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

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S0890-8567(25)00009-7","DOIUrl":"10.1016/S0890-8567(25)00009-7","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 4","pages":"Page A1"},"PeriodicalIF":9.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child and Youth Artwork","authors":"","doi":"10.1016/S0890-8567(25)00012-7","DOIUrl":"10.1016/S0890-8567(25)00012-7","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 4","pages":"Page A8"},"PeriodicalIF":9.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705122","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":"Systematic Review and Meta-Analysis: Predictors of Relapsing, Recurrent, and Chronic Depression in Young People.","authors":"Scott D Tagliaferri, Laura K M Han, Muskan Khetan, Joshua Nguyen, Connie Markulev, Simon Rice, Susan M Cotton, Michael Berk, Enda M Byrne, Debra Rickwood, Christopher G Davey, Peter Koval, Aswin Ratheesh, Patrick D McGorry, Mario Alvarez-Jimenez, Lianne Schmaal","doi":"10.1016/j.jaac.2025.03.019","DOIUrl":"10.1016/j.jaac.2025.03.019","url":null,"abstract":"<p><strong>Objective: </strong>Youth depression disrupts the social and vocational transition into adulthood. Most depression burden is caused by recurring or chronic episodes. Identifying young people at risk for relapsing, recurring, or chronic depression is critical. We systematically reviewed and meta-analyzed the literature on prognostic factors for relapsing, recurrent, and chronic depression in young people.</p><p><strong>Method: </strong>We searched the literature up (MEDLINE, PsycINFO, CINAHL, Embase, CENTRAL, WHO ICTRP, ClinicalTrials.gov, bioRxiv, MedRxiv) to March 6, 2024, and included cohort studies and randomized trials that assessed any prognostic factor for relapse, recurrence, or chronicity of depression in young people (aged 10-25 years at baseline) with a minimum of a 3-month follow-up. We assessed individual study risk of bias using the QUIPS tool and the certainty of evidence via the GRADE approach. We conducted random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment when 3 or more estimates on the same prognostic factor were available. Qualitative synthesis was conducted to identify promising prognostic factors that could not be meta-analyzed.</p><p><strong>Results: </strong>A total of 76 reports of 46 studies (unique cohorts or trials) were included that tested 388 unique prognostic factors in 7,488 young people experiencing depression. The majority of the reports were at high risk of bias (87%). We conducted 22 meta-analyses on unadjusted, and 7 on adjusted, prognostic factors of a poor course trajectory (ie, combined relapse, recurrence, and chronicity). Female sex (adjusted; odds ratio [95% CI] = 1.49 [1.15, 1.93], p = .003), higher severity of depressive symptoms (unadjusted; standardized mean difference [95% CI] = 0.53 [0.33, 0.73], p < .001), lower global functioning (unadjusted; standardized mean difference [95% CI] = -0.35 [-0.60, -0.10], p = .005), more suicidal thoughts and behaviors (unadjusted; standardized mean difference [95% CI] = 0.52 [0.03, 1.01], p = .045), and longer sleep-onset latency (unadjusted; mean difference [95% CI] = 6.96 [1.48, 12.44] minutes, p = .013) at baseline predicted a poor course trajectory of depression. The certainty of the evidence was overall very low to moderate. Promising prognostic factors that could not be meta-analyzed included relational/interpersonal factors (friend relationships and family relationships/structure).</p><p><strong>Conclusion: </strong>Our findings demonstrate the prognostic value of demographic and clinical factors for poor course trajectories of depression in young people. More research is needed to confirm the potential value of relational/interpersonal factors in predicting poor depression course. Limitations of the literature include the high risk of bias of included studies, which indicates that future studies should include large sample sizes and wider diversity of prognostic markers (eg, genetic and neurobiological) in multivariable mod","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743143","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":"Symptoms of Depression, Physical Activity, and Sedentary Time: Within-Person Relations From Age 6 to 18 in a Birth Cohort.","authors":"Silje Steinsbekk, Joakim Skoog, Lars Wichstrøm","doi":"10.1016/j.jaac.2025.03.018","DOIUrl":"10.1016/j.jaac.2025.03.018","url":null,"abstract":"<p><strong>Objective: </strong>To examine the within-person relations between objectively measured physical activity and clinically assessed symptoms of depressive disorders from childhood to late adolescence.</p><p><strong>Method: </strong>Seven waves of biennially collected data from a Norwegian birth-cohort (n = 873; 53% girls) followed from age 6 to 18 years were used. Accelerometers were used to assess total physical activity, moderate-to vigorous physical activity, and sedentary time, and symptoms of depression were assessed by semi-structured psychiatric interviews. Mediators (athletic self-esteem, body image, sports participation) were captured by questionnaires. Random intercept cross-lagged panel models were estimated to test the within-person relations and their potential mediators.</p><p><strong>Results: </strong>From ages 14 to 16 and 16 to 18 years, significant within-person relations were found. Decreased levels of total physical activity (PA) and moderate-to-vigorous physical activity (MVPA) predicted more symptoms of depression (PA: 14-16 years: β = -0.08; 16-18 years: β = -0.09; MVPA: 14-16 years: β = -0.10; 16-18 years: β = -0.07). These relations were not evident at earlier ages. From ages 10 to 12 and 14 to 16 years, an increased number of depressive symptoms predicted decreased levels of physical activity (PA: 10-12 years: β = -0.10; 14-16 years: β = -0.14: MVPA: 10-12 years: β = -0.10; 14-16 years: β = -0.17). We found no evidence for within-person relations between sedentary time and depressive symptoms, and no significant sex differences or mediations.</p><p><strong>Conclusion: </strong>Individuals who increase their physical activity levels from middle to late adolescence are less likely to develop symptoms of depression compared to what they otherwise would. Thus, in this age period, physical activity may protect against depressive symptoms.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743140","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":"Our Journals Will Continue to Follow the Science.","authors":"","doi":"10.1016/j.jaac.2025.03.017","DOIUrl":"10.1016/j.jaac.2025.03.017","url":null,"abstract":"<p><p>Over the last 5 years, our family of journals have made a concerted effort to publish outstanding science on the impacts of structural and social determinants of health, including multiple forms of racism and minoritization (such as marginalization and discrimination based on gender and sexual identity) on the mental health of children and adolescents. We have built an editorial team with the requisite skills to critically assess and strengthen such manuscripts and to create a collaborative and supportive home for experts with a broad range of expertise and backgrounds to contribute to our mission. Summaries of our specific antiracism initiatives in service of these efforts are available as annual reports, the most recent published in December 2024.¹ A focus on structural and social determinants of health has been central to child developmental research for more than a century and is consistent with prominent models of child development, such as Bronfenbrenner's Socio-Ecological Model from 1977² and Meyer's Psychobiological Model from the early 1900s,³ incorporated into the Biopsychosocial Model by Engel in the 1970s.⁴ Indeed, research on the impacts of adverse childhood experiences (eg, poverty, experiencing violence or abuse or living in a family with unstable housing, being a victim of discrimination, and rural-urban disparities in access to care) are core components of our knowledge base and have guided the development of effective interventions at individual and family, school, and community levels.⁵^,⁶.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743134","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":"Challenges and Pearls of Evaluation and Treatment of Adolescents and Emerging Adults With Scrupulosity Obsessive-Compulsive Disorder.","authors":"Carol R Chen, Sara Byczek, Emily Bilek","doi":"10.1016/j.jaac.2025.03.015","DOIUrl":"10.1016/j.jaac.2025.03.015","url":null,"abstract":"<p><p>Obsessive-compulsive disorder (OCD) affects approximately 1% to 2% of youth.¹ Patients with OCD may present with varying degrees of insight into the excessiveness of their compulsive behaviors. This is certainly true among youth, of whom 20% to 45% are thought to have poor or absent insight.² Scrupulosity OCD-characterized by intrusive guilt and fear about moral or religious wrongdoing-is associated with worse symptom severity and insight.³ This form of OCD involves obsessive fear about offending a deity or acting immorally, leading to compulsions like excessive praying, reassurance-seeking, and avoidance of perceived immoral activities. Ritualistic practice and seeking penance are accepted practices in many religions, thus the line between acceptable religious observance and OCD is both difficult and important to distinguish. This may be especially true among adolescent populations who are in the process of developing and internalizing a moral identity. Because scrupulosity rituals may be seen positively within religious communities, diagnosis and treatment are sometimes delayed³. In this article, we present two de-identified cases of adolescence-onset scrupulosity OCD that feature some additional diagnostic challenges and highlight specific recommendations (ie, \"pearls\" of wisdom) for this youth population.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730576","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: Meta-Analysis of Individual Participant Data From Trials of Selective Serotonin Reuptake Inhibitors for Pediatric Obsessive-Compulsive Disorder: A Gold Standard Approach","authors":"Gail A. Bernstein MD","doi":"10.1016/j.jaac.2025.03.016","DOIUrl":"10.1016/j.jaac.2025.03.016","url":null,"abstract":"","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"64 7","pages":"Pages 768-769"},"PeriodicalIF":9.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730578","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":"Characterizing Rare DNA Copy-Number Variants in Pediatric Obsessive-Compulsive Disorder.","authors":"Sarah B Abdallah, Emily Olfson, Carolina Cappi, Samantha Greenspun, Gwyneth Zai, Maria C Rosário, A Jeremy Willsey, Roseli G Shavitt, Euripedes C Miguel, James L Kennedy, Margaret A Richter, Thomas V Fernandez","doi":"10.1016/j.jaac.2025.03.014","DOIUrl":"10.1016/j.jaac.2025.03.014","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder in which genetic factors play an important role. Recent studies have demonstrated an enrichment of rare de novo DNA single-nucleotide variants in persons with OCD compared to controls, and larger studies have examined copy-number variants (CNVs) using microarray data. Our study examines rare de novo CNVs using whole-exome sequencing (WES) data to provide additional insight into genetic factors and biological processes underlying OCD.</p><p><strong>Method: </strong>We detected CNVs using whole-exome DNA sequencing (WES) data from 183 OCD trio families (unaffected parents and children with OCD) and 771 control families to test the hypothesis that rare de novo CNVs are enriched in persons with OCD compared to controls. Our primary analysis used the eXome-Hidden Markov Model (XHMM) to identify CNVs in silico. We performed burden analyses comparing persons with OCD vs controls and downstream biological systems analyses of CNVs in probands with OCD. We then used a second algorithm (GATK-gCNV) to confirm our primary analysis.</p><p><strong>Results: </strong>Our findings demonstrate a higher rate of rare de novo CNVs detected by WES in persons with OCD (0.07 CNVs per proband) compared to controls (0.005) (corrected rate ratio = 11.7 95% CI = 3.6-50.0, p = 4.00×10^-6). We confirmed this enrichment using GATK-gCNV. The majority of these rare de novo CNVs in persons with OCD are predicted to be pathogenic or likely pathogenic, and an examination of genes disrupted by rare de novo CNVs in persons with OCD finds enrichment of several Gene Ontology sets.</p><p><strong>Conclusion: </strong>This study shows for the first time an enrichment of rare de novo CNVs detected by WES in OCD, complementing previous, larger CNV studies and providing additional insight into genetic factors underlying OCD risk.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692523","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: Embracing Complexity When Examining the Social Construct of Race: Nuanced Strategies Are Needed to Reduce Harm and Improve Neurodevelopmental Science.","authors":"Amanda Noroña-Zhou, Michael Coccia, Nicole R Bush","doi":"10.1016/j.jaac.2025.03.008","DOIUrl":"10.1016/j.jaac.2025.03.008","url":null,"abstract":"<p><p>Although advances in neurodevelopmental sciences and clinical care have progressed at lightning speed, our headway in addressing the long history of racism in science and medicine has been notably slower and muddled. Only recently has there been widespread acknowledgement in the scientific community that race is a social construct¹-with greater genetic variability among categorical groups than within-spurring contemporary guidance from the National Academies of Science, Engineering, and Medicine (NASEM)² confirming that \"race\" is not biologically based and that analyses suggesting otherwise are \"misleading and harmful.\" Others have illuminated the problematic use of race-based diagnostic algorithms and practice guidelines, given their contributions to health inequities.³ Race/ethnicity has historically been treated as a confounding or stratification variable in health research, but leaders have argued for revamping this approach⁴^,⁵ to avoid the implication that biological differences underlie observed inequities. Given the pervasiveness of racial/ethnic inequities in neurodevelopmental outcomes and policies and social structures that have led to substantial correlations between poverty and race, the complexity of studying socioeconomic effects precludes one-size-fits-all approaches-particularly in the current sociopolitical climate.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692527","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":"Considerations When Accounting for Race and Ethnicity in Studies of Poverty and Neurodevelopment.","authors":"Clementine Semanaz, Akhgar Ghassabian, Scott Delaney, Fang Fang, David R Williams, Henning Tiemeier","doi":"10.1016/j.jaac.2025.03.007","DOIUrl":"10.1016/j.jaac.2025.03.007","url":null,"abstract":"<p><strong>Objective: </strong>Poverty and systemic racism are intertwined. Children of marginalized racial and ethnic identities experience higher levels of poverty and adverse psychiatric outcomes. Thus, in models of poverty and neurodevelopment, race and ethnicity, as proxies for exposure to systemic disadvantage, are regularly considered confounders. Recently, however, some researchers have claimed that using race and ethnicity as confounders is statistically dubious, and potentially socially damaging. Instead, they argue for the use of variables measuring other social determinants of health (SDoH). We explore this approach herein.</p><p><strong>Method: </strong>Data are from 7,836 children 10 years of age in the Adolescent Brain Cognitive Development Study (ABCD Study). We fit mixed regression models for the association of household poverty measures with psychiatric symptoms, magnetic resonance imaging (MRI)-derived cortical measures, and cognition with and without (1) race and ethnicity adjustment, (2) poverty-by-race and ethnicity interaction terms, and (3) alternative SDoH variables. Propensity-based weights were used to calibrate the sample to key US demographics.</p><p><strong>Results: </strong>For psychiatric and cognitive outcomes, poverty-outcome relationships differed across racial and ethnic groups (interaction of poverty by race and ethnicity, p < .05). For MRI-derived outcomes, adjusting for race and ethnicity changed the estimate of the impact of poverty. Alternative SDoH adjustment could not fully account for the impact of race and ethnicity on the associations explored.</p><p><strong>Conclusion: </strong>Poverty and both race and ethnicity combine to influence neurodevelopment. Results suggest that the effects of poverty are generally inconsistent across race and ethnicity, which supports prior research demonstrating the nonequivalence of SDoH indicators by race and ethnicity. Studies exploring these relationships should assess the interaction between poverty and race and ethnicity and/or should stratify when appropriate. Replacing race and ethnicity with alternative SDoH may induce bias.</p>","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692524","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}