Youth Mental Health

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Psychiatry".

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 24106

Special Issue Editors

Department of Psychiatry, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
Interests: clinical psychiatry; epidemiology; social psychiatry; early intervention in mental health; promotion of mental health
Special Issues, Collections and Topics in MDPI journals
Suicide Prevention Centre, Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
Interests: suicide and suicide prevention; public health; well-being; youth mental health
Special Issues, Collections and Topics in MDPI journals
Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy
Interests: stigma; prevention of mental disorders; school-age approaches to mental health problems; pathways to care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Mental health problems represent the largest burden of disease in young people. In fact, the majority of severe mental disorders has an onset during adolescence or young adulthood. When these disorders are not promptly and adequately treated, the consequences are serious in terms of poor personal and social functioning, and unsatisfactory quality of life. Several risk factors have been identified for the onset of mental disorders in youth. In particular, drug and alcohol use, neglect, physical or sexual abuse, violence, marginalization, bullying, and traumas are the most consistent ones. Therefore, there is an urgent need to develop preventive strategies in order to improve mental health and wellbeing among young people, as well as to promote early interventions aiming to detect and properly treat mental disorders already at their onset.

In recent decades, there has been a paradigm shift in the provision of mental health care, with the affirmation of the model of early intervention in psychosis. Following recent evidence that the onset of the various mental disorders is not yet differentiated, this paradigm has further shifted to youth mental health care, which is a more integrated treatment approach for young people aged 12–25 years suffering from any mental health disturbance.

This reform is still in its infancy, and several obstacles have been identified in the access to mental health services by young people. These obstacles include stigma and discrimination, with a consequent delay in help-seeking, lack of knowledge about mental health disorders, concerns about confidentiality, and fragmentation of mental health services.

We encourage you and your coworkers to submit articles on this topic. Reviews or original articles dealing with the provision of innovative interventions or programmes for young people, or research reports on the obstacles facing youth mental health care or on the impact of risk factors (such as use of cannabis, novel psychoactive substances, cyberbullying, etc.) on the development of mental disorders in young people, are particularly welcome.

Dr. Andrea Fiorillo
Prof. Dr. Maurizio Pompili
Dr. Gaia Sampogna
Guest Editors

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Keywords

  • Youth mental health
  • Public mental health
  • Ultra-high-risk patients
  • Early onset
  • Early intervention for mental disorders
  • Cannabis
  • Novel psychoactive substances
  • Pathways to care

Published Papers (7 papers)

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Research

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14 pages, 336 KiB  
Article
The Relationship between PID-5 Personality Traits and Mental States. A Study on a Group of Young Adults at Risk of Psychotic Onset
by Maria Meliante, Chiara Rossi, Lara Malvini, Clara Niccoli, Osmano Oasi, Simona Barbera and Mauro Percudani
Medicina 2021, 57(1), 33; https://doi.org/10.3390/medicina57010033 - 01 Jan 2021
Cited by 7 | Viewed by 2381
Abstract
Background and Objectives: The diagnosis of psychosis is a challenge for the scientific community, both in terms of its definition and treatment. Some recent studies have investigated the relationship between personality and psychosis onset to prevent or intervene early. Materials and Methods [...] Read more.
Background and Objectives: The diagnosis of psychosis is a challenge for the scientific community, both in terms of its definition and treatment. Some recent studies have investigated the relationship between personality and psychosis onset to prevent or intervene early. Materials and Methods: Sixty young adults were recruited during their first access in 2019 near the Community Mental Health Service of Niguarda Hospital, Milan, Italy. The assessment included the Social and Occupational Functioning Assessment Scale (SOFAS), the Global Assessment of Functioning (GAF) (clinician scales), the 16-item Version of the Prodromal Questionnaire (PQ-16), the Personality Inventory for DSM-5 (PID-5) (self-report), and a clinical session. Statistical analysis was performed by SPSS. Results: The results show a negative correlation between the Detachment domain and the GAF scores. Correlational analysis also highlights that all PID-5 domains, except for Antagonism, have positive correlations with high scores in the PQ-16. The multivariate analysis of variance showed that patients diagnosed with versus without a psychotic disorder significantly differed on Detachment, Antagonism and Psychoticism PID-5 domains. Conclusions: The involvement of the personality construct in psychopathological development is displayed. In particular, higher levels of Detachment and Psychoticism can distinguish people who are more vulnerable to psychosis or who already have overt psychosis from those who do not have a psychotic predisposition. The study highlights the fundamental role of personality traits, emerging from PID-5, to distinguish young adults at risk of onset. Full article
(This article belongs to the Special Issue Youth Mental Health)
10 pages, 321 KiB  
Article
Young Patients with Anorexia Nervosa: The Contribution of Post-Traumatic Stress Disorder and Traumatic Events
by Paola Longo, Enrica Marzola, Carlotta De Bacco, Matilde Demarchi and Giovanni Abbate-Daga
Medicina 2021, 57(1), 2; https://doi.org/10.3390/medicina57010002 - 22 Dec 2020
Cited by 16 | Viewed by 3674
Abstract
Background and Objectives: Anorexia nervosa (AN) is a complex disorder whose etiopathogenesis involves both biological and environmental factors. The aims of the present study were to retrospectively analyze risk factors in young patients with AN and to assess differences in clinical and [...] Read more.
Background and Objectives: Anorexia nervosa (AN) is a complex disorder whose etiopathogenesis involves both biological and environmental factors. The aims of the present study were to retrospectively analyze risk factors in young patients with AN and to assess differences in clinical and eating-related symptoms between patients with and without a diagnosis of post-traumatic stress disorder (PTSD) and with or without a history of acknowledged risk factors. Materials and Methods: Sixty-four patients with AN (<25 years old) were recruited and completed an anamnestic evaluation and the following self-report measures: Eating Disorder Examination Questionnaire (EDE-Q), Childhood Trauma Questionnaire (CTQ), State-Trait Anxiety Inventory (STAI-Y), Beck Depression Inventory (BDI), Life Events Checklist (LEC), and Dissociative Experience Scale (DES). The PTSD diagnosis was assigned according to the Structured Clinical Interview for the DSM-5 (SCID-5). Results: The most frequent risk factors were those associated with relational traumatic events and familiarity for psychiatric disorders. Higher severity of body-related symptoms (i.e., those symptoms impacting on body image and perception and leading to body concerns) emerged in patients with PTSD, versus patients without PTSD diagnosis; however, after controlling for dissociative symptoms, only differences in BMI remained significant. Concerning other risk factors, those with a history of childhood trauma were more depressed than patients without such history and those with familiarity with eating disorders reported more AN-related hospitalizations in the past than those individuals without familiarity. Conclusion: These results suggest the importance of investigating the presence of risk factors and PTSD diagnosis in patients with AN, and to treat post-traumatic symptoms in young patients in order to decrease the risk of developing severe forms of AN. Moreover, a particular focus on those patients with a family member affected by an eating disorder could be of clinical utility. Full article
(This article belongs to the Special Issue Youth Mental Health)
9 pages, 477 KiB  
Article
Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study
by Francesco Bartoli, Daniele Cavaleri, Federico Moretti, Bianca Bachi, Angela Calabrese, Tommaso Callovini, Riccardo M. Cioni, Ilaria Riboldi, Renata Nacinovich, Cristina Crocamo and Giuseppe Carrà
Medicina 2020, 56(11), 613; https://doi.org/10.3390/medicina56110613 - 15 Nov 2020
Cited by 16 | Viewed by 2945
Abstract
Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults [...] Read more.
Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults with severe mental disorders. Materials and Methods: Data for ≤25-year-old inpatients with a severe mental disorder and consecutively admitted between 1 January 2016 and 30 June 2019 were collected. Subjects were retrospectively assessed over a follow-up period of one year after the index discharge to track readmissions—i.e., the primary outcome variable. Standard descriptive statistics were used. The association between variables and 1-year rehospitalization was estimated using the univariate Cox proportional hazards regression model. We then carried out a multivariable Cox regression model, also estimating the covariate-adjusted survivor function. Hazard ratios (HRs) with related 95% confidence intervals (95% CIs) were provided. Results: The final sample included 125 individuals. The multivariable Cox regression model estimated that co-occurring substance use disorders (HR = 2.14; 95% CI: 1.08 to 4.26; p = 0.029) and being admitted for a suicide attempt (HR = 2.49; 95% CI: 1.13 to 5.49; p = 0.024) were both significant predictors of 1-year rehospitalization. Conclusions: Our study showed that comorbid substance use disorders and being admitted for a suicide attempt were predictors of early readmission in youths with severe mental disorders. Although their generalizability is limited, our findings could contribute to improve the quality of young patients’ mental health care by identifying vulnerable subjects who may benefit from tailored interventions to prevent rehospitalizations. Full article
(This article belongs to the Special Issue Youth Mental Health)
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Review

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13 pages, 2518 KiB  
Review
The Role of New Technologies to Prevent Suicide in Adolescence: A Systematic Review of the Literature
by Alberto Forte, Giuseppe Sarli, Lorenzo Polidori, David Lester and Maurizio Pompili
Medicina 2021, 57(2), 109; https://doi.org/10.3390/medicina57020109 - 26 Jan 2021
Cited by 17 | Viewed by 6169
Abstract
Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the [...] Read more.
Background and objectives: Suicide in adolescents represents a major public health concern. To date, a growing number of suicide preventive strategies based on the use of new technologies are emerging. We aimed to provide an overview of the present literature on the use of new technologies in adolescent suicide prevention. Materials and methods: An electronic search was run using the following keywords: Technology OR Technologies OR APP OR Application OR mobile application) AND (Adolescent OR youth OR puberty) AND (Suicid* OR Self-harm OR self-destruction). Inclusion criteria were: English language, published in a peer-reviewed journal, suicide prevention with the use of new technologies among adolescents. Results: Our search strategy yielded a total of 12 studies on the use of telemedicine, 7 on mobile applications, and 3 on language detection. We also found heterogeneity regarding the study design: 3 are randomized controlled trials (RCT), 13 are open-label single group trials, 2 are randomized studies, and 1 is a cross-sectional study. Telemedicine was the most adopted tool, especially web-based approaches. Mobile applications mostly focused on screening of depressive symptoms and suicidal ideation, and for clinical monitoring through the use of text messages. Although telepsychiatry and mobile applications can provide a fast and safe tool, supporting and preceding a face-to-face clinical assessment, only a few studies demonstrated efficacy in preventing suicide among adolescents through the use of these interventions. Some studies suggested algorithms able to recognize people at risk of suicide from the exploration of the language on social media posts. Conclusions: New technologies were found to be well accepted and tolerated supports for suicide prevention in adolescents. However, to date, few data support the use of such interventions in clinical practice and preventive strategies. Further studies are needed to test their efficacy in suicide prevention among adolescents and young adults. Full article
(This article belongs to the Special Issue Youth Mental Health)
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18 pages, 1034 KiB  
Review
Mental Health Disturbances and Related Problems in Italian University Medical Students from 2000 to 2020: An Integrative Review of Qualitative and Quantitative Studies
by Gaia Sampogna, Giovanni Marcos Lovisi, Francesca Zinno, Valeria Del Vecchio, Mario Luciano, Érika Gonçalves Loureiro Sol, Roberto José Gervásio Unger, Antonio Ventriglio and Andrea Fiorillo
Medicina 2021, 57(1), 11; https://doi.org/10.3390/medicina57010011 - 24 Dec 2020
Cited by 6 | Viewed by 2718
Abstract
Background and objectives: The presence of mental health problems in the population of medical students in Italy has been evaluated in several cross-sectional studies, which have used different methodologies and study designs. However, a global overview of the prevalence of mental health [...] Read more.
Background and objectives: The presence of mental health problems in the population of medical students in Italy has been evaluated in several cross-sectional studies, which have used different methodologies and study designs. However, a global overview of the prevalence of mental health problems in Italian medical students is not available, although this would be essential for promoting preventive strategies and supportive treatments. Materials and Methods: An integrative review aiming to describe the prevalence of mental health problems in Italian medical students has been performed. Results: The most relevant findings are the high prevalence of substance use, in particular alcohol and nicotine, and of depressive and anxiety disorders in Italian medical students. In particular, substance use ranges from 13 to 86%, which is higher compared to Italian students coming from other faculties. Italian medical students show a high rate of smoking and of depressive symptoms of about 20%. Conclusions: Our findings highlight the need to develop appropriate supportive interventions for the medical student population, which are rarely provided and implemented among the routine activities of Italian medical universities. A relevant aspect to be considered is the stigma and anticipated discrimination attached to mental disorders, which reduce the help-seeking process in medical students. Full article
(This article belongs to the Special Issue Youth Mental Health)
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15 pages, 742 KiB  
Review
Environmental Risk Factors for Bipolar Disorders and High-Risk States in Adolescence: A Systematic Review
by Giulia Menculini, Pierfrancesco Maria Balducci, Luigi Attademo, Francesco Bernardini, Patrizia Moretti and Alfonso Tortorella
Medicina 2020, 56(12), 689; https://doi.org/10.3390/medicina56120689 - 11 Dec 2020
Cited by 10 | Viewed by 3044
Abstract
Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic [...] Read more.
Background and objectives: A deeper comprehension of the role that environmental risk factors play in the development of adolescent Bipolar Disorder (BD), as well as in the evolution of high-risk states for BD, may entangle further prevention and treatment advances. The present systematic review is aimed at critically summarizing evidence about the role that environmental risk factors play in the development of BD in adolescence and their interaction with BD high-risk states. Materials and Methods: MEDLINE/Pubmed, Scopus and Web of Science datasets were systematically searched until 4 September 2020. Original studies that reported information about the role of environmental risk factors in the development of BD during adolescence, or assessing their influence on the development of psychopathology in high-risk states for BD, were considered for inclusion. Two blind researchers performed title/abstract, full-text screening, and hand-screening of relevant references. The risk of bias was assessed by means of the Newcastle-Ottawa Scale. Results: Fourteen studies were included in the review. Negative stressful life events, particularly sexual and physical abuse, but also emotional mistreatment, were associated with more severe psychopathology in adolescents with BD, as well as with higher risk for developing mood disorders in BD offspring. Similar findings were detected for familial environment-related features, such as parental rejection and low perceived care, while no univocal results were found when analyzing familial functioning. Conclusions: The present systematic review confirmed the relevant role that environmental risk factors, particularly negative stressful live events and family-related features, play in the development of BD psychopathology during adolescence. Future studies are expected to clarify possible further environmental factors that may be implicated in the development of BD during youth that may serve as target of prevention and early treatment strategies. Full article
(This article belongs to the Special Issue Youth Mental Health)
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11 pages, 348 KiB  
Review
A Synthetic Literature Review on the Management of Emerging Treatment Resistance in First Episode Psychosis: Can We Move towards Precision Intervention and Individualised Care?
by Siân Lowri Griffiths and Max Birchwood
Medicina 2020, 56(12), 638; https://doi.org/10.3390/medicina56120638 - 24 Nov 2020
Cited by 3 | Viewed by 2162
Abstract
Treatment resistance is prevalent in early intervention in psychosis services, and causes a significant burden for the individual. A wide range of variables are shown to contribute to treatment resistance in first episode psychosis (FEP). Heterogeneity in illness course and the complex, multidimensional [...] Read more.
Treatment resistance is prevalent in early intervention in psychosis services, and causes a significant burden for the individual. A wide range of variables are shown to contribute to treatment resistance in first episode psychosis (FEP). Heterogeneity in illness course and the complex, multidimensional nature of the concept of recovery calls for an evidence base to better inform practice at an individual level. Current gold standard treatments, adopting a ‘one-size fits all’ approach, may not be addressing the needs of many individuals. This following review will provide an update and critical appraisal of current clinical practices and methodological approaches for understanding, identifying, and managing early treatment resistance in early psychosis. Potential new treatments along with new avenues for research will be discussed. Finally, we will discuss and critique the application and translation of machine learning approaches to aid progression in this area. The move towards ‘big data’ and machine learning holds some prospect for stratifying intervention-based subgroups of individuals. Moving forward, better recognition of early treatment resistance is needed, along with greater sophistication and precision in predicting outcomes, so that effective evidence-based treatments can be appropriately tailored to the individual. Understanding the antecedents and the early trajectory of one’s illness may also be key to understanding the factors that drive illness course. Full article
(This article belongs to the Special Issue Youth Mental Health)
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