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Individuals aged 15–24 years, defined by WHO (2019) as “youth,” experience elevated mental health risks, yet most do not access timely support due to barriers including stigma, poor symptom recognition and limited help-seeking confidence. Mental health literacy (MHL) interventions aim to address these barriers, but evidence regarding their effectiveness, delivery modalities, cultural adaptation and methodological quality remains fragmented. This systematic review followed PRISMA 2020 guidelines and examined the characteristics and effectiveness of MHL interventions for youth aged 15–24 across Jorm’s (2000) three core domains of recognition, knowledge and attitudes. Five databases (CINAHL, APA PsycArticles, APA PsycInfo, Scopus and PubMed) were searched on 4 September 2024 for randomized and quasi-experimental studies, with narrative synthesis conducted due to heterogeneity and risk of bias assessed using a standardized tool. Twenty-four studies involving 13,624 participants were included. Mental health knowledge improved consistently across interventions and delivery formats, whereas recognition and attitudinal outcomes showed greater variability and were more strongly associated with diagnosis-specific content, contact-based elements and cultural adaptation. Only five studies explicitly reported cultural or contextual adaptation, and eight incorporated positive mental health components, of which only one evaluated positive mental health outcomes. The evidence base was dominated by high-income Western settings, with sparse representation from low- and middle-income countries. Most studies demonstrated moderate-to-high risk of bias, limiting definitive conclusions about efficacy. Overall, youth MHL interventions reliably improve knowledge, but evidence for sustained effects on recognition, stigma reduction and help-seeking remains mixed. Future research should prioritize culturally responsive, developmentally appropriate and methodologically rigorous designs, including systematic measurement of positive mental health outcomes, to strengthen the global evidence base.
To evaluate food marketing techniques used in Canadian recreation and sport facilities and assess the healthfulness of foods and beverages marketed by the techniques.
Design:
Cross-sectional content analysis of photographed food marketing instances coded for marketing techniques according to Health Canada’s Monitoring Protocol, developed for monitoring food marketing techniques across settings, supplemented with new inductively identified codes and sport-related marketing techniques. Healthfulness was classified as ‘of concern’ or ‘not of concern’ according to cut-offs of sodium, sugar and saturated fat established by Health Canada.
Setting:
Recreation and sport facilities in Canada
Participants:
134 facilities with 2576 food marketing instances
Results:
91·4 % of food marketing instances included at least one general marketing technique. Branded infrastructure, displays and furniture was the most prevalent (87·9 %) and appeared with another technique half of the time. Sport-related marketing appeared in 12·2 % of marketing instances, with most referring to sponsors. Most (86·5 %) marketing instances were ‘of concern’. Food marketing instances with sport-related marketing (97·6 %) were significantly more likely to be ‘of concern’ than without sport-related marketing (84·6 %) (χ2 = 20·54, P < 0·001). Three new indicators – appeals to taste, appeals to emotion, and cross-channel references – captured persuasive elements not addressed by the current monitoring protocol.
Conclusions:
This study highlights the presence of food branding and the use of sport-related marketing to promote unhealthy products/brands in recreation and sports facilities. Monitoring protocols may underestimate exposure to persuasive food marketing by overlooking subtle, symbolic and cross-channel techniques. Future research can be improved by including subtle techniques and reinforced messages across marketing channels.
Internet-delivered parent-led interventions can be useful for treating anxiety in children and adolescents, and they also help increase access to services while reducing time and cost.
Aims
This review aimed to investigate the effects of internet-delivered parent-led interventions on reducing anxiety in children and adolescents.
Method
A search of PubMed, PsycArticles, Cochrane Library, and Google Scholar databases identified 13 studies published between 2013 and 2024, which examined internet-delivered, parent-led interventions targeting anxiety in children.
Results
Internet-delivered parent-led interventions had overall positive effects on reduced anxiety in children and adolescents that could be maintained through follow-up. Interventions directly targeting anxiety symptoms had significant treatment effects.
Discussion
Internet-delivered parent-led interventions may be effective in reducing anxiety symptoms in children and adolescents, particularly when the intervention directly targets anxiety rather than focusing solely on parenting approaches. Interventions supplemented with therapist support, such as telephone consultations, appear to enhance treatment outcomes and help maintain effects over time. Two-thirds of the included studies had a moderate risk of bias, and one-third had a serious risk of bias. Further studies using rigorous methodologies are needed to strengthen the evidence base.
Non-suicidal self-injury (NSSI) is a major clinical and public health issue in adolescence. Although psychological factors such as depression, anxiety and emotion dysregulation have been widely examined, less is known about how pain perception and autonomic reactivity interact with these variables in NSSI.
Aims
This study aimed to compare pressure pain threshold (PPT), autonomic responses and psychological characteristics between adolescents with NSSI and healthy controls, and to explore associations between pain perception, psychopathology, emotion regulation and NSSI functions.
Method
Sixty-eight adolescents (34 with NSSI, 34 controls) participated. PPT was assessed using a pressure algometer. Depressive symptoms, anxiety symptoms and emotion regulation difficulties were measured, and NSSI functions were evaluated using a standardised tool. Systolic (SBP)/diastolic blood pressure and heart rate were recorded before and after pain stimulation. Correlational analyses and mixed (repeated measures) analyses of variance were performed.
Results
The NSSI group showed a significantly higher PPT than controls (mean difference 1.43 kg/cm2; 95% CI: 0.64–2.00; p < 0.001). A significant group × time interaction emerged for SBP (η2 = 0.09), indicating a blunted post-pain response in the NSSI group. Emotion regulation difficulties were positively associated with PPT (r = 0.28). PPT was also positively correlated with sensation seeking (r = 0.36), autonomy (r = 0.34) and peer bonding (r = 0.36) functions of NSSI.
Conclusions
Adolescents with NSSI demonstrate elevated pain thresholds and altered autonomic reactivity. These findings highlight the importance of considering pain processing alongside psychological characteristics and NSSI functions in clinical assessment and intervention planning.
Self-regulation is central to adolescent emotional and cognitive development, and deficits in self-regulation may associate with depression and anxiety. This scoping review maps the use of the Emotional Go/No-Go (EGNG), Delay Discounting Task (DDT), and Balloon Analogue Risk Task and Youth version (BART) in studies of adolescent depression and anxiety, examines consistency of task implementation, and identifies methodological and geographic gaps.
Methods:
A PRISMA-ScR–compliant search was conducted in MEDLINE (PubMed), Scopus, and PsycINFO from database inception to 15 December 2025 (initial search: 1 December 2023; updated: 15 December 2025). Data were charted using a standardised form. Eligible studies included adolescents, employed EGNG, DDT, or BART, and assessed depressive or anxiety symptoms.
Results:
Thirty reports were included (EGNG n = 21; DDT n = 3; BART n = 6). Twenty-six studies (87%) were conducted in high-income countries and 24 (80%) were English language. Twenty-two studies were cross-sectional (EGNG n = 18/21; DDT n = 2/3; BART n = 2/6); five employed longitudinal designs, and two employed experimental manipulations. Fourteen studies (47%) reported significant task performance associations with depression or anxiety (EGNG n = 8/21; DDT n = 2/3; BART n = 4/6); the remaining studies reported no significant associations. The directionality of associations differed across study populations and methodologies.
Conclusion:
The current literature is concentrated in English-speaking higher-income contexts and has yielded few and inconsistent associations with adolescent depression and anxiety. Future research should harmonise protocols, expand evidence from low- and middle-income settings, and increase longitudinal and intervention-based studies to assess sensitivity to change and clinical utility.
Adolescent suicidal behavior is a major global public health concern. Risks are often shaped not only by individual behaviors alone but also by broader constellations of health lifestyles. We aim to identify distinct adolescent health lifestyles and assess their associations with suicidal ideation and suicide attempts. Using data from the 2022 Luxembourg Health Behaviour in School-aged Children survey, latent class analysis identified five health lifestyle classes based on seven behaviors (diet, physical activity, substance use and problematic social media use). Hierarchical logistic regression was employed to assess associations with past-year suicidal ideation and suicide attempt. Compared to Class 1 (Healthy behaviors), adolescents in Class 2 (High substance use) had significantly higher odds of suicidal ideation (odds ratio [OR] = 2.5, 95% confidence interval [CI]: 2.0–3.1) and suicide attempt (OR = 2.9, 95% CI: 2.2–3.8). Class 3 (Digital vulnerabilities) also showed elevated odds of ideation (OR = 3.0, 95% CI: 2.2–4.0) and attempt (OR = 2.3, 95% CI: 1.6–3.4). Class 4 (High alcohol use) was associated with suicidal ideation only (OR = 1.4, 95% CI: 1.1–1.8). Class 5 (No substance use) showed no significant associations with either outcome. Our findings underscore the importance of considering multidimensional health lifestyles, including emerging risks such as vaping and problematic social media use in adolescent suicide prevention strategies.
Jo was admitted to our hospital for complex pain and complications of intestinal failure. An 18-year-old with a complex medical and psychiatric history, Jo had been frequently hospitalized for suicidal ideation, chronic pain, and complications from intestinal dysmotility. Ethics was consulted during this stay because Jo requested to stop artificial nutrition and hydration and be allowed to die with support from hospice care. Throughout this case, the care team had concerns for capacity, honoring a patient’s right to refuse medical care, caring for a patient with a history of trauma, belonging to the LGBTQ+ community, with a chronic illness. This case explores the complex course of Jo’s case and identifies ethical options that fit within the narrative of this patient’s complex story.
Investigating the relationship between behavioural addictions and mental health is essential due to their impact on well-being and the significant barriers they create to achieving lasting recovery. The aim of the study was to examine the prevalence of food addiction, problematic internet use, and internet gaming disorder among 866 high school students (grades 9–12) in Turkey, Bingöl and their associated with impulsivity, emotional regulation, depression, anxiety, and stress.
Methods:
The sample was selected using a convenience sampling approach. Data were collected via online questionnaires using validated scales and analysed with SPSS package programme.
Results:
The prevalence of food addiction was 6.9%, problematic internet use 14.3%, and internet gaming disorder 0.9%. Problematic internet use relatively high prevalence likely reflects adolescents’ increased exposure to digital devices. Mental health factors were found to be significantly related to behavioural addictions: depression, anxiety, and stress predicted food addiction; depression and stress predicted problematic internet use, and anxiety was linked to internet gaming disorder.
Conclusions:
This study contributes to the literature by examining multiple behavioural addictions and their common risk factors simultaneously and provides a comprehensive perspective. It is also one of the rare studies examining food addiction with other behavioural addictions. More research is needed to develop better intervention programmes and policies in the issue.
Adult major depression (MDD) studies implicate reward- and control-network dysconnectivity in suicidality, but it is unclear whether analogous alterations characterize adolescents, whose neural systems are still maturing.
Methods
Resting-state fMRI was obtained from 102 adolescents (12–17 years): 21 MDD with suicidal ideation (SI), 33 MDD without SI, and 48 matched healthy controls. Seed-based analyses targeted bilateral nucleus accumbens (NAc), ventral tegmental area (VTA), and bilateral dorsolateral prefrontal cortex (DLPFC).
Results
Between-group effects were specific to NAc circuitry. Adolescents with SI showed reduced coupling of the left NAc with the left superior parietal lobule (BA7) versus controls, and diminished connectivity between the right NAc and right frontal pole (BA47) versus depressed peers without SI. No significant differences emerged for DLPFC- or VTA-seeded connectivity.
Conclusions
The identified functional dysconnectivities in reward-related circuits, particularly the FCs between the NAc and both the frontal pole and superior parietal lobule, may be implicated in the manifestation of suicidality among adolescents with MD. However, the lack of significant associations for DLPFC- and VTA-seeded FC in adolescent MDSI requires further elucidation.
A 15-year-old female presented with exertional chest pain and near-syncope. Imaging revealed a large left sinus of Valsalva aneurysm compressing the left coronary artery. She underwent successful surgical repair. Intraoperative and pathologic findings confirmed Takayasu arteritis. This case highlights a rare aetiology of cardiac chest pain in adolescents and underscores the importance of evaluating for an underlying vasculitis when a sinus of Valsalva aneurysm is identified.
Individuals with mental health difficulties (MHD) have a substantial reduction in life expectancy compared to the general population. It is increasingly recognised that mental health services need to improve physical healthcare as a priority. Sexual health, including consideration of high-risk sexual behaviours, medication side effects, and challenges in romantic relationships, is a further important but under-recognised aspect of overall health. We discuss some of the current issues relating to physical and sexual health, with a particular focus on youth with MHD and how we might implement holistic care in Ireland. Prioritising the resourcing of these issues could facilitate the implementation of a Shared Model of Care as recommended in Ireland’s National Mental Health Policy, Sharing the Vision.
This population-based cross-sectional study investigated the complex interplay of factors influencing high ultra-processed food (UPF) consumption among Brazilian adolescents using a hierarchical socio-ecological model. Data from 100 028 adolescents (13–17 years) enrolled in public and private schools nationwide were collected via self-administered questionnaires from the 2019 National School Health Survey. High UPF consumption was defined as ≥ 7 subgroups consumed on the previous day based on the NOVA classification. Poisson regression adjusted for complex sampling and hierarchical structure identified prevalence ratios (PR) for associated factors. High UPF consumption was significantly associated with younger age (PR = 1·22; 95 % CI 1·11, 1·34), regular breakfast consumption (PR = 1·32; 95 % CI 1·23, 1·42), regular screen time during meals (PR = 1·36; 95 % CI 1·27, 1·45), frequent UPF purchases at and around school (PR for canteen: 1·57; 95 % CI 1·43, 1·72; street vendors: 1·71; 95 % CI 1·55, 1·89), higher maternal education (PR 1·23, 95 % CI 1·12, 1·36) and lower parental supervision (PR 1·34, 95 % CI 1·11, 1·62). Living in the South (PR 1·50, 95 % CI 1·34, 1·69), Southeast (PR 1·30, 95 % CI 1·17, 1·44) and Midwest regions (PR 1·21, 95 % CI 1·09, 1·34) also correlated with higher consumption. Conversely, high body satisfaction and attending private school showed an inverse association. These findings underscore the intricate, multilevel influences on UPF consumption among Brazilian adolescents. Integrated interventions, spanning schools, family environments and public policies are crucial for promoting healthier eating habits and preventing obesity in this vulnerable population.
To extend the current understanding of executive function (EF) deficits in youth with neurofibromatosis type 1 by investigating the impact of cognitive load on performance compared to typically developing children.
Methods:
In this prospective multicenter study, 42 children with neurofibromatosis type 1 (NF1) (ages 7–18) completed neuropsychological assessments of intellect and executive functioning. Age- and sex-matched controls (n = 42) were drawn from the normative database for the tasks of executive control (TEC). Multivariate and supplementary univariate analyses examined group differences and task effects (inhibitory control and working memory demand). Associations between TEC performance and parent-reported executive dysfunction (BRIEF) were also explored.
Results:
Both groups showed reduced accuracy and speed with increased inhibitory demand and made fewer errors with increased working memory demand. However, children with NF1 were significantly less accurate and consistent across tasks, particularly under higher cognitive load, while controls improved or maintained performance. Significant group × cognitive load interactions were observed, and laboratory-based deficits in NF1 were associated with parent-reported executive dysfunction.
Conclusions:
Children with NF1 experience unique and multidimensional decrements in EF performance in response to increased cognitive load, unlike typically developing peers. These deficits appear to be clinically relevant. Targeting working memory and inhibitory control may reduce susceptibility to cognitive overload and improve outcomes for children with NF1.
Anhedonia and depression symptoms have been linked to potential deficits in reward learning. However, how anhedonia impacts the ability to adjust and learn about the effort required to obtain rewards remains unclear.
Methods
We examined young people (N = 155, 16–25 years) with a range of depression and anhedonia symptoms using a probabilistic instrumental reward and effort learning task. Participants were asked to learn which options to choose to maximize reward or minimize effort for reward. We compared the exerted effort (button pressing speed) for high (puppy images) vs low (dog images) rewards and collected subjective reports of “liking,” “wanting,” and “willingness to exert effort.” Computational models were fit to the learning data and estimated parameter values were correlated with depression and anhedonia symptoms.
Results
As depression symptoms and consummatory anhedonia increased, reward liking decreased, and as anticipatory anhedonia increased, liking, wanting, and willingness to exert effort for reward decreased.
Participants exerted more effort for high rewards than for low rewards, but anticipatory anhedonia diminished this difference.
Higher consummatory anhedonia was associated with poorer reward and effort learning, and with increased temperature parameter values for both learning types, indicating a higher tendency to make exploratory choices. Higher depression symptoms were associated with lower reward learning accuracy.
Conclusion
We provide novel evidence that anhedonia is associated with difficulties in modulating effort as a function of reward value and with the underexploitation of low effort and high reward options. We suggest that addressing these impairments could be a novel target for intervention in anhedonic young people.
Non-suicidal self-injury (NSSI) among adolescents severely jeopardizes their well-being and has emerged as a significant global public health challenge. However, research on the trends in NSSI among adolescents remains scarce. This study sought to uncover the evolving patterns in the severity of NSSI among adolescents and the factors that influence these patterns. The Deliberate Self-Harm Inventory was employed to measure the severity of NSSI among adolescents. Relevant studies were retrieved from both Chinese databases (CNKI, Wanfang, and VIP) and English databases (Web of Science, PubMed, Scopus, ProQuest, and Wiley). A total of 70 articles (71 studies; N = 96,382) were included in this review. The data spanned from 2007 to 2023. The analysis revealed the following: (1) Although the severity of NSSI showed a small to moderate upward trend from 2007 to 2023, this increase did not reach statistical significance. (2) No significant differences in trends were observed among Asia, Europe, and the America. (3) Adolescents with clinical samples exhibited a more pronounced upward trajectory in NSSI severity compared to those with non-clinical samples. (4) Social development indicators (GDP per capita, Human Development Index, and Internet penetration rate) and social well-being (happiness index) exhibited significant positive correlations with NSSI among adolescents. Conversely, lower social equity (higher Gini coefficient) was associated with reduced NSSI among adolescents. This study elucidated the changing trends in NSSI among adolescents and offered novel insights for the early prevention and individualized intervention of NSSI among adolescents.
This chapter provides an overview of young people with mental health needs and the development of forensic mental health and youth justice services for young people. The provision of inpatient and community forensic child and adolescent mental health services is outlined in more detail, including referral criteria, characteristics of the young people who access the service and outcomes of the provision.
Mood disorders are a leading cause of illness and disability in children and adolescents. Effective treatment is available, and early identification and intervention improves prognosis. This chapter provides a comprehensive summary of the epidemiology, aetiology and clinical features of depression and bipolar disorder in young people. We provide evidence-based recommendations for the prevention and treatment of mood disorders in children and adolescents, including psychological and pharmacological interventions, and novel and emerging treatment options. We present research on predictors of treatment outcome and prognosis of mood disorders in young people, and highlight areas for further research. This chapter will help clinicians identify and treat young people with mood disorders in a range of clinical settings.
Bodily Distress Disorder and Dissociative Disorders are disorders frequently encountered across paediatric specialties. These disorders place high psychosocial, educational and financial strains on children and their families as well as a substantial burden on the health care system with a potential risk for iatrogenic harm to the child due to unnecessary diagnostic evaluations and fruitless treatment attempts leading to increased costs. Predisposing factors include neurodevelopmental disorders and often co-morbidities such as anxiety and depression exist. The current best evidence-based treatment is psychological interventions that involve active participation from both the child and the parents. As early diagnostics and relevant intervention may improve prognosis and potentially decrease the risk of continued persistent and disabling somatic and co-occurring psychiatric symptoms later in life, it is important to address these disorders in young people. Due to the particular characteristics of somatic complaints combined with a high risk of psychiatric co-morbidities and specialised psychological interventions as best evidence-based practice, the diagnostics and treatment should optimally take place in close collaboration between the paediatric/medical setting and child and adolescent psychiatry.
A burgeoning body of evidence suggests a higher prevalence of nonsuicidal self-injury (NSSI) behaviors among adolescents. This study aimed to examine the comorbid internalizing symptoms and suicidal behaviors, along with associations between dissociative experiences and suicide risk in adolescents attending a psychiatric outpatient unit in Ankara, Türkiye. The study included 81 adolescents aged 12–18 years, who engaged in NSSI and sought treatment at a psychiatric outpatient clinic. Psychiatric evaluations were conducted through semi-structured clinical interviews. NSSI behaviors were assessed using the Inventory of Statements About Self-Injury, and suicide risk was measured using the Suicide Probability Scale. Additionally, internalizing symptoms and dissociative experiences were evaluated using the Revised Children’s Anxiety and Depression Scale-Child Version and the Adolescent Dissociative Experiences Scale, respectively. Moderate to high correlations were found among suicide risk, dissociation, NSSI severity, anxiety and internalizing scores. Mediation analysis revealed that NSSI significantly mediated the relationship between dissociation and suicide risk. These findings indicate that assessing both dissociation and NSSI could provide valuable insights into comprehending and addressing adolescent suicide, thereby facilitating the development of targeted interventions to mitigate the effects of dissociative experiences.
US data from the National Health and Nutrition Examination Survey estimates that the prevalence of obesity among US adolescents (ages 12–19) has reached 22.9% of the paediatric population, with nearly 9% meeting criteria for severe obesity (body mass index ≥120% of the 95th percentile or ≥35 kg/m2). These alarming figures underscore the cumulative impact of paediatric obesity, including established associations with impaired cardiometabolic health. The study “Cardiac Geometry Alterations Following Bariatric Surgery in Severely Obese Adolescents: A One-Year Follow-Up Study of a Randomized Controlled Trial” advances this understanding by comparing lifestyle intervention alone versus lifestyle therapy in combination with the application of bariatric surgery (e.g. laparoscopic adjustable gastric banding). As the first prospective randomised trial to assess cardiac geometric and following adolescent metabolic and bariatric surgical intervention, the findings demonstrate significant improvements in cardiac geometry among surgical participants, suggesting partial reversal of obesity-related cardiac remodelling. While these short-term results are encouraging, durability remains uncertain given the study’s small sample size and previous reports of significant weight regain and higher-than-expected complication rates following gastric banding. Considerations for future investigational designs should incorporate an expanded age range with regards to overall eligibility as well as bariatric procedures other than the gastric band, that offer long-term weight loss (i.e., vertical sleeve gastrectomy and gastric bypass). Longer-term and comprehensive follow-up will be critical to delineate the longitudinal cardiometabolic outcomes of surgical versus medical interventions for severe adolescent obesity.