children lack access to those interventions in low-income countries. This study evaluates a universal school-based intervention in Lebanon for children, including refugees, aimed at improving personal competence and reducing mental health symptoms including anxiety, depression, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder. The study involved 1,920 Lebanese and Syrian children in grades 4 to 7, attending public schools in Lebanon. The program comprised 13 sessions administered in classrooms by teachers supervised by fieldworkers. Data collection included pre- and post-intervention assessments using standardized measures to evaluate outcomes. We used linear mixed models to test for intervention effect. Moderators such as childhood adversity, positive home environment, and environmental sensitivity were also tested using three-way interaction. Our intervention led to significant improvements in personal competence and secondary outcomes such as depression, anxiety, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder symptoms. Childhood adversity and environmental sensitivity influenced intervention effects on some secondary outcomes. However, personal competence improvements were consistent across all student subgroups, highlighting the intervention's broad efficacy, even among students with various risk or protective factors. Our study emphasizes the significance of school-based interventions for addressing childhood personal competence and mental health symptoms, especially in low-income countries with limited access to mental health services.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2887-2897"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794885","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 dynamic relationships between fear of negative evaluations, non-suicidal self-injury, and suicidal ideation among Chinese adolescents: a mediated latent growth model.","authors":"Danrui Chen, Xinglin Zhou, Yunhong Shen, Jiefeng Ying, Jiajing Zhang, Shiting Zhan, Ruyun Wu, Nan Kang, Dong Yang, Jianing You","doi":"10.1007/s00787-025-02664-2","DOIUrl":"10.1007/s00787-025-02664-2","url":null,"abstract":"<p><p>Previous longitudinal studies have explored the developmental mechanisms of non-suicidal self-injury (NSSI) and suicidal ideation (SI) in adolescents and primarily focused on variable levels rather than trajectories (e.g., intercepts and slopes). The present study aimed to explore the developmental trajectories of NSSI and SI among Chinese adolescents, emphasizing the predictive roles of fear of negative evaluations (FNE) and thwarted belongingness (TB) on these trajectories from an interpersonal perspective. The latent growth model was incorporated to construct a mediation model of FNE, TB, NSSI, and SI. A total of 515 adolescents (M_age = 12.309, SD = 0.807; 49.3% girls) completed questionnaires on 4 waves, 6 months apart. The results showed that: (1) FNE showed a curvilinear growth trajectory, with a progressively smaller growth rate; TB, NSSI, and SI all showed a linearly decreasing trajectory; (2) in the relationship between FNE and NSSI, TB's intercept mediated the relationship from FNE's intercept to NSSI's; (3) in the relationship between FNE and SI, TB's intercept mediated the relationship from FNE's intercept to SI's intercept, as well as to SI's slope. Meanwhile, TB's slope mediated the relationship from FNE's slope to SI's. This study reveals the dynamic developmental trajectories of FNE, TB, NSSI, and SI in Chinese adolescents. Notably, TB plays a different mediating role between FNE, NSSI, and SI, highlighting its critical role in the development of these behaviors. Early interventions targeting FNE and enhanced belongingness may help prevent or reduce NSSI and SI in adolescents.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2669-2684"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596458","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":"Comparison of the long-term outcome of home vs. inpatient treatment: 18-24 months follow-up of a non-randomized controlled trial.","authors":"Daniel Graf, Stefan Lerch, Ulrich Böhnke, Corinna Reichl, Michael Kaess","doi":"10.1007/s00787-025-02677-x","DOIUrl":"10.1007/s00787-025-02677-x","url":null,"abstract":"<p><p>Home Treatment (HT) in child and adolescent psychiatry is an increasingly important topic in the current context of global crises and strained mental health systems. We implemented a HT program provided by a multiprofessional treatment team and compared long-term outcomes of 27 patients (48% female, Ø15.15 ± 2.77 years) with those of 48 patients (69% female, Ø16.35 ± 2.87 years) who received inpatient treatment as usual (I-TAU). Psychopathology was assessed using the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA[-SR]) and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF) at admission, discharge, and 18-24 months after discharge. Treatment outcomes were analyzed using mixed models. The results showed that patients in the HT arm had significantly lower HoNOSCA scores at follow-up (β = -4.25 [95%CI: -7.64 to -0.86], SE = 1.73, p = 0.014) and higher GAF scores (β = 12.09 [95%CI: 4.48 to 19.70], SE = 3.88, p = 0.002) compared to those in the I-TAU arm. No significant differences were observed in HoNOSCA-SR scores (β = -2.46 [95%CI: -9.16 to 4.30], SE = 3.43, p = 0.48) and readmission rates (OR = 1.23 [95%CI = 0.47 to 3.20], p = 0.67). These results highlight the potential of HT in improving long-term functional and psychopathological outcomes in youth mental health. HT may be an equally effective and even more sustainable type of treatment for child and adolescent mental disorders. The trial was preregistered at the German Clinical Trials Register (DRKS00025424, 05/27/2021).</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2697-2705"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596436","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":"Neural effect of childhood maltreatment on neurovascular coupling in adolescent depression.","authors":"Sangni Liu, Dandan Fan, Cancan He, Xinyi Liu, Haisan Zhang, Hongxing Zhang, Zhijun Zhang, Chunming Xie, PingLei Pan","doi":"10.1007/s00787-025-02708-7","DOIUrl":"10.1007/s00787-025-02708-7","url":null,"abstract":"<p><p>Childhood maltreatment (CM) is a pivotal risk factor for depression, yet its potential contribution to major depressive disorder (MDD) in adolescents requires further investigation. This study aims to scrutinize the specific impact of CM on neurovascular coupling (NVC) in adolescents with MDD. A cohort of 189 adolescents, comprising 54 MDD with CM, 45 MDD without CM, 33 healthy controls (HC) with CM, and 57 HC without CM, underwent multimodal MRI scans. Cerebral blood flow (CBF) was computed to evaluate vascular responses, while functional connectivity strength (FCS) and amplitude of low-frequency fluctuation (ALFF) were measured to assess neuronal activity. NVC was calculated using whole gray matter CBF-neuronal activity correlation coefficients and regional CBF/neuronal activity ratios. MDD×CM interactions on NVC, CBF, and neuronal activity were analyzed, with further exploration of the associations between these abnormal NVC ratios and CM experience. Support vector machine classifiers were employed to differentiate MDD adolescents. Results revealed a significant MDD×CM interactive effect on CBF-FCS coefficients at whole gray matter level. Regionally, these interactions on NVC ratios primarily occurred in the reward systems, including bilateral anterior cingulate/orbitofrontal cortex, thalamus/mesial temporal lobe, and left occipitotemporal lobe, correlating with CM measurements. Notably, the integration of NVC ratio, CBF, and neuronal activity yielded robust classification performance in distinguishing MDD adolescents. These findings reinforce the importance of reward system for MDD adolescents related to CM, proposing a novel neuroimaging biomarker for early recognition of adolescent depression.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2859-2870"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771595","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":"Hair cortisol concentration and mental health during childhood and adolescence: evidence that higher cortisol concentration is associated with externalizing problems in a large Brazilian population-based birth cohort.","authors":"Luciana Tovo-Rodrigues, Laura Moreira Goularte, Isabel Oliveira Bierhals, Iná S Santos, Thais Martins-Silva, Luis Augusto Rohde, Isabel Oliveira de Oliveira, Andrea Gonzalez, Alicia Matijasevich, Joseph Murray","doi":"10.1007/s00787-025-02693-x","DOIUrl":"10.1007/s00787-025-02693-x","url":null,"abstract":"<p><p>Childhood and adolescence are pivotal periods for mental health. The hypothalamic-pituitary-adrenal axis is the primary stress system and its chronic activation is measurable via hair cortisol concentration (HCC), indicating long-term stress exposure. While HCC is linked to adult mental health, this relationship remains unclear among youth. Although a bidirectional relationship is possible, the impact of mental health problems on HCC in youths has been comparatively underexplored. This study aimed to assess the association between symptoms of mental health problems in childhood and adolescence and HCC levels at age 15 in a Brazilian population-based cohort. We analyzed data from the 2004 Pelotas Birth Cohort, which includes 4,231 children followed from birth. At ages 6, 11 and 15 years, mental health symptoms were assessed using the Strengths and Difficulties Questionnaire (SDQ). At age 15, HCC was measured from 3 cm hair samples, quantified through the enzyme-linked immunosorbent assay. To evaluate the cumulative impact of mental health symptoms from childhood to adolescence, group-based trajectory analysis was conducted. Subsequently, linear regression models were used to estimate associations between mental health scores and HCC, with adjustment for relevant covariates. Regression coefficients were exponentiated to improve interpretability. SDQ total difficulties (β = 1.004 [1.000;1.008]) and conduct problems (β = 1.017 [1.004;1.030]) at age 6 were associated with HCC at age 15 in adjusted models. Hyperactivity/inattention symptoms at ages 6 (β = 1.009 [1.001;1.018]) and 11 (β = 1.013 [1.004;1.022]) were associated with HCC in adjusted models. At age 15, hyperactivity/inattention symptoms and HCC was associated with HCC in the partially adjusted model (β = 1.009 [1.000;1.017]). Trajectories of chronic conduct problems and hyperactivity between ages 6 and 15 were also associated with elevated HCC, although for hyperactivity/inattention symptoms the association was not significant. These associations emphasize the links between mental health and chronic stress over time, especially between both conduct problems and hyperactivity/inattention symptoms in relation to higher concentrations of HCC.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2739-2752"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630237","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}