Search Results (325)

Introduction: Functional gastrointestinal disorders (FGIDs), conceptualized as disorders of gut–brain interaction, are among the most common chronic or recurrent conditions in childhood, affecting approximately 20–30% of children worldwide across community and clinical settings. FGIDs are associated with substantial impairments in quality of life, frequent school absences, and high levels of psychological comorbidity, contributing to a considerable burden for families and healthcare systems. Despite their high prevalence, the pathophysiology remains incompletely understood, with evidence pointing to a multifactorial interplay of biological, psychological, and environmental factors. Given their frequency across healthcare settings and their significant psychosocial and economic impact, a better characterization of FGIDs in real-world pediatric populations is needed. This retrospective chart review aimed to examine patterns of FGIDs and their associations with gender, temporal factors, geographic setting, and hospitalization burden in a Swiss pediatric cohort within a biopsychosocial framework. Methods: This retrospective chart review study included 1445 patients aged 0–18 years. Patients were selected based on having received an ICD-10 diagnosis attributed to FGID. The frequency and distribution of the aforementioned factors were determined, as well as their associations with each other. Results: A male predominance of FGIDs in newborns (p < 0.001), a female predominance in adolescents (p < 0.001), and sex-based differences in subtype distribution (p < 0.001) was found in this cohort of patients. A higher proportion of FGID cases were found among children in urban areas than in rural and suburban areas. Infants were hospitalized for significantly longer periods on average than older children and males were hospitalized for longer periods on average than females. Discussion and conclusions: These findings highlight the importance of early, integrated, interdisciplinary care pathways. Given the growing mental health issues affecting adolescent girls and the well-documented bidirectional relationship between emotional stress and FGID symptoms, it is suggested that early psychological screening and family-based interventions could reduce the chronicity of symptoms, prevent unnecessary hospitalizations and improve long-term health outcomes. Full article

Background/Objectives: Screen time in children and adolescents has become a prominent public health concern, yet most research has focused on community samples, leaving clinically referred youth underrepresented. This study examined predictors of weekday (WD-ST) and weekend screen time (WE-ST) in a clinical child and adolescent psychiatric sample, with a particular focus on problematic use of the internet (PUI), externalizing symptoms, and fear of missing out (FoMO). Methods: A retrospective secondary analysis of pooled datasets from multiple clinical studies was conducted with 173 adolescents (66.5% female; age range 12–18 years) receiving child and adolescent psychiatric treatment at the University Hospital of Salzburg, Austria. Multivariate linear regression analyses examined self-esteem, adaptive and maladaptive emotion regulation strategies, internalizing and externalizing symptoms, FoMO, and PUI as predictors of WD-ST and WE-ST separately. p-values were adjusted for multiple comparisons using the Benjamini–Hochberg False Discovery Rate correction. Results: In the follow-up hierarchical regression models, PUI was the strongest and most consistent predictor across both models, independently explaining 15.0% of variance in WD-ST time and remaining the only significant predictor in the final WE-ST. Externalizing symptoms significantly predicted WD-ST (β = 0.219, p = 0.021) but not WE-ST. FoMO showed a consistent positive association with WD-ST across both regression models, though this did not reach statistical significance. Self-esteem, emotion regulation strategies, and internalizing symptoms were not significantly associated with screen time in either model. Conclusions: Screen time in clinical adolescent populations cannot be adequately captured by duration alone. PUI reflects a compulsive quality of digital engagement independent of broader psychopathological burden, and the observed difference in weekday versus weekend predictors is consistent with a potential role of daily structure, though this was not formally tested in the present study. Routine clinical assessment should prioritize PUI-focused evaluation over aggregate screen time as a more sensitive indicator of clinically relevant digital engagement. Full article

Background: In recent years, there has been a growing concern regarding social media driving the decline of mental health, especially among adolescents. However, scientific consensus remains mixed, with many studies reporting only small or inconsistent associations. Aims: This paper aims to present the latest and most influential findings in the field of social media, with a focus on understanding the impact it has on adolescents’ mental health by looking at clinical versus non-clinical populations. Method: We conducted a comprehensive search through Scopus, looking for scientific articles and reviews published from January 2020 to March 2026 that include social media and adolescents with mental health conditions. We examined social media use patterns, affordances, mechanisms of impact, and clinical versus non-clinical populations. Results: There is limited literature comparing clinical versus non-clinical adolescent populations. Adolescents with mental health disorders spend more time online, teens with internalizing conditions report being more prone to social comparison and more sensitive to digital feedback, while those with externalizing conditions report a lack of control over how much time they spend on social media. Screen time alone is not sufficient to determine the impact on mental health. Among the features that might be associated with mental health problems are sharing personal content and scrolling through others’ posts. Conclusions: The impact of social media could be shaped by pre-existing vulnerabilities. There is a need for longitudinal study designs to test temporal associations and more research to cover the gap on clinical populations to develop better policies and interventions. Full article

Internal state terms (ISTs) include words describing emotions, thoughts, volitions, obligations, desires, and perceptions. This scoping review aimed to map and synthesize evidence regarding the production of ISTs in individuals with Autism Spectrum Disorder (ASD) without intellectual disability and to investigate the effects of age, gender, Theory of Mind (ToM) skills, and elicitation tasks on their production. A literature search was conducted manually and electronically in Scopus, ScienceDirect, ERIC, and PubMed, identifying 29 peer-reviewed empirical studies published between 2006 and 2025. Findings were heterogeneous. Some studies reported lower IST production in individuals with ASD compared to neurotypical controls, whereas others found differences only in specific IST categories, mainly cognition and emotion terms, or reported no significant group differences. Findings regarding gender, ToM skills, and elicitation tasks were mixed. In both groups, older participants produced more ISTs than younger participants; however, developmental trajectories suggested that emotion and cognition terms were particularly challenging for individuals with ASD, who required more time to acquire them than their typically developing (TD) peers. Furthermore, TD participants produced significantly more ISTs when narrating people’s everyday interactions, whereas communication context did not appear to influence IST production in individuals with ASD. Research examining IST production in preschoolers and adults with ASD remains limited, and little is known about the developmental trajectories of ISTs in this population. Full article

Background: The rising rate of referrals to outpatient psychiatry is difficult to manage. To explore intake and pre-assessment strategies to reduce strain related to the high volume of referrals, two intake tools and two caregiver symptom rating tools were trialled in a child and adolescent outpatient mental health clinic in Ontario, Canada. Methods: Intake personnel completed two tools in addition to the routine intake procedure in a feasibility study. Caregivers completed two symptom-rating tools, and feedback on the use of the tools was sought with a survey. Results: There were statistically significant differences between priority groups (i.e., determination as usual with high, medium, or low priority) on both intake tools, but no statistically significant differences between either caregiver rating tool were found. Conclusions: Standardizing the assessment process may facilitate care. Caregiver ratings did not align with triage priorities; however, these ratings may inform clinical assessments. Full article

This study examined whether family functioning and impulsivity differentiate offense categories or represent shared vulnerability factors among justice-involved adolescents. A cross-sectional survey was conducted in two juvenile correctional facilities and included 159 incarcerated male adolescents aged 13–18 years (mean 16.3 ± 1.1). Participants completed a case report form, the Family Assessment Scale (FAS), and the UPPS Impulsive Behavior Scale. Offenses were classified as property crimes (42%), crimes against persons (31%), sexual offenses (17%), and drug-related crimes (10%). Substance use was highly prevalent (smoking 86.8%; alcohol 61.0%), and 34.6% had experienced repeat incarceration, most frequently in property and drug-related offenses (p < 0.001). Peer influence was the most commonly reported reason for delinquency (44.7%). Family dysfunction was common across the sample, particularly in domains related to parental involvement and behavioral control with some variation across offense categories. In contrast, impulsivity levels were elevated but did not significantly differ between crime categories. These findings support a shared vulnerability perspective, suggesting that dysfunctional family environments and substance-related risk contexts operate across offenses, while impulsivity may represent a general risk rather than an offense-specific determinant. These results highlight the importance of family-centered and developmentally informed interventions in juvenile justice settings. Full article

Background/Objectives: Parent report is often used to assess dental fear in early childhood, but its association with later child-reported dental fear remains unclear. This study primarily examined whether parent-reported dental fear at age 5 was associated with child-reported dental fear at age 9, and secondarily explored two options derived from the modified Children’s Fear Survey Schedule–Dental Subscale (CFSS-DS-M): a single general dental fear item and a pragmatic multi-item score. Methods: This secondary longitudinal observational analysis used data from the FinnBrain Birth Cohort Study. Mothers and fathers rated child dental fear at age 5 using the CFSS-DS-M. Children self-reported dental fear at age 9 using the Modified Dental Anxiety Scale (MDAS). Associations of the single item and five-item score with age-9 MDAS score were examined separately for mother- and father-reported data using Spearman correlations and adjusted linear regression models. Exploratory factor analysis examined the structure of the five-item score. Results: Treatment-specific CFSS-DS-M items frequently received “no experience” responses. The pragmatic five-item score showed an exploratory one-factor structure and was more feasible than the full 11-item score. Associations with age-9 dental fear were small. In adjusted analyses, both mother-reported measures were positively associated with age-9 dental fear. In father-reported data, the single item was not associated, whereas the five-item score showed a positive predictor-level association, although the adjusted model was not statistically significant. Conclusions: Parent-reported dental fear at age 5 provides modest information about later child-reported dental fear. In population-based cohorts in early childhood, less treatment-specific items may be useful when assessing dental fear. Full article

Background: Mental health problems often begin in adolescence, yet early detection and intervention remain limited. This study assesses the prevalence of psychological distress and its correlates among high-school students in Makkah, Saudi Arabia, and explores whether specific symptom clusters of depression, anxiety and bipolar/mania can be identified using the General Health Questionnaire-30 (GHQ-30). Methods: A cross-sectional survey was conducted during the 2025–2026 academic year using stratified cluster sampling. A total of 535 students aged 15–18 years completed a questionnaire containing the validated Arabic GHQ-30 and demographic, socioeconomic and lifestyle items. The GHQ-30 was scored with binary 0-0-1-1 scoring (cut-off ≥ 6) to define cases of psychological distress. Item clusters were used to screen for probable depression, anxiety and bipolar/mania. Descriptive statistics characterized the sample. Associations were examined using chi-square tests and multivariable logistic regression. Results: Overall, 70.5% of participants screened positive for psychological distress. The prevalences of probable depression, anxiety and bipolar/mania were 33.1%, 28.2% and 31.2%, respectively. In adjusted models, female gender, insufficient sleep, lack of physical activity and exposure to bullying were associated with increased odds of psychological distress; longer sleep was protective. History of mental health conditions was a strong predictor of probable depression, whereas medication use was protective. Older age and higher paternal education were protective for anxiety. Bullying was the most consistent predictor across all symptom clusters. Conclusions: Psychological distress is highly prevalent among Makkah high-school students. Key determinants include gender, sleep duration, lack of physical activity and bullying. Routine school-based mental health screening, sleep-hygiene education, anti-bullying initiatives and early referral pathways are warranted. Further research should examine and validate GHQ-30 item clusters for specific disorders. Full article

Child and adolescent mental health (CAMH) is a global concern that is increasingly recognized and prioritized. Worldwide, mental health conditions affect a significant number of children and adolescents; however, access to CAMH services remains limited. This study sought to explore the implementation of child and adolescent mental health services in the rural Chris Hani District of the Eastern Cape province, South Africa, from the perspectives of health professionals and teachers, focusing on strengths, weaknesses, opportunities, and threats. Using a qualitative approach, a sample of 36 participants (12 health professionals and 24 teachers) was purposively recruited. Data were collected through face-to-face, semi-structured individual interviews and focus group discussions. Thematic analysis identified several strengths, including effective screening and identification of CAMH problems, training in psychiatry and psychology, teacher support, collaboration with stakeholders, and the availability of policy and guidelines. Key weaknesses included inadequate CAMH training, a limited CAMH workforce, personal barriers, guidelines primarily oriented toward physical health, and insufficient basic infrastructure. Opportunities for improvement include enhancing the skills of the existing workforce, increasing engagement in extramural activities, and empowering parents with knowledge of available CAMH services. Identified threats included the normalization of CAMH symptoms, challenges involving parents and feeder schools, stigma, poor stakeholder collaboration, and inadequate guidelines. Overall, the analysis of strengths, weaknesses, opportunities, and threats reflects the broader challenges present in low-resource settings that hinder the implementation of CAMH services. It also highlights the need for integrative approaches to implementing CAMH services in rural contexts, while identifying opportunities to improve service delivery. Full article

Background: Autism spectrum disorder (ASD) arises from complex gene–environment interactions. While trace element abnormalities have been studied, associations with autism severity remain inconsistent. Ratios indicating detoxification balance, rather than single toxic elements, may better reflect severity. Objective: To examine the relationships between urinary trace element levels, detoxification-related element ratios, and autism severity measured by the Childhood Autism Rating Scale (CARS). Methods: In a cross-sectional study of 168 participants (103 ASD, 65 controls), thirty urinary trace elements were quantified by ICP-MS. ASD patients were stratified by CARS into subthreshold ASD (n = 29), mild–moderate ASD (n = 36), and severe ASD (n = 38). Analyses included Mann–Whitney U, Kruskal–Wallis, and Spearman correlation tests, focusing on Li/Pb, Cu/Pb, and Cr/Pb ratios. Results: Individual elements showed weak associations with CARS; lead correlated positively (ρ = 0.209, p = 0.035) and lithium inversely (ρ = −0.194, p = 0.051). In contrast, element ratios showed stronger links: Li/Pb (ρ = −0.349, p = 0.0003), Cu/Pb (ρ = −0.320, p = 0.0011), and Cr/Pb (ρ = −0.209, p = 0.035). Severe ASD exhibited modest 90th-percentile elevations for toxic elements but high heterogeneity. Conclusions: Single-element levels showed limited associations with ASD severity. Element ratios, particularly Li/Pb, showed stronger statistical associations than individual elements in this cross-sectional dataset; however, these findings should be interpreted as candidate correlates rather than causal or clinically validated biomarkers. Full article

Objectives: The aim of this study was to analyze current trends in screen exposure and to provide a deeper understanding of the relationships between temperament, screen exposure, and psychological adjustment in preschoolers. Methods: The study was conducted in kindergartens and one health center in the city of Zagreb, using a convenience sample of 115 mothers who assessed their preschool children’s screen exposure, temperament, and psychological adjustment. Results: Descriptive data analysis indicated that children’s screen time generally fell within the American Academy of Child and Adolescent Psychiatry’s recommended guidelines. Correlation analysis indicated that externalizing problems were significantly positively correlated with impulsivity, activity, emotionality, and weekend screen time. Conversely, prosocial behavior was negatively correlated with impulsivity and weekend screen exposure. Moderation analyses revealed that weekend screen time significantly altered the associations between temperament and externalizing problems. Specifically, longer weekend screen exposure weakened the relationships between Impulsivity and externalizing problem and between Activity and externalizing problems, suggesting that screen time may buffer the impact of high-risk temperament profiles on behavioral difficulties. Weekend screen time did not moderate the relationship between Emotionality and externalizing problems. Similarly, longer screen exposure weakened the negative association between Impulsivity and prosocial behavior, indicating that screen time may reduce the extent to which impulsive temperament undermines prosocial functioning in preschool children. Conclusions: These findings provide deeper insight into the role of temperament and screen time exposure in predicting both maladaptive and prosocial behaviors among preschool-aged children. Full article

Objectives: This longitudinal study examined the association of parents’ dental anxiety during early pregnancy with the stability of brushing their own and their children’s teeth from the age of one to four years. Methods: The study used data from the FinnBrain Birth Cohort Study, which included 816 mothers and 379 fathers who completed questionnaires on dental anxiety at gestational week 14 and on toothbrushing frequency for themselves and their child at the ages of 1, 2, and 4 years. Dental anxiety was assessed using the Modified Dental Anxiety Scale. The stability of toothbrushing was categorized as stable good (twice daily or more at all time points), fluctuating, good at 4 years (fluctuates over time points, but good at age 4 years), fluctuating, poor (less than twice daily) at 4 years (fluctuates over time points, but poor at age 4 years), stable poor (poor at all time points). Unordered multinomial logit models regarding the association of parents’ dental anxiety on brushing their own and their children’s teeth were adjusted for education, and education and parents’ own toothbrushing, respectively. Results: Compared to the mothers who brushed their teeth twice daily throughout the study (“stable good”), those belonging to the “fluctuating, good at 4 years” group and those belonging to the “stable poor/poor at 4 years” group were more likely to have higher dental anxiety (OR = 1.07, 95% CI = 1.01–1.13 and OR = 1.04, 95% CI = 1.00–1.08, respectively). This association was not found among fathers. Parents’ dental anxiety was not associated with the brushing of their children’s teeth. Conclusions: Attending to the mother’s dental anxiety during pregnancy could improve her toothbrushing. Full article

Background/Objectives: Adolescents admitted for emergency psychiatric hospitalization frequently present with severe and heterogeneous psychopathology. In clinical practice, some adolescent inpatients appear to present a broader symptom pattern suggestive of emotional dysregulation. However, it remains unclear whether they can truly be distinguished in this population and whether they differ meaningfully from adolescents with predominantly depressive presentations. Methods: We conducted a retrospective cross-sectional chart review with subgroup analysis based on the medical records of patients aged 11–17 years hospitalized on an emergency basis at the Department of Child and Adolescent Psychiatry in Poznań, Poland, between January and December 2024. Patients were assigned either to an emotional dysregulation group, defined by affective dysregulation and behavioral dyscontrol, or to a depressive presentations group, comprising adolescents with depressive presentations who did not meet criteria for the emotional dysregulation profile. Broader clinical characteristics, adverse childhood experiences, and prior treatment history were compared between groups. Results: A total of 139 adolescents were included (85 in the emotional dysregulation group and 54 in the depressive presentations group). The median age was 13 years [Q1–Q3: 13–14] in the emotional dysregulation group and 14 years [Q1–Q3: 12.25–14] in the depressive presentations group; girls comprised 77.6% and 83.3% of the groups, respectively. The emotional dysregulation group more often presented with conflict-ridden relationships, a more frequent history of suicide attempts (72.9% vs. 50.0%, p = 0.006), and a higher number of suicide attempts (median 1 [Q1–Q3: 0–2] vs. 0.5 [Q1–Q3: 0–1], p = 0.012), as well as more frequent exposure to adversity-related experiences. Furthermore, this group had a higher number of previous psychiatric hospitalizations (median 1 [Q1–Q3: 1–2] vs. 1 [Q1–Q3: 1–1], p = 0.001) and a longer history of psychiatric treatment. In contrast, social withdrawal was more characteristic of the depressive presentations group. Conclusions: Routinely collected clinical records may capture a clinically meaningful subgroup of adolescents with a symptom profile suggestive of emotional dysregulation. Compared with the depressive presentations group, these adolescents showed greater interpersonal difficulties, more recurrent suicide attempts, greater adversity burden, and a longer history of psychiatric treatment. Further prospective studies using standardized measures are needed. Full article

Background: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) are characterized by neuropsychiatric symptoms linked to immune dysregulation. Emerging evidence highlights the role of host–microbiome interactions in modulating neuro-immune functions via gut–brain axis signaling; however, its contribution to PANDAS pathophysiology remains poorly understood. Methods: We conducted microbiome analysis from samples collected across multiple sites of PANDAS patients including nasal, throat and stool. We performed an integrated multi-omics analysis of stool samples from pediatric PANDAS cases and healthy controls, including discordant twin pairs. Microbial composition and function were assessed using 16S rRNA gene sequencing, shotgun metagenomics, while untargeted metabolomic profiling was performed using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS). Results: PANDAS cases exhibited reduced alpha diversity and significantly altered beta diversity compared to controls, indicating shifts in gut microbial composition. Shotgun metagenomic analysis revealed differential enrichment of functional pathways, including diminished quorum sensing, altered gamma-aminobutyric acid (GABA) biosynthesis, and microbial degradation processes. Multiple gut–brain modules (GBMs) and gut metabolic modules (GMMs) associated with neurotransmission, transport activities and metabolism were significantly perturbed in PANDAS. Metabolomic profiling showed reduced functional diversity and distinct clustering of metabolic profiles, with differential abundance of amino acids, bile acids, and neuroactive compounds. Integrative analysis further identified disrupted microbe–metabolite networks allied to gut–brain signaling. Conclusions: Our findings reveal significant functional shifts in gut microbiota composition, functional capacity and metabolite profile in PANDAS, suggesting dysregulation of the gut–brain axis signaling. This study provides a foundation for development of microbiome-based biomarkers and therapeutic strategies for pediatric neuropsychiatric disorders. Full article

Background: Preterm birth is a significant early-life stressor associated with increased psychiatric vulnerability and long-term functional impairments in school-aged children. Objective: To compare behavioral–emotional outcomes and functional competence between school-aged preterm and term-born children, examining perinatal, cognitive, and socioeconomic predictors. Methods: 140 children aged 6–10 (70 preterm, 70 age-matched controls) were assessed using the Child Behavior Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ). Functional competence—defined as participation in daily activities, social interactions, and school performance—was examined alongside behavioral–emotional outcomes. Predictors included gestational age, birth weight, SES, and cognitive ability. Results: Preterm birth was associated with higher SDQ scores in emotional problems, hyperactivity, and peer problems. CBCL results showed lower total functional competence scores, specifically in activities, social participation, and school performance. Longer NICU stay predicted higher internalizing problems and lower social participation. Cognitive ability was linked to lower SDQ externalizing and internalizing scores. SES was not a significant predictor. Conclusions: Preterm birth and prolonged NICU hospitalization are linked to persistent behavioral–emotional and functional vulnerabilities. These findings underscore the need for early, integrated developmental monitoring within a preventive psychiatry framework to identify psychiatric vulnerability and support functional participation. Full article