Journal of the American Academy of Child and Adolescent Psychiatry最新文献

{"title":"Systematic Umbrella Review and Meta-Meta Analysis: Effectiveness of Physical Activity in Improving Depression and Anxiety in Children and Adolescents.","authors":"Ben Singh,Hunter Bennett,Aaron Miatke,Dorothea Dumuid,Rachel Curtis,Ty Ferguson,Jacinta Brinsley,Kimberley Szeto,Emily Eglitis,Mason Zhou,Catherine E M Simpson,Jasmine M Petersen,Joseph Firth,Carol A Maher","doi":"10.1016/j.jaac.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.007","url":null,"abstract":"OBJECTIVEDepression and anxiety are prevalent and rising in children and adolescents, prompting interest in exercise as a potential therapeutic intervention. The aim of this systematic umbrella review and meta-meta-analysis was to evaluate the effects of exercise on depression and anxiety symptoms in children and adolescents and identify the most promising exercise-based approaches.METHODThis systematic umbrella review was preregistered (PROSPERO ID: CRD42024533558) and followed PRISMA and PRIOR guidelines. A search of 11 databases identified systematic reviews and meta-analyses of randomised controlled trials (RCTs) evaluating the effects of exercise (aerobic, resistance, mind-body exercise) on depression and anxiety symptoms in children and adolescents. Risk of bias was assessed using the AMSTAR-2 tool and certainty of evidence was assessed using GRADE. Meta-analyses were conducted to combine effect sizes, using random effects models. Subgroup analyses were performed to examine participant and intervention characteristics.RESULTSTwenty-one systematic reviews (n=375 RCTs, n=38,117 participants aged 5-18 years) were included. Participants had various clinical conditions including depression, psychosocial disorders, obesity, cancer, as well as healthy individuals. The pooled analysis found moderate effect sizes favouring exercise for symptoms of depression (SMD = -0.45 [95% CI, -0.59 to -0.31], I2 = 71.37%, p<0.01, 180 RCTs, n=34,490 participants) and anxiety (SMD = -0.39 [95% CI, -0.61 to -0.17], I2 = 68.1%, p<0.01, n=55 RCTs, n=24,797 participants). Mixed exercise modes and moderate-intensity exercise had the largest effects on depression, while resistance exercise was most effective for symptoms of anxiety. Interventions that were <12 weeks were more effective for depression compared with ≥12-week interventions. Benefits were generally consistent across populations. The certainty of evidence was moderate for depression and low to moderate for anxiety.CONCLUSIONThis meta-meta-analysis finds that exercise reduces depression and anxiety symptoms in children and adolescents. These results suggest that structured exercise programs should be considered as part of comprehensive care approaches.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"3 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Racism, Brain Development, and Internalizing and Externalizing Symptoms: Findings From the ABCD Study.","authors":"Shanting Chen,Catalina Lopez-Quintero,Amanda Elton","doi":"10.1016/j.jaac.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.005","url":null,"abstract":"OBJECTIVERacial discrimination drives health disparities among racial/ethnic minority youth, creating chronic stress that affects brain development and contributes to mental and behavioral health issues. This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study to examine the neurobiological mechanisms linking discrimination to mental and behavioral health outcomes.METHODA sample of 3,321 racial/ethnic minority youth was split into training (80%, n=2,674) and testing (20%, n=647) groups. Propensity-score-weighted machine learning was used to assess the effects of perceived discrimination on two-year changes in resting-state functional connectivity between three subcortical regions (nucleus accumbens, amygdala, hippocampus) and large-scale brain networks. Mediation analyses evaluated whether brain changes mediated sex-specific effects on internalizing or externalizing symptoms.RESULTSPerceived discrimination was significantly associated with two-year changes in connectivity of the nucleus accumbens, amygdala, and hippocampus in both cross-validation and independent testing. Key findings included decreases in nucleus accumbens connectivity with retrosplenial-temporal and sensorimotor (hand) networks, decreases in amygdala connectivity with the sensorimotor (mouth) network, and increases in hippocampal connectivity with the auditory network. These changes suggest accelerated maturation in these connections among youth reporting higher discrimination levels. Moderated mediation analyses revealed sex differences, with discrimination-related changes in nucleus accumbens connectivity linked to poorer internalizing outcomes in female participants.CONCLUSIONSThe results indicate perceived racial discrimination experienced in adolescence impact subcortical-cortical brain development, which affect mental and behavioral health outcomes in a sex-specific manner.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"108 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Screen Time in the Age of AI: Supporting Healthier Habits for Teens from the Inpatient Setting.","authors":"Conrad W Safranek,Charlotte M Schwarz","doi":"10.1016/j.jaac.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.006","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"17 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incarceration and Subsequent Psychosocial Outcomes: A 16-Year Longitudinal Study of Youth After Detention.","authors":"Sara E Thomas,Karen M Abram,David Aaby,Leah J Welty,Jennifer L Arzu,Joeann M Salvati,Linda A Teplin","doi":"10.1016/j.jaac.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.004","url":null,"abstract":"OBJECTIVETo investigate the dose of incarceration and subsequent psychiatric and psychosocial functioning in justice-involved youth 16 years after detention (median age 32).METHODParticipants were from the Northwestern Juvenile Project, a prospective, longitudinal study of 1,829 youth randomly sampled at intake from the Cook County Juvenile Temporary Detention Center, 1995-1998, stratified by sex, race and ethnicity, age, and legal status (processed as juvenile or adult). The study measured incarceration \"dose\": (1) the depth of involvement, i.e. the type of facility where youth were incarcerated as they aged (juvenile-only, adult jail [but not prison], or prison); and (2) total number of days incarcerated. Psychosocial outcomes were: positive mental health, no problematic substance use, educational attainment, gainful activity, residential independence, interpersonal functioning, parenting responsibility, and desistance from criminal activity. Regression models comparing outcomes by facility type were propensity weighted.RESULTSMale participants in the prison group achieved fewer psychosocial outcomes (3.3; 95% CI 3.1-3.5) vs those in the jail (4.8; 95% CI 4.2-5.4) and juvenile-only (5.2; 95% CI 4.3-6.0) groups. Participants only incarcerated in juvenile detention were more likely to achieve every socioeconomic outcome vs those who had been in prison. More time incarcerated was associated with poorer outcomes for male and female participants; findings varied by facility type. Among male participants in prison, each additional year incarcerated reduced the odds of positive mental health.CONCLUSIONHigher doses of incarceration were adversely associated with psychiatric and psychosocial functioning in adulthood. Black and Hispanic men are disproportionately incarcerated and thus disproportionately affected. Community mental health service providers are in a unique position to collaborate with correctional facilities to provide early interventions and services for successful reentry to the community.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"6 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Technology, Social Media, and Current Events Profoundly Affect Adolescents","authors":"Kirti Veeramachaneni BS","doi":"10.1016/j.jaac.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.001","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"60 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Fixing Implementation Science's Implementation Problem.","authors":"David S Mandell","doi":"10.1016/j.jaac.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.04.003","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"66 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Antidepressant Exposure and Risk of Depression and Anxiety Disorders: An Electronic Health Records-Based Cohort Study.","authors":"Ardesheer Talati,Jennifer L Vande Voort,Launia J White,David Hodge,Cynthia J Stoppel,Myrna M Weissman,Jay A Gingrich,William V Bobo","doi":"10.1016/j.jaac.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.03.026","url":null,"abstract":"OBJECTIVETo examine the associations of serotonergic antidepressant exposure during pregnancy with the risk of depression and anxiety disorders in offspring.METHODThe Mayo Clinic Rochester Epidemiology Project medical records-linkage system was used to study offspring born to mothers who were prescribed selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors (S/NRI users, n=837) during pregnancy (1997-2010). Cox regression models were used to calculate hazard ratios (HRs) to examine associations of S/NRIs with diagnosed depression and anxiety, defined based on a review of medical records by two board-certified psychiatrists, using no maternal antidepressant use during pregnancy (non-users, n=863) and maternal antidepressant use in the year prior to pregnancy (former users, n=399) as control groups.RESULTSAfter all adjustments for covariates, children born to S/NRI users during pregnancy did not differ in onset of depression or anxiety than the children of non-users (Adjusted Hazard Ratios, (aHR [95% CI]=1.00 [0.74, 1.85]) or former users (aHR=0.94 [0.69, 1.27]). The above associations were similar when exposure was limited only to SSRIs.CONCLUSIONOur results suggest that the higher rates of childhood and adolescent depression or anxiety conditioned on maternal S/NRI use in pregnancy are more likely to be driven by maternal depression or underlying propensity for depression rather than direct pharmacological effects of in utero S/NRI exposure.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"37 1","pages":""},"PeriodicalIF":13.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asking Preadolescents About Suicide is Not Associated With Increased Suicidal Thoughts.","authors":"Laura Hennefield, Katherine R Luking, Rebecca Tillman, Deanna M Barch, Joan Luby, Renee J Thompson","doi":"10.1016/j.jaac.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.03.025","url":null,"abstract":"<p><strong>Objective: </strong>Rising rates of suicidal thoughts and behaviors (STBs) in preadolescents make suicide-risk screening in this age group critical to reduce harm. Although screening appears generally safe for youth aged 12+, effects in preadolescents remain unknown. This study tested iatrogenic effects of repeated suicide-risk screening in two groups of preadolescents (aged 8-12): a lower-risk group with no prior STBs, and a higher-risk group who had experienced STBs.</p><p><strong>Method: </strong>The Ask-Suicide Screening Questions (ASQ) screener, modified to query suicidal thoughts over the prior week, was administered to 194 preteens from the Pediatric Suicidality Study (PED-SI) over 12 months. PED-SI is a study of preschool-onset depression following children recruited at ages 3-6 for depression and non-depressed peers. Lower-risk preadolescents (n=68) completed monthly screens, whereas higher-risk preadolescents (n=124) completed weekly screens, administered remotely via text or email. We examined correlations between screen completion rates and positive screens, changes in positive screens over time, and if previous screen completion predicted a positive future screen. Bayes Factors assessed for meaningfulness of null effects.</p><p><strong>Results: </strong>192 preadolescents (Mage=10.13 years; 63% boys;, 37% girls 79.2% White, 8.9% Black, 9.9% Multiracial, 2.1% Asian; 7.3%, Hispanic) completed at least one screen. Findings from inferential statistics and supported by Bayes factors indicated no evidence that repeated screening increased suicidal thoughts in either group. In the lower-risk group positive screens were rare (1.6%), with no significant increases over time. In the higher-risk group 7% of screens were positive, but this frequent screening did not exacerbate suicidal thoughts.</p><p><strong>Conclusion: </strong>Suicide-risk screening appears safe for preadolescents. Clinicians can proceed with screening preadolescents with increased confidence that the benefits outweigh the risks.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Media Representation and Intergenerational Communication in Immigrant Families.","authors":"Seeba Anam, Manal Khan, Afifa Adiba, Deepika Shaligram","doi":"10.1016/j.jaac.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.03.024","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Treatment of Youth with Bipolar Disorders.","authors":"Cynthia A Fontanella, Kristy M Nguyen, Elyse N Llamocca, Rui Huang, Danielle L Steelesmith, Taryn L Mayes, Eric A Youngstrom, Susan dosReis","doi":"10.1016/j.jaac.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.jaac.2025.02.018","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about racial/ethnic disparities in the treatment of pediatric bipolar disorder. This study examined racial and ethnic differences in prescription fill patterns and receipt of recommended treatment among Medicaid-enrolled youth.</p><p><strong>Method: </strong>A retrospective longitudinal cohort study using Medicaid claims data from 36 states was conducted for youth 10-17 years-old with a \"new episode\" of bipolar disorder from January 1, 2017 through December 31, 2018 (N=16,807). Measures related to receipt of guideline-concordant care included: filled prescription of a mood stabilizer or antipsychotic, any antidepressant monotherapy, and any psychotherapy visit within 90 days of the new episode of bipolar disorder. We used generalized linear mixed models to examine differences by race/ethnicity in guideline-concordant treatment patterns.</p><p><strong>Results: </strong>Two-fifths (39.5%) of the cohort filled prescriptions for the recommended treatment of mood stabilizers or antipsychotic medication and about half (47.6%) received psychotherapy within 90 days of the first diagnosis during the 365-day follow-up period. Few youth (17.5%) received antidepressant monotherapy. After controlling for demographic, clinical, and contextual factors, both Hispanic (adjusted odds ratio [AOR]=0.70, 95% CI: 0.64-0.77) and non-Hispanic Black youth (AOR = 0.58, 95% CI: 0.53-0.63) had lower odds of filling a mood stabilizer or antipsychotic prescription compared to non-Hispanic White youth. Non-Hispanic Black youth also had lower odds of antidepressant monotherapy (AOR=0.57, 95% CI: 0.50-0.64) or receiving psychotherapy (AOR=0.89, 95% CI: 0.81-0.97) than non-Hispanic White youth.</p><p><strong>Conclusion: </strong>Racial/ethnic differences in guideline-concordant treatment for youth with bipolar disorder underscore the need to identify barriers to recommended care for minoritized youth.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}