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Department/Unit:Child and Adolescent Psychiatry
Editors' Note: Second Annual Report Regarding JAACAP's Antiracist Journey [Editorial]
Novins, Douglas K; Althoff, Robert R; Cortese, Samuele; Drury, Stacy S; Frazier, Jean A; Henderson, Schuyler W; McCauley, Elizabeth; Njoroge, Wanjikũ F M; Singh, Manpreet Kaur; White, Tonya; Bath, Eraka; Billingsley, Mary K
In 2020, we wrote to you of our dedication and vision for this Journal "to be antiracist at every level," outlining the following 6 initiatives "to reshape the Journal to pursue this vision:" (1) Issuing a Call for Papers on racism and its impacts on child development and children's mental health; (2) updating our Guide for Authors to emphasize that we will evaluate articles submitted to the Journal on whether their study designs are inclusive and their discussions consider and address human diversity and structural determinants of health in the context of their research questions and hypotheses; (3) assembling a special collection of Journal articles on bias, bigotry, discrimination, racism, and mental health inequities; (4) accelerating our efforts to make our Editorial Board inclusive and representative of our community of scientists and practitioners as well as the communities we serve; (5) engaging in continuing education and dialogue as an Editorial Board that will include antiracism training and praxis; and (6) critically examining "our editorial and peer review process to ensure it is antiracist."1 In this Editors' Note, we write to update you on our progress, including a new initiative we started in the past year: (7) a new option for authors to add a statement to their manuscripts regarding the inclusion and diversity initiatives and practices they employed in pursuing their work. With the launch this year of JAACAP Open, the Academy's new open access publication and the newest member of the JAACAP family of journals, we have expanded opportunities to pursue these efforts, and look forward to sharing more about JAACAP Open in future updates.
PMID: 36182011
ISSN: 1527-5418
CID: 5470412
Perceived medical care quality during COVID-19 illness links socioeconomic disadvantage to vaccine hesitancy
Kjos, Nils; Hendrix, Cassandra L; Thomason, Moriah E
Maximizing vaccine uptake is critical for the optimal implementation of COVID-19 immunization programs. Indicators of socioeconomic status (SES) have been associated with variations in COVID-19 vaccine uptake in the United States. The present study investigates COVID-19 vaccination behavior in individuals with history of COVID-19 infection, with the specific goal of understanding whether experiences during illness explain socioeconomic disproportionalities in vaccine uptake. We leveraged a large sample of adults (n = 1584) infected with COVID-19 in NYC to examine this question, investigating whether specific experiences during illness explained the association between socioeconomic status and COVID-19 vaccine hesitancy. Data from this study were collected during February and March 2021. Principal component analysis was used to create three composite variables that measure distinct COVID-19 related experiences: infection-related health impacts, pandemic-related psychosocial disruption, and perceived quality of medical care during COVID-19 illness. Neither infection-related impacts nor psychosocial disruption were related to vaccine hesitancy after adjusting for related sociodemographic covariates. However, perceptions of higher quality care received during COVID-19 illness predicted decreased COVID-19 vaccine hesitancy. Furthermore, mediation analysis revealed that perceived care quality during COVID-19 illness mediate the relationship between objective socioeconomic risk and COVID-19 vaccine hesitancy. These findings highlight patient-reported care quality during illness as a novel target that may increase vaccine uptake among socioeconomically vulnerable populations.
PMCID:9550282
PMID: 36245805
ISSN: 2211-3355
CID: 5360112
Editorial Perspective: COVID-19-related publications on young people's mental health - what have been the key trends so far and what should come next? [Editorial]
Cortese, Samuele; Sabe, Michel; Solmi, Marco
In this Editorial Perspective, we take a systematic look at the overall nature of the Covid-19 related research on mental health in children and young people, to gain insight into the major trends in this area of research and inform future lines of investigation, clinical practices, and policies. By means of state-of-the-art scientometric approaches, we identified 3,692 relevant research outputs, mainly clustering around the following themes: (a) mental health consequences of the Covid-19 pandemic in children and young people; (b) impact of the pandemic on pre-existing psychiatric disorders; (c) family outcomes (i.e., family violence and parental mental health); and (d) link between physical and mental conditions. Only 23% of the retrieved publications reported new data, the remaining ones being reviews, editorials, opinion papers, and other nonempirical reports. The majority of the empirical studies used a cross-sectional design. We suggest that future research efforts should prioritise: (a) longitudinal follow-up of existing cohorts; (b) quasi-experimental studies to gain insight into causal mechanisms underlying pandemic-related psychopathology in children and young people; (c) pragmatic randomised controlled trials (RCTs) to test evidence-based intervention strategies; and (d) evidence-based guidelines for clinicians and policymakers.
PMID: 35438193
ISSN: 1469-7610
CID: 5218242
Supporting immigrant caregivers during the COVID-19 pandemic: Continuous adaptation and implementation of an early childhood digital engagement program
Rojas, Natalia M; Katter, Julie; Tian, Ran; Montesdeoca, Jacqueline; Caycedo, Camila; Kerker, Bonnie D
Digital messaging programs have the potential to be a powerful, low-cost, technological tool to support multiple facets of caregivers' knowledge, and implementation of developmentally appropriate caregiver-child activities among diverse immigrant populations. However, involving caregivers and community stakeholders in the cultural and linguistic tailoring of interventions to optimize utilization and engagement may be critical to ensuring messaging programs' usability and acceptability. The purpose of this mixed-method study was to use the dynamic adaptation process (DAP) within an Exploration, Preparation, Implementation, Sustainment (EPIS) framework to examine the implementation of a digital messaging program, developed at the beginning of the COVID-19 pandemic, aimed at providing Spanish-, English-, and Mandarin-speaking immigrant caregivers with caregiver-child activities that supported children's development and caregivers' knowledge. Building upon the EPIS framework, using DAP, we assessed the feasibility and acceptability of a messaging program via short message service or multimedia message service, WeChat, and Remind and webinar program during the COVID-19 pandemic. The study illustrated how a digital messaging program is a feasible mechanism for sharing developmentally and culturally appropriate information with immigrant caregivers. In addition, the use of the DAP and the EPIS framework allowed us to continuously track the process of cultural adaptation, identify barriers and facilitators of the outreach program, and examine how implementation unfolded across all three groups of caregivers.
PMID: 35901459
ISSN: 1573-2770
CID: 5276802
The impact of maternal depression on child mental health treatment and models for integrating care: a systematic review
Engelhard, Caitlin; Hishinuma, Earl; Rehuher, Davis
Maternal depression negatively impacts child mental health and is a well-known risk factor for child psychopathology. However, maternal depression treatment and child mental health treatment are rarely integrated. The purpose of this review was to assess the impact of maternal depression on child mental health treatment, including (1) how treatment of maternal depression affects child mental health outcomes, (2) the impact of maternal depression on children receiving mental health care, and (3) emerging models that address maternal depression in primary-care pediatrics and child mental health settings. A systematic literature review was conducted using PubMed and PsycInfo. Initial search yielded 224 records, and after exclusion, 29 papers were reviewed. Effective treatment of maternal depression is associated with a significant decrease in child psychiatric symptoms. Maternal depression negatively affects child mental health treatment in that there is a high rate of untreated mental illness among mothers of psychiatrically ill children, and maternal depression impedes effective child mental health treatment. Current models to address maternal depression in child settings include screening in pediatric primary care, psychotherapy for depressed mothers of psychiatrically ill children, and emerging models that integrate maternal and child mental health treatment. Effective treatment of maternal depression significantly improves child mental health and should be better integrated into child treatment. Opportunities to improve care include more robust screening for parental mental illness, supports to refer parents to psychiatric care, and on-site services for parents. Such interventions hold promise, but require significant support from a multidisciplinary team.
PMID: 36327004
ISSN: 1435-1102
CID: 5353652
Treatment of ADHD in preschool children
Cortese, Samuele
PMID: 36306806
ISSN: 2352-4650
CID: 5359722
The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis
Idrees, Iman; Bellato, Alessio; Cortese, Samuele; Groom, Madeleine J
We carried out a systematic review and meta-analysis to investigate the effects of stimulant and non-stimulant medications on autonomic functioning in people with ADHD (PROSPERO: CRD42020212439). We searched (9th August 2021) PsycInfo, MEDLINE, EMBASE, Web of Science and The Cochrane Library, for randomised and non-randomised studies reporting indices of autonomic activity, (electrodermal, pupillometry and cardiac), pre- and post-medication exposure in people meeting DSM/ICD criteria for ADHD. In the narrative syntheses, we included 5 electrodermal studies, 1 pupillometry study and 57 studies investigating heart rate and blood pressure. In the meta-analyses, 29 studies were included on blood pressure and 32 on heart rate. Administration of stimulants, and to a lesser degree, non-stimulants increased heart rate and blood pressure in people with ADHD. Similarly, an upregulation of arousal, reflected in increased electrodermal activity and pupil diameter was observed following stimulant use. Yet, the methodological diversity of studies presented in this review reinforces the need for more standardised and rigorous research to fully understand the relationship between arousal, medication, and behaviour in ADHD.
PMID: 36427764
ISSN: 1873-7528
CID: 5378512
Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review
Huang, Keng-Yen; Kumar, Manasi; Cheng, Sabrina; Urcuyo, Anya Elena; Macharia, Paul
AIM/OBJECTIVE:Adolescents in low-and-middle-income countries (LMICs) are facing numerous developmental, sexual and reproductive health (SRH) challenges including exposure to multidimensional violence. Gender-based violence (GBV) specifically intimate partner violence (IPV) are both highly prevalent in LMICs and are strongly linked with poor SRH outcomes. However, GBV and IPV interventions have not yet been adequately integrated in SRH due to individual, social, cultural, service, and resource barriers. To promote long-term SRH, a more holistic approach that integrates GBV and IPV, and adolescent development needs is imperative. Digital health has the potential to address multiple service setup, provision, and addressing access barriers through designing and providing integrated SRH care. However, there are no guidelines for an integrated digital SRH and development promotion for adolescents in LMICs. METHODS:An umbrella review was conducted to synthesize evidence in three inter-related areas of digital health intervention literature: (i) SRH, (ii) GBV specifically IPV as a subset, and (iii) adolescent development and health promotion. We first synthesize findings for each area of research, then further analyze the implications and opportunities to inform approaches to develop an integrated intervention that can holistically address multiple SRH needs of adolescents in LMICs. Articles published in English, between 2010 and 2020, and from PubMed were included. RESULTS:Seventeen review articles met our review inclusion criterion. Our primary finding is that application of digital health strategies for adolescent SRH promotion is highly feasible and acceptable. Although effectiveness evidence is insufficient to make strong recommendations for interventions and best practices suggestions, some user-centered design guidelines have been proposed for web-based health information and health application design for adolescent use. Additionally, several digital health strategies have also been identified that can be used to further develop integrated GBV-IPV-SRH-informed services to improve adolescent health outcomes. We generated several recommendations and strategies to guide future digital based SRH promotion research from our review. CONCLUSIONS:Rigorous research that focuses on intervention effectiveness testing using a combination of digital health strategies and standardized albeit contextualized outcome measures would be important. Methodological improvement such as adoption of longitudinal experimental design will be crucial in generating evidence-based intervention and practice guidelines for adolescents in LMICs.
PMCID:9675248
PMID: 36401323
ISSN: 1472-6963
CID: 5371772
Early trauma and schizophrenia onset: preliminary results of an outpatient cohort in Brazil
Trovão, Leandro de Oliveira; Alves, Gilberto Sousa; Carrilho, Carolina Gomes; Ricci, Thaysse Gomes; Bittencourt, Lays; Alves, Cândida; Brito, Natália Costa; Nardi, Antonio EgÃdio; Malaspina, Dolores; Veras, André Barciela
OBJECTIVE:To assess the prevalence of early trauma in individuals with onset of schizophrenia at early (≤ 18 years) and adult (> 18 years) ages (EOP and AOP, respectively). and explore relationship between the onset of disease and clinical variables, including traumatic events, psychotic and mood symptoms. METHODS:Subjects with SZ (n=71) and EOP and AOP were compared for the history of psychological trauma, sexual abuse, and physical punishment through the Early Trauma Inventory Self Report - Short Form (ETISR-SF); a history of comorbidities and affective disorders through the Diagnostic Interview for Psychosis and Affective Disorders, Positive and Negative Syndrome Scale, Liebowitz Social Anxiety Scale and the Calgary Depression Scale for Schizophrenia was correlated with the disease duration. RESULTS:Early trauma was significantly associated with an early onset psychotic episode (r = -0.315, p < 0.01). General trauma and depressive symptoms in adulthood were also associated (r = 0.442, p < 0.01), as well as social anxiety symptoms and early trauma (r = 0.319, p < 0.01). ETISR-SF global scores and the psychical abuse item were significantly higher in the EOP than in the AOP. In the hierarchical regression, PANSS scores were better predicted by the duration of disease and age of first psychotic episode (R=0.303). CONCLUSIONS:Our results support the hypothesis that early trauma, including physical abuse, may play a relevant role in schizophrenia symptoms, such as an earlier psychotic occurrence, as well as features of other psychiatric disorders, such as greater severity of social anxiety and depression.
PMID: 33872478
ISSN: 2238-0019
CID: 4846822
Clinical characteristics according to sex and symptom severity in children with selective mutism: a four-center study
Dogru, Hicran; Ucuz, Ilknur; Uzun Cicek, Ayla; Comertoglu Arslan, Semiha
INTRODUCTION/UNASSIGNED:Clinical information regarding selective mutism (SM), a persistent and debilitating psychiatric disorder, in children is extremely limited. We aimed to examine sociodemographic characteristics and comorbid psychiatric conditions and identify clinical variables associated with sex and SM severity among children with SM. METHODS/UNASSIGNED:We analyzed the medical records of 49 children who received treatment for SM in four different tertiary hospitals in Turkey between 2016 and 2021. Children's charts were reviewed to examine clinical characteristics, comorbidities, and response to treatment. RESULTS/UNASSIGNED:= 0.039) than males. The vast majority of children received two or more psychiatric diagnoses. Children in the severe group had a longer duration of illness, higher rates of psychiatric comorbidity, speech delay, and treatment resistance. CONCLUSION/UNASSIGNED:Our study suggests that SM may have different clinical features according to sex and symptom severity of SM. More information about children with SM is needed to understand the development and maintenance of SM.
PMID: 36384394
ISSN: 1502-4725
CID: 5371622