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There has been growing interest in economic evidence regarding treatment of mental disorders.

Background: Psychotic-like experiences (PLEs) are common in clinical adolescent samples and form a continuum based on their frequency and intensity. PLEs can have harmful effects on both behaviour and affect. Methods: Prevalence and subjective distress due to PLEs were assessed with the Prodromal Questionnaire-Brief (PQ-B) and depressive symptoms with the Beck Depression Inventory (BDI-21A) among adolescents (N = 399; 71.7% female, mean age 14.9 years, range 13–18) entering specialized adolescent psychiatric services. Various PQ-B Distress scale cut-off points were tested for their ability to detect high and low BDI scores using the superiority index, the effect size for mean difference, and spline regressions. Results: The mean number of endorsed PLEs assessed with the PQ-B was 3.27 (SD 3.64; males: M 1.75; SD 2.78; females: M 3.89; SD 3.78), while mean PQ-B Distress scores were 20.33 (SD 18.03; males: M 11.84; SD 13.90; females: M 23.74; SD 18.40). The most common PLE within both genders were experiences of paranoia and suspiciousness, with a prevalence of 59.9%. BDI scores and PQ-B distress scores were strongly associated (r = 0.534, p<.001). Superiority indices, effect sizes, and spline regressions indicated that a low PQ-B Distress cut-off of 2 or 3 was most informative both when using BDI as a continuous variable and when dichotomized as mild depression (≥10) or major depressive disorder (≥16). Conclusion: PLEs are common among adolescent entering psychiatric care. Even a relatively small amount of distress due to PLEs indicates clinical levels of depressive symptoms. [ABSTRACT FROM AUTHOR]

We investigated whether the associations between involvement in bullying and emotional and behavioral symptoms among adolescents differ according to sexual orientation. Respondents were 25 147 boys and 25 257 girls in comprehensive school (M[subscript age] 15.4, SD 0.6), and 33 231 males and 36 765 females in upper secondary education (M[subscript age] 17.4, SD 0.8) in Finland. Data were analyzed using cross-tabulations with Chi-square statistics and logistic regression. SMY reported more symptoms and more involvement in bullying than did heterosexual youth. Involvement in bullying as both victim and perpetrator was associated with emotional and behavioral symptoms among all adolescents, regardless of their sexual orientation. These associations were mainly consistent across sexual orientation groups. The few differences found suggested weaker associations among SMY than among heterosexual youth.

Mental health problems are common in adolescence and seeking help for them is becoming more common. Referrals to adolescent mental healthcare have recently increased in Finland.

We analyzed the associations between sexual orientation and subjection to/perpetration of bullying at school, taking into account confounding by psychiatric symptom dimensions and involvement in the other role. Survey data among 25,147 boys and 25,257 girls in comprehensive school, and 33,231 boys and 36,765 girls in upper secondary education in Finland were used. Data were analyzed using cross-tabulations with Chi-square statistics and logistic regression. Even though associations between sexual minority status and subjection to bullying grew weaker when confounding was controlled for, independent associations were found in both boys and girls, and in both younger and older adolescents. Positive associations first seen between same sex attraction and bullying perpetration leveled out and partially turned inverse when controlling for confounding. Uncertainty about one's interests had different associations with involvement in bullying in different age groups.

Aim: Psychosis‐Like Experiences (PLEs) and depressive symptoms are correlated in clinical adolescent populations. However, symptom‐level associations between the two phenomena are not clear. Methods: We analysed factor structures of a PLE instrument, the Prodromal Questionnaire‐Brief (PQ‐B), based on dimensions of positive symptoms of schizophrenia, and a depression measurement instrument, the Beck Depression Inventory (BDI‐21A) and performed a network analysis of item‐level associations between the two measures. The sample consisted of 417 adolescents (range 13–18 years of age, mean 14.9 years, 72.4% females) entering secondary psychiatric services at Helsinki metropolitan area, Finland. Results: Confirmatory factor analysis resulted in adequately fitting 2‐factor solution, one for PQ‐B and one for BDI‐21, with a strong correlation coefficient of 0.605 between the two factors. In the network analysis, PQ‐B and BDI‐21 both formed their own clusters, and two significant pathways were estimated between PQ‐B and BDI‐21 clusters: 1. the association between paranoid thinking and distorted body image, and 2. the association between somatic preoccupation and worry about problems of one's mind. Conclusions: Even though on a general, factor level, PLEs and depressive symptoms were strongly correlated, unique associations between symptoms of the two constructs were sparse. These findings should be considered in the psychiatric assessment and in the care of adolescents. [ABSTRACT FROM AUTHOR]

Schools are among the most important setting for preventive interventions among adolescents. There are evidence-based intervention programs for adolescents at risk for and with early signs of mental health problems but one demanding task is to detect the ones who are in need of an intervention. The aim of the present study was to analyze associations between self-esteem, depressive symptoms, and social anxiety in order to determine clinically relevant cut-points for male and female adolescents' self-esteem as measured with the Rosenberg Self-Esteem Scale (RSES). The participants of the present prospective study, started in 2002-2003, were 2070 adolescents aged 15 years (1,167 girls and 903 boys) at two study sites in Finland who participated at both baseline and 2-year follow-up. Self-esteem was related to depressive symptoms and social anxiety, and the RSES was able to discriminate between cases of depression and social phobia. The present study suggests a cutoff of 25 points to classify low self-esteem in both girls and boys. Low self-esteem may function as an indicator of various forms of internalizing psychopathology. The RSES is worth further examination as a potential screening tool for adolescents in risk of psychopathology. (Contains 4 tables and 2 figures.)

Earlier research has associated early puberty with emotional and behavioral symptoms particularly among girls, while among boys, findings have been contradictory as to whether risks are associated with early or late pubertal timing. We studied the association between pubertal timing and substance use behaviors in middle adolescence in a 2-year follow up study of 2,070 (mean age 15.5 years, SD 0.36; 56.4% females) Finnish adolescents. Pubertal timing was measured by age at menarche/oigarche. Eleven years or less was classified as early, 12-13 years as normative and 14 years or later as late pubertal timing. Substance use behaviors were elicited by a number of questions related to alcohol use patterns, smoking and cannabis use. As factors that could explain the association between pubertal timing and substance use, we studied depressive symptoms, delinquency and aggression, and parental monitoring. In boys, all these substance use behaviors were the more common the earlier the puberty and the associations persisted at age 17. Among girls, early pubertal timing was similarly associated with substance use behaviors at age 15, but no longer at age 17. The associations between pubertal timing and substance use behaviors persisted when symptom dimensions and parental monitoring were added into the models. Early puberty is a risk factor for substance use particularly among boys. Among girls, the impact of pubertal timing already tempers off during adolescence.

Associations of peer victimization with adolescent depression and social phobia (SP), while controlling for comorbidity between them, have not been sufficiently explored in earlier research. A total of 3156 Finnish adolescents aged 15-16 years participated in a survey study. Self-reported peer victimization, as well as self-reported depression (Beck Depression Inventory), SP (Social Phobia Inventory), and selected background variables were assessed. Frequency of overt and covert peer victimization was examined among four groups: (1) adolescents with depression non-comorbid with SP (DEP), (2) those with SP non-comorbid with depression (SP), (3) those with both SP and depression (SP+DEP), and (4) controls, with neither. A logistic regression analysis controlling for confounding familial (family moving, parental unemployment), and psychopathology (delinquency, aggressiveness, general anxiety) covariates was conducted to confirm the associations between peer victimization and the four groups. Among boys the comorbid SP+DEP group reported the highest rates of both overt and covert victimization, these being significantly higher than among both DEP and SP groups. Among girls covert victimization was again most frequent in the SP+DEP group, but overt victimization was not more frequent in the comorbid group than it was in the DEP and SP groups. In the logistic regression analysis depression without SP did not maintain an independent association with either type of victimization. Instead, SP without depression with ORs from 2.8 to 4.3, and SP comorbid with depression, with ORs between 3.2 and 11.4 had independent associations with peer victimization. In conclusion, overt and covert peer victimization seem to be associated with SP, rather than depression, among adolescents. (Contains 2 figures and 3 tables.)

The study aimed to investigate the associations between different levels of depression with different aspects of school performance. The target population included 2516 7th-9th grade pupils (13-17 years) of whom 90% completed the questionnaire anonymously in the classroom. Of the girls 18.4% and of the boys 11.1% were classified as being depressed (R-Beck Depression Inventory (BDI), the Finnish version of the 13-item BDI). The lower the self-reported grade point average (GPA) or the more the GPA had declined from the previous term, the more commonly the adolescents were depressed. Depression was associated with difficulties in concentration, social relationships, self-reliant school performance and reading and writing as well as perceiving schoolwork as highly loading. The school performance variables had similar associations with depression among both sexes when a wide range of depression was studied but gender differences appeared when studying the severe end of the depression scale. Our study indicates that pupils reporting difficulties in academic performance should be screened for depression. (Contains 2 tables.)