Background Bipolar disorder is identified as a cause of severe damage to the physical,psychological and social functioning of adolescents and young adults.Aims The aim of this study is to ascertain the trends in the b...Background Bipolar disorder is identified as a cause of severe damage to the physical,psychological and social functioning of adolescents and young adults.Aims The aim of this study is to ascertain the trends in the burden of bipolar disorder among individuals aged 10-24 years at global,regional and national levels from 1990 to 2019.Methods The data analysed in this study were from the Global Burden of Diseases 2019.The numbers,rates per 100000 population,average annual percentage changes(AAPCs)of incidence,prevalence and years lived with disability(YLDs)of bipolar disorder are reported at the global,regional and national levels among individuals aged 10-24 years.Global trends by age,sex and Social Development Index(SDI)were further analysed.Results Globally,the incidence of bipolar disorder among adolescents and young adults increased from 79.21 per 100000 population(95%uncertainty interval(Ul):58.13 to 105.15)in 1990 to 84.97 per 100000 population(95%Ul:61.73 to 113.46)in 2019,AAPC 0.24(95%confidence interval(Cl):0.22 to 0.26).In the past three decades,there has been an increase in incidence,prevalence and YLDs in both males and females.The largest increase in incidence between 1990 and 2019 was observed in those aged 20-24 years old from 51.76 per 100000 population(95%Ul:26.81 to 87.20)in 1990 to 58.37 per 100000 population(95%UI:30.39 to 98.55)in 2019;AAPC 0.42(95%Cl:0.38 to 0.47).By the SDI quintile,the largest increase in incidence was observed in the middle SDl;however,the high SDI countries had the highest incidence.Regionally,the largest increase in incidence was observed in southern Latin America.At the national level,the most pronounced increase in the incidence was in Greenland.Conclusions The global increase in incidence among adolescents and young adults between 1990 and 2019 indicates that strategies to improve their mental health still need to be emphasised.展开更多
Background Anxiety disorders are the most common psychiatric problems,affecting approximately 1 in 12 children and 1 in 4 adolescents.Understanding the incidence,burden and correlated risks of anxiety disorders among ...Background Anxiety disorders are the most common psychiatric problems,affecting approximately 1 in 12 children and 1 in 4 adolescents.Understanding the incidence,burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success,stagnation and emerging threats,thereby facilitating effective improvement strategies.Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries.To examine the association between anxiety disorders and social indicators(healthcare access and quality of life).Methods Data were obtained from the Global Burden of Disease Study 2019.The age-standardised incidence rates(ASIRs)and disability-adjusted life years(DALYs)were reported to assess the burden of anxiety disorders,and the estimated annual percentage change was calculated to quantify the temporal trends.Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs.Results Globally,there were 932 million incident cases of anxiety disorders in children and adolescents,739.29 per 100000 ASIRs and 380.62 million DALYs in 2019.From 1990 to 2019,the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%.Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries.Portugal reported the highest ASIR of anxiety disorders,while Mexico had the largest increase rate of ASIR.In 2019,Portugal reported the highest number of DALYs(1001.71 million),and India(212.09 million)reported the lowest number of DALYs.The burden of anxiety disorders was positively correlated with the average number of psychiatrists,psychologists and nurses in the mental health sector(per 100000),and quality of life and the correlation coefficients were 0.58,0.67,0.43 and 0.53,respectively.Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years.However,the incidence and disease burden in developed countries are still increasing steadily.Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status,as well as the cultural and regional characteristics of each country.展开更多
Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and th...Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.Methods 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as participants.Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms.Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two groups.Results‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest variance.The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.Conclusion Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.展开更多
To the editor:Mood disorders(MD)are serious mental illnesses that commonly affect adolescents,leading to a high incidence of suicidal behaviour.1 In China,the suicide attempt(SA)rate for adolescents with MD is 51.96%,...To the editor:Mood disorders(MD)are serious mental illnesses that commonly affect adolescents,leading to a high incidence of suicidal behaviour.1 In China,the suicide attempt(SA)rate for adolescents with MD is 51.96%,2 and over 500000 adolescent SA are reported annually in the USA due to depression.3 Risk factors for SA include gender,hormone levels,family conflict and,particularly,negative cognitive styles such as rumination.展开更多
A nationally representative sample of 1640 Chinese urban adolescents (mean age=14.5 years) and their parents and teachers were surveyed to examine the associations between relationships with teachers and parents and a...A nationally representative sample of 1640 Chinese urban adolescents (mean age=14.5 years) and their parents and teachers were surveyed to examine the associations between relationships with teachers and parents and adolescents' developmental outcomes such as academic performance, psychological well-being, altruistic behaviors, and misconduct. Results showed that the quality of adolescents' relationships with teachers was highly correlated with adolescent outcomes, in most cases more so than for relationships with parents. Furthermore, such associations were the same across both genders and three grade levels. These findings suggest that teachers may play an especially significant role in Chinese adolescent development. This study adds to the small but growing literature on the importance of teachers as well as other non-parental adults in adolescent psychosocial development.展开更多
Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Metho...Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4% （1/25） and 7.1% （1/14） respectively, with no significant difference （P〉0.05）.展开更多
Background Depression in adolescents is recognised as a global public health concern,but little is known about the trajectory of its clinical symptoms and pathogenesis.Understanding the nature of adolescents with depr...Background Depression in adolescents is recognised as a global public health concern,but little is known about the trajectory of its clinical symptoms and pathogenesis.Understanding the nature of adolescents with depression and identifying earlybiomarkers can facilitatepersonalised intervention andreducediseaseburden.Aims To track multidimensional outcomes of adolescents with depression and develop objective biomarkers for diagnosis,as well as response to treatment,prognosis and guidance for early identification and intervention.Methods This is a multidimensional cohort study on the Symptomatic trajectory and Biomarkers of Early Adolescent Depression(sBEAD).We planned to recruit more than 1000 adolescents with depression and 300 healthy controls within 5 years.Multidimensional clinical presentations and objective indicators are collected at baseline,weeks 4,8,12 and 24,and years 1,2,3,4 and 5.Conclusions To the best of our knowledge,this is the first longitudinal cohort study that examines multidimensional clinical manifestations and multilevel objective markers in Chinese adolescents with depression.This study aims at providing early individualised interventions for young,depressed patients to reduce the burden of disease.展开更多
To define the criteria of posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis. Methods By reviewing the medical records and roentgenograms of 17 patients with adolescent idiopathic sco...To define the criteria of posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis. Methods By reviewing the medical records and roentgenograms of 17 patients with adolescent idiopathic scoliosis who un-derwent posterior selective thoracic fusion, the curve type, Cobb angle, apical vertebral rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed. Results There were 17 King type Ⅱ patients (PUMC type: Ⅱb1 13, Ⅱc3 4). The coronal Cobb angle of thoracic curve be-fore and after operation were 56.9°and 21.6° respectively, the mean correction rate was 60.1%. The coronal Cobb angle of lumbar curve before and after operation were 34.8° and 12.1° respectively, and the mean spontaneous correction rate was 64.8%. At final follow-up, the coronal Cobb angle of thoracic and lumbar curve were 23.5° and 15.2° respectively, there were no significant changes in the coronal Cobb angle, apical vertebral translation and rotation compared with that after operation. One patient had 12° of thoracolumbar kyphosis after operation, no progression was noted at final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.9 levels were saved compared with fusing both the th-oracic and lumbar curves. Conclusion Posterior selective thoracic fusion can be safely and effectively performed in King type Ⅱ patients with a mo-derate and flexible lumbar curve, which can save more mobile segments and at the same time can maintain a good coronal and sagittal balance.展开更多
Adolescence is the peak period for the incidence of anxiety disorders.Recent findings have revealed the immaturity of neural networks underlying emotional regulation in this population.Brain vulnerability to anxiety i...Adolescence is the peak period for the incidence of anxiety disorders.Recent findings have revealed the immaturity of neural networks underlying emotional regulation in this population.Brain vulnerability to anxiety in adolescence is related to the unsynchronised development of anxiety-relevant brain functional systems.However,our current knowledge on brain deficits in adolescent anxiety is mainly borrowed from studies on adults.Understanding adolescent-specific brain deficits is essential for developing biomarkers and brain-based therapies targeting adolescent anxiety.This article reviews and compares recent neuroimaging literature on anxiety-related brain structural and functional deficits between adolescent and adult populations,and proposes a model highlighting the differences between adolescence and adulthood in anxiety-related brain networks.This model emphasises that in adolescence the emotional control system tends to be hypoactivated,the fear conditioning system is immature,and the reward and stress response systems are hypersensitive.Furthermore,the striatum’s functional links to the amygdala and the prefrontal cortex are strengthened,while the link between the prefrontal cortex and the amygdala is weakened in adolescence.This model helps to explain why adolescents are vulnerable to anxiety disorders and provides insights into potential brain-based approaches to intervene in adolescent anxiety disorders.展开更多
Objective To evaluate the different influences of anterior and posterior correction and fusion approaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis.Methods The retrospective study was c...Objective To evaluate the different influences of anterior and posterior correction and fusion approaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis.Methods The retrospective study was conducted with the medical records and radiographs of adolescent idiopathic thoracolumbar/lumbar scoliosis patients that underwent anterior(group A) or posterior(group B) correction and fusion surgery from December 1998 to May 2008.The correction of the main curve and changes of the disc wedging were analyzed.Results Fifty-three patients were included,26 in group A and 27 in group B.The mean coronal Cobb angles of the main curve in group A and group B were significantly corrected after surgery(P<0.05),with an average correction rate of 75.2% and 88.2%,respectively.Upon final follow-up,the coronal Cobb angles of the two groups were 18.9°±11.1° and 7.7°±5.6°,respectively,with an average correction loss of 6.8°±6.5° and 2.7°±3.3°,respectively.The coronal Cobb angle after operation and at final follow-up,and the correction rate were significantly better in group B than those in group A(P<0.05),while the coronal Cobb angle loss in group A was greater than that in group B(P<0.05).The disc wedging before operation,after operation,and at final follow-up were 3.2°±3.0°,5.7°±3.0°,and 8.6°±4.4° in group A,and 2.4°±3.2°,3.3°±3.4°,and 3.7°±3.6° in group B,respectively.Postoperative disc wedging was significantly larger compared with preoperative measurements in group A(P<0.05),but not in group B(P>0.05).The difference between disc wedging at final follow-up and that after surgery was significant in group A(P<0.05),but not in group B(P>0.05).Between the two groups,group A had larger disc angles after operation and at final follow-up(P<0.05),and a greater loss of disc angle(P<0.05).Conclusion For adolescent idiopathic thoracolumbar/lumbar scoliosis,posterior approach using all pedicle screws might produce a better result in terms of disc wedging compared with anterior approach.展开更多
Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we ai...Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.Methods: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory(MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS(19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at <15 months(n=30) vs. ≥15 months(n=33). Binary MPI results(normal-abnormal) were also compared between the two groups.Results: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio(OR) at 1.05 for every 1-month increase [95% confidence interval(CI) 1.02–1.08;P=0.002]. Subjects with pain duration at ≥15 months have lower faking good response score(P<0.001 vs. those with pain duration at <15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores(P<0.05). Pain duration was significantly associated with the MPI variables.Conclusions: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.展开更多
Objective.To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. Method.Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. Result. Endometriosi...Objective.To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. Method.Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. Result. Endometriosis is the most common cause of chronic pelvic pain in adolescents. There may be a natural progression of endometriosis from atypical lesions in adolescents to classic lesions in adults. Congenital abnormalities of the reproductive tract are the main reasons for the adolescent endometriosis. Conclusion. Endometriosis should be strongly suspected in adolescent girls with chronic pelvic pain,especially unresponsive to oral contraceptives and nonsteroidal anti-inflammatory drugs. The treatment involves the operations and medicines.展开更多
To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studi...To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studies and 10 studies,reported a higher risk of overweight and obesity in adolescents experiencing FI,respectively(OR 1.38,95%CI 1.20‒1.58,P<0.0001;OR 1.11,95%CI 1.01‒1.22,P=0.035,respectively).Based on the pooled results,adolescents with severe FI had the highest risk of OW/OB(OR 1.45,95%CI 1.20‒1.75,P<0.0001).The pooled OR indicated no signifi cant association between FI and OW/OB,when the adolescents were stratifi ed into those under 6 years old and those between 6 and 18 years old.Eleven studies assessed the relationship between FI and the risk of chronic diseases.The anemia subgroup was significantly associated with FI(OR 1.67,95%CI 1.30‒2.13,P<0.0001).Severe FI was reported to increase the risk of hypertension(OR 1.59,95%CI 1.28‒1.98,P<0.0001).Furthermore,a pooled analysis revealed a signifi cant association between FI and the risk of chronic diseases in both 6 and 6-18-year-old subgroups.展开更多
Objective: Discuss impacts of family environment over Hainan province adolescent drug taking behavior.Methods: Adopt "Investigation Questionnaire of Family Environment of Drug Abuse Adolescent in Hainan Province&...Objective: Discuss impacts of family environment over Hainan province adolescent drug taking behavior.Methods: Adopt "Investigation Questionnaire of Family Environment of Drug Abuse Adolescent in Hainan Province" that compiled by self and "Family Environment Scale(FES-CV-Ⅲ)" for research tools.To carry out questionnaire investigation to the 352 drug taking adolescents,who come from "The First Reeducation Through Labor Institute in Hainan Province","The Second Reeducation Through Labor Institute in Hainan Province" and "The Center of Spirit Drug Treated in Hainan Province",then give the data analysis and correlation analysis of the differences.Results: The Cohesion、Intellectual-Cultural orientation、Active-Recreational orientation、Organization、Expressiveness、Independence and Achievement Orientation scores of the drug taking adolescent families in Hainan province were significantly lower than normal samples in China,but the Moral-Religious Emphasis、Conflict and Control scores were significantly higher than the normal samples.Conclusions: The drug taking adolescent not only lack of well-educated families,but also has not been a good school education;most of their families belong to the low social class;adverse family environment is an important reason for drug abuse by adolescent.展开更多
Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adol...Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adolescent outpatients with early AS were included and compared with 31 age-matched male controls. Age (year), height (cm), total body weight (kg) together with body mass index (BMI, kg/m 2) of all subjects and disease duration (month), BASMI, BASFI, BASDAI, SASSS as well as ESR (mm/h) of AS patients were obtained. Lumbar 2-4 bone mineral content (L 2-4BMC, g) and lumbar 2-4 areal bone mineral density (L 2-4 BMD, g/cm 2) were evaluated using dual-energy X-ray absorptiometry (DEXA) with Lunar DPX-IQ device and lumbar 2-4 volumetric bone mineral apparent density (L 2-4 BMAD, g/cm 3) was subsequently calculated. Correlation and multiple regression analyses were performed. Results: Compared with 31 age-matched male controls, AS patients had significantly lower L 2-4BMD [(0.984±0.142) g/cm 2 vs (1.055±0.137) g/cm 2, P=0.049] and L 2-4BMAD [(0.1527±0.0173) g/cm 3 vs (0.1630±0.0195) g/cm 3, P=0.032]. In AS patients, multiple regression analysis identified that only the factor of height was significantly correlated with L 2-4BMC (R=0.673, P=0.000) and the factor of weight had predominant influences on L 2-4BMD (R=0.620, P=0.000) as well as L 2-4BMAD (R=0.510, P=0.003). Conclusion: The young patients with early AS had marked reduction in lumbar spine bone mineral densities, which indicated an important primary event leading to osteoporosis. Positive effects of height and weight on lumbar spine bone mass and densities could expectantly make favorable contributions to early prevention of AS associated bone loss and subsequent osteoporosis.展开更多
Low socioeconomic status(SES)is a well-established risk factor for general and mental health problems.However,there is no widely accepted definition or operationalisation for SES,leading to varied interpretations in r...Low socioeconomic status(SES)is a well-established risk factor for general and mental health problems.However,there is no widely accepted definition or operationalisation for SES,leading to varied interpretations in research.In a critical review of the child and adolescent mental health literature,we map how SES is defined and measured.We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES.Our analysis revealed fundamental problems such as the lack of clear definitions,insufficient detail on variables used and limited measures directly reported by adolescents.Wediscuss issuesrelatedtomeasurement techniques and their impact on reproducibility,policy development and intervention design.Based on our findings,we recommend using SES measures that directly assess the socioeconomic position of children and adolescents.Additionally,we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection.The wide range of distinct measures used to represent SES,coupled with insufficient reporting,likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships.This,in turn,makes the path to effective health interventions more challenging.展开更多
Dear editor,Several types of tumors affect adolescents.Despite being rare,the Ewing sarcoma fami ly of tumors represents the second most common primary bone malignancy in children and adolescents.Paraneoplastic Cushin...Dear editor,Several types of tumors affect adolescents.Despite being rare,the Ewing sarcoma fami ly of tumors represents the second most common primary bone malignancy in children and adolescents.Paraneoplastic Cushing syndrome i s a wel l-known condi t ion characterized by an ectopic secretion of ACTH(or CRH),and in turn of cortisol by tumor cells.Paraneoplastic Cushing syndrome is however very rare in Ewing sarcoma,and to our knowledge,it was only described once.展开更多
基金the National Natural Science Foundation of China(grant number 71974114)。
文摘Background Bipolar disorder is identified as a cause of severe damage to the physical,psychological and social functioning of adolescents and young adults.Aims The aim of this study is to ascertain the trends in the burden of bipolar disorder among individuals aged 10-24 years at global,regional and national levels from 1990 to 2019.Methods The data analysed in this study were from the Global Burden of Diseases 2019.The numbers,rates per 100000 population,average annual percentage changes(AAPCs)of incidence,prevalence and years lived with disability(YLDs)of bipolar disorder are reported at the global,regional and national levels among individuals aged 10-24 years.Global trends by age,sex and Social Development Index(SDI)were further analysed.Results Globally,the incidence of bipolar disorder among adolescents and young adults increased from 79.21 per 100000 population(95%uncertainty interval(Ul):58.13 to 105.15)in 1990 to 84.97 per 100000 population(95%Ul:61.73 to 113.46)in 2019,AAPC 0.24(95%confidence interval(Cl):0.22 to 0.26).In the past three decades,there has been an increase in incidence,prevalence and YLDs in both males and females.The largest increase in incidence between 1990 and 2019 was observed in those aged 20-24 years old from 51.76 per 100000 population(95%Ul:26.81 to 87.20)in 1990 to 58.37 per 100000 population(95%UI:30.39 to 98.55)in 2019;AAPC 0.42(95%Cl:0.38 to 0.47).By the SDI quintile,the largest increase in incidence was observed in the middle SDl;however,the high SDI countries had the highest incidence.Regionally,the largest increase in incidence was observed in southern Latin America.At the national level,the most pronounced increase in the incidence was in Greenland.Conclusions The global increase in incidence among adolescents and young adults between 1990 and 2019 indicates that strategies to improve their mental health still need to be emphasised.
基金This work was supported by the National Natural Science Foundation of China(82173636)the International Institute of Population Health,Peking University Health Science Center(Number:JKGL202302)the National Key Research and Development Plan Project(2022YFC3600904).The funders had no role in study design,data collection and analysis,decision to publish or preparation of the manuscript.
文摘Background Anxiety disorders are the most common psychiatric problems,affecting approximately 1 in 12 children and 1 in 4 adolescents.Understanding the incidence,burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success,stagnation and emerging threats,thereby facilitating effective improvement strategies.Aims To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries.To examine the association between anxiety disorders and social indicators(healthcare access and quality of life).Methods Data were obtained from the Global Burden of Disease Study 2019.The age-standardised incidence rates(ASIRs)and disability-adjusted life years(DALYs)were reported to assess the burden of anxiety disorders,and the estimated annual percentage change was calculated to quantify the temporal trends.Pearson’s correlation was used to investigate country-level risk factors for incidence and DALYs.Results Globally,there were 932 million incident cases of anxiety disorders in children and adolescents,739.29 per 100000 ASIRs and 380.62 million DALYs in 2019.From 1990 to 2019,the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%.Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries.Portugal reported the highest ASIR of anxiety disorders,while Mexico had the largest increase rate of ASIR.In 2019,Portugal reported the highest number of DALYs(1001.71 million),and India(212.09 million)reported the lowest number of DALYs.The burden of anxiety disorders was positively correlated with the average number of psychiatrists,psychologists and nurses in the mental health sector(per 100000),and quality of life and the correlation coefficients were 0.58,0.67,0.43 and 0.53,respectively.Conclusions The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years.However,the incidence and disease burden in developed countries are still increasing steadily.Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status,as well as the cultural and regional characteristics of each country.
基金This study was supported by the STI2030-Major Projects(2021ZD0202000 to YZ)the National Natural Science Foundation of China(82101612 to YJ)+1 种基金the Science and Technology Innovation Program of Hunan Province(2023RC3083 to BL&2021RC2040 to YJ)the Central South University Postdoctoral Programme(YJ)and the Postgraduate Innovative Project of Central South University(SX).
文摘Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.Methods 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as participants.Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms.Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two groups.Results‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest variance.The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.Conclusion Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.
基金This study was supported by the Planning Program of the Health Committee of Ganzhou(2022-1-5)the Key R&D Program of Jiangxi Province(20202BBGL73106)grants from the National Science Foundation of China(81771435).
文摘To the editor:Mood disorders(MD)are serious mental illnesses that commonly affect adolescents,leading to a high incidence of suicidal behaviour.1 In China,the suicide attempt(SA)rate for adolescents with MD is 51.96%,2 and over 500000 adolescent SA are reported annually in the USA due to depression.3 Risk factors for SA include gender,hormone levels,family conflict and,particularly,negative cognitive styles such as rumination.
文摘A nationally representative sample of 1640 Chinese urban adolescents (mean age=14.5 years) and their parents and teachers were surveyed to examine the associations between relationships with teachers and parents and adolescents' developmental outcomes such as academic performance, psychological well-being, altruistic behaviors, and misconduct. Results showed that the quality of adolescents' relationships with teachers was highly correlated with adolescent outcomes, in most cases more so than for relationships with parents. Furthermore, such associations were the same across both genders and three grade levels. These findings suggest that teachers may play an especially significant role in Chinese adolescent development. This study adds to the small but growing literature on the importance of teachers as well as other non-parental adults in adolescent psychosocial development.
文摘Objective To analyze the influence of segmental pedicle screws versus hybrid instrumentation on the correction results in adolescent idiopathic scoliosis patients undergoing posterior selective thoracic fusion. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent selective thoracic fusion from February 2000 to January 2007 in our hospital, the patients were divided into 2 groups according to different instrumentation fashions： Group A was hook-screw-rod （hybrid） internal fixation type, Group B was screw-rod （all pedicle screws） internal fixation type, and the screws were used in every segment on the concave side of the thoracic curve. The parameters of the scoliosis were measured and the correction results were analyzed. Results Totally, 48 patients （7 males, 41 females） were included, with an average age of 14.4 years old and a mean follow-up time of 12.3 months. Thirty and 18 patients were assigned to group A and group B, respectively. The mean preoperative coronal Cobb angles of the thoracic curve were 48.8° and 47.4°, respectively. After surgery, they were corrected to 13.7° and 6.8°, respectively. At final follow-up, they were 17.0° and 9.5°, with an average correction rate of 64.6% and 79.0%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The mean preoperative coronal Cobb angles of the lumbar curve were 32.6° and 35.2°, respectively. After surgery, they were corrected to 8.6° and 8.3°, respectively. At final follow-up, they were 10.3° and 11.1°, with an average correction rate of 66.8% and 69.9%, respectively, and the correction rate of group B was significantly higher than that of group A （P=0.003）. The correction loss of the thoracic curve and lumbar curve in the 2 groups were 3.1° and 1.8°, 2.4° and 2.4°, respectively. No significant difference was noted （both P〉0.05）. The decompensation rate at final follow-up in these 2 groups were 4% （1/25） and 7.1% （1/14） respectively, with no significant difference （P〉0.05）.
基金supported by the National Key R&D Program of China(grant number 2022ZD0211700)National Natural Science Foundation of China(grant no.81771466)+1 种基金Health Science and Technology Project of Guangzhou(grant no.20211A010037)Guangzhou Municipal Psychiatric Disease Clinical Transformation Laboratory,Guangzhou,China(grant no.201805010009).
文摘Background Depression in adolescents is recognised as a global public health concern,but little is known about the trajectory of its clinical symptoms and pathogenesis.Understanding the nature of adolescents with depression and identifying earlybiomarkers can facilitatepersonalised intervention andreducediseaseburden.Aims To track multidimensional outcomes of adolescents with depression and develop objective biomarkers for diagnosis,as well as response to treatment,prognosis and guidance for early identification and intervention.Methods This is a multidimensional cohort study on the Symptomatic trajectory and Biomarkers of Early Adolescent Depression(sBEAD).We planned to recruit more than 1000 adolescents with depression and 300 healthy controls within 5 years.Multidimensional clinical presentations and objective indicators are collected at baseline,weeks 4,8,12 and 24,and years 1,2,3,4 and 5.Conclusions To the best of our knowledge,this is the first longitudinal cohort study that examines multidimensional clinical manifestations and multilevel objective markers in Chinese adolescents with depression.This study aims at providing early individualised interventions for young,depressed patients to reduce the burden of disease.
文摘To define the criteria of posterior selective thoracic fusion in patients with adolescent idiopathic scoliosis. Methods By reviewing the medical records and roentgenograms of 17 patients with adolescent idiopathic scoliosis who un-derwent posterior selective thoracic fusion, the curve type, Cobb angle, apical vertebral rotation and translation, trunk shift, and thoracolumbar kyphosis were measured and analyzed. Results There were 17 King type Ⅱ patients (PUMC type: Ⅱb1 13, Ⅱc3 4). The coronal Cobb angle of thoracic curve be-fore and after operation were 56.9°and 21.6° respectively, the mean correction rate was 60.1%. The coronal Cobb angle of lumbar curve before and after operation were 34.8° and 12.1° respectively, and the mean spontaneous correction rate was 64.8%. At final follow-up, the coronal Cobb angle of thoracic and lumbar curve were 23.5° and 15.2° respectively, there were no significant changes in the coronal Cobb angle, apical vertebral translation and rotation compared with that after operation. One patient had 12° of thoracolumbar kyphosis after operation, no progression was noted at final follow-up. There was no trunk decompensation or deterioration of the lumbar curve. In this group, 3.9 levels were saved compared with fusing both the th-oracic and lumbar curves. Conclusion Posterior selective thoracic fusion can be safely and effectively performed in King type Ⅱ patients with a mo-derate and flexible lumbar curve, which can save more mobile segments and at the same time can maintain a good coronal and sagittal balance.
基金This work was supported by the National Key R&D Program of China(2018YFC2001600)National Natural Science Foundation of China(81971682,81571756,81270023)+10 种基金Natural Science Foundation of Shanghai(20ZR1472800)Project of Shanghai Children’s Health Service Capacity Construction(GDEK201702)Shanghai Sailing Programme(20YF1441900)Shanghai Municipal Commission of Education-Gaofeng Clinical Medicine Grant Support(20171929)Hundred-Talent Fund from Shanghai Municipal Commission of Health(2018BR17)Shanghai Mental Health Center Clinical Research Center(CRC2018DSJ01-5CRC2019ZD04)Research Funds from Shanghai Mental Health Center(13dz2260500)Institute-level Projects of Shanghai Mental Health Center(2020-YJ03,2018-YJ-02,2018-YJ-03)Qihang Foundation of Shanghai Mental Health Center(2019-QH-02)Shanghai Jiao Tong University School of Medicine Child Developing Brain Research Centre.
文摘Adolescence is the peak period for the incidence of anxiety disorders.Recent findings have revealed the immaturity of neural networks underlying emotional regulation in this population.Brain vulnerability to anxiety in adolescence is related to the unsynchronised development of anxiety-relevant brain functional systems.However,our current knowledge on brain deficits in adolescent anxiety is mainly borrowed from studies on adults.Understanding adolescent-specific brain deficits is essential for developing biomarkers and brain-based therapies targeting adolescent anxiety.This article reviews and compares recent neuroimaging literature on anxiety-related brain structural and functional deficits between adolescent and adult populations,and proposes a model highlighting the differences between adolescence and adulthood in anxiety-related brain networks.This model emphasises that in adolescence the emotional control system tends to be hypoactivated,the fear conditioning system is immature,and the reward and stress response systems are hypersensitive.Furthermore,the striatum’s functional links to the amygdala and the prefrontal cortex are strengthened,while the link between the prefrontal cortex and the amygdala is weakened in adolescence.This model helps to explain why adolescents are vulnerable to anxiety disorders and provides insights into potential brain-based approaches to intervene in adolescent anxiety disorders.
文摘Objective To evaluate the different influences of anterior and posterior correction and fusion approaches upon disc wedging in adolescent idiopathic thoracolumbar/lumbar scoliosis.Methods The retrospective study was conducted with the medical records and radiographs of adolescent idiopathic thoracolumbar/lumbar scoliosis patients that underwent anterior(group A) or posterior(group B) correction and fusion surgery from December 1998 to May 2008.The correction of the main curve and changes of the disc wedging were analyzed.Results Fifty-three patients were included,26 in group A and 27 in group B.The mean coronal Cobb angles of the main curve in group A and group B were significantly corrected after surgery(P<0.05),with an average correction rate of 75.2% and 88.2%,respectively.Upon final follow-up,the coronal Cobb angles of the two groups were 18.9°±11.1° and 7.7°±5.6°,respectively,with an average correction loss of 6.8°±6.5° and 2.7°±3.3°,respectively.The coronal Cobb angle after operation and at final follow-up,and the correction rate were significantly better in group B than those in group A(P<0.05),while the coronal Cobb angle loss in group A was greater than that in group B(P<0.05).The disc wedging before operation,after operation,and at final follow-up were 3.2°±3.0°,5.7°±3.0°,and 8.6°±4.4° in group A,and 2.4°±3.2°,3.3°±3.4°,and 3.7°±3.6° in group B,respectively.Postoperative disc wedging was significantly larger compared with preoperative measurements in group A(P<0.05),but not in group B(P>0.05).The difference between disc wedging at final follow-up and that after surgery was significant in group A(P<0.05),but not in group B(P>0.05).Between the two groups,group A had larger disc angles after operation and at final follow-up(P<0.05),and a greater loss of disc angle(P<0.05).Conclusion For adolescent idiopathic thoracolumbar/lumbar scoliosis,posterior approach using all pedicle screws might produce a better result in terms of disc wedging compared with anterior approach.
文摘Background: The relationship between physical and psychopathological features in complex regional pain syndrome(CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.Methods: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory(MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS(19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at <15 months(n=30) vs. ≥15 months(n=33). Binary MPI results(normal-abnormal) were also compared between the two groups.Results: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio(OR) at 1.05 for every 1-month increase [95% confidence interval(CI) 1.02–1.08;P=0.002]. Subjects with pain duration at ≥15 months have lower faking good response score(P<0.001 vs. those with pain duration at <15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores(P<0.05). Pain duration was significantly associated with the MPI variables.Conclusions: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.
基金The authors would like to thank the study participants for volunteering and the other faculty members of Thassim Beevi Abdul Kader College for women,Kilakarai for their help and assistance.The authors would also like to thank UGC,New Delhi for providing financial funding under major research project.
文摘Objective.To study the characteristics, diagnosis and treatment of endometriosis in adolescent patients. Method.Six cases of adolescent endometriosis in our hospital were reviewed retrospectively. Result. Endometriosis is the most common cause of chronic pelvic pain in adolescents. There may be a natural progression of endometriosis from atypical lesions in adolescents to classic lesions in adults. Congenital abnormalities of the reproductive tract are the main reasons for the adolescent endometriosis. Conclusion. Endometriosis should be strongly suspected in adolescent girls with chronic pelvic pain,especially unresponsive to oral contraceptives and nonsteroidal anti-inflammatory drugs. The treatment involves the operations and medicines.
文摘To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studies and 10 studies,reported a higher risk of overweight and obesity in adolescents experiencing FI,respectively(OR 1.38,95%CI 1.20‒1.58,P<0.0001;OR 1.11,95%CI 1.01‒1.22,P=0.035,respectively).Based on the pooled results,adolescents with severe FI had the highest risk of OW/OB(OR 1.45,95%CI 1.20‒1.75,P<0.0001).The pooled OR indicated no signifi cant association between FI and OW/OB,when the adolescents were stratifi ed into those under 6 years old and those between 6 and 18 years old.Eleven studies assessed the relationship between FI and the risk of chronic diseases.The anemia subgroup was significantly associated with FI(OR 1.67,95%CI 1.30‒2.13,P<0.0001).Severe FI was reported to increase the risk of hypertension(OR 1.59,95%CI 1.28‒1.98,P<0.0001).Furthermore,a pooled analysis revealed a signifi cant association between FI and the risk of chronic diseases in both 6 and 6-18-year-old subgroups.
文摘Objective: Discuss impacts of family environment over Hainan province adolescent drug taking behavior.Methods: Adopt "Investigation Questionnaire of Family Environment of Drug Abuse Adolescent in Hainan Province" that compiled by self and "Family Environment Scale(FES-CV-Ⅲ)" for research tools.To carry out questionnaire investigation to the 352 drug taking adolescents,who come from "The First Reeducation Through Labor Institute in Hainan Province","The Second Reeducation Through Labor Institute in Hainan Province" and "The Center of Spirit Drug Treated in Hainan Province",then give the data analysis and correlation analysis of the differences.Results: The Cohesion、Intellectual-Cultural orientation、Active-Recreational orientation、Organization、Expressiveness、Independence and Achievement Orientation scores of the drug taking adolescent families in Hainan province were significantly lower than normal samples in China,but the Moral-Religious Emphasis、Conflict and Control scores were significantly higher than the normal samples.Conclusions: The drug taking adolescent not only lack of well-educated families,but also has not been a good school education;most of their families belong to the low social class;adverse family environment is an important reason for drug abuse by adolescent.
文摘Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adolescent outpatients with early AS were included and compared with 31 age-matched male controls. Age (year), height (cm), total body weight (kg) together with body mass index (BMI, kg/m 2) of all subjects and disease duration (month), BASMI, BASFI, BASDAI, SASSS as well as ESR (mm/h) of AS patients were obtained. Lumbar 2-4 bone mineral content (L 2-4BMC, g) and lumbar 2-4 areal bone mineral density (L 2-4 BMD, g/cm 2) were evaluated using dual-energy X-ray absorptiometry (DEXA) with Lunar DPX-IQ device and lumbar 2-4 volumetric bone mineral apparent density (L 2-4 BMAD, g/cm 3) was subsequently calculated. Correlation and multiple regression analyses were performed. Results: Compared with 31 age-matched male controls, AS patients had significantly lower L 2-4BMD [(0.984±0.142) g/cm 2 vs (1.055±0.137) g/cm 2, P=0.049] and L 2-4BMAD [(0.1527±0.0173) g/cm 3 vs (0.1630±0.0195) g/cm 3, P=0.032]. In AS patients, multiple regression analysis identified that only the factor of height was significantly correlated with L 2-4BMC (R=0.673, P=0.000) and the factor of weight had predominant influences on L 2-4BMD (R=0.620, P=0.000) as well as L 2-4BMAD (R=0.510, P=0.003). Conclusion: The young patients with early AS had marked reduction in lumbar spine bone mineral densities, which indicated an important primary event leading to osteoporosis. Positive effects of height and weight on lumbar spine bone mass and densities could expectantly make favorable contributions to early prevention of AS associated bone loss and subsequent osteoporosis.
文摘Low socioeconomic status(SES)is a well-established risk factor for general and mental health problems.However,there is no widely accepted definition or operationalisation for SES,leading to varied interpretations in research.In a critical review of the child and adolescent mental health literature,we map how SES is defined and measured.We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES.Our analysis revealed fundamental problems such as the lack of clear definitions,insufficient detail on variables used and limited measures directly reported by adolescents.Wediscuss issuesrelatedtomeasurement techniques and their impact on reproducibility,policy development and intervention design.Based on our findings,we recommend using SES measures that directly assess the socioeconomic position of children and adolescents.Additionally,we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection.The wide range of distinct measures used to represent SES,coupled with insufficient reporting,likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships.This,in turn,makes the path to effective health interventions more challenging.
文摘Dear editor,Several types of tumors affect adolescents.Despite being rare,the Ewing sarcoma fami ly of tumors represents the second most common primary bone malignancy in children and adolescents.Paraneoplastic Cushing syndrome i s a wel l-known condi t ion characterized by an ectopic secretion of ACTH(or CRH),and in turn of cortisol by tumor cells.Paraneoplastic Cushing syndrome is however very rare in Ewing sarcoma,and to our knowledge,it was only described once.
