The unequal impacts of the COVID-19 pandemic on young adults' mental health. Predictors of vulnerability and resilience using longitudinal birth cohort data in the UK.

INTRODUCTION: Previous studies have demonstrated deteriorations in young adult mental health during the COVID-19 pandemic, but evidence suggests heterogeneity in the mental health impacts of the pandemic. We sought to identify factors which may predict changes in psychological distress and wellbeing during the COVID-19 pandemic in UK young adults. METHODS: A total of 2607 young adults from the Millennium Cohort Study were included. Psychological distress and mental wellbeing were measured using the Kessler-6 and Short Warwick-Edinburgh Mental Wellbeing Scale, respectively. Assessment occurred at three timepoints between the ages of 17-19: 2018/19 (pre-COVID Baseline), May 2020 (COVID Wave 1) and September/October 2020 (COVID Wave 2). Latent change score models were used to study change in distress and wellbeing across the study period, as well as the impact of sex, relative family poverty, parental education, preexisting mental health difficulties and perceived social support on these changes. RESULTS: The latent change score models suggested both distress and wellbeing tended to increase across the study period. Being female and in relative poverty predicted greater increases in distress and/or poorer wellbeing. Higher levels of parental education and greater perceived social support were protective against increased distress and associated with improved wellbeing. CONCLUSIONS: The impact of the COVID-19 pandemic on UK young adult mental health is complex. We provide further evidence for a distinction between symptoms of poor mental health and wellbeing. Research is urgently needed to assess the long-term impacts of the COVID-19 pandemic on the mental health and wellbeing of young people, particularly in more vulnerable groups.

Lived experiences of depression in autistic children and adolescents: A qualitative study on child and parent perspectives.

BACKGROUND: Depression is highly prevalent in autistic children and adolescents. Despite this, little is known about the nature of the autistic child's subjective experience of depression and the impact of depression on their lives. METHODS: We therefore conducted a qualitative study using thematic analysis with 7 autistic children and adolescents and their parents to identify common themes and individual differences. All children had previously experienced at least one depressive episode. RESULTS: Six main themes were identified: (1) Autism related experiences; (2) Difficulties with peer relationships; (3) Co-occurring relationships between anxiety and depression; (4) Impactful pessimism and anhedonia; (5) Impactful difficulties with focus and concentration and (6) Feelings of irritability, including aggressive behaviours. Parent's accounts of their children's experience of depression mirrored the child's perspective. Novel findings included reports of depression related restriction of diet variety and masking of mental health difficulties. Children and parents linked being autistic and developing depression, referring to the difficulties of being autistic in a complex, neurotypical world. CONCLUSIONS: These results highlight key challenges that autistic children and their families experience, calling for increased awareness of the impact of depression on autistic young people.

Epilepsy and seizures in young people with 22q11.2 deletion syndrome: Prevalence and links with other neurodevelopmental disorders.

OBJECTIVE: The true prevalence of epileptic seizures and epilepsy in 22q11.2 deletion syndrome (22q11.2DS) is unknown, because previous studies have relied on historical medical record review. Associations of epilepsy with other neurodevelopmental manifestations (eg, specific psychiatric diagnoses) remain unexplored. METHODS: The primary caregivers of 108 deletion carriers (mean age 13.6 years) and 60 control siblings (mean age 13.1 years) completed a validated epilepsy screening questionnaire. A subsample (n = 44) underwent a second assessment with interview, prolonged electroencephalography (EEG), and medical record and epileptologist review. Intelligence quotient (IQ), psychopathology, and other neurodevelopmental problems were examined using neurocognitive assessment and questionnaire/interview. RESULTS: Eleven percent (12/108) of deletion carriers had an epilepsy diagnosis (controls 0%, P = 0.004). Fifty-seven of the remaining 96 deletion carriers (59.4%) had seizures or seizurelike symptoms (controls 13.3%, 8/60, P < 0.001). A febrile seizure was reported for 24.1% (26/107) of cases (controls 0%, P < 0.001). One deletion carrier with a clinical history of epilepsy was diagnosed with an additional type of unprovoked seizure during the second assessment. One deletion carrier was newly diagnosed with epilepsy, and two more with possible nonmotor absence seizures. A positive screen on the epilepsy questionnaire was more likely in deletion carriers with lower performance IQ (odds ratio [OR] 0.96, P = 0.018), attention-deficit/hyperactivity disorder (ADHD) (OR 3.28, P = 0.021), autism symptoms (OR 3.86, P = 0.004), and indicative motor coordination disorder (OR 4.56, P = 0.021). SIGNIFICANCE: Even when accounting for deletion carriers diagnosed with epilepsy, reports of seizures and seizurelike symptoms are common. These may be "true" epileptic seizures in some cases, which are not recognized during routine clinical care. Febrile seizures were far more common in deletion carriers compared to known population risk. A propensity for seizures in 22q11.2DS was associated with cognitive impairment, psychopathology, and motor coordination problems. Future research is required to determine whether this reflects common neurobiologic risk pathways or is a consequence of recurrent seizures.