Elie G Karam, Josleen Al Barathie, Ingrid Kabalan, Youmna Cassir Haddad, Caroline Cordahi Tabet, Nadine Melhem
{"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}
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
{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507972/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Childhood trauma: the elephant in the room in child and adolescent psychiatry.","authors":"Carmen Moreno, Renzo Abregú-Crespo, María Mayoral","doi":"10.1007/s00787-025-02861-z","DOIUrl":"10.1007/s00787-025-02861-z","url":null,"abstract":"","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2627-2629"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085503","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}
Daniel Graf, Stefan Lerch, Ulrich Böhnke, Corinna Reichl, Michael Kaess
{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508014/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danrui Chen, Xinglin Zhou, Yunhong Shen, Jiefeng Ying, Jiajing Zhang, Shiting Zhan, Ruyun Wu, Nan Kang, Dong Yang, Jianing You
{"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<sub>age</sub> = 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":"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}
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
{"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}
Marcela Radunz, Catherine Johnson, Bridianne O'Dea, Tracey D Wade
{"title":"Interventions for self-harm and suicidality in paediatric emergency departments: a meta-review.","authors":"Marcela Radunz, Catherine Johnson, Bridianne O'Dea, Tracey D Wade","doi":"10.1007/s00787-025-02706-9","DOIUrl":"10.1007/s00787-025-02706-9","url":null,"abstract":"<p><p>Paediatric emergency department (ED) presentations for self-harm and suicidality have significantly increased worldwide in the past decade, making paediatric EDs a key point of contact for young people experiencing suicidal ideation. Since 2022, four systematic reviews have been conducted on interventions for self-harm/suicidality in paediatric EDs, but findings were limited by small sample sizes and high heterogeneity. This meta-review provides recommendations to guide clinical practice and future research to enhance the quality of interventions in paediatric EDs for addressing self-harm and suicide related behaviours. Of 286 studies identified, five reviews synthesising 14 individual studies on ED-based interventions published up to May 2022 were included. Key themes and conclusions were synthesised. Three main themes emerged including: lack of informative trials, low levels of intervention effectiveness and common intervention elements. Informativeness of prior trials was limited by small sample sizes, lack of globally relevant research and limited stakeholder perspectives. Common intervention elements included: follow-up contact post-ED discharge, family involvement and psychoeducation with safety planning. Limited progress has been made in this field, likely due to challenges in conducting rigorous trials in paediatric EDs. Research has failed to incorporate voices of young people and their families, crucial for meeting their needs. Future research must prioritise co-design with youth, parents, and stakeholders as a critical next step in developing more effective paediatric ED interventions. Digital tools may offer promise for delivering interventions in the ED but should complement face-to-face professional contact.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2649-2658"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788167","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}
Kelsey K Wiggs, Taryn E Cook, Isha Lodhawala, Emma N Cleary, Kimberly Yolton, Stephen P Becker
{"title":"Setting a research agenda for examining early risk for elevated cognitive disengagement syndrome symptoms using data from the ABCD cohort.","authors":"Kelsey K Wiggs, Taryn E Cook, Isha Lodhawala, Emma N Cleary, Kimberly Yolton, Stephen P Becker","doi":"10.1007/s00787-025-02667-z","DOIUrl":"10.1007/s00787-025-02667-z","url":null,"abstract":"<p><p>Little research has examined early life risk for symptoms of cognitive disengagement syndrome (CDS) despite a well-established literature regarding co-occurring outcomes (e.g., attention-deficit/hyperactivity disorder). The current study estimated bivariate associations between early life risk factors and CDS in a large and representative sample of U.S. children. We conducted secondary analyses of baseline data from the Adolescent Brain Cognitive Development (ABCD) study (N = 8,096 children, 9-10 years old). Birthing parents reported early life risk factors on a developmental history questionnaire, including parental, prenatal, delivery and birth, and developmental milestone information. They also completed the Child Behavior Checklist, which includes a CDS subscale that was dichotomized to estimate the odds of elevated CDS symptoms (i.e., T-score > 70) in children related to risk indices. We observed significantly elevated odds of CDS related to parental risk factors (i.e., unplanned pregnancy, pregnancy awareness after 6 weeks, teenage parenthood), birthing parent illnesses in pregnancy (i.e., severe nausea, proteinuria, pre-eclampsia/toxemia, severe anemia, urinary tract infection), pregnancy complications (i.e., bleeding), prenatal substance exposures (i.e., prescription medication, tobacco, illicit drugs), delivery and birth risk factors (i.e., child blue at delivery, child not breathing, jaundice, incubation after delivery), and late motor and speech milestones in children. Several early-life risk factors were associated with elevated odds of CDS at ages 9-10 years; study design prevents the determination of causality. Further investigation is warranted regarding early life origins of CDS with priority given to risk indices that have upstream commonalities (i.e., that restrict fetal growth, nutrients, and oxygen).</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2685-2696"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596371","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":"Comparative analysis of the risk of severe bacterial infection and septicemia in adolescents and young adults with treatment-resistant depression and treatment-responsive depression - a nationwide cohort study in Taiwan.","authors":"Jia-Ru Li, Yu-Chen Kao, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Chih-Sung Liang, Mu-Hong Chen","doi":"10.1007/s00787-025-02684-y","DOIUrl":"10.1007/s00787-025-02684-y","url":null,"abstract":"<p><p>Previous studies have shown an association between depression and increased susceptibility to infection in the general population. However, there has been no prior research specifically examining the relationship between treatment-resistant depression (TRD) and severe bacterial infections (SBI) in adolescents and young adults. This retrospective observational cohort study utilized the Taiwan National Health Insurance Research Database (NHIRD) from 2001 to 2010. It included adolescents (12-19 years of age) and young adults (20-29 years of age) diagnosed with major depressive disorder (MDD), comprising 6958 cases of TRD and 27,832 cases of antidepressant-responsive depression (ARPD). The TRD and ARPD groups were further matched (4:1) by chronological age, age at diagnosis of depression, sex, residence, and family income. The primary outcomes were severe bacterial infections (SBI) and septicemia. Cox regression analysis was conducted to identify the risk of hospitalization due to SBI or septicemia during the follow-up period. Compared with controls, the ARPD group had increased risks of SBI (hazard ratio [HR] with 95% confidence interval [CI]: 3.90, 2.73-5.57) and septicemia (HR, 95% CI: 2.56, 1.34-4.91). Notably, the risks of SBI and septicemia appeared to be further elevated in the TRD group. The TRD group exhibited higher incidences of SBI (HR, 95% CI: 6.99, 4.73-10.34) and septicemia (HR, 95% CI: 2.85, 1.28-6.36) than the control group. Adolescents and young adults with TRD had 6.99-fold and 3.90-fold increased risks of SBI and septicemia compared to individuals without MDD, respectively. Therefore, healthcare providers need to be vigilant when monitoring and implementing preventive measures in this population.</p>","PeriodicalId":11856,"journal":{"name":"European Child & Adolescent Psychiatry","volume":" ","pages":"2659-2667"},"PeriodicalIF":4.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582202","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}