Frontiers in child and adolescent psychiatry最新文献

{"title":"Faith, family, and stigma after parental divorce: psychological well-being among Indonesian Muslim adolescent girls.","authors":"Slametiningsih, Achir Yani S Hamid, Mustikasari Mustikasari, Raden Irawati Ismail","doi":"10.3389/frcha.2026.1928639","DOIUrl":"10.3389/frcha.2026.1928639","url":null,"abstract":"<p><strong>Background: </strong>Parental divorce can disrupt adolescents' identity, security, and belonging. In Muslim-majority Indonesia, divorce is also interpreted through cultural expectations of family unity, filial respect, family reputation, and religious meaning. These meanings may intensify stigma, but they may also provide adolescents with moral language for patience, hope, and self-restraint.</p><p><strong>Objective: </strong>This study explored how Indonesian Muslim adolescent girls make sense of psychological well-being after parental divorce, with attention to Islamic cultural meanings, family relationships, stigma, and coping.</p><p><strong>Methods: </strong>This qualitative original research used Interpretative Phenomenological Analysis (IPA). Semi-structured face-to-face interviews were conducted with 15 Muslim adolescent girls aged 14-15 years who had experienced parental divorce for at least one year. Participants were recruited purposively from a junior high school in Bekasi City, Indonesia. Interviews were conducted in Bahasa Indonesia, audio-recorded, transcribed verbatim, translated for reporting, and analyzed through idiographic case-by-case interpretation, cross-case theme development, reflexive journaling, and researcher consensus.</p><p><strong>Results: </strong>Four superordinate themes were identified: negotiating loss and self-acceptance after family rupture; relational ecosystems as both protection and vulnerability; moving from reactive survival toward purposeful autonomy; and Islamic cultural context and moral meaning-making. Participants described divorce as more than a family event. It became a public and moral experience shaped by the label of \"broken home,\" expectations to respect parents, fear of gossip, and the wish to remain a good Muslim daughter.</p><p><strong>Conclusion: </strong>In this single-school qualitative study, psychological well-being after parental divorce among Indonesian Muslim adolescent girls was shaped by emotional, relational, cultural, and religious processes. These findings suggest that school and community support should address stigma and emotional distress while engaging respectfully with Islamic family values in context-specific ways.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1928639"},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review to characterize functional tic-like behaviors.","authors":"Joseph B Gary, Jacob S Shaw, Joseph F McGuire","doi":"10.3389/frcha.2026.1936806","DOIUrl":"10.3389/frcha.2026.1936806","url":null,"abstract":"<p><strong>Background: </strong>Functional tic-like behaviors (FTLBs) have emerged as a prominent clinical presentation within the context of the COVID-19 pandemic. Although FTLBs share phenomenological overlap with Tourette Syndrome and other tic disorders (collectively Tourette Syndrome, TS), evidence suggests that differences exist in demographics, phenomenology, clinical course, psychiatric comorbidity, and response to intervention. Given the rapid rise in the incidence of FTLBs-along with their complex clinical presentation-we provide a systematic review and integrated synthesis of the extant literature.</p><p><strong>Methods: </strong>We conducted a systematic review following PRISMA guidelines. PubMed and PsycINFO databases searches were completed in June 2026, using terms related to functional tics and TS. Inclusion criteria were English-language studies reporting clinical data on FTLB with sample sizes of 8 or greater. Case reports, non-human studies, and commentaries were excluded. Thirty-nine studies were included. Data were extracted on demographics, phenomenology, clinical course, psychiatric comorbidity, and treatment responsiveness. Since multiple reports originated from the same data repositories, information was synthesized qualitatively by study sample and conceptual domain.</p><p><strong>Results: </strong>The results of our review suggest that FTLBs predominantly affect adolescents and young adults and exhibit a strong female predominance-with higher than anticipated representation of gender-diverse individuals. Compared with TS, the onset of FTLB symptoms was abrupt and characterized by complex motor movements and vocalizations that cause functional impairment. While there is a considerable overlap between FTLBs and TS, there were distinctions in patterns of psychiatric comorbidities. Pharmacological and cognitive behavioral therapy (CBT) provided some benefit for individuals with FTLBs, but the therapeutic target of these interventions was not specified.</p><p><strong>Conclusions: </strong>While sharing some similarities, FTLBs have a distinct clinical presentation from TS. There is some evidence to inform treatment approaches, but findings are complicated by the retrospective nature of most extant reports. Future research is essential to characterize longitudinal trajectories, underlying mechanisms, and evaluation of targeted interventions in randomized clinical trials.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1936806"},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of mother-youth biobehavioral synchrony during stress in predicting youth well-being.","authors":"Christina A Rowley, Juelle Ford, Frances Haofei Li, Zahara O Cuevas-Kovanis, Monet Ruiz, Jennifer A Somers, Jessica L Borelli","doi":"10.3389/frcha.2026.1923350","DOIUrl":"10.3389/frcha.2026.1923350","url":null,"abstract":"<p><strong>Introduction: </strong>Parent-child physiological synchrony may reflect coordinated regulatory processes, but its meaning appears to vary across developmental and interactional contexts. Greater synchrony has been associated with more and less adaptive functioning, suggesting that synchrony should not be interpreted as inherently beneficial. The current study examined whether mother-youth trend-level physiological synchrony during a dyadic stressor was associated with multiple indicators of wellbeing in preadolescence.</p><p><strong>Method: </strong>One hundred seventy-three mother-child dyads (Mothers: <i>M_age</i>  = 41.60 years; Youth: <i>M_age</i>  = 9.54 years, range = 8-12; 53% female) completed the Performance Challenge Task, during which youth attempted unsolvable puzzles while mothers observed. Respiration rate, root mean square of successive differences (RMSSD), and respiratory sinus arrhythmia (RSA) were assessed simultaneously in mothers and youth. Youth reported positive and negative affect, depressive symptoms, anxiety, and aggression; mothers reported youth internalizing and externalizing symptoms. Growth models estimated each participant's physiological trajectory across the task, and mother and youth trajectories were covaried to estimate trend-level synchrony.</p><p><strong>Results: </strong>Greater RSA synchrony was associated with higher post-stressor positive affect after accounting for pre-stressor positive affect, higher mother-reported internalizing symptoms, and lower mother-reported externalizing symptoms. RMSSD synchrony showed a nonsignificant trend toward higher youth-reported anxiety (<i>p</i> = 0.08), and respiration-rate synchrony showed a nonsignificant trend toward lower mother-reported externalizing symptoms (<i>p</i> = 0.06). Most other associations were nonsignificant.</p><p><strong>Discussion: </strong>Findings did not support a uniformly adaptive interpretation of physiological synchrony. Instead, associations varied across outcomes and physiological indices, underscoring the importance of considering what form of synchrony is measured and the context in which it occurs.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1923350"},"PeriodicalIF":1.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-enabled and comparator digital interventions for adolescent mental health (2020-2025): early detection, human-AI collaboration, and ethical governance-a PRISMA-ScR scoping review.","authors":"Noorayisahbe Mohd Yaacob, Mohamed Doheir, Ali Algumaei, Mohammed Nasser Al-Andoli, Jamil Abedalrahim Jamil Alsayaydeh, Abdelrafe Elzamly, Abd Samad Basari","doi":"10.3389/frcha.2026.1905782","DOIUrl":"10.3389/frcha.2026.1905782","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Mental health difficulties among adolescents and youth (ages 10-24) are increasing globally, yet early intervention remains impeded by stigma, service shortages, and cultural barriers. AI-enabled technologies including chatbots, automated screening tools, and machine learning-based predictive models have been proposed as scalable approaches to address these gaps, alongside non-AI digital interventions such as therapist-guided internet-delivered cognitive behavioral therapy (iCBT) and smartphone-based CBT applications, which are examined as comparator evidence given their stronger controlled-design evidence base.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines and Joanna Briggs Institute (JBI) methodology. A systematic database search across six databases (PubMed, Scopus, ProQuest, SpringerLink, Web of Science, and ScienceDirect), supplemented by manual and forward-citation searching, yielded 10,962 records, of which 19 studies met the predefined inclusion criteria. A Human-AI Collaboration Role framework comprising a four-level continuum from fully human-led to fully automated delivery was applied as a predefined coding dimension across all included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Most studies focused on depression and anxiety among mid-to-late adolescents in high-income countries (68.4%). Therapist-guided iCBT was the most rigorously studied format using randomized and controlled designs; AI chatbots, predictive models, and large language model (LLM)-based systems demonstrated feasibility or engagement outcomes in a limited number of studies and contexts, though randomized diagnostic chatbot trials specifically remain absent for participants under 18 years; at least one randomized non-diagnostic chatbot trial (a body-image intervention) has been conducted in this age group. Equity-related reporting was inconsistent: socioeconomic status was reported in only 10.5% of studies and cultural adaptation in 42.1%; restriction to English-language publications may further underrepresent non-Western and low- and middle-income-country evidence relevant to these equity findings. Key implementation challenges included inconsistent safeguarding protocols for minors, algorithmic bias, data privacy concerns, and insufficient integration with clinical and educational systems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The evidence base remains preliminary and methodologically heterogeneous, insufficient to support conclusions about clinical effectiveness or generalizability to diverse adolescent populations. These findings represent a descriptive map of the current evidence landscape rather than an assessment of effectiveness. Future research should prioritize adequately powered adolescent-focused trials, participatory co-design approaches, culturally informed adaptations, and transpare","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1905782"},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone acquisition as an inflection point in early adolescence digital exposome: relevance to mental health.","authors":"Ziv Bren, Kate T Tran, Ronald Clinton, Elina Visoki, Lani A Tran, Nadine Michel, Tyler M Moore, Samuel D Pimentel, Ran Barzilay","doi":"10.3389/frcha.2026.1940646","DOIUrl":"10.3389/frcha.2026.1940646","url":null,"abstract":"<p><strong>Objective: </strong>Acquisition of the first smartphone represents a major developmental transition. However, evidence on its effects on adolescent health and behavior remains limited. We assessed associations between first smartphone acquisition around age 12 and changes in mental health, environmental and lifestyle (exposomic) factors, and examined potential pathways underlying these associations.</p><p><strong>Methods: </strong>We analyzed longitudinal data from 3,486 participants in the U.S. Adolescent Brain Cognitive Development (ABCD) Study who did not have a smartphone by age 12 (2-year assessment wave). We tested the association between smartphone acquisition (exposure) between age 12 to 13 (the 2- and 3-year assessments) and age 13 self-reported mental health (Brief Problem Monitor [BPM]) and exposomic outcomes including digital (screen time, social media, gaming, streaming, cyberbullying) and offline (sleep duration, school performance, exercise, bullying and reading) measures. Mixed-effects regression models accounted for sociodemographic, family, and developmental covariates. To reduce confounding, models additionally adjusted for pre-exposure measures of each outcome assessed at age 12, prior to smartphone acquisition. Mediation models examined indirect effects of smartphone acquisition on mental health through total screen time, social media account ownership, and bedtime media use.</p><p><strong>Results: </strong>Compared with youth who remained smartphone-free at age 13 (<i>n</i> = 1,940), smartphone acquisition (<i>n</i> = 1,546) was associated with worse BPM internalizing, attention, and total scores (all p's ≤ 0.003), more screen time, greater odds of having a social media account, less sleep, and more frequent bedtime use of social media, video games, and streaming (all p's < 0.001). Smartphone acquisition was not associated with differences in externalizing symptoms, academic performance, exercise, or bullying/cyberbullying (all p's > 0.05). Mediation analyses suggested indirect associations between smartphone acquisition and mental health through total screen time, social media account ownership, and bedtime media use (all indirect effects <i>p</i> ≤ 0.002); collectively, these factors accounted for most of the association, with social media use contributing the largest indirect effect.</p><p><strong>Conclusion: </strong>Smartphone acquisition is associated with several environmental and lifestyle changes in the following year, particularly around bedtime. These changes may represent mechanisms linking smartphone acquisition to mental health symptoms. Findings provide insight into potential behavioral pathways associated with smartphone acquisition and adolescent mental health and may inform future intervention studies.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1940646"},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of an observational tool to evaluate how community health workers engage low-income latino parents in parent-child interaction therapy.","authors":"Hanan N Salem, Francesca Rodriguez, Juliana Ison, Dainelys Garcia, Jason F Jent, Eileen M Davis, Betty Alonso, W Andrew Rothenberg, Natalie Espinosa, Camille Perez, Yanet M Rivera, Lilian M Orbano-Flores, Carla Rincon, Miya L Barnett","doi":"10.3389/frcha.2026.1856265","DOIUrl":"https://doi.org/10.3389/frcha.2026.1856265","url":null,"abstract":"<p><strong>Background: </strong>Caregiver engagement in behavioral parent training (BPT) interventions can have a significant impact on treatment outcomes and retention. Yet, low-income families of color often experience low rates of engagement in treatment due to structural and sociocultural barriers. BPT models partnering with community health workers (CHWs) have shown promise in addressing these barriers and increasing treatment engagement. The current study examines the engagement strategies utilized by CHWs when providing support to families receiving Parent-Child Interaction Therapy (PCIT + CHW) by identifying common CHW engagement strategies utilized in treatment (e.g., active listening, psychoeducation) and how they influence components of engagement (e.g., alliance, attendance).</p><p><strong>Methods: </strong>Among families receiving a telehealth delivered PCIT + CHW model (<i>n</i> = 26), two recorded sessions (i.e., first session and a second randomly selected session throughout treatment) per family were coded for engagement strategy delivery. Families included primarily Latino children (96%) and their primary caregivers. Data about caregiver perceived therapeutic alliance, treatment attendance, homework completion, and PCIT skill acquisition were collected.</p><p><strong>Results: </strong>Findings suggest that, on average, CHWs utilized total strategies (i.e., sum of all strategies) and alliance-based strategies (i.e., active listening, conveying partnership, and positive regard) to a moderate extent. Alliance strategies delivered during the first session were associated with caregiver-perceived therapeutic alliance, caregiver-perceived effectiveness of the tasks guiding treatment, and caregiver homework completion in the first phase of treatment.</p><p><strong>Conclusion: </strong>Findings indicate CHWs use a range of engagement strategies, and early use of alliance-based strategies influence multiple components of engagement. Implications for training and involving CHWs in children's mental health services are discussed.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1856265"},"PeriodicalIF":1.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Longitudinal data analysis in child and adolescent mental health, volume II.","authors":"Joseph M Boden, Shuting Zheng, Jessica A Kerr, Tomoya Hirota","doi":"10.3389/frcha.2026.1979900","DOIUrl":"https://doi.org/10.3389/frcha.2026.1979900","url":null,"abstract":"","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1979900"},"PeriodicalIF":1.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive endophenotypes in neurodevelopmental disorders: social cognition and executive functions in children with Autism Spectrum Disorder Level 1 and Attention-Deficit/Hyperactivity Disorder.","authors":"Grazia Maria Giovanna Pastorino, Miriam Olivieri, Antonio Aquino, Noemi Mungo, Rossella Suriano, Francesca Felicia Operto","doi":"10.3389/frcha.2026.1920753","DOIUrl":"10.3389/frcha.2026.1920753","url":null,"abstract":"<p><strong>Introduction: </strong>Executive Functions (EF) and Social Cognition (SC) show strong interdependence, yet it remains unclear whether social difficulties in neurodevelopmental disorders, such as Autism Spectrum Disorder Level 1 (ASD1) and Attention Deficit/Hyperactivity Disorder (ADHD), arise from shared EF related mechanisms or reflect disorder specific neurocognitive architectures. Comparative studies integrating both ecological and performance based measures remain scarce. This study aims to analyze the relationship between executive functions and Social Cognition skills across three matched developmental groups: Autism Spectrum Disorder Level 1 (ASD1), Attention-Deficit/Hyperactivity Disorder (ADHD), and Typical Development (TD).</p><p><strong>Methods: </strong>A total of 123 children aged 6-11 years participated in the study: ASD1 (<i>N</i> = 42), ADHD (<i>N</i> = 43), and TD (<i>N</i> = 38). Participants were evaluated using the WISC-IV, BRIEF-2, and selected subtests of the NEPSY-II. Non-parametric group comparisons and multiple linear regression models within the clinical groups were performed.</p><p><strong>Results: </strong>Both clinical groups showed widespread EF and SC impairments compared to TD peers, but with distinct profiles. ADHD exhibited pronounced deficits in inhibition and attentional control (Inhibition, Auditory/Visual Attention), whereas ASD1 showed greater impairment in SC (ToM, AR), cognitive flexibility (Shift), and rule-guided tasks (Response Set, DesignFluency). Regression models revealed disorder-specific EF-SC relationships: in ADHD, SC performance was strongly scaffolded by EF (Inhibition, Auditory Attention, Design Fluency; ToM model R² = 0.72). In ASD1, ToM was predicted primarily by AR and Response Set (R² = 0.55), indicating relative independence from basic inhibitory and attentional resources.</p><p><strong>Conclusions: </strong>Despite superficially similar social difficulties, ASD1 and ADHD display distinct patterns of association between EF and SC: executive-regulatory deficits in ADHD versus primary mentalizing and shifting impairments in ASD1. These findings support the need for transdiagnostic profiling to optimize early screening and to guide targeted, domain-specific rehabilitative and psychoeducational interventions for each diagnostic profile.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1920753"},"PeriodicalIF":1.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jointly held care documents in child and adolescent mental health services: a systematic review.","authors":"Neve Jones, James Roe, Josephine Holland","doi":"10.3389/frcha.2026.1863944","DOIUrl":"10.3389/frcha.2026.1863944","url":null,"abstract":"<p><strong>Background: </strong>Young people accessing Child and Adolescent Mental Health Services (CAMHS) in the UK represent a digital native generation, but practices around digital care documents lag behind. Jointly held care documents could be a way of improving accessibility and inclusion of young people and parents/carers in care planning.</p><p><strong>Methods: </strong>Systematic searches of MEDLINE, Embase, CINAHL, PsycINFO, PsycArticles, King's Fund, Google Scholar, The Health Foundation, Social Care Online, Cochrane Library, Royal College of Psychiatrists, Web of Science and EconLit databases were conducted alongside grey literature searches. All eligible studies investigating the use of jointly held care documents in Child and Adolescent Mental Health Services were included. Risk of bias was assessed using an adapted version of the Hawker critical appraisal tool.</p><p><strong>Results: </strong>Seven studies, from research groups in the Netherlands, the USA and Norway were included. Existing studies have looked at perceptions of quality and engagement, facilitators and barriers, clinical effectiveness and adolescent and professional acceptability. Studies have used a range of methodologies and were generally of high quality, finding that jointly held care documents were mainly positively thought of by young people and parents/carers, but there was ambivalence from healthcare professionals around information sharing and the practicalities of co-creation.</p><p><strong>Conclusion: </strong>The current literature shows good acceptability of jointly held and co-created care documents amongst young people and parents. Barriers to implementation mainly exist amongst professionals.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420250652309.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1863944"},"PeriodicalIF":1.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and feasibility of the Ushirikiano treatment model for Kenyan adolescents: a pilot randomized controlled trial.","authors":"Nabila Amin Ali, Shillah Mwaniga Mwavua, Obadia Yator, Joseph Kathono, Anja C Huizink, Manasi Kumar","doi":"10.3389/frcha.2026.1890788","DOIUrl":"10.3389/frcha.2026.1890788","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents in low- and middle-income countries experience high rates of common mental disorders (CMDs) but have limited access to adolescent-friendly, evidence-based care. While Interpersonal Psychotherapy for Adolescents (IPT-A) is effective, brief group IPT-A delivered through task-shifted, stepped-care has not been rigorously evaluated in Kenyan primary care.</p><p><strong>Methods: </strong>We conducted a pilot randomized controlled trial to examine the acceptability, feasibility, and preliminary effectiveness of the Ushirikiano treatment model, a task-shifted, stepped-care approach combining a brief (four-session) group IPT-A (IPT-G-A) delivered by community health promoters, with fluoxetine for severe cases where indicated. Adolescents aged 12-18 years with DSM-5 TR depression, anxiety, and/or somatic symptom disorder (<i>N</i> = 32) were randomized to the Ushirikiano Model or enhanced treatment as usual (eTAU). Quantitative and qualitative data were collected at baseline, post-treatment, and at follow-up at months 1 and 2. The COM-B framework informed the assessment of behavior change.</p><p><strong>Results: </strong>All adolescents in the intervention arm were retained compared with 69% in eTAU. Intervention fidelity ranged from moderate to high and showed improvement with supervision. Participants found the intervention acceptable, relevant, and supportive, and reported applying IPT-G-A skills to handle interpersonal and school-related stressors. Community health promoters reported increased confidence with blended training and ongoing supervision. Preliminary outcomes trends suggested potential reductions in depressive symptoms and modest functional improvement in the Ushirikiano arm, with most participants achieving symptomatic remission at the month 2 follow-up. As a pilot study, these findings provide preliminary evidence of potential benefit and support further evaluation of the intervention in a fully powered trial.</p><p><strong>Conclusion: </strong>The Ushirikiano treatment model appears acceptable and feasible for addressing adolescent depression in Kenyan primary care. While preliminary findings suggest the potential for improvements in depressive symptoms and functioning, the study was not designed to establish effectiveness and did not assess for anxiety and somatic symptom disorder. These findings support further evaluation in fully powered trials to determine clinical effectiveness for CMDs, cost-effectiveness, and optimal implementation strategies.</p><p><strong>Clinical trial registration: </strong>https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=33227, Pan African Clinical Trial Registry, PACTR202503728947243.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1890788"},"PeriodicalIF":1.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}