This study aims to identify and summarize existing qualitative empirical research on children's experiences of living with their mental ill-health.

A scoping review with a systematic search of the databases PubMed, CINAHL, and PsychINFO was conducted. The search generated 9,864 studies, which were screened by title, abstract, and full text.

Forty articles were included comprising 826 children aged 8-19 years. The key findings were described in four themes: Identifying oneself with mental ill-health, Managing suffering and daily challenges, Seeking supportive and caring relationships and Navigating a complex school environment. Being identified with mental ill-health brought challenges for children's everyday struggles. Their own coping strategies as well as supportive relationships with friends and adults were important. However, the balance between support and stress was complex.

Children have a desire to manage and comprehend their complex everyday lives of living with mental ill-health and wish for supported yet independent decision-making. Attitudes of friends, adults and professionals are important in providing understanding and non-judgemental support, valuable for children's well-being. Open conversations about mental health and providing accessible, child-centred interventions based on the needs expressed by children are necessary. This study contributes to the literature by emphasizing the central role of children's voices in matters of mental ill-health.

Cognitive Therapy for Social Anxiety Disorder (CT-SAD) based on the Clark & Wells model is a complex intervention comprised of a series of therapeutic elements. Two of the key ingredients are the self-focused attention and safety behaviour experiment and video feedback. The present study examined the effects of these two therapeutic procedures in adolescents with SAD, as well as common themes of the young people's social fears and negative self-images.

35 participants with a diagnosis of SAD completed internet-delivered CT-SAD as part of a randomised controlled trial. We conducted a series of paired samples t-tests to evaluate the effects of the self-focused attention and safety behaviour experiment and video feedback. We applied Latent Dirichlet Allocation to identify latent topics based on participants' description of their social fears and negative self-images that were elicited during the course of these therapy procedures.

Participants reported lower anxiety and more positive self-appraisals when focusing externally and dropping safety behaviours, compared to when focusing internally and using safety behaviours (ps < 0.0025). After they watched the videos compared to before, they reported more positive appraisals of their appearance and performance (ps < 0.0025). The differences in these outcomes were significantly larger when they focused internally and used safety behaviours, compared to focusing externally and dropping safety behaviours (ps < 0.0025). Topic modelling identified six social fear topics and five negative self-image topics.

Self-focused attention, safety behaviours, and negative self-imagery are modifiable with the 'self-focused attention and safety behaviour experiment' and 'video feedback' as part of internet delivered CT-SAD.

Stark socioeconomic inequalities in childhood mental health have been widely reported. Understanding whether they vary with age, by type of difficulty or sex can inform public health policies to tackle socioeconomic inequalities. We investigated the effects of early life childhood socioeconomic circumstances (SECs) (maternal education and household income) on developmental trajectories of externalising and internalising difficulties in childhood and adolescence, in males and females from the UK-representative Millennium Cohort Study (N = 15383). We estimated the Slope Index of Inequality (SII) (absolute difference between the most versus least advantaged) using linear mixed-effects regression models, on parent-reported Strengths and Difficulties Questionnaire externalising and internalising difficulties score, at 5, 7, 11, 14, and 17 years(y). The mean externalising score was high at 5y (4.8 [95 %CI: 4.7, 4.9]) and decreased slightly, while mean internalising score increased over childhood, reaching 3.9 [3.8, 4.1] by 17y, with a steeper trend for females in adolescence. Lower maternal education was associated with greater externalising scores at 5y (SII, Male: 3.0 [2.7 to 3.3]; Female: 2.7 [2.4, 3.0]) with inequalities decreasing slightly up to 17y (SII Male: 2.4 [2.0 to 2.7], Female: 2.5 [2.1, 2.8]). Inequalities in internalising scores increased slightly over childhood (SII Female 5y: 1.3 [1.1, 1.6]; 17y: 1.9 [1.5, 2.3]; SII Male 5y = 1.6 [1.3, 1.8], 17y = 1.8 [1.5, 2.2]). Patterns were similar using household income. Disadvantaged SECs are associated with persistently higher levels of parent-reported mental health difficulties up to 17y, with larger effects on externalising than internalising difficulties, but little differences by sex or socioeconomic measure.

Substance use disorders (SUD) frequently occur alongside bipolar disorder (BD), with some studies indicating a 29 % comorbidity rate in Western populations [1]. The relationship between BD and SUD is intricate and bidirectional - drug misuse can increase the risk of developing BD, and individuals with BD have a higher risk of developing SUD. This complex interplay often leads to earlier BD onset, more hospitalizations, and reduced effectiveness of pharmacological treatments, particularly mood stabilizers. This work aims to describe the impact of drugs in the risk of relapse in BD and to approach the differences in the evolution in substance users compared to non-users.

We conducted a prospective cohort study including the patients admitted to Hospital Clínic of Barcelona acute psychiatric unit with the diagnosis of manic or mixed episode during the period between 2015 and 2019. We established a follow-up of 3 years from the date of admission in which hospital readmissions are examined.

The study, which included 279 patients, concluded that only tobacco users showed significantly higher rates of emergency room (ER) visits and hospital readmissions in the period study, while cannabis was only associated with earlier onset of illness, current manic polarity, the presence of psychotic symptoms and a higher likelihood of discontinuing treatment. Alcohol, cocaine and stimulants did not appear to have an association with the variables studied.

Lack of follow-up information from people leaving the region or changing to private sector services, lack of detailed information around the pattern and history of consumption.

Tobacco seemed to have a clear negative association with the course of the illness. Cannabis, while its use was not associated with the relapse rate, was indirectly associated with variables suggesting a more severe symptomatology and a possible qualitatively different course of illness. More evidence is needed to define the mechanisms and patterns related to these effects.

Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder that often begins early in childhood. Patients with OCD are known to seek help late after disorder onset, and therefore have a long duration of untreated illness (DUI), which is found to correlate with negative clinical outcomes. No meta-analysis has previously investigated this issue.

Our protocol was pre-registered with PROSPERO (CRD42020165226). We followed PRISMA-guidelines and searched for relevant articles in four electronic databases. Meta-analyses of means based on random-effects (Der-Simonian-and-Laird-method) were used to derive the pooled estimates. Subgroup-analyses and meta-regressions were conducted to explore possible factors affecting help-seeking and DUI.

We included N = 31 studies in the quantitative synthesis, with 16 studies proving data for age at help-seeking and 16 studies providing data for duration of untreated illness. The pooled mean age at help-seeking was 28.66 years (95 % CI: 27.34-29.98), while the pooled mean interval between age at disorder onset and help-seeking was 6.97 (95 % CI: 5.69-8.24), and the pooled mean duration of untreated illness was 80.23 months (68.72-91.75), around 6.69 years, all with p < 0.001. Specific OCD-related factors affected help-seeking and duration of untreated illness.

Patients with OCD seek for help late in the course of the disorder and have a long duration of untreated illness, which is associated with more negative prognosis. This meta-analysis confirms the long duration of untreated illness in OCD and proposes possible factors associated with the length of the help-seeking process and DUI.

To mitigate barriers to care among youth (12-25 years), community-based organizations have increasingly integrated peer support as a complement to clinical mental health care; however, information regarding the integration process is lacking. To explore organizational perspectives regarding the contexts and mechanisms underlying integration of peer support for youth accessing mental health services from community-based, youth-serving organizations. Representatives from community-based youth-serving organizations completed a survey describing the contexts in which they are located and their experiences integrating peer support. Text responses were analyzed using directed content analysis. 21 organizations serving youth aged 11-29 years responded. Three generic categories were identified: 1) Context is key and safe environments, 2) Supportive organizations and valuing lived experience, 3) Benefits for peer support providers and receivers and purposeful integration into the organization. Peer support integration requires valuing of the lived experience of peers and creation of a safe organizational environment.

Open Dialogue approaches to family therapy emphasize the voicing of multiple perspectives in a supportive collaborative environment. In a novel application of Open Dialogue, this study explored how parents of students at an Australian independent school experienced Open Dialogue meetings within a school setting. Using reflexive thematic analysis, we analyzed 4 h of audio recordings of three focus groups involving 14 parents. Parents reported that Open Dialogue meetings promoted closer relationships between the school, parents, and students and focused on adapting to the needs of the student. However, Open Dialogue meetings also interacted with parents' expectations and the school's reputation for student wellbeing to amplify parents' perceptions of the school's responsibility. Open Dialogue meetings promoted closer collaborative relationships between parents, students, and staff. Clinicians need to be mindful of broader social attitudes that influence a parent's experience, and to set up appropriate expectations to mitigate potential problems.

There is growing awareness of the negative impact that extreme weather events (also known as climate disasters) have on psychological and social wellbeing. Adolescents are particularly vulnerable to the psychosocial impacts of these events, but research specific to this population is scant. This study examined the impact of exposure to extreme weather events on climate concerns, psychological distress, and social exclusion in a large nationwide sample of adolescents.

Data on exposure to extreme weather events, climate concerns, psychological distress, and indicators of social exclusion were obtained from the 2023 Mission Australia Youth Survey-Australia's largest cross-sectional survey of adolescents aged 15 to 19 (N = 19,501). Multivariable multinomial and logistic regression analyses were used to identify participant-specific characteristics that were associated with exposure to extreme weather events and examine the association between event exposure and psychological distress/social exclusion.

Adolescents living outside major cities, in lower socioeconomic areas, who identify as trans or gender diverse, living with disability, culturally or linguistically diverse (CALD) and/or Indigenous, were more likely to encounter extreme weather events. Compared to adolescents who were not exposed to extreme weather events, those who were exposed were at greater risk of experiencing climate concerns, psychological distress, financial hardships, and housing challenges. Adolescents whose households were impacted experienced greater financial hardship and housing challenges than those whose communities (but not households) were impacted.

Adolescents impacted by extreme weather events experience an increased risk of psychological distress, housing challenges and financial difficulties. Post-event recovery/resilience strategies need to prioritise mental health, housing, and financial support services, with a particular emphasis on supporting adolescents from historically disadvantaged or marginalised backgrounds.

The clinical profiles of youth presenting to early intervention mental health services are heterogeneous, with various sub-groups proposed and little information about the longitudinal stability of profiles, especially those associated with bipolarity.

802 youth aged 12-25-years (Mean = 18.26; 66 % females) accessing primary-care based mental health clinics were assessed at baseline and 417 were re-assessed after 12-months. An exploratory factor analysis of 62 items from six validated rating scales of the severity of mental and physical ill-health was conducted. Seven factors (anxiety, sleep, depression, restlessness, distress, activation, somatic complaints) were derived and modelled using latent profile analysis. Associations between profile membership, clinical outcomes and functioning were examined. Conditional probabilities of shifting to a different profile longitudinally were computed.

Three profiles were revealed which were psychometrically invariant across baseline and follow-up: (1) 'High distress with high activation' (32 % baseline, 25 % follow-up); (2) 'High distress without activation' (31 % baseline, 26 % follow-up); and (3) 'Moderate distress' (37 % baseline, 33 % follow-up). A fourth profile, 'Low distress' (16 %), emerged at follow-up. Profiles did not differ by age at baseline or sex. 'High distress with high activation' was more likely to be impaired longitudinally, and to meet criteria for a full-threshold mental disorder at follow-up. About 39 % of youth retained the same profile longitudinally, while 16 % shifted to lower distress, and 13 % shifted to higher distress.

These findings suggest that activation is a marker of poorer clinical and functional outcomes in youth presenting for mental health care.

Neurodevelopmental disorders (NDDs) encompass a diverse range of impairments affecting brain development and functions, often presenting as deficits in motor skills, cognitive abilities, language development and neuropsychiatric health. The emergence of next-generation sequencing has unveiled numerous genetic variants linked to NDDs, implicating molecular pathways involved in essential neuronal processes such as synaptic plasticity, neuronal architecture and proteostasis. Central to these processes is the Mediator complex, a highly conserved multi-subunit assembly crucial for RNA polymerase II (Pol II)-dependent transcription. The Mediator functions as a key regulator of gene expression, playing a pivotal role in coordinating cellular processes essential for neuronal differentiation and developmental signaling cascades. Increasingly evidence has shown that its dysfunction is highly associated with the pathogenesis of NDDs. This review aims to comprehensively examine the structural and functional characteristics of individual mediator subunits. We will focus on clinical case reports and recent preclinical studies that highlight the connection between genetic abnormalities in the Mediator complex and specific neurodevelopmental phenotypes, ultimately guiding the development of enhanced diagnostic tools and therapeutic interventions. Furthermore, this review will advance our understanding of the general role transcriptional regulation plays in the etiology of NDDs.

In this study, the combination of functional state magnetic resonance spectroscopy (fMRS) and cognitive tasks was used to conduct subgroup analyses on early-onset OCD (EO) and non-early-onset OCD (non-EO) and explore differences in the glutamatergic system and cognitive function among OCD subtypes. A total of 70 OCD and 30 healthy controls (HCs) underwent clinical evaluation and were subsequently divided into the EO or non-EO groups. Next, both resting and functional state MRS data were collected, with the anterior cingulate cortex (ACC) serving as the region of interest. Quantitative analysis of MRS data yielded precise neurometabolic concentrations, which were then statistically analyzed alongside inhibitory function, as measured by the Go-nogo task. The final analysis included 92 participants (22 EO-OCD, 41 non-EO OCD, and 29 HCs). EO-OCD patients had significantly higher Glx levels (p = 0.044) and lower GSH levels (p = 0.009) in the functional state compared to the non-EO group. Moreover, in the EO group, correlation analysis revealed a positive correlation between the functional state Glx levels and the average response time for errors in the nogo task (r = 0.526, p = 0.014). Additionally, resting-state GSH levels were positively correlated with total Y-BOCS scores (r = 0.854, p < 0.001). Overall, early-onset OCD may represent a distinct subtype that requires targeted interventions, as evidenced by the imbalance in the glutamatergic system observed in early-onset OCD patients. Additionally, in early-onset patients, Glx concentration during activation was related to cognitive impairment.

Limited research examining the relationship between cardiovascular comorbidities and psychological anxiety & depression in the elderly, and the conclusions are inconsistent. This study aimed to investigate the intricate relationships between them among the pariticipants aged 60 years and above.

Utilizing multivariate logistic regression and stratified analysis to analyze the association between cardiovascular comorbidities and psychological anxiety & depression. Trend analysis was performed to evaluate the risk of developing depression and anxiety as the number of diseases increased. Interaction analysis was utilized to explore potential factors underlying the comorbidity of cardiovascular diseases and depression.

Among 11,960 elder participants (mean age 82 years, 46.5 % male), the prevalences of psychological anxiety, depression, and ≥2 types of cardiovascular diseases are 11.7 %, 25.8 %, and 24.7 %, respectively. Compared to subjects without cardiovascular diseases, those with 2, 3, and 4 types of cardiovascular diseases respectively have increased risk of depression, with corresponding ORs (95 % CI) being 1.23 (1.08-1.40), 1.50 (1.24-1.81), and 1.91 (1.42-2.56), respectively. Trend analysis shows that for each additional cardiovascular comorbidity, the risk of depression increases by 15 % (OR 1.15, 95%CI 1.10-1.20). The interaction effect showed that social activities were both additive and multiplicative factors affecting cardiovascular comorbidity and depression. The association between the risk of anxiety and the complexity of cardiovascular comorbidities is not strong (P > 0.05).

As the complexity of cardiovascular comorbidity increases, the risk of depression skyrockets among older adults, social activities may serve as a remedy.

There is growing evidence that tobacco smoking causes depression, but it is unclear which constituents of tobacco smoke (e.g. nicotine, carbon monoxide) may be responsible. We used Mendelian randomisation (MR) to measure the independent effect of nicotine on depression, by adjusting the effect of circulating nicotine exposure [via nicotine metabolite ratio (NMR)] for the overall effect of smoking heaviness [via cigarettes per day (CPD)] to account for the non-nicotine constituents of tobacco smoke.

Univariable MR and multivariable MR (MVMR) were used to measure the total and independent effects of genetic liability to NMR and CPD on major depressive disorder (MDD). Our primary method was inverse variance weighted (IVW) regression, with other methods as sensitivity analyses.

For the exposures, we used genome-wide association study (GWAS) summary statistics among European ancestry individuals for CPD (n = 143 210) and NMR (n = 5185). For the outcome, a GWAS of MDD stratified by smoking status was conducted using individual-level data from UK Biobank (n = 35 871-194 881).

Genetic variants associated with NMR (n = 6) and CPD (n = 53).

Univariable MR-IVW indicated a causal effect of CPD on MDD [odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.04-1.23, P = 0.003] but no clear evidence for an effect of NMR on MDD (OR = 0.98, 95% CI = 0.97-1.00, P = 0.134). MVMR indicated a causal effect of CPD on MDD when accounting for NMR (IVW: OR = 1.19, 95% CI = 1.03-1.37, P = 0.017; Egger: OR = 1.13, 95% CI = 0.89-1.43, P = 0.300) and weak evidence of a small effect of NMR on MDD when accounting for CPD (IVW: OR = 0.98, 95% CI = 0.96-1.00, P = 0.057; Egger: OR = 0.98, 95% CI = 0.96-1.00, P = 0.038).

The role of nicotine exposure in risk of depression cannot be entirely dismissed. However, the causal effect of tobacco smoking increasing depression risk appears to be largely independent of circulating nicotine exposure, which implies the role of alternative causal pathways.

Many young people (YP) struggle with their mental health and look online for help. To capitalise on their digital presence, we need to better understand how and where they seek information online and what they think of what they find.

We recruited 24 YP (aged 13-18 years). Online interviews were co-conducted by research team members and trained young researchers. We presented a persona with depression symptoms and asked about potential sources of information/support they might seek. They were also asked to think aloud while searching online and reviewing mental health resources (NHS, Young Minds). We used reflexive thematic analysis.

Analysis generated four themes: (1) the online help-seeking process, showcasing where YP look for information and why; (2) the mismatch between the information YP expected to find and the reality; (3) the strategies YP employed to determine a source's trust and credibility and (4) individual differences that can influence help-seeking.

Participants initiated their online search by Googling symptoms. They trusted NHS websites for basic medical information, while charities provided detailed content. Despite scepticism about content, social media offered validation. Online resources should prioritise visual appeal, user-friendliness, age-appropriate and personalised content and peer insights. Codesign is imperative to ensure high-quality, impactful research.

Introduction: Elite athletes experience sport-specific stressors and are at risk of developing mental health symptoms during and after their careers. E-Mental health interventions may pioneer a new approach to health care, which could help overcome barriers regarding its accessibility for elite athletes. This study aims to examine the needs and demands regarding the design and content of e-mental health interventions for elite athletes. Methods: A cross-sectional study was conducted via a web-based survey with N = 275 elite athletes, of which 167 were female and who participated in a variety of individual and/or team sports. Previous experience using e-mental health interventions was assessed. Needs and demands regarding format, frequency, content, and topics of an e-mental health intervention were analyzed descriptively and were compared between individual and team athletes using ANOVAs. Results: Elite athletes expressed a preference for an individual program via smartphone app (94.2%) with audio/video material (69.1%) and interactive tasks (60.4%). Regarding the frequency of e-mental health intervention, athletes in individual (62.2%) and team sports (60.0%) both preferred weekly intervention with sessions lasting between 20 and 30 min, whereas athletes engaged in both kinds of sports favored an intervention either on a weekly basis (44.7%) or on request (38.3%). The most relevant topics of e-mental health interventions for elite athletes were "Coping with pressure" (92%) and "Self-worth/self-esteem" (90%). Conclusions: The results of this study highlight the potential relevance of a user-centered design approach and could contribute valuable insights into developing e-mental health interventions for elite athletes.

Mental health problems and traits capturing psychopathology are common and often begin during adolescence. Decades of twin studies indicate that genetic factors explain around 50% of individual differences in adolescent psychopathology. In recent years, significant advances, particularly in genomics, have moved this work towards more translational findings.

This review provides an overview of the past decade of genetically sensitive studies on adolescent development, covering both family and genomic studies in adolescents aged 10-24 years. We focus on five research themes: (1) co-occurrence or comorbidity between psychopathologies, (2) stability and change over time, (3) intergenerational transmission, (4) gene-environment interplay, and (5) psychological treatment outcomes.

First, research shows that much of the co-occurrence of psychopathologies in adolescence is explained by genetic factors, with widespread pleiotropic influences on many traits. Second, stability in psychopathology across adolescence is largely explained by persistent genetic influences, whereas change is explained by emerging genetic and environmental influences. Third, contemporary twin-family studies suggest that different co-occurring genetic and environmental mechanisms may account for the intergenerational transmission of psychopathology, with some differences across psychopathologies. Fourth, genetic influences on adolescent psychopathology are correlated with a wide range of environmental exposures. However, the extent to which genetic factors interact with the environment remains unclear, as findings from both twin and genomic studies are inconsistent. Finally, a few studies suggest that genetic factors may play a role in psychological treatment response, but these findings have not yet been replicated.

Genetically sensitive research on adolescent psychopathology has progressed significantly in the past decade, with family and twin findings starting to be replicated at the genomic level. However, important gaps remain in the literature, and we conclude by providing suggestions of research questions that still need to be addressed.

This study registered rates of specific treatment options for mental disorders as well as their long-term outcome.

The history of mental disorders was used as a proxy for diagnosis. The data came from the COMET-G study (40 countries; 54,826 subjects, 64.73 % females, 35.45±13.51 years old). The analysis included descriptive statistics, Risk Ratios, t-tests, and ANCOVA's.

24.14 % reported a history of any mental disorder (depression >12 %, non-affective psychosis and Bipolar disorder 1 % each, >20 % self-injury, >10 % had attempted suicide, 7.17 % illegal substance abuse). Most patients were not under any kind of treatment (59.44 %) and most were not receiving treatment as recommended (e.g. 90 % of Bipolar and 2/3 of psychotic patients). No treatment at all and psychotherapy as monotherapy were consistently related to poorer outcomes. In anxiety or depression, only antidepressant monotherapy and benzodiazepines, in Bipolar disorder only antipsychotic monotherapy in males and antidepressant monotherapy in females and in non-affective psychosis antipsychotics and psychotherapy in females only, were related to good outcomes. No treatment modality was related to a good outcome in those with a history of self-harm, suicidal attempts, or illegal substance use. Only depression and treatment with antidepressants were related to metabolic syndrome.

In the community, the overwhelming majority of mental patients do not receive appropriate treatment or, even worse, no treatment at all. The outcome is unfavourable for the majority and only a few selective treatment options seem to make a difference.

Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.

The two-polarity model of personality development posits that personality vulnerabilities, specifically dependency and self-criticism, play a critical role in adolescent psychopathology risk. This theoretical framework emphasizes the importance of understanding how these vulnerabilities manifest and develop during adolescence, as adolescents face distinct developmental challenges at different stages. However, existing research overlooks the impact of stage-specific challenges on the development of personality vulnerabilities.

This study included 24,946 Chinese adolescents (Mage ± SD = 15.50 ± 2.03; 46.50 % girls) divided into three age groups: early (10-13 years, N = 4652), middle (14-17 years, N = 15,065), and late (18-20 years, N = 5229). We employed network analysis to investigate the symptom structure of self-criticism and dependency through different adolescent stages, focusing on core symptoms (highly connected nodes), bridges (links between dependency and self-criticism), and potential causal relationships.

Feelings of disappointing others and loneliness after arguments are consistently central to self-criticism and dependency, respectively. Connections between these vulnerabilities change across stages. Evidence from the directed acyclic graph suggests that self-criticism gradually replaces dependency as the key to triggering experiences of personality vulnerability from early to late adolescence.

This study identified the personality vulnerability network structure across three stages of adolescents. The results highlight a developmental shift in the triggering sequences of personality vulnerability, moving from predominantly dependency in early adolescence to increased self-criticism in later stages. These insights underscore the significance of the developmental context in shaping personality vulnerabilities across adolescence and offer crucial directions for stage-specific interventions.

Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.

Anxiety disorders are the most prevalent psychiatric conditions in the general population. Despite the early observation of family aggregation of anxiety disorders with a heritability of 30% to 50%, their exact genetic structure is not yet determined. Evidence suggests a composition of common and rare genetic factors contributing to the etiology of anxiety disorders. Recent hypothesis-free genome-wide association studies in mega cohorts mostly with a broad anxiety phenotype rendered an increasing number of novel genetic loci. Epigenetic research is still in its infancy with first evidence showing dynamic changes in response to environmental influences and during the therapy course.

Mapping differential brain structures for psychiatric problems has been challenging due to a lack of regional convergence and poor replicability in previous brain-behavior association studies. By leveraging two independent large cohorts of neurodevelopment, the ABCD and Generation R Studies (total N = 11271), we implemented an unsupervised machine learning technique with a highly stringent generalizability test to identify reliable brain-behavior associations across diverse domains of child psychiatric problems. Across all psychiatric symptoms measured, one multivariate brain-behavior association was found, reflecting a widespread reduction of cortical surface area correlated with higher child attention problems. Crucially, this association showed marked generalizability across different populations and study protocols, demonstrating potential clinical utility. Moreover, the derived brain dimension score predicted child cognitive and academic functioning three years later and was also associated with polygenic scores for ADHD. Our results indicated that attention problems could be a phenotype for establishing promising multivariate neurobiological prediction models for children across populations. Future studies could extend this investigation into different development periods and examine the predictive values for assessment of functioning, diagnosis, and disease trajectory in clinical samples.

The objective of this paper is to summarise the policy implications of key findings from the 2020-22 Australian National Study of Mental Health and Wellbeing (NSMHWB). We provide an analysis of policy implications of four papers in this issue of the journal from the 2020-22 NSMHWB (N = 15,893) and the 2007 NSMHWB (N = 8841). The 2020-2022 NSMHWB reported a lifetime prevalence rate of common mental disorders of 40.2% (95% confidence interval [CI] = 39.2-41.3) and 12-month prevalence rate of 20.2% (95% CI 19.5-21.0). Overall, adult Australians were significantly more likely to experience a 12-month mental disorder in 2020-22 compared with 2007, with the change most striking in among those aged 16-24 years (odds ratio [OR] 1.2, 95% CI 1.1-1.3). Individuals aged 16-24 years in 2020-22 were significantly more likely to experience a 12-month anxiety disorder (OR 2.9, 95% CI = 2.3-3.7, depressive disorder (OR 2.8 95% CI = 2.1-3.9) or comorbidity (relative risk [RR] = 1.4, 95% CI = 1.2-1.7) compared with those aged 16-24 years in 2007. In 2020-22, the proportion of Australians who had experienced suicidal ideation, suicide plans and suicide attempts in the past 12 months was 3.3%, 1.1% and 0.3%. Under half (46.5% 95% CI 44.1-48.8) of adults with a 12-month mental disorder sought treatment. Mental disorders remain an endemic feature of Australia's overall health landscape and appear to be increasing, especially in younger cohorts. While service use rates have improved over time, there is still some way to go. Epidemiological surveys such as the 2020-22 NSMHWB are important for understanding changing prevalence and the population not accessing services. Innovative prevention and treatment strategies will be needed to address the increasing rates of disorders in younger Australian adults. Equally innovative and bold policy responses will be essential.

Cognitive impairment, a core symptom of psychiatric disorders, is frequently observed in adolescents exposed to early-life stress (ES). However, the underlying neural mechanisms are unclear, and therapeutic efficacy is limited. Targeting parvalbumin-expressing interneurons (PVIs) in the medial prefrontal cortex (mPFC), we report that ES reduces mPFC PVI activity, which causally mediated ES-induced cognitive deficits in adolescent male mice through chemogenetic and optogenetic experiments. To understand the possible causes of PVI activity reduction following ES, we then demonstrated that ES upregulated corticotropin-releasing hormone (CRH) receptor 1 [CRHR1, mainly expressed in pyramidal neurons (PNs)] and reduced activity of local pyramidal neurons (PNs) and their excitatory inputs to PVIs. The subsequent genetic manipulation experiments (CRHR1 knockout, CRH overexpression, and chemogenetics) highlight that ES-induced PVI activity reduction may result from CRHR1 upregulation and PN activity downregulation and that PVIs play indispensable roles in CRHR1- or PN-mediated cognitive deficits induced by ES. These results suggest that ES-induced cognitive deficits could be attributed to the prefrontal CRHR1-PN-PVI pathway. Finally, treatment with antalarmin (a CRHR1 antagonist) and environmental enrichment successfully restored the PVI activity and cognitive deficits induced by ES. These findings reveal the neurobiological mechanisms underlying ES-induced cognitive deficits in adolescent male mice and highlight the therapeutic potentials of PVIs in stress-related cognitive deficits in adolescent individuals.

Bipolar disorder (BD) affects approximately 2% of the global population, characterized by alternating episodes of mania or hypomania, and depression. It comprises two main types: bipolar I disorder, marked by severe manic episodes, and bipolar II disorder, defined by milder hypomanic episodes. Individuals often experience rapid cycling and significant comorbidities, leading to decreased productivity and increased mortality rates. Early diagnosis and intervention are crucial for better outcomes. Both genetic and environmental factors contribute to BD's etiology, with genetic research promising improved diagnosis, novel therapeutic targets, and societal understanding that may help destigmatize the disorder.

New approaches to mental health and substance use prevention, that bridge research and diagnostic silos are urgently needed to address rising trends in mental illness amongst young people. Engaging diverse stakeholders, including young people, in setting research priorities could aid the development of innovative responses, enhance research and improve translation. While previous activities have identified priorities for Australian mental health and substance use prevention research, none have centred young people as a primary stakeholder. The current study is a critical next step to understand youth perspectives.

This Youth Priorities Project was coproduced with members of The Matilda Centre and PREMISE NHMRC Centre of Research Excellence Youth Advisory Board. The project involved three iterative stages: (1) an online survey; (2) consultations via focus groups and (3) a final consensus workshop to summarise key recommendations for principles, priorities and actions.

A diverse group of young people aged 16-25 were recruited for Stage 1 (n = 653), Stage 2 (n = 7) and Stage 3 (n = 3). Youth participants emphasised the need for increased investment in prevention research targeting a broad range of social determinants and health behaviours and their intersecting effects on youth mental ill health. There were strong calls to government to address economic drivers of mental health, to increase timely access to subsidised mental health support, and to better equip schools to support student wellbeing and mental health.

Young people had valuable and unique insights on how research and policy responses regarding youth mental health and substance use could be improved.

A coproduction Research Team (CPRT) was established, including two youth researchers who guided all stages of the research from conceptualisation, ethics approval, survey and study design, analysis and write-up. A Youth Advisory Board was also consulted.