Behaviours that challenge are highly prevalent in children with an intellectual disability and can be detrimental to their quality of life and opportunities.

The systematic review aimed to investigate the effectiveness of current interventions in reducing behaviours that challenge in children with an intellectual disability (≤18 years-old).

We searched five databases (PsychINFO, MEDLINE, Embase, Web of Science and CINAHL) on 26 April 2022 and 1 July 2024, and identified 18 randomised controlled trials (1443 participants) eligible for inclusion since 2014 – 11 investigated non-pharmacological and 9 investigated pharmacological interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

Non-pharmacological interventions (mostly psychosocial) were significantly effective (Hedges’ g = −0.20; 95% CI [−0.35, −0.05]), whereas pharmacological interventions (including a wide range of drug classes and substances) were not (g = 0.03; 95% CI [−0.17, 0.24]). Studies using the Child Behaviour Checklist reported significant reductions (g = −0.18; 95% CI [−0.34, −0.02]), whereas studies using the Aberrant Behaviour Checklist did not (g = 0.04; 95% CI [−0.16, 0.25]). A random-effects meta-analysis indicated no overall significant reduction in behaviours that challenge (g = −0.12; 95% CI [−0.24, 0.00]).

It is important to note that most studies included were conducted in Western countries and had small sample sizes, and findings may be due to the outcome measures used. Findings support current recommendations that non-pharmacological interventions should be first-line treatment for behaviours that challenge in this population. Evidence highlighted the need for better quality, adequately powered randomised controlled trials.

Youth exposed to poverty and adversities like violence are at higher risk of mental health problems (MHP), but whether antipoverty interventions can reduce this risk remains unclear. We examined the association between participation in the Brazilian Cash Transfer Program (BFP) and mental health of children/adolescents exposed to different levels of adversity.

Observational study using nearest-neighbor propensity score matching to compare BFP participants and non-participants from the Itaboraí study, a community-based cohort of 1,189 children/adolescents (6–15 years) assessed at two waves (meaninterval: 12.9 months).Measures included the Child Behaviour Checklist (CBCL) externalizing, internalizing, and total problems scales; an adversity score derived from a confirmatory factor analysis on violence victimization at home (WorldSAFE), school (threat/maltreatment/being chased by peers) and community (Survey of Exposure to Community Violence), and stressful life events (UCLA Posttraumatic Stress Disorder Reaction Index); and BFP exposure for at least 12 months (yes/no). Latent change score models tested whether BFP participation predicted changes in CBCL T-scores, moderated by adversity levels.

A total of 330 BFP participants were matched with 330 non-participants with similar sociodemographic characteristics. Decreases in total (b=−0.124, SE=0.034, p<0.001), externalizing (b=−0.122, SE=0.036, p=0.001), and internalizing problems (b=−0.141, SE=0.033, p<0.001) between baseline and follow-up were observed among BFP participants exposed to higher levels of adversity compared with non-participants.

BFP participation was associated with reduced MHP only among children/adolescents facing high adversity, suggesting the program may help break the cycle between poverty and mental health problems—but benefits are concentrated among the most vulnerable.

The formative years of childhood and adolescence shape the course of future mental health. The COVID-19 pandemic has been associated with increased mental health problems in young people. This study aimed to examine changes in referrals and clinical activity in a child and adolescent mental health service (CAMHS) in Qatar following the pandemic.

To explore changes in referral trends and clinical activity in CAMHS, including referral numbers, reasons, sources, demographics, urgency and multidisciplinary team (MDT) allocation, comparing pre-pandemic (2019) with post-pandemic periods (2021, 2022).

A retrospective analysis of referral data from CAMHS was conducted. Data were collected from the administrative paper data archived in the relevant department for the years 2019, 2021 and 2022. Referral data included: source, reason, urgency, patient demographics and outcome. Chi-square analysis was employed to compare referral trends and patient characteristics across the 3 years. Binary logistic regression was used to identify factors associated with urgent referrals.

A significant increase in referrals was observed post-pandemic, with notable changes in referral reasons (increased mood and anxiety disorders), sources (increased referrals from public and private hospitals) and urgency (higher proportion of urgent referrals). MDT allocation shifted towards psychiatrists, with a decrease in joint assessments.

The COVID-19 pandemic had a substantial impact on CAMHS referrals and clinical activity in Qatar. The observed changes highlight the urgent need for additional resources and services. Adapting service delivery models and strengthening collaboration between healthcare sectors are crucial to addressing the evolving mental health needs of children and adolescents effectively.

To identify trajectories of Indonesian children and adolescent’s BMI-z scores between 1993 and 2014, examine whether the pattern differs by sex and assess associations with host, agent and environmental factors.

Longitudinal data were from the Indonesian Family Life Survey with up to five measurements of height and weight. Group-based trajectory models investigated changes in BMI-z score across time; differences by sex were investigated using random effect (mixed) models. The association between the trajectories and host, agent and environmental factors were examined using multinomial logistic regression.

Thirteen provinces in Indonesia.

Indonesian children and adolescents aged 6–18 years (n 27 394 for BMI-z trajectories; n 8805 for risk factor analyses).

Mean BMI-z score increased from –0·743 sd in 1993 to –0·414 sd in 2014. Four distinct trajectory groups were estimated with mean BMI-z increasing more rapidly in the most recent time periods. One group (11·7 % of participants) had a mean BMI-z entirely within the moderately underweight range; two had trajectories in the normal range and one (5·6 %) had a mean BMI-z starting in the overweight range but within the obesity range by 2014. There were differences in trajectory groups by sex (P< 0·001). Those born in 2000s, frequent consumption of meat, fast foods, soft drinks and fried snacks, and living in urban areas were associated with rapid gain weight.

These trajectories highlight the double burden of malnutrition and suggest that the prevalence of overweight and obesity is likely to increase substantially unless public health interventions are implemented.

Weight misperception has been reported as a common problem in high-income countries, but there is a paucity of high-quality empirical evidence in low- and middle-income countries, especially among children and adolescents. This study estimates the prevalence of weight misperception and investigates changes over time among children and adolescents in China, as well as identifies factors that may affect this weight misperception.

The China Health and Nutrition Survey, which is a repeated, representative cross-sectional study employing multistage random cluster processes.

A Chinese national survey across fifteen provinces and municipal cities.

Data from children and adolescents aged 6–16 years from six consecutive waves between 2000 and 2015 were included.

The final sample totalled 7110 children and adolescents. The overall prevalence of weight misperception was largely stable between 2000 and 2015 (range: 34·1–37·3 %). Sex and age groups were associated with weight misperception, with boys and younger participants more likely to misperceive their weight status. In addition, dieting and being physically active or inactive were associated with increased rates of weight misperception.

Weight misperception is common among youth in China and is unequally shared with several subpopulations at increased risk. Researchers and health promoters are called to recognise weight misperception when addressing overweight and obesity countermeasures, and more tailored public health initiatives are warranted to more effectively reach those with weight misperceptions.

To develop effective mental health interventions for children and adolescents, it is essential to understand the intricate link between functional disability and mental well-being in this group.

To explore the network connections between various aspects of functional disability and mental well-being in young people with disabilities.

We analysed data from the Multiple Indicator Cluster Surveys in 47 low- and middle-income countries, tracking progress towards health-related sustainable development goals. Our focus was on children and adolescents aged 5–17 with functional disabilities. Mental well-being was gauged using carer-reported signs of depression, anxiety and disability on the Child Functioning Module. Network-analysis techniques were used to examine links between mental well-being and functional disability domains.

The study included 32 669 eligible children aged 5–17 with functional disabilities (14 826 females and 17 843 males). The core domains of disability with the strongest connections to poor mental well-being were difficulties in accepting change, making friends, behavioural control (controlling own behaviour) and remembering/concentrating. These associations remained largely consistent across different genders and developmental stages. However, there were notable gender differences and age-related shifts in the relationships between specific disabilities and mental well-being. In particular, signs of anxiety in males and depression in females were most associated with functional disability overall, while signs of depression had the closest links to disability in adolescents.

The network perspective may enable the design of tailored interventions and support services that consider age and gender differences. Further research should continue to explore these complex relationships, incorporating novel methodologies like network-analysis to enhance the understanding of these associations.

Childhood and adolescence are vulnerable periods for mental disorders, and the COVID-19 pandemic has exacerbated mental health challenges in this population. We aimed to estimate changes in the global burden of mental disorders among children and adolescents before and during the pandemic.

Using data from the Global Burden of Diseases Study 2021, we analyzed incidence, prevalence, and years lived with disability (YLDs) for mental disorders in individuals aged 5–24. Annual percent changes in age-standardized rates were calculated, and a Bayesian age–period–cohort model estimated the expected and additional burden based on pre-pandemic trends.

In 2021, an estimated 123.0 million new cases of mental disorders were reported among children and adolescents, with an 11.8% average annual increase in the age-standardized incidence rate during the pandemic. Anxiety disorders, which previously ranked third, became the leading cause of nonfatal disability (12.9 million [8.0–19.3] YLDs), while depressive disorders rose to fourth place (10.9 million [6.8–16.5] YLDs). The burden grew in most regions, especially among females, those aged 15–24, and in high sociodemographic index (SDI) areas. Based on pre-pandemic data, we estimated an additional burden of 795.0, 165.9, and 622.8 new cases per 100,000 population for total mental disorders, anxiety disorders, and depressive disorders globally in 2021, respectively. Spearman correlation analysis showed a significant positive correlation between additional burden and SDI levels.

These findings highlight the increased burden of mental disorders among children and adolescents during the pandemic, emphasizing the need for targeted post-pandemic mental health support.

Cognitive control deficits are one of the main symptoms of psychosis. The basic neural oscillation patterns associated with cognitive control are already present in early adolescence. However, as previous studies have focused on adults with psychosis, it is unclear whether neurobiological impairments in cognitive control are present in children and adolescents with first-episode psychosis (FEP) or clinical high-risk (CHR) state for psychosis.

To explore the deficits of electroencephalogram related to cognitive control tasks in children and adolescents with FEP and CHR.

Electroencephalogram was recorded in untreated 48 patients with FEP, 24 patients with CHR and 42 healthy controls aged 10–17 years, while performing the visual oddball task. The N2 amplitude, theta and alpha oscillations were then analysed and compared between groups.

There was no significant group difference in N2 amplitude (P = 0.099). All groups showed increased theta and alpha oscillations relative to baseline before the stimulus in the frontal, central, left fronto-central and right fronto-central areas. These changes differed significantly between groups, with the FEP group showing significantly smaller theta (P < 0.001) and alpha (P < 0.01) oscillation than healthy controls. Theta and alpha oscillations in the CHR group did not differ significantly from the FEP group and healthy controls.

These results suggest that neural damage has already occurred in the early stage of psychosis, and that abnormal rhythmic activity of neurons may constitute the pathophysiological mechanism of cognitive dysfunction related to early-onset psychosis.

To investigate the relationship between the dietary approaches to stop hypertension (DASH)-style dietary patterns in childhood and cardiometabolic risk (CMR) in adolescence/early adulthood.

Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC) prospective cohort. Diet diary data collected at 7, 10 and 13 years were used to calculate DASH-style diet scores (DDS). Multivariable linear regression models were used to investigate the associations between the DDS at 7, 10 and 13 years and CMR scores, calculated at 17 and 24 years.

The ALSPAC cohort included children born in south-west England in 1991–1992.

Children with complete dietary, covariate and cardiometabolic data at 17 (n 1,526) and 24 years (n 1,524).

A higher DDS at 7 and 10 years was negatively associated with CMR scores at 17 years (β = –0·64 (95 % CI –1·27, –0·006), Ptrend=0·027 for fifth v. first DDS quintile at 7 years; β = –0·73 (95 % CI –1·35, –0·12) and Ptrend=0·037 for fifth v. first DDS quintile at 10 years) and at 24 years (β = –0·92 (95 % CI –1·49, –0·34) Ptrend = 0·001 for fifth v. first DDS quintile at 7 years; β = –0·60 (95 % CI –1·20, –0·05) Ptrend = 0·092 for fifth v. first DDS quintile at 10 years). No associations were found between the DDS at 13 years and CMR score at 17 and 24 years.

Greater adherence with a DASH-style diet during childhood was associated with better cardiometabolic health in adolescence/adulthood in the ALSPAC cohort. The components of the DASH diet could be recommended to improve children’s cardiometabolic health.

Previous pandemics have had negative effects on mental health, but there are few data on children and adolescents who were receiving ongoing psychiatric treatment.

To study changes in emotions and clinical state, and their predictors, during the COVID-19 pandemic in France.

We administered (by interview) the baseline Youth Self-Report version of the CoRonavIruS Health Impact Survey v0.3 (CRISIS, French translation) to 123 adolescent patients and the Parent/Caregiver version to evaluate 99 child patients before and during the first ‘lockdown’. For 139 of these patients who received ongoing treatment in our centre, treating physicians retrospectively completed longitudinal global ratings for five time periods, masked to CRISIS ratings.

The main outcome measure was the sum of eight mood state items, which formed a single factor in each age group. Overall, this score improved for each age group during the first lockdown. Clinician ratings modestly supported this result in patients without intellectual disability or autism spectrum disorder. Improvement of mood states was significantly associated with perceived improvement in family relationships in both age groups.

Consistent with previous studies of clinical cohorts, our patients had diverse responses during the pandemic. Several factors may have contributed to the finding of improvement in some individuals during the first lockdown, including the degree of family support or conflict, stress reduction owing to isolation, limitations of the outcome measures and/or possible selection bias. Ongoing treatment may have had a protective effect. Clinically, during crises additional support may be needed by families who experience increased conflict or who care for children with intellectual disability.

Ecuador has a high prevalence of household food insecurity (HFI) and is undergoing nutritional and epidemiologic transition. Evidence from high-income countries has reported negative or null associations between HFI and physical activity (PA) in children. It remains uncertain whether the same is true of those from low- and middle-income countries like Ecuador whose environmental and socio-demographic characteristics are distinct from those of high-income countries. We aimed to investigate the association of HFI with PA, sedentary behaviour (SB) and anthropometric indicators in children.

Cross-sectional analysis of data from the nationally representative 2018 Ecuadorian National Health and Nutrition Survey. Data were collected on HFI, PA, SB, socio-demographic characteristics and measured height and weight. Unadjusted and adjusted linear, log-binomial and multinomial logistic regression analyses assessed the relationship of HFI with PA, SB, stunting and BMI-for-age.

Ecuador.

23 621 children aged 5–17 years.

Marginal and moderate-severe HFI was prevalent in 24 % and 20 % of the households, respectively. HFI was not associated with PA, SB, stunting nor underweight. Moderate-severe HFI was associated with a lower odds of overweight and obesity. However, adjustment for household assets attenuated this finding for overweight (adjusted OR:0·90, 95 % CI: 0·77, 1·05) and obesity (adjusted OR: 0·88, 95 % CI: 0·71, 1·08).

HFI is a burden in Ecuadorian households, but is not associated with PA, SB nor anthropometric indicators in children aged 5–17 years. However, a concerning prevalence of insufficient PA was reported, emphasising the critical need for evidence-based interventions aimed at promoting PA and reducing SB.