Child and Adolescent Psychiatry and Mental Health最新文献

{"title":"A comparison of body image components, including attentional bias and body appraisal, in adolescents with anorexia nervosa or depression, and non-clinical controls.","authors":"Inken Kirschbaum-Lesch, Anne Radix, Laura Mokros, Anca Sfärlea, Belinda Platt, Gerd Schulte-Körne, Eni S Becker, Martin Holtmann, Tanja Legenbauer","doi":"10.1186/s13034-026-01160-y","DOIUrl":"10.1186/s13034-026-01160-y","url":null,"abstract":"<p><strong>Background: </strong>Body image disturbance (BID) is increasingly recognized as a transdiagnostic factor. Beyond its established role in anorexia nervosa (AN), specific components of BID are also associated with the development and maintenance of psychopathology in adolescent Major Depressive Disorder (MDD). However, measurements of different body image components (perceptual, affective, cognitive, and behavioral)-especially objective behavioral measures-remain scarce; the assessment of attentional biases (AB) represents a promising tool to fill this gap.</p><p><strong>Methods: </strong>In the present study, two clinical groups of adolescent inpatients (MDD: n = 28; AN: n = 34) and non-clinical controls (NCC: n = 39; aged 13-19 years) completed a body-related Stroop task and a free-viewing task including a body appraisal. Participants also completed questionnaires assessing shape concerns, social appearance anxiety, body checking, avoidance, and reassurance.</p><p><strong>Results: </strong>The AN and the NCC groups revealed a significant body-related AB, whereas the MDD group did not. Regarding body appraisal, the clinical groups rated their bodies more negatively than the NCC group. On shape concerns, anxiety, and body avoidance/checking, the AN group showed elevated scores compared to the MDD group. Notably, the NCC only differed significantly from the AN group regarding shape concerns.</p><p><strong>Conclusions: </strong>The three groups exhibited distinct BID profiles, identifying pathological body appraisal as a transdiagnostic feature that suggests body dissatisfaction interventions could also mitigate adolescent depressive symptoms. Furthermore, the lack of behavioral differences between healthy adolescents and the AN group underscores the need for early prevention targeting checking and avoidance to prevent the progression into clinical eating disorders.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"When the safe place is not safe\": therapists' perspectives on implementing TF-CBT during the war in Ukraine.","authors":"Maike Garbade, Mariia Hrynova, Cedric Sachser, Elisa Pfeiffer","doi":"10.1186/s13034-026-01142-0","DOIUrl":"10.1186/s13034-026-01142-0","url":null,"abstract":"<p><strong>Background: </strong>Since the beginning of the Russian war against Ukraine in 2022, various evidence-based trauma-focused therapies have been implemented in a region that was previously structurally underserved. Despite the high demand for psychotherapeutic care, little is known about the practical implementation of these therapies under conditions of war. The aim of this qualitative study was to explore the experiences of Ukrainian therapists in delivering Trauma-focused Cognitive Behavioral Therapy (TF-CBT) for children and adolescents during the war and to identify benefits, specific challenges and necessary adaptations.</p><p><strong>Method: </strong>In April 2023, three focus groups were conducted with a total of seven Ukrainian therapists who were part of the \"TF-CBT Ukraine\" project. The focus groups were transcribed, translated into English, and analyzed using qualitative content analysis with MAXQDA.</p><p><strong>Results: </strong>All participants had already initiated or successfully completed TF-CBT treatments and reported positive therapeutic experiences underscoring the acceptability and perceived benefit of the intervention under highly adverse conditions. At the same time, a range of challenges was identified, including an unstable security situation, unreliable internet connections, frequent relocation of clients, and difficulties in working with parents. Therapists discuss possible reasons for this, like the parents' own psychological burden or the limited mental health literacy within the general population. Therapists described specific adaptations in their therapeutic practice to address these challenges, including adjustments to pacing, and enhanced efforts in psychoeducation and stabilization.</p><p><strong>Conclusion: </strong>The findings indicate therapists perceive TF-CBT as generally feasible under conditions of war, highlighting its robustness as an evidence-based intervention in humanitarian settings. However, the results also emphasize the necessity of context-specific adaptations to address ongoing instability, structural barriers, and sociocultural factors. Beyond the Ukrainian context, these findings provide valuable implications for the implementation and scaling of trauma-focused interventions in other war- and crisis-affected regions. They further underscore the importance of sustained training, supervision, and support for therapists to ensure treatment fidelity, as well as the need to integrate mental health literacy initiatives at the community level to maximize both effectiveness and long-term sustainability.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-affirming psychiatry: a minority stress and phenomenological framework for child and adolescent mental health.","authors":"Jamie D Agapoff, E Diane Stapleton, Gerrit van Schalkwyk","doi":"10.1186/s13034-026-01147-9","DOIUrl":"10.1186/s13034-026-01147-9","url":null,"abstract":"<p><p>This perspective article introduces Gender Affirming Psychiatry (GAP), a conceptual framework that integrates queer phenomenology, the gender minority stress model, and gender-affirming care to guide psychiatric assessment, formulation, and treatment of transgender and gender diverse (TGD) youth. This approach acknowledges the cultural and institutional structures that negatively impact the mental health of gender diverse youth, while leveraging resilience, community connection, and support structures that are known to improve mental health outcomes. In this time of greater awareness and increased scrutiny, GAP is a practical, person-centered approach that is clinically sound and ethically grounded.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of intelligence in PTSD treatment outcomes: evidence from a multicenter TF-CBT trial with youth.","authors":"Sabrina Berardi, Hanna Christiansen, Sebastian Deutscher, David Daniel Ebert, Rebekka Eilers, Katharina Gossmann, Anne Grass, Lena Jaworski, Johanna Kneidinger, Rita Rosner, Katharina Szota, Anna-Carlotta Zarski, Regina Steil","doi":"10.1186/s13034-026-01149-7","DOIUrl":"10.1186/s13034-026-01149-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive ability has been linked to posttraumatic stress disorder (PTSD) vulnerability and may influence trauma-focused treatment response, yet its role in youth Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) outcomes remains unclear. Clarifying this issue is relevant for equitable access to evidence-based care. We examined whether formally assessed IQ was associated with PTSD symptom change from pre- to post-treatment based on youth and caregiver reports and with treatment dropout in children and adolescents undergoing TF-CBT after abuse or neglect.</p><p><strong>Method: </strong>Data came from N = 320 youth aged 5-21 years from a randomized clinical effectiveness trial. Intelligence quotient (IQ) was assessed with standardized tests, PTSD symptoms with the Child and Adolescent Trauma Screen (CATS-2), and dropout was defined as not completing therapy as intended. Symptom change was calculated as post- (T1) minus pre-treatment (T0) and evaluated separately for youth and caregiver reports. Regression models included age, gender, baseline PTSD severity, and treatment satisfaction assessed after treatment as an additional model variable.</p><p><strong>Results: </strong>Mean IQ was M = 97.41 (SD = 13.19, range = 51-138). PTSD severity was high at baseline (M = 34.21, SD = 8.09) and decreased substantially (ΔCATS-2_{T1 ₋ T0} youth report: M = -17.54, SD = 12.34; Cohen's d paired = 1.42). IQ showed small but significant negative correlations with symptom change in youth reports (r = -.14, p = .040) and caregiver reports (r = -.17, p = .018), indicating greater symptom reductions at higher IQ. In regressions, IQ was not a significant predictor in the youth-report model (β = -.10, p = .077), while a small effect remained in the caregiver-report model (β = -.15, p = .011). Baseline PTSD severity and post-treatment satisfaction showed more consistent associations with symptom reduction. Dropout was 29.1%. IQ neither differed between completers and dropouts nor was associated with dropout in logistic regression (OR = 0.99, p = .536), whereas higher post-treatment satisfaction was associated with lower dropout risk.</p><p><strong>Discussion: </strong>TF-CBT was associated with substantial symptom reductions across the observed IQ range, suggesting its suitability for routine care without excluding youth solely on the basis of cognitive ability. Baseline severity and treatment satisfaction at post-treatment showed stronger associations with symptom change and dropout than IQ. Trial registration The BESTFORCAN study was registered in the German Clinical Trial Registry (DRKS00020516) on 12 February 2020.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not all wounds are visible: Peer bullying and psychopathology in child and adolescent psychotherapy outpatients.","authors":"Anna-Luisa Kranhold, Sina Weber, Carolin Köhmstedt, Karen Krause, Dieter Wolke, Silvia Schneider, Babett Voigt","doi":"10.1186/s13034-026-01146-w","DOIUrl":"10.1186/s13034-026-01146-w","url":null,"abstract":"<p><strong>Background: </strong>Bullying poses a major risk for poor mental health. While findings from the general population highlight harmful effects of bullying, data from clinical samples with diverse diagnoses and evidence-based diagnostic methods is rare. This study aimed at exploring the association between psychopathology and active bullying involvement in child and adolescent psychotherapy outpatients.</p><p><strong>Methods: </strong>The preregistered study ( https://aspredicted.org/VYW_9TT ) included data from N = 719 outpatients aged 6-20 years from a German child and adolescent psychotherapy centre. Current experiences as a victim, bully-victim, or bully and distressing bullying-specific intrusions were assessed with a screening instrument. Gold-standard diagnostic assessment of psychopathology provided categorial ICD-10 diagnoses. The Strength and Difficulties Questionnaire depicted a dimensional proxy measure of psychopathology. Analyses included examining the frequencies of the bullying roles (victim, bully-victim, bully) and the occurrence of distressing bullying-specific intrusions, Pearson's chi-square tests for gender-specific differences, binary logistic regression analyses testing the bullying roles as predictors of ICD-10 diagnoses, and multiple one-way ANOVAs examining group differences on the Strength and Difficulties Questionnaire scores between the bullying roles.</p><p><strong>Results: </strong>29% of all outpatients reported to be actively involved in bullying (22% victims, 5% bully-victims, 2% bullies), with 32% frequently experiencing distressing bullying-specific intrusions. While victims were more likely to have mood disorders (ICD-10 F3 disorders), bully-victims were less likely to have internalising and more likely to have externalising disorders and behavioural and emotional disorders with onset usually occurring in childhood and adolescence (ICD-10 F9 disorders). Bullies were more likely to have multiple disorders but less likely to have internalising disorders. Independent from specific diagnoses, victims, bully-victims, and bullies overall reported greater emotional and behavioural difficulties than outpatients without bullying experiences.</p><p><strong>Conclusions: </strong>Among outpatients in child and adolescent psychotherapy, bullying is linked to specific related psychological burden and role-specific psychopathology. Bullying and related psychological burden should be addressed and routinely assessed in mental health care settings. The link between bullying and psychopathology as well as specific intervention methods may be explored further in future research.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148688553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a stepped-care approach for school-age children with mild to moderate ADHD (ESCAschool-moderate): an adaptive intervention study including a randomized controlled trial.","authors":"Manfred Döpfner, Christina Dose, Christopher Hautmann, Martin Hellmich, Lea Teresa Kohl, Anne-Katrin Treier, Elena von Wirth, Katja Becker, Daniel Brandeis, Ute Dürrwächter, Julia Geissler, Sarah Hohmann, Martin Holtmann, Michael Huss, Thomas Jans, Anna Kaiser, Johanna Ketter, Tanja Legenbauer, Sabina Millenet, Luise Poustka, Tobias J Renner, Jasmin Wenning, Tobias Banaschewski","doi":"10.1186/s13034-026-01115-3","DOIUrl":"10.1186/s13034-026-01115-3","url":null,"abstract":"<p><strong>Background: </strong>This German multicenter study aimed to analyze the efficacy of telephone-assisted self-help (TASH) and changes during subsequent adaptive treatment in children with mild-to-moderate ADHD.</p><p><strong>Methods: </strong>Participants were children (6;0-11;11 years) with mild-to-moderate ADHD. Study Step 1 comprised a randomized waitlist-controlled trial on the efficacy of three-month, parent-directed TASH. Depending on their response to TASH, in Step 2, children were assigned to booster TASH (full response), behavior therapy (partial response), or pharmacotherapy plus behavior therapy or counseling (non-response) for six months. The primary outcome was the change in blinded-clinician-rated ADHD symptoms; for subsequent changes (Step 2), we considered semi-blinded ratings. The primary analyses were by intention-to-treat.</p><p><strong>Results: </strong>Of the 163 included children (77.9% boys), 80 were randomized to TASH and 83 to the waitlist control group. Following TASH, 12 children (8.8%) were classified as full responders, 40 (29.2%) as partial responders, and 85 (62.0%) as non-responders. An analysis of covariance did not yield an effect of TASH on the primary outcome (mean between-group difference = 0.00 ± 0.07, 95% CI[- 0.14, 0.13]; p = 0.95; d = -0.01, 95% CI[- 0.37, 0.34]). During Step 2, full responders demonstrated a stable symptom level (piecewise mixed-effects model for repeated measures; d = - 0.07, 95% CI[- 0.61, 0.47], p = 0.80), partial responders a small increase in ADHD symptoms (d = 0.29, 95% CI[0.00, 0.59], p = 0.05), and non-responders a large decrease (d = - 1.00, 95% CI[- 1.27, - 0.73], p < 0.001).</p><p><strong>Conclusions: </strong>TASH is not effective in reducing blinded-clinician-rated ADHD symptoms in children with mild-to-moderate ADHD. Based on the changes within the response groups during Step 2, hypotheses are generated for adaptive treatment after TASH. Trial registration German Clinical Trials Register (DRKS): DRKS0000897; URL: https://drks.de/search/de/trial/DRKS00008973/details ; registered on December 18th 2015.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japi 2.0, a gaming platform to stimulate cognitive and socio-emotional skills in early childhood: results of a pilot randomized controlled trial.","authors":"Jorge Gaete, Natalia Ríos, Cristian A Rojas-Barahona, Gabriel Salgado, Saray Ramírez, Ricardo Araya","doi":"10.1186/s13034-026-01133-1","DOIUrl":"https://doi.org/10.1186/s13034-026-01133-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early childhood is a sensitive developmental period for the acquisition of cognitive and socio-emotional skills that are strongly associated with later mental health, academic achievement, and social functioning. Children growing up in socioeconomically disadvantaged contexts are at increased risk for early emotional and behavioral difficulties, highlighting the need for accessible, scalable, and developmentally appropriate preventive interventions. Japi 2.0 is a tablet-based gaming platform designed to stimulate six interrelated cognitive and socio-emotional skills-working memory, inhibitory control, emotion recognition, social competence, empathy, and cognitive planning-through structured play in preschool settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a pilot cluster randomized controlled trial in low-income preschools in Santiago, Chile. Schools were randomized to either the Japi 2.0 intervention or treatment as usual. The intervention consisted of 24 individual sessions delivered over 12 weeks during regular class hours. Primary outcomes were acceptability (perceived by children, early years educators, and parents) and feasibility (recruitment, retention, attendance, intervention delivery, and data completeness). Secondary outcomes explored preliminary changes in cognitive, socio-emotional, and behavioral functioning using standardized assessments and parent- and teacher-reported measures. Exploratory analyses were conducted using multilevel models adjusted for baseline scores and clustering, based on available outcome data from randomized participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Japi 2.0 showed high acceptability across stakeholders. Educators and parents reported that the game and the accompanying web-based dashboard were engaging, age-appropriate, easy to use, and pedagogically relevant. Children reported high levels of enjoyment and positive emotional experiences during gameplay. Feasibility indicators were satisfactory: most planned sessions were delivered as scheduled, attendance was high, and outcome data completeness was adequate. Exploratory analyses indicated improvements over time in both groups across most outcomes. Preliminary exploratory signals favoring the intervention were observed for empathy and parent-reported emotional and behavioral difficulties; however, these findings should be interpreted cautiously given the small number of clusters and exploratory nature of the analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot trial demonstrates that Japi 2.0 is a feasible and highly acceptable digital intervention for preschool children in low-income educational settings. Although efficacy findings are preliminary, results support progression to a fully powered randomized controlled trial to evaluate effectiveness and longer-term impacts on cognitive, socio-emotional, and behavioral development. Trial registration Clinical Trials NCT06420544, May 20th, 2024. https://www.&lt;/p&gt;&lt;p&gt;&lt;s","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of multiple services from childhood to early adulthood among violent juvenile offenders: a document-based descriptive study.","authors":"Eeva Huikko, Mauri Marttunen, Aulikki Ahlgrén-Rimpiläinen, Terhi Aalto-Setälä, Riikka Lämsä","doi":"10.1186/s13034-026-01140-2","DOIUrl":"https://doi.org/10.1186/s13034-026-01140-2","url":null,"abstract":"<p><strong>Background: </strong>Young violent offenders frequently face significant developmental adversities, including learning difficulties, mental disorders, and substance use during childhood and adolescence. Many also grow up in circumstances requiring child welfare interventions. However, limited information is available regarding the services provided to them.</p><p><strong>Objective: </strong>To describe the timing, duration and components of school support services, child welfare services, as well as mental health services and substance abuse services used by young violent offenders.</p><p><strong>Participants and methods: </strong>Data were derived from the forensic psychiatric examination statements of 42 Finnish violent offenders aged 15-22 years and analyzed using qualitative and quantitative content analyses.</p><p><strong>Results: </strong>Almost all young people (95%) had used at least one service. Service use typically began between ages 7 and 12, with school support services accessed more frequently than other services during this period. The highest rate of single-service use occurred at ages 8-9. Adolescence was characterized by the most extensive multiservice involvement, with the combination of school support, mental health, and child welfare services peaking at age 15. Interruptions longer than one year were more frequent in mental health services than in other services. Evidence-based parent training, multidimensional family therapy, and specialized placements for youth with substance use and mental health problems were used only seldom.</p><p><strong>Conclusions: </strong>Most youth who committed violent offences had received multiple services during childhood and adolescence. Our results highlight the need to develop the timing, suitability and acceptability of services for this specific group of young people in their youth.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of pharmacological, adjunctive, and non-pharmacological interventions across behavioral domains in children and adolescents with autism spectrum disorder: a network meta-analysis.","authors":"Longyan Liu, Xianyang Xin, Zhang Ying","doi":"10.1186/s13034-026-01132-2","DOIUrl":"https://doi.org/10.1186/s13034-026-01132-2","url":null,"abstract":"<p><strong>Objective: </strong>To systematically compare the efficacy of pharmacological, adjunctive, and non-pharmacological interventions across multiple behavioral domains in children and adolescents with autism spectrum disorder (ASD), including irritability, hyperactivity, social withdrawal, stereotypic behavior, and inappropriate speech.</p><p><strong>Methods: </strong>Following the 2020 PRISMA guidelines, five databases were searched from inception to March 2026 for randomized controlled trials (RCTs). A frequentist network meta-analysis was conducted to estimate the comparative efficacy and ranking probabilities of different interventions across behavioral domains (PROSPERO: CRD420261368925).</p><p><strong>Results: </strong>Sixty-seven RCTs (N = 4,203) were included. For irritability, structured exercise ranked highest (SUCRA = 88.0%; SMD = - 1.48, 95% CI -2.24 to - 0.73), followed by risperidone plus adjunctive anti-inflammatory agents (SUCRA = 72.9%) and neuromodulatory agents (SUCRA = 67.8%). For hyperactivity, pharmacological interventions were most effective, with other antipsychotic/ADHD medications ranking highest (SUCRA = 95.1%; SMD = - 1.85, 95% CI -2.50 to - 1.20), followed by structured exercise (SUCRA = 76.1%). Similarly, for stereotypic behavior, pharmacological treatments dominated, with other antipsychotic/ADHD medications achieving the best performance (SUCRA = 92.0%; SMD = - 1.10, 95% CI -1.67 to - 0.52). In contrast, for social withdrawal, structured exercise emerged as the most effective intervention (SUCRA = 98.9%; SMD = - 1.28, 95% CI -1.96 to - 0.60), followed by risperidone plus neuromodulatory agents (SUCRA = 75.3%). For inappropriate speech, structured exercise (SUCRA = 80.1%) and probiotics plus oxytocin (SUCRA = 76.4%) demonstrated the highest rankings, with structured exercise showing a significant effect (SMD = - 0.80, 95% CI -1.40 to - 0.19).</p><p><strong>Conclusion: </strong>This study establishes a domain-specific treatment hierarchy for ASD, demonstrating that intervention effects vary substantially across behavioral domains. Pharmacological approaches are more effective for hyperactivity and stereotypic behaviors, whereas structured exercise shows superior benefits for irritability and social withdrawal. Combination strategies consistently rank highly across multiple domains, supporting the value of multimodal interventions. These findings underscore the importance of individualized, symptom-targeted, and mechanism-informed treatment strategies to optimize clinical outcomes in ASD.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific temporal dynamics of depressive symptoms and emotional resilience in adolescents: a cross-lagged network and simulation-based intervention study.","authors":"Qiu Li, Xueying Liu, Fang Zhou, Weiliang Wang","doi":"10.1186/s13034-026-01138-w","DOIUrl":"https://doi.org/10.1186/s13034-026-01138-w","url":null,"abstract":"<p><strong>Background: </strong>Adolescent depression involves dynamic interactions between depressive symptoms and emotional resilience, with potential gender differences.</p><p><strong>Methods: </strong>A total of 818 adolescents completed the CDI-S and AERQ at two time points. Cross-lagged panel networks were estimated separately for males and females, and node centrality was assessed using in- and out-expected influence indices. Simulation-based interventions identified nodes with the greatest impact on overall symptom activation.</p><p><strong>Results: </strong>In males, sadness showed the largest autoregressive effect, self-deprecation showed the highest out-expected influence, and feeling upset when misunderstood showed the highest in-expected influence. In females, feeling unloved showed the largest autoregressive effect, sadness showed the highest out-expected influence, and feeling upset after criticism the highest in-expected influence. Simulation results indicated that enhancing positive emotion generation alleviated symptoms, whereas sleep- and interpersonal-related dysregulation increased network activation.</p><p><strong>Conclusions: </strong>Emotional resilience-depression dynamics differed by gender, with males showing cognitive-evaluative propagation and females emotion-driven interpersonal sensitivity. Targeted, gender-sensitive interventions focused on positive emotion generation and interpersonal recovery may help reduce depressive symptoms in adolescents.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}