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A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe
Most mental disorders appear by age 14, but in most cases, they remain undiagnosed and untreated well into adulthood. A scoping review showed an absence of systematic reviews that address prevalence rates of mental disorders among children and adolescents in Europe that are based on community studies conducted between 2015 and 2020. To estimate the updated pooled prevalence of Anxiety Disorder, Depressive Disorder, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Autism Spectrum Disorder, Eating Disorders, Substance Use Disorders (SUD), among children and adolescents living in Europe, a search strategy was conducted using MEDLINE, Embase and Psych Info and studies were also identified from reference lists and gray literature. Eligible studies were evaluated for reliability, validity, and bias. Trends of prevalence rates for each mental disorder were calculated. Almost one in five young people in Europe were found to suffer from a mental disorder, with a pooled prevalence rate of 15.5%. Anxiety disorders had the highest pooled prevalence rate (7.9% (95% CI 5.1–11.8%, I2: 98.0%)), followed by ADHD (2.9% (95% CI 1.2–6.9%, I2 = 94.3%)), ODD (1.9% (95% CI 1.0–3.7%, I2 = 98.4%)), depressive disorder (1.7% (95% CI 1.0–2.9%, I2 = 97.7%)), CD (1.5% (95% CI 0.6–3.8%, I2 = 98.8%)) and ASD (1.4% (95% CI 0.4–5.4%, I2 = 99.7%). No studies on SUD were identified. The mental health of children and adolescents may be improved by introducing routine screening, refining diagnostic sensitivity, raising awareness of mental disorders, minimizing stigma and socioeconomic inequality, as well as developing early intervention services. These facilitators of good mental health need to be prioritized, especially at a time of unprecedented risk factors for poor mental health.
Journal Article
Quasi Oppositional Dragonfly Algorithm for Load Balancing in Cloud Computing Environment
In cloud computing (CC), load balancing tasks remain a critical problem in distributing resources from a data center. Ensure that every virtual machine (VM) has a balanced load to maximize capacity utilization. In the CC world, load balancing is a Non-Polynomial (NP) problem resolved with metaheuristic algorithms. A new Quasi-Oppositional Dragonfly Algorithm for Load Balancing (QODA-LB) has been developed to obtain optimum resource scheduling in a CC configuration. The proposed QODA-LB algorithm uses three variables to calculate an objective function: execution time, execution cost, and charge. The QODA-LB algorithm assigns tasks to VM according to its potential and the resulting objective function. Also, the QODA-LB algorithm employs the Quasi-Oppositional Based Learning principle to increase the standard convergence rate of the Dragonfly (DA) algorithm. A complete series of experiments were conducted, and the results were analyzed in various ways to ensure the increased efficiency of the QODA-LB algorithm. Simulation results demonstrated an optimal load balancing efficiency and outperformed key approaches.
Journal Article
The effect of a single dose of methylphenidate on attention in children and adolescents with ADHD and comorbid Oppositional Defiant Disorder
The co-occurrence Oppositional Defiant Disorder (ODD) in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has been associated to difficulties in regulating adverse states, elevated functional impairment, deficits in Executive Functions and high risk for psychopathology. Recent studies have shown that ODD is a negative predictor of a positive response to methylphenidate (MPH) treatment for ADHD symptoms in children and adolescents and that patients with a diagnosis of comorbid ADHD and ODD are less likely to respond favorably to pharmacological treatment with MPH. We conducted a naturalistic study to understand the clinical characteristics of drug-naïve children and adolescents with ADHD that influence the response to MPH by measuring the effect on attention. Specifically, we investigated whether a single dose of MPH differently affects the performance of 53 children and adolescents with ADHD with or without ODD comorbidity. In addition, participant characteristics such as symptom severity, functional impairment, and associated behavioral and emotional symptoms at baseline were examined to better understand what aspects affect the response to MPH. We found that a single dose of MPH improved the attention of children and adolescents with ADHD without ODD more than those with comorbid ADHD and ODD, resulting in reduced reaction times. Our findings indicated that children and adolescents with comorbid ADHD and ODD and those with ADHD alone did not exhibit differences in measures of attention prior to taking MPH, nor in demographic variables (age, intelligence quotient, gender), clinical characteristics related to symptom severity, and adaptive behaviors. However, we observed differences between the two groups in certain behavioral aspects, including the Dysregulation Profile and disruptive behaviors. Assessing symptoms in combination with the presence of ADHD can be beneficial in determining which individuals would derive the greatest benefits from treatment.
Journal Article
An identity perspective on coopetition in the craft beer industry
Research Summary: To further our understanding of how and why organizations engage in coopetition, we explore cooperative and competitive actions in the craft beer industry. Through an inductive field study, including interviews with craft brewery owners, we propose collective identity and collective norms play a critical role in the persistence of coopetition over time. Our process model suggests that (a) an oppositional collective identity, (b) the shared belief that a rising tide lifts all boats, and (c) the shared belief that advice and assistance should be paid forward, can lead to the persistence of coopetition beyond market category emergence. Managerial Summary: This paper develops a theory of how smaller, craft‐based organizations (i.e., “Davids”) encourage cohesion and cooperation amongst themselves when operating against an incumbent market of mass‐producers (i.e., “Goliaths”). An ideological opposition to existing players can lead to a shared belief that helping organizations like your own benefits everyone—the rising tide lifts all boats mentality. Similarly, when organizations first enter a market and receive help from established members, they can feel compelled to help others who enter the market after—the pay‐it‐forward mentality. Together, these mechanisms offer an explanation as to how and why coopetition might persist in a market category over time.
Journal Article
Comorbidity prevalence and treatment outcome in children and adolescents with ADHD
Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011–2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%). Patients with ADHD of combined type and with severe impairment (CGI-S ≥5) were more likely to present comorbidity. 382 of 724 (53%) followed up patients improved after 1 year of treatment. ADHD with comorbidity showed greater improvement when treated with combined interventions or methylphenidate alone. Specifically, combined treatment showed significant superiority for ADHD with learning disorders (ES 0.66) and ODD (ES 0.98), lower for ADHD with sleep or anxiety disorders. Training intervention alone showed only medium efficacy (ES 0.50) for ADHD and learning disorders. This study was the first describing comorbidity patterns of ADHD in Italy, confirming, in a multicenter clinical setting, that ADHD is more often a complex disorder. Findings highlight important diagnostic, therapeutic, and service organization aspects that should be broadly extended to ensure an appropriate and homogenous ADHD management.
Journal Article
A Systematic Review of Mental Health Disorders of Children in Foster Care
Objectives:
This article summarizes the rate of mental health disorders of foster children, the specific types of disorders faced by this population, and how factors such as type of abuse or placement variables can affect mental health outcomes.
Method:
A search in PsycInfo Ovid, EMBASE Elsevier, and Cochrane Library Wiley resulted in 5,042 manuscripts that were independently reviewed by two authors, yielding 25 articles.
Inclusion criteria:
Published in or after 2000, written in English, and having a population sample of foster children (ages 0–18) in Western countries including the United States, Norway, Australia, and Canada.
Results:
Foster children have higher rates of mental health disorders than those of the general population. The most common diagnoses include oppositional defiant disorder/conduct disorder, major depressive disorder, post-traumatic stress disorder, and reactive attachment disorder. Variables such as type of maltreatment and type of placement predicted mental health outcomes.
Conclusions and implications of key findings:
Children in foster care experience more mental health disorders, as a response to either the circumstances that led to being removed from their homes or the experience of being placed in foster care. These results demonstrate the necessity for providers to consider mental health issues when caring for children in foster care and to perform appropriate screenings and assessments. With adequate trauma-informed training, providers can quickly become comfortable and competent in identifying mental health needs of children in foster care who have experienced trauma.
Journal Article
The relationship of sensory processing with ADHD and its co-occurring behavioural symptoms based on both undirected and directed network analysis
Background
Attention-deficit hyperactivity/impulsivity disorder (ADHD) commonly co-occurs with sensory processing (SP), autistic traits (ATs), and oppositional defiant disorder (ODD). Our aim is to explore the relationships among SP, ADHD symptoms, ATs, and ODD symptoms in a large sample of children with ADHD and elucidate the potential role of sensory dysfunction in ADHD comorbidity patterns using symptomatic network analyses.
Methods
A total of 2676 children with ADHD aged 6 to 11 years were recruited from Peking University Sixth Hospital. For all subjects, the ADHD symptom severity was rated using the ADHD Rating Scale, ODD symptom severity using the related items in the Children’s Clinical Diagnostic Interview Scale, SP symptom severity using the Child Sensory Integration Scale, and ATs using related items in the CBCL. R 4.2.1 packages including
mgm
,
qgraph
, and
bnlearn
were used for network analysis.
Results
In the Graphical Gaussian Model (GGM), the SP items were connected with ATs and ADHD core symptoms and positioned relatively high in the directed acyclic graph (DAG).
ATs_S
, located higher in the DAG, played an important role in communication in the network as a node for SP and ODD to exert their influence on ADHD, and ADHD items were downstream nodes seemingly dependent on
SP
nodes and
ATs_S
in the network.
Conclusions
SP may be fundamental to the complex manifestations in children with ADHD, especially given its close relationship with ATs profiles.
ATs_S
might play an essential role in communication in this symptomatic network. These findings may help clarify possible relationships of different symptoms in ADHD and provide potential targeted interventions to improve core symptoms of ADHD as well as ATs and ODD symptoms.
Clinical trial number
Not applicable.
Journal Article
Parenting Behaviors as Mediators of the Association Between Parental Internalizing Symptoms and Child Externalizing Symptoms
This study analyzes whether the association between parental internalizing symptoms (depression, anxiety, stress) and child symptoms of attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) is mediated by positive and negative parenting behaviors. Cross-sectional data of 420 parents of children (age 6–12 years) with elevated levels of externalizing symptoms were collected in a randomized controlled trial. Measures included parent ratings of their internalizing symptoms and parenting behaviors and of their child’s externalizing symptoms. Two mediation models were examined, one including ADHD symptoms and one including ODD symptoms as the dependent variable. Parental internalizing symptoms were modeled as the independent variable and positive and negative parenting behaviors were modeled as parallel mediators. Regression analyses support negative parenting behavior as a mediator of the association between parental internalizing symptoms and child ODD symptoms. For the ADHD model, no significant mediator could be found. Future studies should use prospective designs and consider reciprocal associations.
Journal Article
Children's opposition, marital and life satisfaction: the mediating role of parenting stress
Objective The present study examines the association of children's oppositional behavior with marital and life satisfaction by examining the mediating role of parenting stress. Background Previous research indicates that parents of children who exhibit behavioral problems often experience parenting stress and lower marital and life satisfaction. However, few studies have addressed the underlying mechanisms, and even fewer have focused on the effects of children's nonclinical oppositional behaviors while obtaining data from both parents. Method Participants were 211 parent dyads (N = 422) of typically developing preschool children. Data on child's oppositional behavior, parenting stress, and marital and life satisfaction were obtained from both parents simultaneously and analyzed using the common fate mediation model. Results Parenting stress was found to fully mediate the associations between children's oppositional behavior and marital and life satisfaction, whereas marital satisfaction was found to partially mediate the association between parenting stress and life satisfaction. Conclusions Children's oppositional behaviors lead to lower marital and life satisfaction through a mechanism of parenting stress, and parenting stress negatively affects life satisfaction, both directly and indirectly, through marital satisfaction. Implications Therapeutic interventions for treating children's oppositional behaviors can usefully include a direct focus on reducing parenting stress and enhancing parents’ ability to cope with child‐related stress as a couple, thus improving parents’ satisfaction with their marital relationship and with life in general.
Journal Article