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The Suicidal Ideation Questionnaire (SIQ) and the Suicidal Ideation Questionnaire-Junior (SIQ-Jr) were designed to capture suicidal ideation in adolescents and are often used in clinical trials. Our aim was to identify and appraise the published literature with respect to the validity, reliability, responsiveness, and interpretability of the SIQ and SIQ-Jr. We conducted a systematic review following COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines to identify, appraise, and synthesize published literature on measurement properties and interpretability of the SIQ and SIQ-Jr. We searched MEDLINE, Embase, APA PsycINFO, CINAHL, Web of Science, and Scopus from inception to May 16, 2023, to identify sources relevant to our aim. We identified 15 sources meeting our eligibility criteria. The body of literature did not meet COSMIN standards to make recommendations for use with regard to these measurement instruments. Further research is needed, with a focus on content validity and structural validity, prior to recommending the SIQ and SIQ-Jr for use in clinical practice and in clinical trials. No specific grant funding was used for this review. In this systematic review, authors analyzed 15 sources examining measurement properties of the Suicidal Ideation Questionnaire and Suicidal Ideation Questionnaire-Jr. Both measures are designed to capture suicidal ideation in adolescents and are used in clinical practice and clinical trials. The authors identified sufficient evidence for convergent validity for both measures. Authors concluded that further research is needed to support content validity, structural validity as a unidimensional scale (as they are often used) as well as their internal consistency, test-retest reliability, discriminative validity, predictive validity, and interpretability of these measures. The authors also emphasize the need to consider the limitations of these measures for researchers studying suicidal ideation and clinicians using these measures in their assessments of young people. [ABSTRACT FROM AUTHOR]

Key Points: Question: Is age stratification relevant for estimating the prevalence and burden associated with mental disorders and substance use disorders in the period from childhood to early adulthood? Findings: In this cross-sectional study using data from the 2019 Global Burden of Disease study, there was a high prevalence of mental disorders affecting children and youths, indicating that more than 1 of 10 (or 293 million) individuals aged 5 to 24 years globally live with a diagnosable mental disorder—in terms of burden, around one-fifth of all disease-related disability (considering all causes) was attributable to mental disorders among this population. Additionally, this age period encompasses about one-fourth of the mental disorder burden across the entire life course. Meaning: Given the implications of the early onset and lifetime burden of mental and substance use disorders for policy making, age-disaggregated data are essential for a more accurate understanding of vulnerability and more effective prevention and intervention initiatives. This cross-sectional study estimates the global prevalence and years lived with disability associated with mental disorders and substance use disorders across 4 age groups (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) using data from the 2019 Global Burden of Disease. Importance: The period from childhood to early adulthood involves increased susceptibility to the onset of mental disorders, with implications for policy making that may be better appreciated by disaggregated analyses of narrow age groups. Objective: To estimate the global prevalence and years lived with disability (YLDs) associated with mental disorders and substance use disorders (SUDs) across 4 age groups using data from the 2019 Global Burden of Disease (GBD) study. Design, Setting, and Participants: Data from the 2019 GBD study were used for analysis of mental disorders and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex. Data for the 2019 GBD study were collected up to 2018, and data were analyzed for this article from April 2022 to September 2023. Exposure: Age 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 to 24 years. Main Outcomes and Measures: Prevalence rates with 95% uncertainty intervals (95% UIs) and number of YLDs. Results: Globally in 2019, 293 million of 2516 million individuals aged 5 to 24 years had at least 1 mental disorder, and 31 million had an SUD. The mean prevalence was 11.63% for mental disorders and 1.22% for SUDs. For the narrower age groups, the prevalence of mental disorders was 6.80% (95% UI, 5.58-8.03) for those aged 5 to 9 years, 12.40% (95% UI, 10.62-14.59) for those aged 10 to 14 years, 13.96% (95% UI, 12.36-15.78) for those aged 15 to 19 years, and 13.63% (95% UI, 11.90-15.53) for those aged 20 to 24 years. The prevalence of each individual disorder also varied by age groups; sex-specific patterns varied to some extent by age. Mental disorders accounted for 31.14 million of 153.59 million YLDs (20.27% of YLDs from all causes). SUDs accounted for 4.30 million YLDs (2.80% of YLDs from all causes). Over the entire life course, 24.85% of all YLDs attributable to mental disorders were recorded before age 25 years. Conclusions and Relevance: An analytical framework that relies on stratified age groups should be adopted for examination of mental disorders and SUDs from childhood to early adulthood. Given the implications of the early onset and lifetime burden of mental disorders and SUDs, age-disaggregated data are essential for the understanding of vulnerability and effective prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

Background: Depression is a common condition among adolescents, with rates continuing to rise. A gap exists between evidence-based recommendations for the treatment of depression and clinical practice. Integrated Care Pathways (ICPs) can help address this gap, but to date no study has examined how young people and their caregivers experience ICPs and whether these pathways are an acceptable form of care. This study used focus groups with adolescents, caregivers, and service providers to examine experiences of an ICP. Methods: Six individual interviews with service providers, four focus groups with youth, and two focus groups with caregivers were completed. Data was analyzed consistent with Braun & Clarke's Thematic Analysis Framework within an interpretivist paradigm. Results and Conclusion: The study demonstrated that ICPs are acceptable to youth and their caregivers and that ICPs facilitate shared decision making between youth/caregivers and care providers. Findings also indicated that youth are willing to engage with ICPs particularly when there is a trusted clinician involved who helps interpret and tailor the ICP to the young person's experience. Further questions include how to best integrate these into the overall system and how to further tailor these pathways to support youth with diagnostic complexity and treatment resistance. [ABSTRACT FROM AUTHOR]

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This study aimed to systematically identify and appraise clinical practice guidelines (CPGs) relating to the assessment and management of suicide risk and self-harm in children and adolescents. Our research question is as follows: For young people (under 18 years old) presenting to clinical care with suicide ideation or a history of self-harm, what is the quality of up-to-date CPGs? Using the PRISMA format, we systematically identified CPGs meeting our inclusion and exclusion criteria. Subsequently, two independent raters conducted appraisals of the eligible CPGs using the Appraisal of Guidelines for Research and Evaluation II instrument. CPGs were then classified as "poor quality," "minimum quality," and "high quality" using operationally defined criteria developed a priori. We identified 10 eligible CPGs published or renewed between 2005 and May 2017. Only the long-term management of self-harm CPGs produced by the National Institute for Health and Care Excellence met "high-quality" criteria. Despite multiple options of CPGs published to choose from, only one was identified as "high quality," where bias is adequately minimized. Clinicians are advised to direct resources to implementing the "high-quality" CPG. [ABSTRACT FROM AUTHOR]

Objective/background: A considerable subgroup of adolescents does not respond to standard antidepressant treatments. There are some indications that sleep disordered breathing may contribute to refractory depression in adults, but little is known about how it may relate to the course of depressive disorders in adolescents. Focussing on a group of Canadian adolescents with treatment resistant depression (TRD), this study aimed to investigate how the severity of residual depressive symptoms following unsuccessful antidepressant trials relates to breathing disturbances during sleep.Patients/methods: A retrospective chart review was conducted at a tertiary mental health facility. Polysomnography, the Beck Depression Inventory-II (BDI-II), and the Epworth Sleepiness Scale (ESS) were collated from 18 adolescents (15-18 years old, 44% females) patients with depressive disorders who did not respond to at least two 4-week trials of antidepressant medications.Results: Of this sample, 39% reported at least mild levels of excessive daytime sleepiness, and 55% had an apnea/hypopnea index ≥1. Worse depressive symptoms correlated with higher RDI (r = 0.53, p = 0.022). This was mainly driven by respiratory effort-related arousals occurring during NREM sleep (r = 0.52, p = 0.029). No significant correlation was found between depressive symptoms and other respiratory or sleep variables. Higher daytime sleepiness correlated significantly with lower minimum oxygen desaturation (r = -0.51, p = 0.030).Conclusions: These results suggest that even subtle respiratory disturbances during sleep may play a role in persistent depressive symptoms and treatment resistance. Early screening for sleep-related breathing disturbances in adolescents with TRD may be relevant, since previous work suggests that treating sleep-related breathing disturbances can attenuate depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Conventional treatments for youth depression, such as antidepressants, have modest efficacy, side effects, and ongoing controversies regarding safety. Repetitive transcranial magnetic stimulation (rTMS), specifically theta burst stimulation (TBS), applied to the dorsolateral prefrontal cortex (DLPFC) has demonstrated efficacy for the treatment of depression in adults. However, the feasibility and clinical response to TBS for youth depression has yet to be explored.Methods: Twenty participants between the ages of 16 to 24 years old with MDD were recruited. The intervention consisted of 10 treatment sessions over the course of two weeks, in which participants received intermittent TBS and continuous TBS stimulation to the left and right DLPFC, respectively. Change in the Hamilton Rating Scale for Depression (HRSD-17) score was the primary outcome. Clinical assessments occurred at baseline, after the fifth treatment session, and within a week after treatment completion.Results: Of the twenty participants, eighteen received all TBS sessions, and seventeen completed all clinical assessments. There was a significant reduction in depressive symptoms following treatment completion (p < 0.001). Four of the twenty patients had more than 50% reduction in their depressive symptoms, two of whom achieved remission. All participants received and tolerated at least six daily TBS treatments with no major adverse events.Limitations: Study was an uncontrolled, open-label design.Conclusion: Ten sessions of TBS was feasible, well tolerated, and appeared to have clinical effects for the treatment of depressed youth. Future sham-controlled randomized trials are warranted to validate these findings in a larger cohort of youth depression. [ABSTRACT FROM AUTHOR]