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Psychological Medicine May 2021Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Given the widespread nature and clinical consequences of self-harm and suicidal ideation among adolescents, establishing the efficacy of developmentally appropriate treatments that reduce both self-harm and suicidal ideation in the context of broader adolescent psychopathology is critical.
METHODS
We conducted a systematic review and meta-analysis of the Dialectical Behaviour Therapy for Adolescents (DBT-A) literature on treating self-injury in adolescents (12-19 years). We searched for eligible trials and treatment evaluations published prior to July 2020 in MEDLINE/PubMed, Scopus, Google Scholar, EMBASE, and the Cochrane Library databases for clinical trials. Twenty-one studies were identified [five randomized-controlled trials (RCTs), three controlled clinical trials (CCTs), and 13 pre-post evaluations]. We extracted data for predefined primary (self-harm, suicidal ideation) and secondary outcomes (borderline personality symptoms; BPD) and calculated treatment effects for RCTs/CCTs and pre-post evaluations. This meta-analysis was pre-registered with OSF: osf.io/v83e7.
RESULTS
Overall, the studies comprised 1673 adolescents. Compared to control groups, DBT-A showed small to moderate effects for reducing self-harm (g = -0.44; 95% CI -0.81 to -0.07) and suicidal ideation (g = -0.31, 95% CI -0.52 to -0.09). Pre-post evaluations suggested large effects for all outcomes (self-harm: g = -0.98, 95% CI -1.15 to -0.81; suicidal ideation: g = -1.16, 95% CI -1.51 to -0.80; BPD symptoms: g = -0.97, 95% CI -1.31 to -0.63).
CONCLUSIONS
DBT-A appears to be a valuable treatment in reducing both adolescent self-harm and suicidal ideation. However, evidence that DBT-A reduces BPD symptoms was only found in pre-post evaluations.
Topics: Adolescent; Borderline Personality Disorder; Dialectical Behavior Therapy; Female; Humans; Male; Self-Injurious Behavior; Suicidal Ideation; Young Adult
PubMed: 33875025
DOI: 10.1017/S0033291721001355 -
International Journal of Environmental... Dec 2022Eating disorders (EDs) are common among children and adolescents and are characterized by excessive concerns for physical appearance, distorted body image, and fear of... (Meta-Analysis)
Meta-Analysis Review
Eating disorders (EDs) are common among children and adolescents and are characterized by excessive concerns for physical appearance, distorted body image, and fear of gaining weight. The purpose of this review is to evaluate the follow-up of EDs from adolescence to adulthood, analyzing persistence, relapses, and associated comorbidities. We searched scientific articles in PubMed, PsycInfo, Scopus, and Embase through two research strings, one for quantitative outcomes (recovery/persistence, relapse, and remission) and one for the other outcomes (psychiatric and medical comorbidities, substance use, and social-relational complications). From a total of 8043 retrieved articles, we selected 503 papers after exclusion of duplicates and title/abstract screening. After a full-text evaluation, we included 16 studies eligible for this review. We performed a meta-analysis describing the quantitative results, and we created a narrative synthesis for the qualitative outcomes. Results: Our results confirm that EDs can persist in early adulthood in 40.7% of cases with a relapse percentage of 24.5%. Individuals with an ED more frequently present with an empathy deficit and comorbid anxiety and depressive disorders. EDs are chronic and complex disorders, more frequent in females. In most cases, EDs reduce the autonomy of individuals who present many difficulties in affirming their independence from parental family.
Topics: Adolescent; Female; Child; Humans; Adult; Feeding and Eating Disorders; Comorbidity; Anxiety Disorders; Substance-Related Disorders
PubMed: 36498309
DOI: 10.3390/ijerph192316237 -
Jornal de Pediatria 2015To review the clinical characteristics, comorbidities, and management of insomnia in childhood and adolescence. (Review)
Review
OBJECTIVES
To review the clinical characteristics, comorbidities, and management of insomnia in childhood and adolescence.
SOURCES
This was a non-systematic literature review carried out in the PubMed database, from where articles published in the last five years were selected, using the key word "insomnia" and the pediatric age group filter. Additionally, the study also included articles and classic textbooks of the literature on the subject.
DATA SYNTHESIS
During childhood, there is a predominance of behavioral insomnia as a form of sleep-onset association disorder (SOAD) and/or limit-setting sleep disorder. Adolescent insomnia is more associated with sleep hygiene problems and delayed sleep phase. Psychiatric (anxiety, depression) or neurodevelopmental disorders (attention deficit disorder, autism, epilepsy) frequently occur in association with or as a comorbidity of insomnia.
CONCLUSIONS
Insomnia complaints in children and adolescents should be taken into account and appropriately investigated by the pediatrician, considering the association with several comorbidities, which must also be diagnosed. The main causes of insomnia and triggering factors vary according to age and development level. The therapeutic approach must include sleep hygiene and behavioral techniques and, in individual cases, pharmacological treatment.
Topics: Adolescent; Central Nervous System Diseases; Child; Child, Preschool; Depression; Humans; Infant; Neurodevelopmental Disorders; Sleep Initiation and Maintenance Disorders
PubMed: 26392218
DOI: 10.1016/j.jped.2015.08.006 -
Public Health Nutrition Jan 2018To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence. (Review)
Review
OBJECTIVE
To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence.
DESIGN
A systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible.
SUBJECTS
Healthy children and adolescents.
RESULTS
Twenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat cereals) were selected. Most of the studies (n 15) had a cohort design. Consumption was generally evaluated by means of FFQ or food records; and body composition, by means of double indirect methods (bioelectrical impedance analysis and skinfolds). Most of the studies that evaluated consumption of groups of ultra-processed foods and soft drinks/sweetened beverages found positive associations with body fat.
CONCLUSIONS
Our review showed that most studies have found positive associations between consumption of ultra-processed food and body fat during childhood and adolescence. There is a need to use a standardized classification that considers the level of food processing to promote comparability between studies.
Topics: Adiposity; Adolescent; Adolescent Behavior; Child; Child Behavior; Fast Foods; Food Handling; Health Behavior; Humans; Observational Studies as Topic; Pediatric Obesity; Prevalence; Snacks
PubMed: 28676132
DOI: 10.1017/S1368980017001331 -
Anales Del Sistema Sanitario de Navarra Aug 2022Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the... (Review)
Review
Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portu-guese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.
Topics: Adolescent; Anorexia; Bulimia; Bulimia Nervosa; Female; Humans; Male; Social Networking; Thinness
PubMed: 35972299
DOI: 10.23938/ASSN.1009 -
Atencion Primaria 2019To assess the effectiveness of the interventions to prevent a pregnancy in adolescence.
OBJECTIVE
To assess the effectiveness of the interventions to prevent a pregnancy in adolescence.
DESIGN
Systematic review.
DATA SOURCES
The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence.
STUDY SELECTION
A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale.
RESULTS
Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P>.05) for any of the results analysed in this review.
CONCLUSION
There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate.
Topics: Adolescent; Female; Health Education; Health Knowledge, Attitudes, Practice; Humans; Pregnancy; Pregnancy in Adolescence; Primary Prevention; Program Evaluation
PubMed: 29903543
DOI: 10.1016/j.aprim.2018.04.003 -
Child and Adolescent Mental Health May 2022The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to... (Review)
Review
BACKGROUND
The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic's global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes.
METHODS
We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme.
RESULTS
Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes.
CONCLUSIONS
This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.
Topics: Adolescent; Anxiety; COVID-19; Child; Exercise; Female; Humans; Mental Health; Pandemics
PubMed: 34455683
DOI: 10.1111/camh.12501 -
Sleep Medicine Reviews Apr 2023Despite much attention on digital media use and young peoples' sleep, the literature on digital media and its impact on sleep in older adolescents and young adults... (Review)
Review
Despite much attention on digital media use and young peoples' sleep, the literature on digital media and its impact on sleep in older adolescents and young adults remains to be synthesized. We conducted a systematic review of studies including young people aged 16-25 years. We searched Medline, Web of Science, and CINAHL for observational studies, identifying 60 studies. These studies were assessed for methodological quality. Only studies rated as moderate or high-quality studies were included (n = 42). A narrative synthesis summarized the impact of digital media use on eight sleep outcomes: Bedtime; Sleep onset latency or problems falling asleep; Sleep duration; Early awakening; Sleep disturbance; Daytime tiredness and function; Sleep deficits; Sleep quality. In summary, digital media use was associated to shorter sleep duration and poorer sleep quality. These associations were found for general screen use and use of mobile phone, computer, internet, and social media, but not for television, game console, and tablet use. Most studies investigating bedtime or nighttime use found associations to poor sleep outcomes. Later bedtime and daytime tiredness were associated with mobile phone use at night. Additional research is warranted to draw solid conclusions about the causal direction and to understand the underlying mechanisms.
Topics: Young Adult; Humans; Adolescent; Adult; Internet; Sleep; Sleep Initiation and Maintenance Disorders; Cell Phone; Sleep Wake Disorders
PubMed: 36638702
DOI: 10.1016/j.smrv.2022.101742 -
BMC Psychology Apr 2023Adolescents have extensive use of screens and, they have common complains related to mental health. Here a systematic review was done to understand the association...
BACKGROUND
Adolescents have extensive use of screens and, they have common complains related to mental health. Here a systematic review was done to understand the association between screen time and adolescent's mental health.
METHOD
This review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. An update search was performed in January 2023 with the following keywords: "screen time," "adolescent," and "mental health" on PubMed, PsycINFO and Scopus databases.
RESULTS
50 articles were included, most have found associations between screen exposure and mental health in adolescents. The most used device by adolescents was the smartphone and the use on weekdays was associated with diminished mental well-being. Social media use was negatively associated with mental well-being and, in girls, associated at higher risk for depression.
CONCLUSION
Excessive screen time in adolescents seems associated with mental health problems. Given the profusion and disparity of the results, additional studies are needed to clarify elements such as the screen content or the interaction of adolescents with different screen devices.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42022302817.
Topics: Female; Humans; Adolescent; Screen Time; Mental Health; Smartphone; Depression; Psychological Well-Being
PubMed: 37081557
DOI: 10.1186/s40359-023-01166-7 -
Nutrients Mar 2023Overweight and obesity in childhood and adolescence represents one of the most challenging public health problems of our century owing to its epidemic proportions and... (Review)
Review
Overweight and obesity in childhood and adolescence represents one of the most challenging public health problems of our century owing to its epidemic proportions and the associated significant morbidity, mortality, and increase in public health costs. The pathogenesis of polygenic obesity is multifactorial and is due to the interaction among genetic, epigenetic, and environmental factors. More than 1100 independent genetic loci associated with obesity traits have been currently identified, and there is great interest in the decoding of their biological functions and the gene-environment interaction. The present study aimed to systematically review the scientific evidence and to explore the relation of single-nucleotide polymorphisms (SNPs) and copy number variants (CNVs) with changes in body mass index (BMI) and other measures of body composition in children and adolescents with obesity, as well as their response to lifestyle interventions. Twenty-seven studies were included in the qualitative synthesis, which consisted of 7928 overweight/obese children and adolescents at different stages of pubertal development who underwent multidisciplinary management. The effect of polymorphisms in 92 different genes was assessed and revealed SNPs in 24 genetic loci significantly associated with BMI and/or body composition change, which contribute to the complex metabolic imbalance of obesity, including the regulation of appetite and energy balance, the homeostasis of glucose, lipid, and adipose tissue, as well as their interactions. The decoding of the genetic and molecular/cellular pathophysiology of obesity and the gene-environment interactions, alongside with the individual genotype, will enable us to design targeted and personalized preventive and management interventions for obesity early in life.
Topics: Adolescent; Child; Humans; Pediatric Obesity; Overweight; Body Mass Index; Genotype; Polymorphism, Single Nucleotide
PubMed: 36986146
DOI: 10.3390/nu15061416