Frontiers in child and adolescent psychiatry最新文献

{"title":"Prevalence and psychosocial correlates of depressive symptom risk among secondary school students in Saudi Arabia: a mixed-methods study.","authors":"Ibrahim Awad Eljack Ibrahim, Abdullah M Alshahrani, Abdullah Hassan Alhalafi, Kamal Eldin Hussein Elhassan, Abubakar Mohamed Jibo, Partha Nandi, Adel M Alshahrani, Ahmed A Alghamdy, Awn S Alhersh, Ayed M Al-Qahtani, Asim M Alasmari, Ali H Alhelal, Hani Abdulrahman F Al-Qahtani, Hassan S Alshahrani, Ribi M Alhersh","doi":"10.3389/frcha.2026.1926540","DOIUrl":"10.3389/frcha.2026.1926540","url":null,"abstract":"<p><strong>Objectives: </strong>Adolescent depression is a major public health concern with important psychosocial and educational implications. This study examined the distribution of a depressive-symptom-risk/general-distress composite and its psychosocial correlates among secondary school students in Bisha Province, Saudi Arabia, and explored teachers' perspectives on how depressive symptoms or distress affect students in school settings.</p><p><strong>Methods: </strong>A school-based cross-sectional mixed-methods study was conducted during the 2024-2025 academic year. Quantitative data were analyzed from 425 secondary school students using a self-administered questionnaire containing a 17-item depressive-symptom-risk composite and psychosocial stressor items. Composite items were coded from 0 to 7 (theoretical total range 0-119; observed range 0-84). For descriptive purposes, four sample-specific, non-diagnostic score bands were used (0-24, 25-38, 39-67, and ≥68), and the primary logistic-regression outcome was dichotomized as 0-24 vs. ≥25. Analyses included chi-square tests, Spearman correlation, Kruskal-Wallis tests, and multivariable logistic regression, with <i>p</i>-values corrected for multiple comparisons using the Benjamini-Hochberg procedure. Qualitative data were obtained through semi-structured interviews with 42 teachers and analyzed thematically. Ethical approval was obtained from the University of Bisha Institutional Review Board.</p><p><strong>Results: </strong>Overall, 47.1% of students had an elevated composite score (≥25). In the 425-student analytical sample, family conflict (aOR = 5.47) and emotional or physical violence (aOR = 3.40) remained significantly associated with elevated scores after correction for multiple comparisons; bullying showed a positive uncorrected association (aOR = 1.68) that did not survive correction. Health-related conditions, smoking, and family history of mental illness were also associated with higher score bands in bivariate analyses. Gender-stratified analyses showed that, after correction, family conflict remained significant among male students, while family conflict and emotional/physical violence remained significant among female students; associations for bullying among males and sexual harassment among females were positive but did not survive correction and should be interpreted as suggestive. Composite scores were not significantly associated with academic performance (CGPA). Teachers reported emotional withdrawal, behavioral changes, reduced classroom engagement, and limited training in identifying and supporting affected students.</p><p><strong>Conclusions: </strong>Elevated depressive-symptom-risk composite scores were common among secondary school students and were strongly associated with modifiable psychosocial stressors, particularly family conflict and exposure to violence. Because the instrument and its score bands are not diagnostic thresholds, the findings should be interpre","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1926540"},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984365","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":"Psychological impact of armed conflict and forced displacement on children and adolescents.","authors":"Maryam Masoomi, Mahdieh Saeidi, Mona Salehi, Sakshi Prasad, Omar Alzein, Deblina Roy, Mohita Joshi, Sasidhar Gunturu","doi":"10.3389/frcha.2026.1912159","DOIUrl":"https://doi.org/10.3389/frcha.2026.1912159","url":null,"abstract":"<p><strong>Introduction: </strong>Armed conflict and forced displacement disrupt the safety, caregiving, education, and healthcare essential for healthy child development, placing children and adolescents at increased risk for adverse mental health outcomes. This narrative review summarizes the psychological consequences of war and displacement and highlights trauma-informed interventions across different stages of recovery.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted using PubMed and Google Scholar. Studies published between January 2000, and January 2025 were identified using keywords related to children, adolescents, armed conflict, war, forced displacement, refugee populations, mental health outcomes, post-traumatic stress disorder (PTSD), depression, anxiety, and psychosocial interventions. Relevant English-language articles addressing psychological outcomes and intervention strategies among conflict-affected youth were reviewed and synthesized.</p><p><strong>Results: </strong>Across studies, exposure to armed conflict and displacement was consistently associated with elevated rates of PTSD, depression, anxiety, behavioral disturbances, sleep problems, and impaired social functioning. Mental health effects were observed during acute crises and often persisted long after conflict exposure, increasing the risk of chronic psychiatric disorders and intergenerational transmission of trauma. Protective factors included stable caregiving relationships, educational continuity, social support, and access to community-based psychosocial services. However, significant disparities in service availability and accessibility were reported, particularly among displaced and refugee populations.</p><p><strong>Conclusion: </strong>Armed conflict and forced displacement harm children through direct trauma exposure, disrupted caregiving, loss of educational and social structure, chronic deprivation, and barriers to care, with effects that persist well beyond the acute phase. Trauma-focused cognitive behavioral therapy and narrative exposure therapy have the strongest supporting evidence but are the least scalable in active conflict, whereas group and non-specialist approaches offer reach with more variable effects. Intergenerational transmission is best supported for psychological, familial, and social pathways; biological mechanisms remain preliminary. Stepped, layered, and culturally adapted delivery embedded in schools, families, and primary care is needed.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1912159"},"PeriodicalIF":1.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992917","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":"Profiles of gifted students through the eyes of their teachers: identifying students at risk for underachievement.","authors":"Fae Aimée van der Weijden, Lisette Hornstra, Evelyn H Kroesbergen","doi":"10.3389/frcha.2026.1678145","DOIUrl":"10.3389/frcha.2026.1678145","url":null,"abstract":"<p><strong>Introduction: </strong>Not all gifted students realize their full potential and many gifted students are underachieving. To examine whether gifted primary school students at risk for underachievement can be identified by their teachers early on, the current study aimed to examine (1) whether different profiles can be distinguished among gifted students based on teacher ratings of observable characteristics (classroom behavior, task commitment, educational performance, teacherchild relationship quality, and peer relations), (2) to what extent the identified profiles and students' profile membership are stable over time, and (3) to what extent profile membership is associated with achievement (growth).</p><p><strong>Methods: </strong>Participants were two cohorts of Grade 3 students from primary schools in all districts of the Netherlands achieving above the 90th percentile on a cognitive ability test (<i>N</i> = 1,303; M_age = 8,44 years), who were assessed again in Grade 6.</p><p><strong>Results: </strong>Latent Profile Analyses revealed four profiles of gifted students in Grade 3, which mostly represented general quantitative differences in teacher ratings: above average, average independent and low conflict, average, and below average. Similar profiles were found in Grade 6, having similar sizes as in Grade 3. Latent Transition Analyses showed that half of the students changed profile between Grades 3 and 6. Profile membership in Grade 3 was related to achievement in Grades 3 and 6 (reading fluency, reading comprehension, and math) and, to a small extent, to achievement growth between Grades 3 and 6.</p><p><strong>Discussion: </strong>This study suggests that quantitatively distinct groups of gifted students can be distinguished based on teacher ratings of students' characteristics and that students' cognitive and non-cognitive characteristics, as observed by their teacher, could help to identify students at risk for underachievement.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1678145"},"PeriodicalIF":1.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972516","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":"Early motor trajectories and distinct psychopathological profiles in adolescents born very and extremely preterm.","authors":"Emanuela Claudia Turco, Davide Fausto Borrelli, Federica Cimmino, Laura Caiazza, Lorenzo Petrolini, Tommaso Vitali, Cecilia Ferrari, Benedetta Piccolo, Susanna Esposito, Maria Carmela Pera, Matteo Tonna","doi":"10.3389/frcha.2026.1894705","DOIUrl":"10.3389/frcha.2026.1894705","url":null,"abstract":"<p><strong>Background: </strong>In recent decades, advances in neonatal care have led to a substantial reduction in mortality associated with prematurity. However, preterm birth remains the leading contributor to long-term neurodevelopmental impairment across the lifespan. The present study aimed to longitudinally assess neurodevelopmental outcomes in individuals born very preterm (VPT) or extremely preterm (EPT) and to retrospectively investigate associations between early neurodevelopmental trajectories and psychopathological and functional profiles in adolescence.</p><p><strong>Methods: </strong>The study included 52 adolescents aged 14-18 years, drawn from an original cohort of 118 individuals born before 31 weeks of gestation between 2005 and 2011. Neonatal clinical and anamnestic data were collected, and early neurodevelopment within the first two years of life was assessed using the Bayley Scales of Infant and Toddler Development, Second Edition. Fifteen years later, participants underwent a multidimensional follow-up assessment via self-administered questionnaires delivered through a secure web-based platform. Both participants and one parent completed a comprehensive psychopathological evaluation, including the Child Behavior Checklist (CBCL), Autism Spectrum Quotient (AQ), Obsessive-Compulsive Inventory (OCI), Prodromal Questionnaire-16 (PQ-16), and Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE).</p><p><strong>Results: </strong>The mean gestational age was 28 weeks (SD = 1.8; range: 23-31), and the mean birth weight was 1,120.8 g (SD = 322.4). VPT individuals showed higher AQ scores, suggesting increased vulnerability to autistic traits, whereas EPT individuals exhibited higher CBCL Attention Problems scores, consistent with ADHD-related features. Latent Profile Analysis identified a two-profile solution: Profile 1 (\"High autism traits\") was characterized by elevated AQ scores and relatively low OCI, PQ-16, and IPASE scores, whereas Profile 2 (\"High psychotic and OCD traits\") showed markedly elevated PQ-16, IPASE and OCI scores. Hierarchical multiple regression analyses revealed that the Psychomotor Development Index slope was the only significant predictor of later social functioning (B = -5.782, <i>β</i> = -.289, <i>p</i> = .040), with more favorable early motor trajectories associated with fewer social difficulties in adolescence.</p><p><strong>Conclusions: </strong>Very and extremely preterm birth are associated with long-term neurodevelopmental and psychopathological vulnerability. Early motor development appears to be a key predictor of later social functioning, potentially shaping distinct developmental trajectories toward autism-related features or psychosis vulnerability.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1894705"},"PeriodicalIF":1.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972544","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 phenotype- and potency-gated extracellular vesicle allocation hypothesis for autism.","authors":"Burak Tatlı, İbrahim Kamer","doi":"10.3389/frcha.2026.1942419","DOIUrl":"10.3389/frcha.2026.1942419","url":null,"abstract":"<p><p>Autism is a heterogeneous neurodevelopmental condition for which a single extracellular vesicle (EV) product is unlikely to match every biological context. We hypothesized that four development-coded EV candidates should be allocated by convergent phenotype, biomarker, and patient-derived functional response rather than diagnosis alone. EXO2, a cord-blood-plasma EV candidate, was tested only in an immune-inflammatory endophenotype characterized by regression or severe irritability along with objective inflammatory activity, after excluding pain, sleep disorder, epilepsy, infection, and other mimics. EXO3, a dental-pulp mesenchymal-stromal-cell EV candidate, was tested in a synaptic-developmental endophenotype with prominent language impairment or intellectual disability, but only if the patient-derived neurons show improved neurite, synaptic, and network function. EXO1, a Wharton-jelly mesenchymal-stromal-cell EV candidate, was tested in a circuit-plasticity endophenotype dominated by abnormalities in social communication, sensory, and repetitive behaviors using a concordant neuronal-network assay. R-EXO, an umbilical-cord-tissue mesenchymal-stromal-cell EV candidate, remained an exploratory option for a neurovascular-barrier/extracellular matrix endophenotype. Regression, language delay, or behavior alone are not selection biomarkers. Each lot must pass identity, purity, safety, and phase-specific potency gates. Sequential use of EXO2, followed by EXO1, EXO3, or, in exceptional cases, R-EXO is predicted to outperform ungated or simultaneous use when inflammation masks a residual developmental mechanism. This is a falsifiable preclinical framework and does not support clinical administration.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1942419"},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956819","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":"Co-designing and piloting adolescent-adapted social rhythm therapy for young people with unipolar and bipolar depression: a mixed-methods feasibility case series.","authors":"Gonzalo Salazar de Pablo, Claudia Aymerich, Zahra Kamran, Cecilia Sanjuan-Ortiz, Nuria Laherran-Cantera, Shantal Zeb, Eleonora Armyra, Allan H Young, Aditya Sharma, Cornelius Ani, Manasi Kumar, Holly A Swartz","doi":"10.3389/frcha.2026.1909726","DOIUrl":"10.3389/frcha.2026.1909726","url":null,"abstract":"<p><strong>Objective: </strong>Depressive and bipolar disorders commonly emerge during adolescence and are associated with disturbances in sleep, daily routines and social rhythms, as well as functional impairment. Social Rhythm Therapy (SRT) targets these processes. However, adult-derived rhythm protocols do not adequately reflect adolescents' school and family schedules, developmental autonomy, social and digital routines, or preferences regarding monitoring. Direct youth co-design is therefore needed to improve developmental fit, engagement and feasibility. We addressed this gap by co-designing the Social Therapy for Adolescent Rhythms in Depression (STAR-D), an adolescent-adapted SRT intervention, and evaluating its feasibility and acceptability within routine Child and Adolescent Mental Health Services (CAMHS).</p><p><strong>Methods: </strong>A two-phase mixed-methods feasibility design was used. Phase 1 involved co-production and intervention adaptation using questionnaire feedback from 10 adolescents, an in-depth interview with one Young People's Advisory Group representative, and feedback from six clinicians. TIDieR principles guided intervention description and adaptation. Phase 2 piloted STAR-D in adolescents receiving care in Lambeth CAMHS, London, UK. Feasibility was assessed through referral, uptake, retention and completion. Acceptability was assessed through qualitative feedback. Exploratory clinical outcomes were described using measures of functioning, depressive symptoms and manic symptoms.</p><p><strong>Results: </strong>Phase 1 feedback identified priorities for intervention adaptation, including accessible language, explicit links between routines and mood, personalised goals and flexible delivery. These findings informed an eight-session STAR-D protocol. In Phase 2, seven young people were referred, six accepted and started STAR-D, and five completed all eight sessions. Participants described the intervention as supportive, collaborative and accessible. However, they suggested simplifying daily monitoring to reduce burden. Quantitative completion and missingness data for monitoring forms were not prospectively collected. Exploratory clinical trajectories were variable.</p><p><strong>Conclusion: </strong>STAR-D was feasible to deliver and acceptable to most participants in this small, uncontrolled, single-service pilot. The findings support further optimisation, particularly of routine monitoring, followed by a larger multicentre controlled mechanistic trial. Future work should test whether changes in sleep-wake regularity, daily routines and social rhythm stability mediate changes in mood and functioning, and should evaluate unipolar and bipolar presentations with sufficient diagnostic stratification.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1909726"},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956965","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":"Referral pathways as mechanisms of child maltreatment identification: evidence from a German Childhood-House.","authors":"Silke Pawils, Elisa Grossmann, Axel Heinemann, Benjamin Ondruschka","doi":"10.3389/frcha.2026.1907809","DOIUrl":"10.3389/frcha.2026.1907809","url":null,"abstract":"<p><strong>Background: </strong>Adverse childhood experiences-related child maltreatment, including abuse and neglect, are major threats to children's safety, health, and development. Their identification depends on recognition and referral processes occurring across multiple professional systems. Childhood-Houses, based on Child Advocacy Center and Barnahus principles, provide multidisciplinary assessment and support for children with suspected maltreatment experiences.</p><p><strong>Objective: </strong>This study examined whether identified child maltreatment profiles and multidisciplinary assessment processes differed according to referral pathways to a German Childhood-House. In addition, perspectives of external referrers regarding interdisciplinary collaboration were explored.</p><p><strong>Methods: </strong>A quantitative observational study was conducted using two complementary data sources. Routine documentation data from children and adolescents referred to the Childhood-House Hamburg between January and September 2023 were analyzed (<i>n</i> = 731). Furthermore, an exploratory online survey among external referrers from youth welfare services, healthcare, and law enforcement agencies was conducted in the same period (<i>n</i> = 66). Descriptive and exploratory analyses examined differences in referral pathways, identified maltreatment profiles, multidisciplinary assessment procedures, and collaboration experiences.</p><p><strong>Results: </strong>Referral pathways were associated with distinct child maltreatment profiles. Medical, physical, and emotional neglect were identified predominantly among youth welfare referrals, while physical abuse and sexualized violence occurred more frequently among healthcare and law enforcement referrals. Multidisciplinary assessment procedures also differed across referral pathways. Referrers reported generally positive collaboration experiences but identified needs for improvement regarding psychological assessment, feedback procedures, and interdisciplinary communication.</p><p><strong>Conclusions: </strong>The findings indicate that referral pathways serve as important mechanisms of child maltreatment identification and influence access to multidisciplinary child protection services. Strengthening standardized identification procedures, referral structures, and cross-sector collaboration may support more comprehensive responses to ACE-related child maltreatment experiences.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1907809"},"PeriodicalIF":1.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957139","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: Rising stars in developmental psychopathology and mental health 2024.","authors":"Nicky Wright, Christine Puckering","doi":"10.3389/frcha.2026.1937431","DOIUrl":"10.3389/frcha.2026.1937431","url":null,"abstract":"","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1937431"},"PeriodicalIF":1.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914539","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 mediating role of psychological resilience and coping styles among Chinese medical students in the relationship between perceived social support and learning engagement among medical students.","authors":"Yue Li, Fan Zhang, Mengran Zhang, Hua Zhu, Zhe Jin","doi":"10.3389/frcha.2026.1835372","DOIUrl":"10.3389/frcha.2026.1835372","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between college medical students' Perceived Social Support and learning engagement and the mediating role of psychological resilience and coping styles.</p><p><strong>Methods: </strong>The Perceived Social Support Scale (PSSS), the Simple Medical Coping Style Questionnaire (SCSQ), Ego-resiliency Scale (ER89), and the Undergraduate Work Engagement Scale (UWES-S) were selected to conduct a questionnaire survey of 2,375 medical students.</p><p><strong>Results: </strong>The analysis showed that there was a significant positive relationship between perceived social support, psychological resilience, positive coping styles and learning engagement(<i>r</i> = 0.274∼0.973,<i>P</i> < 0.01);The results of the mediated effects test indicated that the mediated paths of perceived social support affecting learning engagement through psychological resilience and positive coping styles and their chain mediated effects all showed statistical significance respectively (<i>β</i> = 0.083,0.033,0.071).</p><p><strong>Conclusions: </strong>Medical students' perceived social support not only affects learning engagement directly, but also indirectly through the mediating role of psychological resilience and positive coping style and the chain mediating role of psychological resilience-positive coping style.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1835372"},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898522","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":"Guanfacine extended-release use in diagnostic diversity and symptom complexity.","authors":"Gülenay Korkmaz Şahin, Seda Sarı, Zeynep İrem Şener, Nazlı Burcu Özbaran","doi":"10.3389/frcha.2026.1912093","DOIUrl":"10.3389/frcha.2026.1912093","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective chart review examined clinical changes in ADHD symptoms and global functioning following guanfacine extended-release (GXR) initiation in a diagnostically heterogeneous clinical sample of children and adolescents with ADHD.</p><p><strong>Methods: </strong>Thirty-eight children and adolescents aged 6-18 years with ADHD, with or without comorbid neurodevelopmental or psychiatric conditions, who were prescribed guanfacine extended-release were included in the tolerability analysis. Pre-post clinical outcome analyses were conducted in 33 patients who continued GXR for at least three months and had follow-up scale assessments available between weeks 4 and 12 after treatment initiation. Clinical data, including ADHD-related rating scales and autism-related clinical measures, were obtained retrospectively from medical records. Diagnoses were based on DSM-5 criteria, and psychiatric comorbidities were assessed using K-SADS-PL.</p><p><strong>Results: </strong>Of the participants, 76.3% were male. All participants had ADHD, and 63.2% had comorbid ASD. The mean final weight-adjusted GXR dose was 0.05 ± 0.03 mg/kg/day. Adverse effects were reported in 28.9% of patients, most commonly restlessness. Among 33 patients with follow-up assessments obtained between weeks 4 and 12, median CGI-S scores decreased from 5 to 3, while GAS scores increased from 55 to 75. ADHD symptom ratings decreased in most Turgay scale subdomains, particularly attention deficit, hyperactivity/impulsivity, and oppositional defiant symptoms.</p><p><strong>Conclusion: </strong>Guanfacine extended-release use was associated with improvements in ADHD symptom ratings and global functioning in this retrospective clinical sample. Adverse effects were observed in a clinically relevant subset of patients and led to discontinuation in some cases. Given the retrospective design, lack of a control group, small sample size, and concomitant medication use, these findings should be interpreted as preliminary real-world observations.</p>","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 ","pages":"1912093"},"PeriodicalIF":1.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898498","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}