Is recurrent brief depression an expression of mood spectrum disorders in young people?

The clinical relevance of Recurrent Brief Depression (RBD) has not received sufficient attention to date and continues to represent a controversial issue. The present study was carried out in a community sample to evaluate the lifetime prevalence of RDB, the degree of comorbidity, as well as possible risk factors. Subjects from a community survey in Sardinia (Italy) were randomly selected from registers of a rural, an urban and a mining area (n=1040, 461 males, 579 females). Interviews were carried out by physicians using the Italian version of the Composite International Diagnostic Interview Simplified which had been modified for the purpose of this study. Lifetime prevalence of RBD was 7.6%; 5.8% in males, 9% in females. Subjects aged 18 to 24 years presented higher frequencies (13.8%, OR 2.2) than those aged 25 or over. Comorbidity with Major Depression was particularly frequent. RBD was furthermore associated with suicide attempts and substance abuse, thereby constituting an effective health problem. Further epidemiological and clinical studies of RBD are warranted in order to develop specific treatments and prevention strategies.     

Time trends in mental well-being: the polarisation of young people’s psychological distress

Purpose

Previous research on time trends of young people’s mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period.

Methods

GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16–24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene’s homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean.

Results

There was a small but significant increase in mean GHQ-12 among young women (b 0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (p < 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men.

Conclusions

The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008.

     

Editorial Perspective: Cabin fever – the impact of lockdown on children and young people

This article debates the impact of the pandemic lockdown on the mental health of children and young people. It proposes that children and young people have been subject to the kind of psychological distress that has featured as the folk syndrome, cabin fever. Drawing on the evidence about the impact of prolonged confinement and isolation on mental health, not least in penal and spaceflight contexts, the article points to a long tail of mental health challenges for children and young people through and in the wake of the pandemic. Finally, the article summarizes some of the antidotes for cabin fever and new, exciting, creative digital interventions that may assist upstream mental health literacy and complement and support the work of child and adolescent mental health services.     

A qualitative investigation of LGBTQ+ young people’s experiences and perceptions of self-managing their mental health

There is evidence that young people generally self-manage their mental health using self-care strategies, coping methods and other self-management techniques, which may better meet their needs or be preferable to attending specialist mental health services. LGBTQ+ young people are more likely than their peers to experience a mental health difficulty and may be less likely to draw on specialist support due to fears of discrimination. However, little is known about LGBTQ+ young people’s experiences and perceptions of self-managing their mental health. Using a multimodal qualitative design, 20 LGBTQ+ young people participated in a telephone interview or an online focus group. A semi-structured schedule was employed to address the research questions, which focussed on LGBTQ+ young people’s experiences and perceptions of self-managing their mental health, what they perceived to stop or help them to self-manage and any perceived challenges to self-management specifically relating to being LGBTQ+ . Reflexive thematic analysis yielded three key themes: (1) self-management strategies and process, (2) barriers to self-management and (3) facilitators to self-management. Participants’ most frequently mentioned self-management strategy was ‘speaking to or meeting up with friends or a partner’. Both barriers and facilitators to self-management were identified which participants perceived to relate to LGBTQ+ identity. Social support, LGBTQ+ youth groups and community support were identified as key facilitators to participants’ self-management of their mental health, which merits further investigation in future research. These findings also have important implications for policy and intervention development concerning LGBTQ+ young people’s mental health.

     

The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help

Purpose  

In this study, we examined whether young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help are influenced by their own, and their parents’ stigmatising attitudes towards young people with mental disorders.     

Is cigarette smoking associated with suicidal ideation among young people?

OBJECTIVE: The authors examined the association between suicidal ideation in early adulthood and daily tobacco smoking in a community sample of adolescents. METHOD: Participants were enrolled in a longitudinal study of health and development. The factors of disadvantage, impulsiveness, stress, depressed mood, tobacco smoking, other substance use, and parental attachment were included in multivariate modelling of suicidal ideation. RESULTS: Data on tobacco use were available for 764 participants. Early tobacco smoking was significantly predictive of later suicidal ideation, but there was no longer a significant relationship when high levels of stress and depression and low levels of parental attachment in adolescence were included in the multivariate model. CONCLUSIONS: Tobacco smoking in adolescence does not appear to elevate the risk of later suicidal ideation.     

Patients as parents and young people approaching adulthood: how should we manage the interface between mental health services for young people and adults?

PURPOSE OF REVIEW: The present review discusses critically recent research findings (published during the period 2003-2004) on the mental health needs of young people in transition (old adolescents and young adults), including those of young parents. Also, the evidence on effective interventions and service models is considered. RECENT FINDINGS: Emerging evidence indicates that young people have high rates of mental health needs (in addition to high prevalence of psychiatric disorders) that may be related to life transitions. These needs often fall between the remit of adolescent/adult and mental health/social care services, and therefore are not adequately met. With the exception of mental health interventions for early psychosis and psychosocial programmes for teenage parents, there is very limited knowledge on how best to meet the mental health needs of young people in transition. SUMMARY: It is widely recognized that young people in transition require services and interventions tailored to their characteristics, rather than a mere extension to either child/adolescent or adult services. Recent policies and research findings have led to the development of early psychosis interventions, with initial encouraging messages. Similar initiatives are required for young people with nonpsychotic disorders.     

What do children and young people want from mental health services?

PURPOSE OF REVIEW: The purpose of this paper is to review the literature reporting on children and young people's views on child and adolescent mental health services. RECENT FINDINGS: The review demonstrates that there is limited research exploring the views of children and young people regarding mental health services. Despite its limitations, the research available shows that young people, their parents and healthcare providers often have different expectations of services. Young people want accessible services staffed by those they are able to trust and who demonstrate an ability to listen; above all, young people want to be involved in the decisions made about them. SUMMARY: To date, children and young people have not been actively engaged or involved in service development. This is an evolving field and we need to ensure that existing evidence is taken into account as well as investigating further the views of young people. Child and adolescent mental health services need to consider how we serve young people, particularly children, whose perspectives may differ from those of their parents.     

“I have got something positive out of this situation”: psychological benefits of caregiving in relatives of young people with muscular dystrophy

This paper focuses on the psychological benefits of caregiving in key relatives of patients with muscular dystrophies (MD), a group of rare diseases characterized by progressive weakness and restriction of the patient’s functional abilities. We describe whether relatives perceived caregiving to be a positive experience and test whether relatives’ perceptions vary in relation to their view of the patient as a valued person, the degree of involvement in care, and the level of support provided by social network and professionals. The study sample included 502 key relatives of patients aged 4–25 years, suffering from Duchenne, Becker, or limb-girdle MD, in treatment for at least 6 months to one of the eight participating centers, living with at least one relative aged 18–80 years. Of key relatives, 88 % stated that they had gotten something positive out of the situation, 96 % considered their patients to be sensitive, and 94 % viewed their patients as talented. Positive aspects of caregiving were more recognized by key relatives who were more convinced that the patient was sensitive and who perceived that they received higher level of professional help and psychological social support. These results suggest that most key relatives consider that their caregiving experience has had a positive impact on their lives, despite the practical difficulties of caring for patients with MD. Professionals should help relatives to identify the benefits of caregiving without denying its difficulties. Clinicians themselves should develop positive attitudes towards family involvement in the care of patients with long-term diseases.     

Magnetic resonance imaging of the brain in children and young people with cerebral palsy: who reports matters?

Retrospective case note audits were undertaken of children with clinically diagnosed cerebral palsy known to paediatricians and physiotherapists in Sunderland (UK). Evidence of brain magnetic resonance imaging (MRI) was recorded, including expert opinions requested, in order to quantify the perceived mismatch between local, general radiological and regional, specialist neuroradiological reporting, towards ensuring the best possible yield to inform clinical practice and accurate information-sharing with families. One hundred and ninety-seven out of 214 (92%) had documented neuroimaging; 111 out of 197 (56.3%) were dual reported. Only 34 out of 111 reports were concordant overall. Sixty per cent of brain MRI reported as normal locally, were found not to be normal on specialist review. Clinicians requesting brain MRI in children with disordered development must be mindful of the expertise of those reporting. Those based in district settings must network closely with specialists in expert centres, if disabled children and young people are to receive equitable care of the highest standard.     

Eco-crisis and mental health of children and young people: Do child mental health professionals have a role?

Child mental health professionals have an extremely important role to play in their distinct roles as clinicians, therapists, researchers, policy makers, advocates, preventative public health professionals and service developers pertaining to eco-crisis in the child and adolescent populations. This article provides examples of how this can be done.     

Is sexual orientation related to mental health problems and suicidality in young people?

BACKGROUND: This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years. METHODS: Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts. RESULTS: Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95%, CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3). CONCLUSIONS: Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.