Child and Adolescent Psychiatry and Mental Health最新文献

{"title":"The Electronic Psychiatric Semi-structured Interview for Children and Adolescents (EPSI-C): development and psychometric evaluation of an open-access DSM-5-based diagnostic instrument.","authors":"Susanne Olofsdotter, Melpomeni Dragou, Johan Isaksson, Kent W Nilsson, Sofia Vadlin, Maria Hedqvist","doi":"10.1186/s13034-026-01094-5","DOIUrl":"10.1186/s13034-026-01094-5","url":null,"abstract":"<p><strong>Background: </strong>Standardized diagnostic interviews are essential tools for accurate assessment in child and adolescent psychiatry (CAP). However, many existing interviews are restricted by licensing costs, platform dependencies, limited clinical adaptability, or legal ambiguity regarding digital implementation. To address these limitations, the Electronic Psychiatric Semi-structured Interview for Children and Adolescents (EPSI-C) was developed as an open-access, platform-independent instrument aligned with the DSM-5. The modular structure, comprising 22 modules covering the full range of common psychiatric disorders, allows for both systematic and targeted administration. This instrument development and psychometric validation study evaluated the content validity and internal consistency of the EPSI-C.</p><p><strong>Methods: </strong>Content validity was assessed by ten independent experts who rated the relevance of the instrument for assessing DSM-5 diagnostic criteria. Additionally, experts rated six global aspects of clinical utility. Internal consistency was examined in a large naturalistic sample of 3,506 patients (mean age = 12.0 years, SD = 3.2, range 5-18 years; 54.5% girls) assessed with a digital implementation of the EPSI-C during routine outpatient CAP assessments in Sweden.</p><p><strong>Results: </strong>The EPSI-C demonstrated excellent scale-level average content validity for both the screening sections (S-CVI/Ave = 0.95) and full modules (S-CVI/Ave = 0.94). Expert consensus was high (90-100%) regarding overall clinical utility. Internal consistency was acceptable to excellent (α range 0.71 - 0.90) for 87.5% of eligible modules. Lower consistency was observed for modules assessing psychotic disorders (α = 0.53) and anorexia nervosa (α = 0.49), reflecting limited DSM-5 criteria and sub-threshold presentations.</p><p><strong>Conclusions: </strong>The findings support the foundational psychometric properties of the EPSI-C and indicate its clinical feasibility within a high-volume, naturalistic CAP outpatient setting. The current study establishes content validity and internal consistency, while criterion validity remains to be evaluated. As an open-access, modular instrument, EPSI-C offers a scalable solution for the digital implementation of standardized diagnostic interviews in routine clinical practice.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":"20 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833658","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":"Impulsivity in adolescents with MDD and non-suicidal self-injury: a multimodal assessment using psychometric, behavioral, and neurophysiological measures.","authors":"Yuqiong He, Tingyu Yang, Kun Zhang, Shuxian Wu, Chunxiang Huang, Xueping Gao, Xuerong Luo, Yaru Zhang, Xilong Cui","doi":"10.1186/s13034-026-01043-2","DOIUrl":"10.1186/s13034-026-01043-2","url":null,"abstract":"<p><strong>Background: </strong>To investigate multidimensional impulsivity and its neuroelectrophysiological correlates in adolescents with depression and non-suicidal self-injury (NSSI).</p><p><strong>Methods: </strong>A case-control study was conducted including three groups: depressed adolescents with non-suicidal self-injury (NSSI group), depressed adolescents without NSSI (non-NSSI group), and healthy controls (HCs group). The Ottawa Self-Injury Questionnaire was administered to assess NSSI behaviors in depressed participants and to quantify NSSI severity within the NSSI group. Impulsivity was evaluated using a multimodal approach, including the Barratt Impulsiveness Scale-11 (BIS-11), a go/no-go task, and event-related potentials (ERPs), with particular focus on the N2 and P3 components.</p><p><strong>Results: </strong>Both depressed groups exhibited significantly higher BIS-11 total and subscale scores than HCs, particularly in motor impulsivity (p < 0.05). A significant overall group difference was observed in go trials accuracy among the three groups (p = 0.009). Post hoc analyses with Bonferroni correction showed that the NSSI group had significantly lower go-trial accuracy than the HCs group (p_Bonf < 0.05), whereas no significant differences were observed between the NSSI and non-NSSI groups (p_Bonf > 0.05) or between the non-NSSI and HCs groups (p_Bonf > 0.05). No significant group differences were found in N2 or P3 latency or amplitude across the three groups (all p > 0.05). Correlation analyses revealed that NSSI severity over the past 1, 6, and 12 months was positively correlated with BIS-11 total and motor impulsivity scores (r = 0.198-0.417, all p < 0.001) and negatively correlated with go-task accuracy (r =  - 0.248 to - 0.193, all p < 0.001).</p><p><strong>Conclusion: </strong>Depressed adolescents with NSSI exhibited elevated self-reported impulsivity and impaired behavioral inhibitory control, both of which were associated with NSSI severity, whereas no significant neurophysiological differences were observed between depressed adolescents with NSSI and HCs.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833747","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":"Global prevalence of internet gaming disorder in children and adolescents: a systematic review and meta-analysis.","authors":"Joshuan J Barboza, César Bonilla Asalde, Oriana Rivera-Lozada, Maria Mihaela Iuga, Betty R Valdivia, Gabriel Hernández-Juárez, Carlos A Canelo, Roberto A Molina Campuzano, Jonathan C Aguilar-Bueno, Rubén Aguirre-Ipenza, Luis Angel Kong-Lozano","doi":"10.1186/s13034-026-01083-8","DOIUrl":"10.1186/s13034-026-01083-8","url":null,"abstract":"<p><strong>Background: </strong>Internet Gaming Disorder (IGD) has emerged as a significant behavioral concern among youth, yet global prevalence estimates remain inconsistent due to methodological variability. This systematic review and meta-analysis aimed to determine the global pooled prevalence of IGD in children and adolescents.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines and prospective registration in PROSPERO (CRD420251156483) prior to data extraction and analysis, comprehensive searches were conducted in PubMed, Scopus, Web of Science, Embase, and PsycINFO up to September 2025. Eligible observational studies assessed IGD prevalence in individuals aged 6-18 years using standardized diagnostic instruments based on DSM-5 or ICD-11 criteria. A random-effects meta-analysis (DerSimonian and Laird method) with Freeman-Tukey double arcsine transformation was used to pool prevalence estimates. Between-study heterogeneity was quantified using the I² statistic, and publication bias was assessed using funnel plot asymmetry and Egger's regression test.</p><p><strong>Results: </strong>Nineteen studies involving 251,037 participants and 26,868 IGD cases met the inclusion criteria. The pooled global prevalence of IGD among children and adolescents was 10% (95% CI: 6-15%). Individual study estimates ranged from approximately 1% in some European populations to over 25% in studies conducted in Middle Eastern and Latin American settings. Heterogeneity was extreme (I² = 99.7%), and smaller studies tended to report higher prevalence.</p><p><strong>Conclusions: </strong>Approximately one in ten children and adolescents worldwide meet criteria for IGD, underscoring its growing significance as a global mental health concern. Given the substantial heterogeneity observed, the pooled estimate should be interpreted as an average across diverse contexts rather than a uniform global rate. These findings highlight the need for standardized diagnostic criteria, culturally sensitive preventive interventions, and early identification strategies to mitigate long-term psychosocial impact.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811703","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":"Psychophysiological effects of dance/movement therapy on anxiety reduction in adolescents in juvenile detention centers: dopamine and thermoregulatory responses in a controlled study.","authors":"You-Jeong Nam, Eon-Ah Choo, Seunghyun Lee, Seunghyun Na, Young-Hyun Jung, Hwa-Young Lee, Jeong-Beom Lee","doi":"10.1186/s13034-026-01091-8","DOIUrl":"10.1186/s13034-026-01091-8","url":null,"abstract":"<p><strong>Background: </strong>Anxiety among adolescents has increased globally during the COVID-19 pandemic. Adolescents in juvenile detention centers (JDCs) may be particularly vulnerable due to restricted liberty and social isolation. Movement-based interventions such as Dance/Movement Therapy (DMT) have been studied as approaches to support emotional regulation. This exploratory study investigated the psychophysiological effects of a structured DMT intervention on anxiety reduction among adolescents in JDCs, focusing on anxiety-related changes in dopamine (DA) levels and body temperature.</p><p><strong>Methods: </strong>This quasi-experimental study included 55 female adolescents from a single juvenile detention center. Participants were allocated to either a non-DMT control group (n = 30, 16.17 ± 1.73 years), which maintained their usual institutional routine throughout the 8-week study period, or a DMT group (n = 25, 16.23 ± 1.68 years) that completed 24 DMT sessions over the same period. Anxiety and physiological measures were assessed before and after the intervention. Anxiety was measured using the Beck Anxiety Inventory (BAI). Physiological measures included mean body temperature (mTb), calculated from tympanic (core) and skin temperature measurements, and plasma DA levels measured using high-performance liquid chromatography (HPLC).</p><p><strong>Results: </strong>Following the intervention, the DMT group showed a significant reduction in BAI scores (-16%, p < 0.001), along with significant increases in mTb (0.11 ± 0.07 °C, p < 0.001) and DA levels (+ 30%, p < 0.001). BAI scores were negatively correlated with mTb and DA levels, whereas mTb was positively correlated with DA levels.</p><p><strong>Conclusions: </strong>This study provides preliminary evidence that DMT may help alleviate anxiety and support psychophysiological regulation among adolescents in JDCs. However, the exploratory design, single-center setting, and all-female sample may limit generalizability. Future multi-center studies with more diverse samples are needed to confirm these findings and clarify the underlying mechanisms.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811679","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":"Utilization, awareness, and satisfaction with school counselors in Nagoya, Japan: repeated cross-sectional observational surveys.","authors":"Hiromichi Inaba, Masatsugu Sakata, Yoshitaka Nishikawa, Hiroko Tsuboi, Toshiya Murai, Atsurou Yamada","doi":"10.1186/s13034-026-01089-2","DOIUrl":"10.1186/s13034-026-01089-2","url":null,"abstract":"<p><strong>Background: </strong>Mental health issues in childhood and adolescence have become a significant concern in Japan, underscoring the need for accessible school-based mental health care. School counselors (SCs) play a role in providing school-based mental health support; however, they are employed part-time, potentially limiting their presence and accessibility. In 2014, the City of Nagoya implemented a municipal policy assigning full-time SCs to public junior high schools. This study aimed to describe changes in students' utilization, awareness, and satisfaction with SCs within this policy context.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional observational study using administrative survey data collected in 2014, 2015, 2016, 2019, and 2021 from public junior high school students in Nagoya. Teacher surveys were conducted in all survey years, and parent surveys were included in 2021. The surveys measured students' utilization of SCs, awareness of their presence, and subjective evaluations of consultation experiences. Analyses were descriptive and focused on comparisons across survey years; this study did not assess causal effects of the policy.</p><p><strong>Results: </strong>The proportion of students who reported consulting SCs about their worries or problems was higher in later survey years, with values of 2.6% in 2014 and 10.3% in 2021. During the same period, the proportion of students who reported knowing \"absolutely nothing\" about SCs was lower in later survey years, with values of 30.3% in 2014 and 16.1% in 2021. Among students who consulted SCs, subjective evaluations of the consultation experience tended to be more positive in later survey years. By 2021, approximately 95% reported they felt \"glad to be listened to\" or otherwise evaluated the encounter positively. Teacher surveys showed similar patterns, with higher reported use of SC services and more positive perceptions in later survey years.</p><p><strong>Conclusions: </strong>This descriptive study, based on repeated cross-sectional surveys, examined changes in students' utilization, awareness, and satisfaction with SCs following the introduction of full-time SCs in Nagoya. Although causal inference is not possible, these findings provide contextual insights for future evaluation and planning of school-based mental health services. More rigorous study designs are needed to evaluate causal effects of full-time SCs on mental health outcomes and educational equity.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763875","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":"Development of emotion understanding and its association with emotion dysregulation in a community sample of Mandarin-speaking children aged 2-6 years: a cross-sectional study in Taiwan.","authors":"Hsin-Hui Lu, Ying Ru Chen","doi":"10.1186/s13034-026-01088-3","DOIUrl":"10.1186/s13034-026-01088-3","url":null,"abstract":"<p><p>BACKGROUND: Emotion understanding (EU) is a key developmental competence linked to social functioning. However, little is known about its development in Mandarin-speaking children during toddlerhood and the preschool years, or its association with emotion dysregulation. This study examined EU development in children aged 2–6 years using a community sample and explored its relationship with emotion dysregulation. METHODS: In total, 121 Mandarin-speaking children aged 2–6 years and their parents from community settings in Taiwan participated. Children completed cognitive assessments, the Receptive Vocabulary and Picture Naming subtests of WPPSI-IV, and the Test of Emotion Comprehension–Extended Version (TEC-E). Parents completed the Child Behavior Checklist. RESULTS: Children demonstrated significant EU growth between ages 2 and 6 years, consistent with the three-stage sequence proposed by Pons. However, the Desire and Reminder components developed later than expected, suggesting cultural influences. Positive correlations were observed between EU and emotion dysregulation, with the component-scored method more sensitive than the item-scored method in detecting associations. CONCLUSION: Toddlers’ and preschoolers’ level of EU was positively associated with their degree of emotion dysregulation. Clinicians can use children’s EU development to help predict their risk of emotion dysregulation and provide early intervention. Moreover, because cultural effects were inferred from difficulty rankings rather than direct cross-cultural score comparisons, cross-cultural findings should be interpreted with caution. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763877","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":"Exploring childhood separation anxiety in resource-limited contexts: a mixed-methods study with children and caregivers.","authors":"Ana Maria Chamorro Coneo, Pablo Emilio Padilla Solano, Alberto Mario De Castro Correa","doi":"10.1186/s13034-026-01090-9","DOIUrl":"10.1186/s13034-026-01090-9","url":null,"abstract":"<p><p>BACKGROUND: Separation anxiety (SA) is a common childhood experience that, when persistent, can interfere with development and elevate the risk for future anxiety disorders. However, research on SA in Low- and Middle-Income Countries (LMICs) remains scarce, especially among rural children with limited access to mental health services. We examined age and gender differences in SA scores among Colombian children from rural, low-income households, alongside caregivers’ experiences and strategies for managing their children’s anxiety. METHODS: We employed a sequential explanatory mixed-methods design in which 202 children (aged 8–12) completed the Spence Children’s Anxiety Scale (SCAS) to assess SA and overall anxiety, followed by semi-structured interviews with 12 caregivers of children with high SA scores. Quantitative data were analysed using a 2 × 4 ANOVA (gender × age) and qualitative responses were examined using thematic analysis. RESULTS: Twelve-year-olds reported higher overall anxiety, with girls showing higher SA than boys at ages 10 and 12. Caregiver accounts echoed elevated separation concerns while describing a broader range of emotional responses, including anger and withdrawal, and highlighting the emotional and practical demands of caring for children with high SA. CONCLUSIONS: These findings highlight the importance of early recognition of anxiety symptoms and preventive support for children experiencing SA and their caregivers. Expanding access to school-based screening and caregiver psychoeducation programmes may support earlier detection and management of childhood anxiety. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763854","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":"Mechanisms underlying the association between the use of digital social networks and suicidal behavior in adolescents and young adults: a systematic review.","authors":"J M Martín-Calvete, I Ramírez-Uclés","doi":"10.1186/s13034-026-01061-0","DOIUrl":"https://doi.org/10.1186/s13034-026-01061-0","url":null,"abstract":"<p><strong>Background: </strong>In view of the increase in suicides over recent years, this review set out to explore the mechanisms proposed to underlie the association between the use of digital social networks and suicidal behavior in adolescents and young adults. Understanding these mechanisms will help improve the actions aimed at reducing youth suicides.</p><p><strong>Method: </strong>This systematic review of the literature was carried out following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. The search focused on studies published over the past seven years in English or Spanish that are stored in databases like APA PsycINFO, APA PsycArticles, Psychology and Behavioral Sciences Collection, PSICODOC, MEDLINE and the Web of Science (WOS).</p><p><strong>Results: </strong>The search yielded 16 articles for analysis, 13 descriptive empirical studies and 3 review papers identifying various mechanisms of association, including: emotional dysregulation, social contagion, behavioral addiction (to social networks and/or online video games), cyberbullying, exposure to self-harm, negative feelings like helplessness or worthlessness, social disconnection, and sleep disorders.</p><p><strong>Conclusions: </strong>There is increasing evidence of the effects of digital social network use, and of the variables that moderate or mediate its association with suicidal behavior in adolescents and young adults, providing valuable information to design prevention strategies.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763941","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":"A multimethod validation of the frequency of suicidal ideation inventory for adolescents in Peru.","authors":"Denisse Manrique-Millones, Jesús Guerrero-Alcedo, Jonatan Baños-Chaparro, David Villarreal-Zegarra, Nora Wiium","doi":"10.1186/s13034-026-01086-5","DOIUrl":"10.1186/s13034-026-01086-5","url":null,"abstract":"","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721620","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":"Risk factors for physical restraint use with children and youth in community and inpatient mental health settings in Ontario.","authors":"Shannon L Stewart, Abbey L Drew, Danielle Fearon","doi":"10.1186/s13034-026-01084-7","DOIUrl":"10.1186/s13034-026-01084-7","url":null,"abstract":"<p><p>INTRODUCTION: The application of physical restraints in child and youth mental health settings remains controversial. Physical restraints are control interventions involving the use of a physical device or manual holding to restrict a young person’s movement. Although their use is permitted to manage risky behaviours, physical restraints can cause severe physical and psychological harm in children and youth. Existing literature on restraint use focuses on children and youth in inpatient settings, while research on its use in community health settings remains limited. METHODS: The current study aims to examine patterns and risk factors associated with the use of physical restraints among children and youth in both inpatient and community health settings. Data for this study were drawn from the interRAI Child and Youth Mental Health (ChYMH) assessment instruments (including those with developmental disabilities; ChYMH-DD), implemented by trained professionals as part of standard clinical practice. The sample comprised of 32,422 children and youth aged 4–18 receiving mental health services in Ontario between 2012 and 2022, across community and inpatient settings. This study employed a retrospective secondary analysis of assessment data. Logistic regression analysis was used to identify factors associated with physical restraint use. RESULTS: In our sample, males and younger children (4–11) experienced the most physical restraint. Results indicated that children with a diagnosis of autism (ASD), reactive attachment disorder, schizophrenia and other psychotic disorders, and substance use disorder experienced higher rates of physical restraint than those without a diagnosis. Furthermore, externalizing symptoms, internalizing symptoms, risk of suicide and self harm, high caregiver distress, dependent cognitive skills, and living with a nonrelative were associated with physical restraint use. CONCLUSIONS: Findings provide researchers and clinicians with important insights into risk factors for physical restraint among vulnerable children and youth, which can be used to inform care planning and the development of targeted prevention and early intervention programs. This research highlights the importance of identifying trauma, providing trauma-informed care, and using a standardized assessment-to-intervention approach across service sectors to reduce the use of physical restraints in child and youth mental health settings. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697836","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}