Thirty-year trends of anxiety disorders among adolescents based on the 2019 Global Burden of Disease Study.

Background: Anxiety disorders are the most common psychiatric problems, affecting approximately 1 in 12 children and 1 in 4 adolescents. Understanding the incidence, burden and correlated risks of anxiety disorders among children and adolescents can help identify areas of success, stagnation and emerging threats, thereby facilitating effective improvement strategies. Aims: To estimate the incidence and burden trends of anxiety disorders in children and adolescents from 1990 to 2019 in 204 countries and compare the incidence and disease burden in different countries. To examine the association between anxiety disorders and social indicators (healthcare access and quality of life). Methods: Data were obtained from the Global Burden of Disease Study 2019. The age-standardised incidence rates (ASIRs) and disability-adjusted life years (DALYs) were reported to assess the burden of anxiety disorders, and the estimated annual percentage change was calculated to quantify the temporal trends. Pearson's correlation was used to investigate country-level risk factors for incidence and DALYs. Results: Globally, there were 932 million incident cases of anxiety disorders in children and adolescents, 739.29 per 100 000 ASIRs and 380.62 million DALYs in 2019. From 1990 to 2019, the estimated annual percentage change of incidence of anxiety disorders decreased by 2.2%. Significant variations were observed in the age-standardised burden rate and the changing trend of anxiety disorders among countries. Portugal reported the highest ASIR of anxiety disorders, while Mexico had the largest increase rate of ASIR. In 2019, Portugal reported the highest number of DALYs (1001.71 million), and India (212.09 million) reported the lowest number of DALYs. The burden of anxiety disorders was positively correlated with the average number of psychiatrists, psychologists and nurses in the mental health sector (per 100 000), and quality of life and the correlation coefficients were 0.58, 0.67, 0.43 and 0.53, respectively. Conclusions: The incidence and global burden of anxiety disorders in adolescents have continued to decrease over the past 30 years. However, the incidence and disease burden in developed countries are still increasing steadily. Policymakers should design and implement mental health strategies for adolescents based on their specific developmental status, as well as the cultural and regional characteristics of each country.

Development of the Life Gatekeeper suicide prevention training programme in China: a Delphi study.

Background: Youth suicide has been a pressing public mental health concern in China, yet there is a lack of gatekeeper intervention programmes developed locally to prevent suicide among Chinese adolescents. Aims: The current Delphi study was the first step in the systematic development of the Life Gatekeeper programme, the first gatekeeper programme to be developed locally in China that aims to equip teachers and parents with the knowledge, skills and ability to identify and intervene with students at high risk of suicide. Methods: The Delphi method was used to elicit a consensus of experts who were invited to evaluate the importance of training content, the feasibility of the training delivery method, the possibility of achieving the training goals and, finally, the appropriateness of the training materials. Two Delphi rounds were conducted among local experts with diversified professional backgrounds in suicide research and practice. Statements were accepted for inclusion in the adjusted training programme if they were endorsed by at least 80% of the panel. Results: Consensus was achieved on 201 out of 207 statements for inclusion into the adapted guidelines for the gatekeeper programme, with 151 from the original questionnaire and 50 generated from comments of the panel members. These endorsed statements were synthesised to develop the content of the Life Gatekeeper training programme. Conclusions: This Delphi study provided an evidence base for developing the first gatekeeper training programme systematically and locally in China. We hope that the current study can pave the way for more evidence-based suicide prevention programmes in China. Further study is warranted to evaluate the effectiveness of the Life Gatekeeper training programme.

Pornography use among adolescents and the role of primary care.

Given the increase in pornography use among adolescents over the years, we discuss the impact of its use on sexual health development as well as the role of primary care providers (PCPs) in assessing use and providing sexual health education. While pornography use is often viewed negatively, it is important to develop unbiased understanding of the use in order to provide non-judgemental, adolescent-focused and educational care. As PCPs are often the first point of contact when adolescents experience medical and behavioural health concerns, it is essential for them to be equipped to screen for pornography use effectively, create a confidential and comfortable environment to talk about pornography use and sexuality, and be informed of ways to promote open discussion between youth and parents. In addition to PCP involvement, parental collaboration, knowledge and comfortability with discussing pornography use with their child are powerful tools in understanding and navigating pornography use in this population. This special communication seeks to provide an objective view of adolescents' pornography use, guidelines for screening of pornography use and ways to facilitate conversations about the use between adolescents and caregivers.

Efectos de la pandemia por COVID-19 en la salud mental de adolescentes / Effects of the COVID-19 pandemic on adolescent mental health

Objetivo: Analizar los efectos de la pandemia por COVID-19 en la salud mental de adolescentes. Método: Descriptiva documental. Resultados: 15 articulos relacionados al tema de investigación. Conclusión: Mediante el profundo análisis realizado, se puede concluir que, todas las personas se han visto afectadas por la pandemia , sin embargo la población que más sufrió han sido los adolescentes, debido a que han tenido que adaptarse a mecanismo establecidos para frenar el contagio del COVID-19, dejando así a un lado las actividades cotidianas que antes realizaban cómo asistir a clases presencialmente, interactuar con otras personas y concurrir a espacios o eventos públicos ,como consecuencia en el futuro de estos jóvenes se puede generar una serie de trastornos emocionales , puesto que la adolescencia es una etapa fundamental y crucial para el desarrollo de hábitos sociales.

Objective: To analyze the effects of the COVID-19 pandemic on the mental health of adolescents. Method: Descriptive documentary. Results: 15 articles related to the research topic. Conclusion: By means of the deep analysis carried out, it can be concluded that, all people have been affected by the pandemic , however the population that suffered the most has been the adolescents, due to the fact that they have had to adapt to the mechanism established to stop the contagion of COVID-19, thus leaving aside the daily activities that they previously performed how to attend classes in person, interact with other people and attend public spaces or events ,as a result in the future of these young people can generate a series of emotional disorders , since adolescence is a fundamental and crucial stage for the development of social habits

El estudio de casos: método efectivo para el diagnóstico y manejo de trastornos de conducta / Case study: effective method in the diagnosis and treatment of behavioral disorders

RESUMEN Fundamento: los trastornos de conducta constituyen un problema de salud de intervención multidisciplinaria entre instituciones correspondientes a diferentes campos del saber. Su tratamiento a través del estudio de casos como método de indagación detallado, descriptivo y holístico permite su diagnóstico efectivo y orienta hacia una terapéutica integral para su solución. Objetivo: valorar la efectividad del método estudio de casos para el diagnóstico y manejo de los trastornos de conducta. Métodos: se realizó un estudio descriptivo en el municipio de Santa Clara durante febrero de 2018. Se emplearon métodos teóricos: análisis-síntesis, inductivo-deductivo e histórico-lógico; empíricos: análisis documental, historia de vida, observación participante y entrevista a informantes clave y familiares y el método estudio de casos. Resultados: los métodos empleados permitieron conformar un diagnóstico preventivo a partir del análisis minucioso de las características psicopedagógicas y psicosociales del menor, el cual se prescribió como portador de un trastorno de conducta disocial potenciado y generado por patrones, códigos y estilos antisociales asimilados desde sus círculos de amistad, cuyo pronóstico fue desfavorable. Conclusiones: se valoró la efectividad de la aplicación del método estudio de casos para el diagnóstico y manejo de los trastornos de conducta porque permitió la identificación de las potencialidades del entorno del sujeto para enfrentar esta problemática y las existentes en él y en su familia, y la elaboración de estrategias que coadyuvan al éxito de un comportamiento cívico a tono con el proyecto social cubano.

ABSTRACT Background: behavioral disorders are a health problem that requires multidisciplinary action between institutions from different fields of knowledge. Its treatment through the study of cases as a detailed, descriptive and holistic method of research enables the effective diagnosis of it and also it is a guide towards a comprehensive treatment for its solution. Objective: to evaluate the effectiveness of the case study method in the diagnosis and treatment for conduct disorders. Methods: a descriptive study was conducted in Santa Clara municipality during February 2018. Theoretical methods were used: analysis-synthesis method, inductive-deductive method and historical-logical method; empirical methods: documentary analysis method, life history method, participant observation method, key informant interview, family members interview and the case study method. Results: the methods we used made possible to obtain a preventive diagnosis from the detailed analysis of the psycho-pedagogical and psychosocial characteristics of the child, who was prescribed as sufferer of dissociative identity disorder enhanced and generated by patterns, codes and antisocial styles assumed from friendship circles, with an unfavorable prognosis. Conclusions: the effectiveness of the case study method in the diagnosis and treatment for conduct disorders was evaluated since it made possible to identify the potentialities of the subject's environment to face this problem and those inherent in him and his family, and the development of strategies that contribute to success in terms of civic behavior in accordance with the Cuban social project.

Tips and Traps: Lessons From Codesigning a Clinician E-Monitoring Tool for Computerized Cognitive Behavioral Therapy.

BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts). OBJECTIVE: The objectives of our study were as follows: (1) assess clinicians' and adolescents' views on using an e-monitoring tool and to use this information to help shape the development of the tool and (2) assess clinician experiences with a fully developed version of the tool that was implemented in their clinical service. METHODS: A descriptive qualitative study using semistructured focus groups was conducted in New Zealand. In total, 7 focus groups included clinicians (n=50) who worked in primary care, and 3 separate groups included adolescents (n=29). Clinicians were general practitioners (GPs), school guidance counselors, clinical psychologists, youth workers, and nurses. Adolescents were recruited from health services and a high school. Focus groups were run to enable feedback at 3 phases that corresponded to the consultation, development, and postimplementation stages. Thematic analysis was applied to transcribed responses. RESULTS: Focus groups during the consultation and development phases revealed the need for a simple e-monitoring registration process with guides for end users. Common concerns were raised in relation to clinical burden, monitoring risk (and effects on the therapeutic relationship), alongside confidentiality or privacy and technical considerations. Adolescents did not want to use their social media login credentials for e-monitoring, as they valued their privacy. However, adolescents did want information on seeking help and personalized monitoring and communication arrangements. Postimplementation, clinicians who had used the tool in practice revealed no adverse impact on the therapeutic relationship, and adolescents were not concerned about being e-monitored. Clinicians did need additional time to monitor adolescents, and the e-monitoring tool was used in a different way than was originally anticipated. Also, it was suggested that the registration process could be further streamlined and integrated with existing clinical data management systems, and the use of clinician alerts could be expanded beyond the scope of simply flagging adolescents of concern. CONCLUSIONS: An e-monitoring tool was developed in consultation with clinicians and adolescents. However, the study revealed the complexity of implementing the tool in clinical practice. Of salience were privacy, parallel monitoring systems, integration with existing electronic medical record systems, customization of the e-monitor, and preagreed monitoring arrangements between clinicians and adolescents.

Cardiff acne disability index: cross-cultural translation in Korean and its relationship with clinical acne severity, pathological patterns, and general quality of life.

OBJECTIVE: To culturally translate the cardiff acne disability index (CADI) into Korean, and to examine its relationship with clinical acne severity, pathological patterns, and general quality of life (QoL). METHODS: The CADI was culturally and lin- guistically translated into Korean via translation, back-translation, and face validity test process. Two hundred and fifty-four Korean adolescents were asked to complete the Korean version of the CADI (K-CADI), the Phlegm Pattern, the Cold-Heat Pattern, and the Korean version of the General Health Questionnaires. A clinician estimated acne severity for the adolescents, using the Korean Acne Grading System. Finally, reliability and validity of the K-CADI was examined, and the relationships between acne severity, Phlegm, Cold, and Heat patterns, and QoL level were examined via pathway analysis. RESULTS: The K-CADI had satisfactory internal con- sistency (α = 0.827). The examination of construct validity indicated that the K-CADI had one factor (explaining 59.6% of the total variance). Pathway analysis showed satisfactory model fit (normal fit index = 0.960 and comparative fit index = 0.983), and acne-related QoL was determinant to Phlegm, Heat, and Cold patterns (0.13-0.27 of ß), and Phlegm and Heat patterns lowered one's QoL level (0.17-0.34 of ß). CONCLUSION: The K-CADI is a valid and reliable instrument. Phlegm and Heat patterns should be managed when treating acne since they have a moderating effect on general QoL aggravation.

Atuação dos profissionais de psicologia junto à infância e à adolescência nas políticas públicas de assistência social / The actions of psychology professionals in childhood and adolescence in social assistance public policy / Actuación de los profesionales de psicología con respecto a la infancia y adolescencia en las políticas públicas de asistencia social

O presente artigo objetiva analisar as concepções dos profissionais de Psicologia sobre infância e adolescência. Para dar conta de tal objetivo, buscou-se suporte teórico na Psicologia Histórico-Cultural de Vigotski. Participaram deste estudo 11 profissionais de Psicologia, que atuam nos equipamentos das políticas públicas de assistência social da região do Cariri cearense, com idades entre 24 e 55 anos, sendo dez do sexo feminino. O tempo de formação variou de três a 32 anos, dos quais, oito estavam atuando no CRAS, dois no CREAS e um na Casa de Acolhimento. Optou-se por uma abordagem quali-quantitativa, utilizando-se da entrevista semiestruturada para coleta de dados e um questionário para identificação dos dados sociodemográficos dos entrevistados. Para análise das entrevistas, utilizou-se o softwareALCESTE, recorrendo-se à análise clássica, por meio da análise hierárquica descendente. A análise dos dados apontou quatro classes discursivas: violação de direitos, dinâmica da família das crianças e dos adolescentes, atuação dos profissionais de Psicologia, concepção acerca da infância e da adolescência. De modo geral, os profissionais de Psicologia têm uma atuação pautada numa concepção naturalizante, universalista e descontextualizada acerca da infância e da adolescência. Isso acaba comprometendo as ações realizadas por esses profissionais, pois se apresentam distanciadas da realidade concreta, servindo mais como uma ferramenta de controle social das crianças e adolescentes pobres do que como estratégia de efetivação de direitos.(AU)

This study aims to analyze the conceptions about childhood and adolescence that psychology professionals hold to be true. Vygotsky's cultural–historical psychology was used as theoretical support. The study included 11 psychology professionals (10 female, 1 male; age range: 25–55), who work at the social assistance public policies in the Cariri area in Ceará. Their work experience ranged from 3–32 years; eight of them were working in CRAS, two in CREAS, and one in the "Casa de Acolhimento." The qualitative and quantitative approach, used with semi-structured interviews for data collection and a questionnaire for identification of sociodemographic information. ALCESTE software was used for the analysis of the interviews, which resorted to the classical analysis by descending hierarchical analysis. Data analysis indicated four discursive classes: violation of rights, family dynamics of children and adolescents, performance of psychology professionals, and conception of childhood and adolescence. In general, psychology professionals have a naturalistic, universal, and decontextualized conception about childhood and adolescence. This results in compromising the actions performed by these professionals, because these views make them more distant from the concrete reality of these people. Consequently, this action happens more as a social control tool of poor children and adolescents rather than enforcing rights strategy.(AU)

Este artículo tiene como objetivo analizar la concepción de los profesionales de Psicología acerca de la infancia y la adolescencia. Para lograr este objetivo se buscó el apoyo teórico de la Psicología Histórico-Cultural de Vygotsky. En el estudio participaron 11 profesionales de Psicología que trabajan en la política pública de asistencia social de la región del Cariri en Ceará, de 24 a 55 años, siendo diez mujeres. El tiempo de formación varió de tres a 32 años, ocho de ellos estaban trabajando en el CRAS, dos en CREAS y uno en la "Casa de Acogimiento". Se utilizó un enfoque cualitativo y cuantitativo, a través de entrevistas semi-estructuradas para la recolección de datos, y un cuestionario para la identificación de los datos socio-demográficos de los encuestados. Para el análisis de las entrevistas se utilizó el software ALCESTE, recurriéndose al sistema clásico, por el análisis jerárquico descendiente. El análisis de los datos anotó cuatro clases discursivas: violación de los derechos, la dinámica de los niños y adolescentes de la familia, la actuación de los profesionales de Psicología, la concepción acerca de la infancia y la adolescencia. En general, los profesionales de Psicología tienen una acción basada en una concepción naturalista, universal y descontextualizada de la infancia y la adolescencia. Esto termina comprometiendo las acciones realizadas por estos profesionales, pues las hacen más distante de la realidad de estos chicos, siendo más útil como una herramienta de control social de niños y adolescentes pobres que en la aplicación de la estrategia de los derechos.(AU)

Atuação dos profissionais de psicologia junto à infância e à adolescência nas políticas públicas de assistência social / The actions of psychology professionals in childhood and adolescence in social assistance public policy / Actuación de los profesionales de psicología con respecto a la infancia y adolescencia en las políticas públicas de asistencia social

O presente artigo objetiva analisar as concepções dos profissionais de Psicologia sobre infância e adolescência. Para dar conta de tal objetivo, buscou-se suporte teórico na Psicologia Histórico Cultural de Vigotski. Participaram deste estudo 11 profissionais de Psicologia, que atuam nos equipamentos das políticas públicas de assistência social da região do Cariri cearense, com idades entre 24 e 55 anos, sendo dez do sexo feminino. O tempo de formação variou de três a 32 anos, dos quais, oito estavam atuando no CRAS, dois no CREAS e um na Casa de Acolhimento. Optou-se por uma abordagem quali-quantitativa, utilizando-se da entrevista semi estruturada para coleta de dados e um questionário para identificação dos dados sociodemográficos dos entrevistados. Para análise das entrevistas, utilizou-se o software ALCESTE, recorrendo-se à análise clássica, por meio da análise hierárquica descendente. A análise dos dados apontou quatro classes discursivas: violação de direitos, dinâmica da família das crianças e dos adolescentes, atuação dos profissionais de Psicologia, concepção acerca da infância e da adolescência. De modo geral, os profissionais de Psicologia têm uma atuação pautada numa concepção naturalizante, universalista e descontextualizada acerca da infância e da adolescência. Isso acaba comprometendo as ações realizadas por esses profissionais, pois se apresentam distanciadas da realidade concreta, servindo mais como uma ferramenta de controle social das crianças e adolescentes pobres do que como estratégia de efetivação de direitos.

This study aims to analyze the conceptions about childhood and adolescence that psychology professionals hold to be true. Vygotsky's cultural–historical psychology was used as theoretical support. The study included 11 psychology professionals (10 female, 1 male; age range: 25–55), who work at the social assistance public policies in the Cariri area in Ceará. Their work experience ranged from 3–32 years; eight of them were working in CRAS, two in CREAS, and one in the "Casa de Acolhimento." The qualitative and quantitative approach, used with semi-structured interviews for data collection and a questionnaire for identification of sociodemographic information. ALCESTE software was used for the analysis of the interviews, which resorted to the classical analysis by descending hierarchical analysis. Data analysis indicated four discursive classes: violation of rights, family dynamics of children and adolescents, performance of psychology professionals, and conception of childhood and adolescence. In general, psychology professionals have a naturalistic, universal, and decontextualized conception about childhood and adolescence. This results in compromising the actions performed by these professionals, because these views make them more distant from the concrete reality of these people. Consequently, this action happens more as a social control tool of poor children and adolescents rather than enforcing rights strategy.

Este artículo tiene como objetivo analizar la concepción de los profesionales de Psicología acerca de la infancia y la adolescencia. Para lograr este objetivo se buscó el apoyo teórico de la Psicología Histórico-Cultural de Vygotsky. En el estudio participaron 11 profesionales de Psicología que trabajan en la política pública de asistencia social de la región del Cariri en Ceará, de 24 a 55 años, siendo diez mujeres. El tiempo de formación varió de tres a 32 años, ocho de ellos estaban trabajando en el CRAS, dos en CREAS y uno en la "Casa de Acogimiento". Se utilizó un enfoque cualitativo y cuantitativo, a través de entrevistas semi-estructuradas para la recolección de datos, y un cuestionario para la identificación de los datos socio-demográficos de los encuestados. Para el análisis de las entrevistas se utilizó el software ALCESTE, recurriéndose al sistema clásico, por el análisis jerárquico descendiente. El análisis de los datos anotó cuatro clases discursivas: violación de los derechos, la dinámica de los niños y adolescentes de la familia, la actuación de los profesionales de Psicología, la concepción acerca de la infancia y la adolescencia. En general, los profesionales de Psicología tienen una acción basada en una concepción naturalista, universal y descontextualizada de la infancia y la adolescencia. Esto termina comprometiendo las acciones realizadas por estos profesionales, pues las hacen más distante de la realidad de estos chicos, siendo más útil como una herramienta de control social de niños y adolescentes pobres que en la aplicación de la estrategia de los derechos.