Child and Adolescent Psychiatry and Mental Health最新文献

{"title":"Subclinical but significant: A multi-informant comparative study on early socio-emotional difficulties in preterm preschoolers.","authors":"Rowena Van den Broeck, Lisa Gistelinck, Bieke Bollen, Els Ortibus, Gunnar Naulaers, Bart Boets","doi":"10.1186/s13034-026-01082-9","DOIUrl":"10.1186/s13034-026-01082-9","url":null,"abstract":"<p><strong>Background: </strong>Children born preterm face increased risks of neurodevelopmental difficulties, comprised within the \"preterm behavioral phenotype\". This study examined behavioral and socio-emotional development in preterm preschoolers using a multi-informant approach to characterize behavioral profiles, mental health outcomes, and their associations with gestational age, birth weight, and early medical experiences.</p><p><strong>Methods: </strong>102 five-year-old children (70 preterm, 32 full-term) were assessed using standardized measures, including parent and teacher questionnaires (Child Behavior Checklist, Teacher Report Form, Social Responsiveness Scale, ADHD Questionnaire) and direct clinical observation (Autism Diagnostic Observation Schedule-2). Analyses examined group differences and associations with gestational age, birth weight and neonatal intensive care unit (NICU) parameters, including early procedural pain, respiratory support and kangaroo care.</p><p><strong>Results: </strong>Preterm children demonstrated a predominantly subclinical phenotype, characterized by elevated difficulties across domains. Marked informant discrepancies emerged: parents reported more internalizing symptoms, attention deficits, social-communication difficulties, and autism-related traits in the preterm group, whereas teacher ratings showed stronger associations with gestational age, birth weight, and early medical procedures. Early NICU experiences were linked to later outcomes: greater exposure to skin-breaking procedures predicted higher reported behavioral problems, whereas more kangaroo care was associated with fewer reported social difficulties.</p><p><strong>Conclusions: </strong>Preterm preschoolers display subtle yet meaningful socio-emotional vulnerabilities that manifest below clinical thresholds, but still warrant continued surveillance. Divergence between parent and teacher perspectives underscores the importance of multi-informant assessment across contexts. Associations between early procedural pain and later socio-emotional outcomes identify a modifiable risk factor, emphasizing the importance of optimized neonatal pain management and minimizing medical intensity.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688700","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":"Nationwide survey of psychopathology and bullying in tic disorders with and without ADHD.","authors":"Yu-Ju Lin, Fang-Ju Tsai, Susan Shur-Fen Gau","doi":"10.1186/s13034-026-01080-x","DOIUrl":"10.1186/s13034-026-01080-x","url":null,"abstract":"<p><strong>Background: </strong>Attention deficit/hyperactivity disorder (ADHD) and tic disorder (TD) often co-occur. Given the well-established strong link between bullying and adverse psychiatric outcomes, understanding how TD and comorbid ADHD jointly interact to influence bullying involvement is crucial for informing clinical assessment and intervention. This study investigated psychopathology, bullying experiences, and their associations in children with TD, accounting for the influence ADHD, using data from a nationwide epidemiological survey.</p><p><strong>Methods: </strong>The sample included 4816 children in grades 3, 5, and 7, randomly selected from 69 schools across Taiwan. Categorical psychiatric diagnoses were made through structured child interview using the Kiddie Epidemiologic Version of the Schedule for Affective Disorders and Schizophrenia, while dimensional emotional-behavioral problems were measured using the parent-reported Child Behavior Checklist. Bullying experiences were compared among four groups: TD-alone, ADHD-alone, TD+ADHD, and controls. Mediation analyses explored whether emotional-behavioral problems mediated the relationship between TD and bullying experiences.</p><p><strong>Results: </strong>Among participants, 102 (2%) had TD-alone, 388 (8%) had ADHD-alone, and 24 (0.5%) had comorbid TD+ADHD. TD was primarily related to obsessive-compulsive disorder [odds ratio (OR) = 7.35, 95% confidence interval (CI) = 1.93-20.68]. Children with TD exhibited elevated risks of both school (OR = 2.64, 95% CI = 1.47-4.75) and cyberbullying victimization (OR = 2.64, 95% CI = 1.47-4.74), whereas those with ADHD were more likely to be both perpetrators (OR = 2.64, 95% CI = 1.6-4.36) and victims (OR = 2.60, 95% CI = 1.95-3.47) of school bullying. After adjusting for ADHD, age, and sex, TD exerted a direct association with bullying victimization. Social problems and internalizing problems partially mediate the relationship between TD and school bullying victimization. Notably, thought problems had reduced involvement of cyberbullying among children with TD.</p><p><strong>Conclusions: </strong>TD exerted a direct association with school- and cyber-bullying victimization. Health professionals should routinely assess school-and cyber-bullying victimization, even when ADHD is not present.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653812","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":"Support system networks: how support systems shape problematic social media use, mental health, and substance use in Czech adolescents.","authors":"Jakub Helvich, Lukas Novak, Zdenek Meier, Martin Heveri, Peter Tavel","doi":"10.1186/s13034-026-01081-w","DOIUrl":"10.1186/s13034-026-01081-w","url":null,"abstract":"<p><strong>Background: </strong>Problematic social media use (PSMU) has become a critical public health issue, with adolescents being one of the most engaged demographic. However, little is known about how distinct social support systems shape the associations between PSMU, mental health, and substance use.</p><p><strong>Objective: </strong>The first objective was to compare how support systems (peer, classmate, teacher, family, and self) shape the associations between PSMU, mental health, and substance use. The second objective was to explore which support systems are most prominent among boys and girls.</p><p><strong>Methodology: </strong>A representative sample of 5,487 Czech adolescents (50.88% boys, mean age = 15.48, SD = 0.53) was used for the analysis from the 2022 Health Behaviour in School-aged Children study. A network analysis based on undirected Mixed Graphical Models was used to examine the associations. Separate networks for each support system, stratified by gender, were estimated and compared.</p><p><strong>Results: </strong>Teacher and classmate support altered the associations in boys, while peer support was more prominent for girls. Family support altered both networks, though its function varied between genders. Self-support functioned as a bridge symptom in both genders, connecting PSMU with mental health and well-being, particularly in girls. In boys, classmate and family support made the association between PSMU and heated tobacco use as well as irritability absent, whereas in girls, peer and family support shaped the links between PSMU and well-being.</p><p><strong>Conclusion: </strong>The findings highlight the gender-specific nature of support systems and underscore the need for more nuanced approaches when facilitating external and internal support in adolescents.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621967","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":"Association between unhealthy food consumption and mental health outcomes in children and adolescents: an umbrella review.","authors":"Clayton Ulm, Frantasia Hill, Sarah D Mills, Carolyn Chelius, Eric M Hecht","doi":"10.1186/s13034-026-01079-4","DOIUrl":"10.1186/s13034-026-01079-4","url":null,"abstract":"<p><p>BACKGROUND: The consumption of unhealthy food has increased substantially among children and adolescents across the globe. This umbrella review aims to synthesize meta-analyses that assess unhealthy food consumption and mental health outcomes in children and adolescents. METHODS: The protocol was pre-registered with PROSPERO (CRD42023475965). We searched PubMed/MEDLINE, Scopus, Embase, and CINAHL from inception through January 2025 for meta-analyses that estimated associations between unhealthy food exposures and mental health in children and adolescents (< 19 years). Exposures included ultra-processed food (UPF), junk food, World Health Organization unhealthy food indicators (e.g., sweets), and Western dietary pattern. Extracted meta-analyses were replicated, re-evaluated for credibility, and assessed for methodological quality. RESULTS: With a sum total sample size of 2,526,232, our search yielded 15 pooled estimates. Convincing evidence (Class I) linked higher UPF consumption to short sleep duration (odds ratio = 1.30, 95% CI [1.26, 1.33]) and insomnia (odds ratio = 1.47, 95% CI [1.37, 1.57]). Highly suggestive evidence (Class II) related higher UPF consumption to poor sleep quality (odds ratio = 1.53, 95% CI [1.46, 1.60]), and common mental disorders (odds ratio = 1.53, 95% CI [1.44, 1.63]), and higher junk food consumption to depression (odds ratio = 1.62, 95% CI [1.39, 1.90]). Suggestive (Class III) or weak (Class IV) evidence related junk food to anxiety and stress, and junk food, sweets, and Western dietary patterns to attention-deficit/hyperactivity disorder. Associations with sleep dissatisfaction and happiness were not statistically significant. CONCLUSION: Findings suggest that children and adolescents who eat more unhealthy food tend to have poorer mental health. Nutrition-based interventions should prioritize children and adolescents since this population may be particularly susceptible to diet-related poor mental health. Further causal-inference studies should evaluate whether lowering consumption improves youth mental health. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608322","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 differences in a causal model of risk factors underlying early alcohol sipping.","authors":"Andrea Maxwell, Kathryn Cullen, Erich Kummerfeld, Rajita Sinha, Anna Zilverstand","doi":"10.1186/s13034-026-01077-6","DOIUrl":"10.1186/s13034-026-01077-6","url":null,"abstract":"<p><strong>Background: </strong>Early alcohol sipping with permission, here defined as tasting alcohol without necessarily taking a full drink by late childhood with parental permission, is an early marker of future problematic alcohol use. This study aimed to generate an initial data-driven causal model of the potential risk factors underlying early alcohol sipping and probe gender differences in this model.</p><p><strong>Methods: </strong>We used deidentified data from the baseline visit of Adolescent Brain and Cognitive Development (ABCD) Study (N = 9,253; 47.2% girls, ages 9-10 years; 76% White, 20% African-American, 8% Other, 7% Asian, 4% Native; 21% Hispanic); 1,266 (13.7%) in this sample endorsed early alcohol sipping by age 9-10 (40.9% girls). We included the top-ranked environmental, health, and psychological factors underlying early alcohol sipping identified among 2000 + variables in a previous study in the same data set. We applied Causal Discovery Analysis to generate combined (boys and girls) and gender-specific causal models to investigate potential causal links with early alcohol sipping. We evaluated model stability by bootstrapping.</p><p><strong>Results: </strong>First, our causal model of early alcohol sipping in both boys and girls suggested that family-level factors directly linked to substance use (i.e., norms around alcohol use and maternal prenatal alcohol use) were causally linked to early alcohol sipping. Second, our causal model of sipping specific to girls suggested that suicidal ideation was causally linked to early alcohol sipping in girls only. Third, our causal model of sipping specific to boys suggested that early alcohol sipping was causally linked to sensation seeking and disliking school in boys only.</p><p><strong>Conclusions: </strong>The current findings provide an initial model of important risk factors underlying the early onset of alcohol use. More broadly, the results suggest that the mechanisms previously linked to substance use in adolescence and adulthood can be traced back to childhood, and that gender differences are already present at this young age.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589945","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 maladaptive grief and posttraumatic stress in children and adolescents following loss: a systematic review.","authors":"Philipp Jann, Neele Winkler, Harald Karutz, Veronika Hulde, Tobias Hecker","doi":"10.1186/s13034-026-01076-7","DOIUrl":"10.1186/s13034-026-01076-7","url":null,"abstract":"<p><strong>Background: </strong>Traumatic losses in childhood and adolescence can evoke both maladaptive grief symptoms (MGS) and posttraumatic stress symptoms (PTSS). The aim of this study was to systematically review the existing literature to identify which risk factors are shared by both phenomenologies or differentiate between them.</p><p><strong>Methods: </strong>The systematic review was pre-registered in PROSPERO and conducted in accordance with PRISMA guidelines. A systematic literature search was performed in PubMed, Medline, PsycInfo, and Web of Science, identifying 18 studies based on 14 samples that met the inclusion criteria. A quality assessment was performed using the JBI critical appraisal checklist.</p><p><strong>Results: </strong>Encompassing a total of 5,034 individuals, the samples were generally gender-balanced (M = 52% female, SD = 14%) with a mean age of 12.88 years (SD = 2.19). The risk factors were summarised in six superordinate clusters. Intrapersonal reactions were very often significantly associated with both MGS and PTSS. In addition, other mental health problems were examined in most studies and were significantly associated with PTSS and MGS in all of these studies, indicating a very high relevance. We could draw no conclusion regarding demographic factors and the relevance of loss characteristics and circumstances. The quality of the included studies was good, but only three studies were longitudinal.</p><p><strong>Conclusions: </strong>The study emphasizes the relevance of intrapersonal factors and other comorbidity, with detailed discussion of their implications. Improving the specific identification of children and adolescents with high-risk profiles would particularly benefit areas with few resources for care. Due to the relevance of the topic, there is an urgent need for more studies investigating MGS and PTSS following loss in childhood and adolescence in the same sample.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572733","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":"Aggressive behaviour during a standardized play observation in 3 to 6-year-old children with and without refugee experience: an observational study.","authors":"Ana Mihaljevic, Jan Justus Kuther, Monika Fink, Maria Licata-Dandel, Volker Mall, Andrea Hahnefeld","doi":"10.1186/s13034-026-01071-y","DOIUrl":"10.1186/s13034-026-01071-y","url":null,"abstract":"<p><p>BACKGROUND: Exposure to refugee and traumatic experiences in early childhood can dysregulate the stress response system and lower children’s threshold for aggression. This study examines differences in amount and patterns of aggressive play in children with and without refugee or traumatic experiences, while also assessing how other environmental factors, such as flight duration as a marker of cumulated adverse experiences, time spent in the host country, parental distress, and screen exposure, are associated with such behaviour. METHODS: In standardized 10 min free individual play sessions, episodes of aggressive behaviours were observed in 62 children with refugee experience and 64 children from a clinically referred comparison group without refugee experience (aged 3–6 years) and coded into four categories: physical, verbal, instrumental, and symbolic. Emotional states were documented to clarify the background mood and context of the aggressive episodes. Parents reported sociodemographic data, screen time, and filled out the Child and Adolescent Trauma Screening for children aged 3–6 (CATS 3–6), assessing potentially traumatic experiences of their children with corresponding symptoms, and the Refugee Health Screener (RHS) for information on their own mental health and distress levels. We correlated these factors with our structured observations of aggressive episodes during children’s play in a standardized situation. RESULTS: No significant difference in the distribution of aggressive behaviour episodes between the refugee and comparison groups was observed, even after accounting for gender. Symbolic aggression was more frequent among boys from the comparison group (p = 0.014), while no group or gender effects emerged for other aggression categories. Amount of aggressive behaviour was not related to parent-rated traumatic experiences or symptoms, but a significant correlation appeared, with the reported amount of screen time within the male sub-group (ρ = 0.209, p =0 .027). CONCLUSION: Refugee and traumatic experiences showed no association with increased aggressive behaviour, whereas higher screen time was observed alongside elevated amounts of aggressive episodes among boys in our study. Children from both, refugee and clinical comparison group predominantly engaged in non-violent play in calm, low demand setting, highlighting potential protective role of safe, stimulating environments. Trial registration German clinical trials register, registration number: DRKS00025734, date: 07–23-2021. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527129","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":"Abnormal connectivity in the fronto-striatal network in adolescent depression with psychotic symptoms.","authors":"Xinlin Huang, Ju Gao, Xiaowei Tang, Yongming Wang, Feng Gao, Jiaming Tian, Shaochen Cheng, Yutong Li, Xiaobin Zhang, Hongyan Sun","doi":"10.1186/s13034-026-01078-5","DOIUrl":"10.1186/s13034-026-01078-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescent depression patients with psychotic symptoms have a worse prognosis and higher risk of suicide compared to those without psychotic symptoms, however, the neurophysiological underlying pathway is still unclear. The fronto-striatal network (FSN) may play an important role in the association between depression and psychotic symptoms. This study aims to investigate the specific alterations of the FSN in adolescent patients with depression, both with and without psychotic symptoms, and determine whether it could serve as an underlying neuropathological underlying pathway contributing to clinical symptoms.</p><p><strong>Methods: </strong>Based on the presence or absence of psychotic events such as hallucinations or delusions, adolescent depression patients were divided into a psychotic depression (PD) group (n = 32) and a non-psychotic depression (NPD) group (n = 41). All participants underwent comprehensive clinical assessments, including the Brief Psychiatric Rating Scale (BPRS) for general psychopathology and the Patient Health Questionnaire-9 (PHQ-9) for depressive symptom severity. Resting-state functional magnetic resonance imaging data were acquired using a 3.0T scanner. These data were preprocessed and analyzed using independent component analysis (ICA) to identify the FSN for subsequent between group comparisons and correlation analyses.</p><p><strong>Results: </strong>In contrast to NPD, PD group demonstrated decreased connectivity in the bilateral striatum (bilateral caudate and putamen) (cluster-based family-wise error 0.05 correction). Furthermore, a significantly negative correlation was observed between the left striatum and BPRS scores (r = - 0.385, P = 0.030) in PD group, while no correlation was found in NPD group. The mediation analysis results showed that no mediating effect of PHQ-9 scores was found in the left striatum and the BPRS scores of PD group, nor was any mediating effect of PHQ-9 scores in the right striatum and the BPRS scores of NPD group.</p><p><strong>Conclusion: </strong>Our results indicate a distinct alteration in the function connectivity in the bilateral striatal between PD and NPD, providing insights into the potential pathogenesis of psychotic symptoms in adolescent depression.</p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527098","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 an infant and early childhood mental health service at a tertiary care pediatric hospital: a needs assessment, community case study and logic model creation.","authors":"Katherine M Matheson, Constance de Schaetzen, Nicole Sheridan, Anne-Lise Holahan, Melissa Vloet, Sarah Gray, Jenny Carstens, Lara Postl, Barbara Deren, Kathleen Pajer","doi":"10.1186/s13034-026-01068-7","DOIUrl":"10.1186/s13034-026-01068-7","url":null,"abstract":"<p><p>INTRODUCTION: Early attachment relationships and positive childhood experiences are foundational to lifelong mental health, yet specialized services for children under six remain critically scarce. This study sought to characterize the service gap in infant and early childhood mental health (IECMH) in Eastern Ontario, Canada, as a first step in developing a logic model to inform creation of a program to support this population. METHODS: We completed a regional estimation model of IECMH concerns, conducted a semi-structured focus group with community mental health agencies, and administered a survey to pediatric physicians at a regional children’s hospital. Findings from the aforementioned evaluations informed the development of a logic model for a new, responsive, tertiary-level IECMH service. RESULTS: Disruptive behaviours emerged as the most frequently encountered IECMH concern, and respondents identified multiple systemic barriers to accessing care, including insufficient specialist services, prolonged wait times, limited inter-agency collaboration, and a lack of provider awareness and resources. These findings underscored the urgent need to use the logic model to develop a dedicated IECMH clinic, tailored to the unique needs of this vulnerable population. DISCUSSION: While developed within a Canadian regional context, this framework may serve as a flexible template for other jurisdictions seeking to establish or strengthen tertiary-level IECMH services. Adaptation to local service structures, workforce capacity, and population needs will be essential to ensure feasibility and sustainability. Future evaluation will be necessary to assess implementation outcomes, service utilization, and impact on child and family trajectories. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519972","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":"Behind the scars: adolescents with non-suicidal self-injury disorder show profound personality pathology.","authors":"Manuela Gander, Kirstin Goth, Josef Fritz, Kathrin Sevecke","doi":"10.1186/s13034-026-01075-8","DOIUrl":"10.1186/s13034-026-01075-8","url":null,"abstract":"<p><p>BACKGROUND: Non-suicidal self-injury is a significant clinical concern in adolescent psychiatry and frequently co-occurs with a range of psychiatric disorders, including mood disorders, eating disorders, substance use disorders, and personality disorders. With the inclusion of non-suicidal self-injury disorder (NSSID) as a distinct diagnosis in the DSM-5, growing attention has been directed toward its relationship with established psychopathological constructs. This study investigates the association between personality pathology and NSSID in adolescent psychiatric in-patients. In particular, we analyzed the prevalence of personality disorders and impairments of personality functioning (identity, self-direction, empathy, intimacy) according to the AMPD of the DSM-5. METHODS: Our sample consisted of 439 inpatients (mean age = 15.2 years, SD = 1.37; 87 males, 352 females). We used the Structured Clinical Interview for Personality Disorders, the Levels of Personality Functioning questionnaire and the Semi-Structured Interview for Personality Functioning to assess personality pathology, and a structured clinical interview to evaluate the DSM-5 criteria for NSSID. RESULTS: Our results show that adolescents with an NSSID show more severe impairments in all areas of personality functioning and are significantly more likely to be diagnosed with a personality disorder (54%) than adolescents with no NSSID (27%). CONCLUSION: These results highlight the critical role of personality pathology in adolescents with NSSID and underscore the importance of targeted diagnostic and treatment approaches. Disorder-specific interventions for adolescent personality disorders may also be effective for those with severe NSSI. </p>","PeriodicalId":9934,"journal":{"name":"Child and Adolescent Psychiatry and Mental Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520002","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}