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Decreased gut microbial diversity is associated with greater depression symptoms in adults. Findings on the relationship between the gut microbiome and depression or anxiety in children and adolescents are mixed, and evidence syntheses are needed. Seven databases were searched for peer-reviewed studies on the gut microbiome and internalizing symptoms, depression, or anxiety, in children and adolescents (<19 years). Random-effects meta-analyses of alpha diversity indices were performed. Youth advisors validated the research findings’ relevance to their experiences and contributed to dissemination planning. Eight studies were included, representing 2,865 participants (mean age = 11.4 years, SD = 4.3). Study designs were cross-sectional ( n  = 5), longitudinal ( n  = 2), and interventional ( n  = 1). No association was found between alpha or beta diversity and internalizing problems, depression, or anxiety. Increased abundance of genera within phyla Bacillota (e.g., Fusicatenibacter ) and Pseudomonadota (e.g., Escherichia ), along with decreased abundance of other Bacillota genera (e.g., Faecalibacterium ), were associated with depression and anxiety symptoms. This review identified preliminary associations between specific bacterial taxa and depression and anxiety in children and adolescents. Larger studies using comprehensive analytical approaches are needed to explore the role of the gut microbiome in the genesis and treatment of internalizing disorders.

Depression, a burdensome mental health disorder, increases risk of early cardiovascular disease (CVD) in youth. Although the mechanism of association is unknown, emotional eating, an eating behaviour corresponding to eating in response to emotions, may contribute as it relates to both depression and obesity. However, this is poorly understood within the context of children and adolescents. This dissertation explores the role of emotional eating in the association between depression and CVD risk in children and adolescents. Based on meta-analysis of the current literature, depressive symptoms and emotional eating are associated in youth. Further analysis of an outpatient psychiatry program reveals the depression-CVD association is present early in the course of illness and emotional eating is associated with increased CVD risk among female youth with depression. These findings offer better understanding of emotional eating in the depression-CVD risk association and provide initial support for eating-targeted preventative interventions among youth with depression.

Background: Eating in response to emotions (emotional eating) is a potential contributing factor to the association between depression in youth and premature cardiovascular disease risk. Although emotional eating is associated with depression in adults, findings in children and adolescents are mixed. Research Objective: This systematic review aims to determine the association between depression and emotional eating in children and adolescents. Methods: Systematic searches were conducted in seven databases. Studies were included if the study population had a mean age of <18 years and assessed both depression and emotional eating using validated measures. The search generated 12,241 unique studies, of which 37 met inclusion criteria. Random-effects meta-analyses of study outcomes were performed. Results: Thirty-seven studies (26,026 participants; mean age = 12.4 years, SD = 3.1) were included. The mean effect size was significant for both cross-sectional and longitudinal data (Hedges' g=0.48, p<.0001; g=0.37, p=.002, respectively), revealing a positive moderately strong association between depressive symptoms and emotional eating in youth. Among longitudinal studies, the association was stronger when depressive symptoms and emotional eating were assessed using child and adolescent self-report versus parent-report. No studies examined youth with a clinical diagnosis of depression. Discussion: Meta-analyses revealed that depressive symptoms and emotional eating are positively associated in children and adolescents. However, further research in clinical samples is needed. Results provide initial support for the importance of emotional eating in the link between depression and early CVD risk, though further examination is required to determine whether emotional eating is a potential treatment target to decrease CVD risk among adolescents with increased depression symptoms.