Participant Recruitment Issues in Child and Adolescent Psychiatry Clinical Trials with a Focus on Prevention Programs: A Meta-Analytic Review of the Literature.

Introduction: There is a strong need to conduct rigorous and robust trials for children and adolescents in mental health settings. One of the main barriers to meeting this requirement is the poor recruitment rate. Effective recruitment strategies are crucial for the success of a clinical trial, and therefore, we reviewed recruitment strategies in clinical trials on children and adolescents in mental health with a focus on prevention programs. Methods: We reviewed the literature by searching PubMed/Medline, the Cochrane Library database, and Web of Science through December 2022 as well as the reference lists of relevant articles. We included only studies describing recruitment strategies for pediatric clinical trials in mental health settings and extracted data on recruitment and completion rates. Results: The search yielded 13 studies that enrolled a total of 14,452 participants. Overall, studies mainly used social networks or clinical settings to recruit participants. Half of the studies used only one recruitment method. Using multiple recruitment methods (56.6%, 95%CI: 24.5-86.0) resulted in higher recruitment. The use of monetary incentives (47.0%, 95%CI: 24.6-70.0) enhanced the recruitment rate but not significantly (32.6%, 95%CI: 15.7-52.1). All types of recruitment methods showed high completion rates (82.9%, 95%CI: 61.7-97.5) even though prevention programs showed the smallest recruitment rate (76.1%, 95%CI: 50.9-94.4). Conclusions: Pediatric mental health clinical trials face many difficulties in recruitment. We found that these trials could benefit from faster and more efficient recruitment of participants when more than one method is implemented. Social networks can be helpful where ethically possible. We hope the description of these strategies will help foster innovation in recruitment for pediatric studies in mental health.

Longitudinal associations between self-reported attachment dimensions and neurostructural development from adolescence to early adulthood.

The existing literature suggests that individual differences in attachment may be associated with differential trajectories of structural brain development. In addition to maturation during infancy and childhood, developmental trajectories are characteristic of adolescence, a period marked by increasingly complex interpersonal relationships and significant neurostructural and functional plasticity. It remains to be examined whether attachment prospectively relates to neurostructural developmental trajectories during adolescence. In this longitudinal study, we investigated whether self-reported attachment dimensions of anxiety (AX) and avoidance (AV) could predict elements of cortical thickness (CT) and subcortical volume (SV) trajectories in 95 typically developing adolescents (12-19 years old at study baseline). Self-reported scores of AX and AV were obtained at study baseline, and neurostructural development was assessed at baseline and three timepoints over the four following years. Self-reported AX and AV were associated with steeper CT decreases in prefrontal cortical and cortical midline structures as well as anterior temporal cortex, particularly in participants younger at study baseline. Regarding SV, preliminary differential associations were observed between developmental trajectories and attachment dimensions. Our study suggests that interindividual differences in attachment contribute to shaping neurodevelopmental trajectories for several cortical and subcortical structures during adolescence and young adulthood.

Mapping Child and Adolescent Mental Health Services and the Interface During Transition to Adult Services in Six Swiss Cantons.

Rationale: Transition in psychiatry refers to the period where young people transit from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). Discontinuity of care during this period is well-documented but little is known about provisions and transition characteristics and policies across Switzerland. The aim of this article is to describe the architecture of public mental health providers in Switzerland and compare it to EU countries. Method: Two mapping surveys, developed previously for European countries, were adapted and sent to cantonal experts: the adapted European CAMHS Mapping Questionnaire (ECM-Q) assessing the architecture and functioning of CAMHS and the adapted Standardized Assessment Tool for Mental Health Transition (SATMeHT) to map CAMHS-AMHS interface. Results: Data were gathered from six cantons. Activity data and transition policies were comparable between Swiss regions and European countries. The percentage of young people below 19 years who were in care was above 2% in every responding canton with a higher proportion of boys than girls for patients <12 years of age. The transition occurred at the age of 18 years, civil majority, in each canton, and between 0 and 24% (3/7) and 25% and 49% (4/7) of young people were expected to transition. One canton (1/7) benefitted from written guidelines, at the CAMHS level only, regarding transition but none had guidelines for mapping CAMHS/AMHS interface even at the regional level. Conclusion: Despite the availability of resources and even if the possibilities of access to care are on average higher than in many European countries, issues regarding transition remain comparable in six Swiss cantons when compared to Europe. Meaning that beyond resources, it is the coordination between services that needs to be worked on. Importantly, implementing those changes would not require investing financial resources but rather working on the coordination between existing teams.

A common computational principle for vibrotactile pitch perception in mouse and human.

We live surrounded by vibrations generated by moving objects. These oscillatory stimuli propagate through solid substrates, are sensed by mechanoreceptors in our body and give rise to perceptual attributes such as vibrotactile pitch (i.e. the perception of how high or low a vibration's frequency is). Here, we establish a mechanistic relationship between vibrotactile pitch perception and the physical properties of vibrations using behavioral tasks, in which vibratory stimuli were delivered to the human fingertip or the mouse forelimb. The resulting perceptual reports were analyzed with a model demonstrating that physically different combinations of vibration frequencies and amplitudes can produce equal pitch perception. We found that the perceptually indistinguishable but physically different stimuli follow a common computational principle in mouse and human. It dictates that vibrotactile pitch perception is shifted with increases in amplitude toward the frequency of highest vibrotactile sensitivity. These findings suggest the existence of a fundamental relationship between the seemingly unrelated concepts of spectral sensitivity and pitch perception.