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Background: Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of rheumatic conditions in children. Novel drugs have greatly improved disease outcomes; however, outcomes are impacted by limited awareness of the importance of early diagnosis and adequate treatment, and by differences in access across health systems. As a result, patients with JIA continue to be at risk for short- and long-term morbidity, as well as impacts on virtually all aspects of life of the child and family. Main body: Literature on the socioeconomic burden of JIA is largely focused on healthcare costs, and the impact of JIA on patients, families, and communities is not well understood. High quality evidence on the impact of JIA is needed to ensure that patients are receiving necessary support, timely diagnostics, and adequate treatment, and to inform decision making and resource allocation. This commentary introduces the European Joint Programme on Rare Diseases: Producing an Arthritis Value Framework with Economic Evidence: Paving the Way for Rare Childhood Diseases (PAVE) project, which will co-develop a patient-informed value framework to measure the impact of JIA on individuals and on society. With a patient-centered approach, fundamental to PAVE is the involvement of three patient advocacy organizations from Canada, Israel, and Europe, as active research partners co-designing all project phases and ensuring robust patient and family engagement. The framework will build on the findings of projects from six countries: Canada, Germany, Switzerland, Spain, Israel, and Belgium, exploring costs, outcomes (health, well-being), and unmet needs (uveitis, mental health, equity). Conclusion: This unique international collaboration will combine evidence on costs (from family to societal), outcomes (clinical, patient and family outcomes), and unmet needs, to co-design and build a framework with patients and families to capture the full impact of JIA. The framework will support the development of high-quality evidence, encompassing economic and clinical considerations, unmet needs, and patient perspectives, to inform equitable resource allocation, health system planning, and quality of care better aligned with the needs of children with JIA, their families, and communities. Knowledge gained from this novel approach may pave the way forward to be applied more broadly to other rare childhood diseases. [ABSTRACT FROM AUTHOR]

Background: Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of rheumatic conditions in children. Novel drugs have greatly improved disease outcomes; however, outcomes are impacted by limited awareness of the importance of early diagnosis and adequate treatment, and by differences in access across health systems. As a result, patients with JIA continue to be at risk for short- and long-term morbidity, as well as impacts on virtually all aspects of life of the child and family. Main body: Literature on the socioeconomic burden of JIA is largely focused on healthcare costs, and the impact of JIA on patients, families, and communities is not well understood. High quality evidence on the impact of JIA is needed to ensure that patients are receiving necessary support, timely diagnostics, and adequate treatment, and to inform decision making and resource allocation. This commentary introduces the European Joint Programme on Rare Diseases: Producing an Arthritis Value Framework with Economic Evidence: Paving the Way for Rare Childhood Diseases (PAVE) project, which will co-develop a patient-informed value framework to measure the impact of JIA on individuals and on society. With a patient-centered approach, fundamental to PAVE is the involvement of three patient advocacy organizations from Canada, Israel, and Europe, as active research partners co-designing all project phases and ensuring robust patient and family engagement. The framework will build on the findings of projects from six countries: Canada, Germany, Switzerland, Spain, Israel, and Belgium, exploring costs, outcomes (health, well-being), and unmet needs (uveitis, mental health, equity). Conclusion: This unique international collaboration will combine evidence on costs (from family to societal), outcomes (clinical, patient and family outcomes), and unmet needs, to co-design and build a framework with patients and families to capture the full impact of JIA. The framework will support the development of high-quality evidence, encompassing economic and clinical considerations, unmet needs, and patient perspectives, to inform equitable resource allocation, health system planning, and quality of care better aligned with the needs of children with JIA, their families, and communities. Knowledge gained from this novel approach may pave the way forward to be applied more broadly to other rare childhood diseases. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare. Methods: We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018—February 28th, 2022), analyzing the numbers of ED visits (including patients' age, triage categories, and urgent vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utilization was assessed by interrupted time series (ITS) modelling. Results: Based on 304′438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual recovery. This primarily affected children 0–4 years, and both non-urgent and urgent cases. However, the decline in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic. Conclusions: The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, particularly among children 0–4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pandemic. Furthermore, future policy decisions should take regional differences into account. [ABSTRACT FROM AUTHOR]

Background: Though Internet- and mobile-based interventions (IMIs) and mindfulness-based interventions (generally delivered in-situ) appear effective for people with substance use disorders, IMIs incorporating mindfulness are largely missing, including those targeting frequent cannabis use. Methods: This paper details the protocol for a three-arm randomized controlled trial comparing a mindfulness-based self-help IMI (arm 1) and cognitive-behavioral therapy (CBT)-based self-help IMI (arm 2) versus being on a waiting list (arm 3) in their effectiveness reducing cannabis use in frequent cannabis users. Predictors of retention, adherence and treatment outcomes will be identified and similarities between the two active intervention arms explored. Both active interventions last six weeks and consist of eight modules designed to reduce cannabis use and common mental health symptoms. With a targeted sample size of n = 210 per treatment arm, data will be collected at baseline immediately before program use is initiated; at six weeks, immediately after program completion; and at three and six months post baseline assessment to assess the retention of any gains achieved during treatment. The primary outcome will be number of days of cannabis use over the preceding 30 days. Secondary outcomes will include further measures of cannabis use and use of other substances, changes in mental health symptoms and mindfulness, client satisfaction, intervention retention and adherence, and adverse effects. Data analysis will follow ITT principles and primarily employ (generalized) linear mixed models. Discussion: This RCT will provide important insights into the effectiveness of an IMI integrating mindfulness to reduce cannabis use in frequent cannabis users. Trial registration: International Standard Randomized Controlled Trial Number Registry: ISRCTN14971662; date of registration: 09/09/2021. [ABSTRACT FROM AUTHOR]

Response rates in epidemiological studies have generally been decreasing over the past decades. However, when the target group consists of adolescents and young adults, school-based surveys have hitherto been able to mitigate this problem: This age group can be reached relatively easy in the school context (e.g., as compared to reaching them by phone) with very low refusal rates at the student level. However, the present study used a mixed-methods approach and suggests that schools at the organizational level have meanwhile become the problematic bottleneck for school-based surveys, as they increasingly reject requests for study participation. The current article provides insights into promising means for counteracting this trend. Researchers are advised to offer flexible timeframes for schools' participation and to involve institutional gatekeepers who are endorsing their study. Furthermore, researchers, funding agencies, and schools would benefit from joint regional survey coordination systems. Such means will be crucial for the representativeness of future school-based epidemiological surveys. [ABSTRACT FROM AUTHOR]

Background Online preventive interventions can help to reduce the incidence of mental disorders. Whereas knowledge on stakeholders' attitudes and factors relevant for successfully integrating online treatment into existing healthcare systems is available, knowledge is scarce for online prevention. Methods Stakeholders from Germany, Switzerland, Austria and Spain were surveyed. Potential facilitators/delivery staff (e.g. psychologists, psychotherapists) completed an online questionnaire (n  = 183), policy makers (i.e. from the governing sector or health insurance providers) participated in semi-structured interviews (n  = 16) and target groups/potential users of mental illness prevention (n  = 49) participated in ten focus groups. Thematic analysis was used to identify their experiences with and attitudes and needs regarding online programmes to prevent mental disorders. Additionally, it was examined which groups they consider underserved and which factors they consider as fostering and hindering for reach, adoption, implementation and maintenance (cf. RE-AIM model) when integrating online prevention into existing healthcare systems. Results Main advantages of online mental illness prevention are perceived in low structural and psychological barriers. Lack of personal contact, security, privacy and trust concerns were discussed as disadvantages. Relevant needs are high usability and target group appropriateness, evidence for effectiveness and the use of motivational tools. Conclusions Positive attitudes among stakeholders are the key for successful integration of online mental illness prevention into existing healthcare systems. Potential facilitators/delivery staff must receive training and support to implement these programmes; the programmes must be attractive and continuously evaluated, updated and promoted to ensure ongoing reach; and existing infrastructure and contextual factors must be considered. [ABSTRACT FROM AUTHOR]

Background: Previous research on public stigma towards people with mental disorders has mostly targeted adult samples and focused on depression, schizophrenia or mental disorders in general. Hence, the present study aimed to investigate predictors of stigmatizing attitudes towards different mental disorders (including less researched ones) in a representative sample of adolescents and young adults. Methods: Data from the Swiss Youth Mental Health Literacy and Stigma Survey were used (analytical sample: n = 4,932). Each participant was randomly presented with one of five vignettes (depression; alcohol abuse; depression and alcohol abuse combined; schizophrenia; social anxiety). The structure of stigmatizing attitudes was assessed using confirmatory factor analysis. Regression models, implemented within a structural equation framework, were used to study predictors for the identified latent variables. Results: A three-factor model for stigmatizing attitudes–consisting of 'dangerous/unpredictable', 'weak-no-sick', and 'social distance' factors–best fitted the data. Female gender was associated with less stigmatizing attitudes. Associations in opposite directions with different latent factors were found for educational and migration background. Exposure to mental disorders (being personally affected, personally having received professional help or knowing someone close who has received treatment for a mental disorder) was either not or was negatively associated with stigmatizing attitudes. In contrast, current mental health symptoms (heightened levels of psychological distress, problematic alcohol use) were generally not or were positively associated with stigmatizing attitudes. Even though the included predictors had some predictive value, the variance explained by the models was rather small (the adjusted R2 varied between 0.03 and 0.26). Conclusions: The current study indicates that contact with someone who has received treatment for a mental disorder might be an important component of programs aiming to decrease stigmatizing attitudes towards people with mental disorders, since this exposure variable predicted lower levels of stigmatizing attitudes. Furthermore, the findings suggest that target-group interventions for specific subgroups need to be considered, as the process leading to stigmatizing attitudes towards people with mental disorders appears to differ between specific sociodemographic subgroups. [ABSTRACT FROM AUTHOR]

This study aimed to examine associations between risk factors suggested in the pathway model proposed by Billieux et al., demographic and substance use variables, and problematic smartphone use (PSU). The analytical sample consisted of 5,096 Swiss men (mean age = 25.5 years, SD = 1.26). Multiple linear regression analyses were conducted with PSU as dependent and the following as independent variables: (a) Billieux's pathway model variables (depression, social anxiety, ADHD, aggression–hostility, and sensation seeking); (b) substance use variables [alcohol: at-risk risky single-occasion drinking (RSOD); at-risk volume drinking; tobacco use: daily smoking; illicit drug use: more than weekly cannabis use; having used at least one other illicit drug besides cannabis over the preceding 12 months]; and (c) sociodemographic variables (age, language region, and education). All pathway-model variables except sensation seeking were significant predictors of PSU, especially symptoms of social anxiety (β = 0.196) and ADHD (β = 0.184). At-risk RSOD was positively (β = 0.071) associated with PSU, whereas both frequent cannabis use (β = −0.060) and daily cigarette smoking (β = −0.035) were negatively associated with PSU. Higher-achieved educational levels and being from the German-speaking part of Switzerland predicted PSU. The findings of this study can be used to develop tailored interventional programs that address the co-occurrence of certain risky behaviors (e.g., at-risk RSOD and PSU) and target individuals who might be particularly prone to PSU. Such interventions would need to ensure that addressing one problem (e.g., decreasing PSU) does not lead to some other compensatory behavior (e.g., frequent cigarette smoking). [ABSTRACT FROM AUTHOR]

Background and aims: Opioid agonist treatment (OAT) is currently the most effective treatment for people with opioid dependence. In most countries, however, access to the whole range of effective medications is restricted. This study aims to model the distribution of different OAT medications within a naturalistic and relatively unrestricted treatment setting (Zurich, Switzerland) over time, and to identify patient characteristics associated with each medication. Methods: We used generalized estimating equation analysis with data from the OAT register of Zurich and the Swiss register for heroin‐assisted treatment (HAT) to model and forecast the annual proportion of opioids applying exponential distributions until 2018 and patient characteristics between 1992 and 2015. Results: Data from 11 895 patients were included in the analysis. Methadone remains the mainstay of OAT, being prescribed to two‐thirds of patients. Following its approval, the proportion of HAT increased rapidly and is now constant at 12.16% [95% confidence interval (CI) = 11.15–13.17]. The initial increase of proportions of buprenorphine or slow‐release oral morphine (SROM) following their approval for OAT was slower. While in 2014 both medications had a proportion of 10.2% and 10.3%, respectively, our model predicts a further increase of SROM to 19.9% in 2018, with a ceiling level of 25.19% (21.40–28.98%) thereafter. SROM patients display characteristics similar to those treated with methadone; buprenorphine patients show the highest social integration; and HAT patients are the most homogeneous group, with highest mean age, most widespread injecting experience and lowest social integration. Conclusions: Based on data from Zurich, Switzerland from 1992 to 2015, there is no evidence for an excessive demand for a single medication in a naturalistic and liberal opioid agonist treatment setting. Rather, the specific patient characteristics associated with each medication underline the need for diversified treatment options for opioid dependence. [ABSTRACT FROM AUTHOR]

Introduction: In the general population, alcohol use disorder and depression more often occur together than any other combination of a mental illness with a substance use disorder. It is important to have a costeffective intervention that is able to reach at-risk individuals in the early stages of developing alcohol use disorders and depression disorders. Methods and analysis: This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions' cost-utility and costeffectiveness, a full economic evaluation will be performed. Ethics and dissemination: This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peerreviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites. [ABSTRACT FROM AUTHOR]

Purpose: This study examined cross-sectional time trends in health complaints among adolescents living in Switzerland, including differences between population subgroups and sources of differential response to items. Methods: Swiss data were analysed from the Health Behaviour in School-aged Children (HBSC; including 11-15 years old) from 1994 ( n = 7008), 1998 ( n = 8296), 2002 ( n = 9066) and 2006 ( n = 9255). Structural equation modelling was used to assess (1) the structure of the HBSC Symptom Checklist (HBSC-SCL; questionnaire, which asks about the frequency of eight health complaints) and (2) associations between the HBSC-SCL with year of data collection and demographic characteristics of the participants. Results: Two correlated factors fitted the data better than a single factor. The psychological factor included the items 'feeling low,' 'irritability and bad temper,' 'nervousness' and 'difficulties in getting to sleep,' and the somatic factor the items 'headache', 'backache', 'stomach ache' and 'dizziness'. Relative to 1994, lower levels of psychological health complaints were experienced in 1998, 2002 and 2006. However, the changes were only minor. In contrast, somatic health complaints increased monotonically over the years of the survey. Experiencing psychological and somatic health complaints was more pronounced with age among females relative to males and was associated with living in particular language regions of Switzerland. Conclusions: Different cross-sectional time trends were identified for the psychological and somatic latent variables, indicating that both factors should be investigated when studying period effects. [ABSTRACT FROM AUTHOR]

Background and aims Previous studies suggest that the new DSM-5 criteria for alcohol use disorder (AUD) will increase the apparent prevalence of AUD. This study estimates the 12-month prevalence of AUD using both DSM-IV and DSM-5 criteria and compares the characteristics of men in a high risk sample who meet both, only one and neither sets of diagnostic criteria. Design, setting and participants 5943 Swiss men aged 18-25 years who participated in the Cohort Study on Substance Use Risk Factors (C-SURF), a population-based cohort study recruited from three of the six military recruitment centres in Switzerland (response rate = 79.2%). Measurements DSM-IV and DSM-5 criteria, alcohol use patterns, and other substance use were assessed. Findings Approximately 31.7% (30.5-32.8) of individuals met DSM-5 AUD criteria [21.2% mild (20.1-22.2); 10.5% moderate/severe (9.7-11.3)], which was less than the total rate when DSM-IV criteria for alcohol abuse (AA) and alcohol dependence (AD) were combined [36.8% overall (35.5-37.9); 26.6% AA (25.4-27.7); 10.2% AD (9.4-10.9)]. Of 2479 respondents meeting criteria for either diagnoses, 1585 (63.9%) met criteria for both. For those meeting DSM-IV criteria only ( n = 598, 24.1%), hazardous use was most prevalent, whereas the criteria larger/longer use than intended and tolerance to alcohol were most prevalent for respondents meeting DSM-5 criteria only ( n = 296, 11.9%). Two in five DSM-IV alcohol abuse cases and one-third of DSM-5 mild AUD individuals fulfilled the diagnostic criteria due to the hazardous use criterion. The addition of the craving and excluding of legal criterion, respectively, did not affect estimated AUD prevalence. Conclusions In a high-risk sample of young Swiss males, prevalence of alcohol use disorder as diagnosed by DSM-5 was slightly lower than prevalence of DSM-IV diagnosis of dependence plus abuse; 63.9% of those who met either criterion met criteria for both. [ABSTRACT FROM AUTHOR]

Purpose: To compare children with mental and physical health problems regarding (1) perceived disease severity; (2) the impact of their condition on their families; (3) their utilization of health care services (including satisfaction with care); and (4) parents' health literacy about their child's condition and its treatment. Furthermore, we examined whether parents' health literacy differs between types of mental health condition. Methods: Parental reports about their 9- to 14-year-old children with mental ( n = 785) or physical health problems ( n = 475) were analyzed from the population-based National Survey of Children with Special Health Care Needs in Switzerland. Results: Mental health problems were perceived as being more severe ( p < 0.001) and exerting a larger impact upon the family (e.g., financial impact) than physical health problems. Furthermore, fewer parents of children with a mental health problem mentioned having a particular person or place to contact if they needed information or advice regarding the child's condition ( p = 0.004) and were satisfied with the health care services their child received ( p < 0.001). The odds of low health literacy was higher among parents with children suffering from mental health problems vs. parents of children with physical health problems (OR in the adjusted model = 1.92; 95 % CI 1.47-2.50; p < 0.001); this finding held generally for mental health problem (although only a trend was observable for internalizing problems). Conclusions: The large impact of children's mental health conditions on themselves and their families might be reduced by adapting the provision of health care and by increasing parents' health literacy. [ABSTRACT FROM AUTHOR]

Background: Studies about beverage preferences in a country in which wine drinking is relatively widespread (like Switzerland) are scarce. Therefore, the main aims of the present study were to examine the associations between beverage preferences and drinking patterns, alcohol-related consequences and the use of other substances among Swiss young men. Methods: The analytical sample consisted of 5399 Swiss men who participated in the Cohort Study on Substance Use Risk Factors (C-SURF) and had been drinking alcohol over the preceding 12 months. Logistic regression analyses were conducted to study the associations between preference for a particular beverage and (i) drinking patterns, (ii) negative alcohol-related consequences and (iii) the (at-risk) use of cigarettes, cannabis and other illicit drugs. Results: Preference for beer was associated with risky drinking patterns and, comparable with a preference for strong alcohol, with the use of illicit substances (cannabis and other illicit drugs). In contrast, a preference for wine was associated with low-risk alcohol consumption and a reduced likelihood of experiencing at least four negative alcohol-related consequences or of daily cigarette smoking. Furthermore, the likelihood of negative outcomes (alcohol-related consequences; use of other substances) increased among people with risky drinking behaviours, independent of beverage preference. Conclusions: In our survey, beer preference was associated with risky drinking patterns and illicit drug use. Alcohol polices to prevent large quantities of alcohol consumption, especially of cheaper spirits like beer, should be considered to reduce total alcohol consumption and the negative consequences associated with these beverage types. [ABSTRACT FROM AUTHOR]

Purpose: To examine the associations between substance use and other health-risk behaviors and quality of life (QOL) among young men. Methods: The analytical sample consisted of 5,306 young Swiss men who participated in the Cohort Study on Substance Use Risk Factors. Associations between seven distinct self-reported health-risk behaviors (risky single-occasion drinking; volume drinking; cigarette smoking; cannabis use; use of any other illicit drugs; sexual intercourse without a condom; low physical activity) were assessed via chi-square analysis. Logistic regression analyses were conducted to study the associations between each particular health-risk behavior and either physical or mental QOL (assessed with the SF-12v2) while adjusting for socio-demographic variables and the presence of all other health-risk behaviors. Results: Most health-risk behaviors co-occurred. However, low physical activity was not or negatively related to other health-risk behaviors. Almost all health-risk behaviors were associated with a greater likelihood of compromised QOL. However, sexual intercourse without a condom (not associated with both physical and mental QOL) and frequent risky single-occasion drinking (not related to mental QOL after adjusting for the presence of other health-risk behaviors; positively associated with physical QOL) differed from this pattern. Conclusions: Health-risk behaviors are mostly associated with compromised QOL. However, sexual intercourse without a condom and frequent risky single-occasion drinking differ from this pattern and are therefore possibly particularly difficult to change relative to other health-risk behaviors. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to measure the prevalence of adult attention deficit hyperactivity disorder (ADHD) in a large, representative sample of young Swiss men and to assess factors associated with this disorder. Methods: Our sample consisted of 5656 Swiss men (mean age 20 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed with the World Health Organization (WHO) adult ADHD Self Report Screener (ASRS). Logistic regression analyses were conducted to assess the association between ADHD and several socio-demographic, clinical and familial factors. Results: The prevalence of ADHD was 4.0%, being higher in older and French-speaking conscripts. A higher prevalence also was identified among men whose mothers had completed primary or high school/university and those with a family history of alcohol or psychiatric problems. Additionally, adults with ADHD demonstrated impairment in their professional life, as well as considerable mental health impairment. Conclusion: Our results demonstrate that ADHD is common among young Swiss men. The impairments in function and mental health we observed highlight the need for further support and interventions to reduce burden in affected individuals. Interventions that incorporate the whole family also seem crucial. [ABSTRACT FROM AUTHOR]

Background Studies about the association between body mass index (BMI) and health-related quality of life (HRQOL) are often limited, because they 1) did not include a broad range of health-risk behaviors as covariates; 2) relied on clinical samples, which might lead to biased results; and 3) did not incorporate underweight individuals. Hence, this study aims to examine associations between BMI (from being underweight through obesity) and HRQOL in a population-based sample, while considering multiple health-risk behaviors (low physical activity, risky alcohol consumption, daily cigarette smoking, frequent cannabis use) as well as socio-demographic characteristics. Methods A total of 5 387 young Swiss men (mean age = 19.99; standard deviation = 1.24) of a cross-sectional population-based study were included. BMI was calculated (kg/m²) based on self-reported height and weight and divided into 'underweight' (<18.5), 'normal weight' (18.5-24.9), 'overweight' (25.0-29.9) and 'obese' (≥30.0). Mental and physical HRQOL was assessed via the SF-12v2. Self-reported information on physical activity, substance use (alcohol, cigarettes, and cannabis) and socio-demographic characteristics also was collected. Logistic regression analyses were conducted to study the associations between BMI categories and below average mental or physical HRQOL. Substance use variables and socio-demographic variables were used as covariates. Results Altogether, 76.3 % were normal weight, whereas 3.3 % were underweight, 16.5 % overweight and 3.9 % obese. Being overweight or obese was associated with reduced physical HRQOL (adjusted OR [95 % CI] = 1.58 [1.18-2.13] and 2.45 [1.57-3.83], respectively), whereas being underweight predicted reduced mental HRQOL (adjusted OR [95 % CI] = 1.49 [1.08-2.05]). Surprisingly, obesity decreased the likelihood of experiencing below average mental HRQOL (adjusted OR [95 % CI] = 0.66 [0.46-0.94]). Besides BMI, expressed as a categorical variable, all health-risk behaviors and socio-demographic variables were associated with reduced physical and/or mental HRQOL. Conclusions Deviations from normal weight are, even after controlling for important health-risk behaviors and socio-demographic characteristics, associated with compromised physical or mental HRQOL among young men. Hence, preventive programs should aim to preserve or reestablish normal weight. The self-appraised positive mental well-being of obese men noted here, which possibly reflects a response shift, might complicate such efforts. [ABSTRACT FROM AUTHOR]

Purpose: To examine parent-child agreement regarding a child's health-related quality of life (HRQOL) among three health status groups. Methods: Parent-child agreement was evaluated for three health status groups of a population-based sample: (1) children with mental health problems ( N = 461), (2) children with physical health problems ( N = 281), and (3) healthy controls ( N = 699). The KIDSCREEN-27 was used to assess HRQOL. The children were 9-14 years of age. Results: Intraclass correlation coefficients were mostly good across all HRQOL scores and health status groups. This relatively high level of agreement was also reflected by the following findings: first, the AGREE group was the largest in three out of five HRQOL subscales in all health status groups; second, when disagreement occurred, it was often minor in magnitude. Despite this relatively high level of agreement, the means of self-ratings were significantly higher for all HRQOL scores and health status groups than the means of proxy ratings. These higher self-ratings were especially pronounced among children with mental health problems in certain HRQOL domains. Conclusions: Even though the level of parent-child agreement regarding a child's HRQOL is relatively high, it should be considered that children (especially those with mental health problems) often report better HRQOL than their parents. It is, therefore, highly recommended that both proxy- and self-ratings are used to evaluate a child's HRQOL comprehensively. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review studies about the quality of life (QOL) of children with various mental disorders relative to healthy controls and to describe limitations in these studies.Methods: Relevant articles were searched using different databases, by checking reference lists and contacting experts. We included articles that either compared children with mental disorders to healthy controls/norm values or made such a comparison possible.Results: Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected. The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder.Conclusions: Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gaps. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review studies about the quality of life (QOL) of children with various mental disorders relative to healthy controls and to describe limitations in these studies. Methods: Relevant articles were searched using different databases, by checking reference lists and contacting experts. We included articles that either compared children with mental disorders to healthy controls/norm values or made such a comparison possible. Results: Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected. The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder. Conclusions: Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gaps. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to compare health-related quality of life (HRQoL) between children with special health care needs (CSHCN) and those without. In particular, CSHCN who require psychiatric services and those who do not were compared. Methods: A representative community sample of 3,325 children (10-14 years old) was recruited from the Canton of Zurich. Via either computer-assisted telephone interviews or a written questionnaire, special health care needs were assessed using the five-item parent-reported CSHCN Screener. Subsequent to screening, a written questionnaire was sent to a sub-sample of 974 children to acquire more detailed information, both from the children and their parents, about their health and health care utilization, and to assess HRQoL (KIDSCREEN-27) and emotional and behavioral problems (SDQ). A total of 626 children responded to the questionnaire. Multiple linear regression models were used to examine the association between HRQoL and subject group, controlling for other covariates. Results: Among 2,586 children whose parents participated in the screening stage, roughly 18% were identified as CSHCN, with 6.2% requiring psychiatric services. The subsequent survey revealed that those CSHCN who required psychiatric services had the lowest HRQoL scores and highest SDQ scores. CSHCN who utilized psychiatric services were particularly prone to low HRQoL, especially among lower income families. Conclusions: The influence of noticeable emotional and behavioral problems on HRQoL should be afforded more attention, both in clinical practice and empirical studies involving children with special health care needs. [ABSTRACT FROM AUTHOR]

Background: Children with mental health problems have been neglected in health-related quality of life (HRQOL) studies. Therefore, the aims of the current study were 1) to assess the influence of the presence of mental or physical health problems on HRQOL; and 2) to analyze the effects of item overlap between mental health problems and HRQOL-measurements. Methods: Proxy- and self-rated HRQOL (KIDSCREEN-27) of children 9-14 years old was assessed across children with mental health problems (n = 535), children with physical health problems (n = 327), and healthy controls (n = 744). Multiple linear regression analyses were conducted with health status, severity of symptoms, status of medication use, gender and nationality as independent, and HRQOL scores as dependent variables. The effects of item overlap were analyzed by repeating regression analyses while excluding those HRQOL items that contextually overlapped the most frequently-occurring mental health problem (attention deficits). Results: Severity of symptoms was the strongest predictor of reduced HRQOL. However, all other predictors (except for the status of medication use) also contributed to the prediction of some HRQOL scores. Controlling for item overlap did not meaningfully alter the results. Conclusions: When children with different health constraints are compared, the severity of their particular health problems should be considered. Furthermore, item overlap seems not to be a major problem when the HRQOL of children with mental health problems is studied. Hence, HRQOL assessments are useful to gather information that goes beyond the clinical symptoms of a health problem. This information can, for instance, be used to improve clinical practice. [ABSTRACT FROM AUTHOR]

Background: Studies about the association between body mass index (BMI) and health-related quality of life (HRQOL) are often limited, because they 1) did not include a broad range of health-risk behaviors as covariates; 2) relied on clinical samples, which might lead to biased results; and 3) did not incorporate underweight individuals. Hence, this study aims to examine associations between BMI (from being underweight through obesity) and HRQOL in a population-based sample, while considering multiple health-risk behaviors (low physical activity, risky alcohol consumption, daily cigarette smoking, frequent cannabis use) as well as socio-demographic characteristics.Methods: A total of 5 387 young Swiss men (mean age = 19.99; standard deviation = 1.24) of a cross-sectional population-based study were included. BMI was calculated (kg/m²) based on self-reported height and weight and divided into 'underweight' (<18.5), 'normal weight' (18.5-24.9), 'overweight' (25.0-29.9) and 'obese' (≥30.0). Mental and physical HRQOL was assessed via the SF-12v2. Self-reported information on physical activity, substance use (alcohol, cigarettes, and cannabis) and socio-demographic characteristics also was collected. Logistic regression analyses were conducted to study the associations between BMI categories and below average mental or physical HRQOL. Substance use variables and socio-demographic variables were used as covariates.Results: Altogether, 76.3% were normal weight, whereas 3.3% were underweight, 16.5% overweight and 3.9% obese. Being overweight or obese was associated with reduced physical HRQOL (adjusted OR [95% CI] = 1.58 [1.18-2.13] and 2.45 [1.57-3.83], respectively), whereas being underweight predicted reduced mental HRQOL (adjusted OR [95% CI] = 1.49 [1.08-2.05]). Surprisingly, obesity decreased the likelihood of experiencing below average mental HRQOL (adjusted OR [95% CI] = 0.66 [0.46-0.94]). Besides BMI, expressed as a categorical variable, all health-risk behaviors and socio-demographic variables were associated with reduced physical and/or mental HRQOL.Conclusions: Deviations from normal weight are, even after controlling for important health-risk behaviors and socio-demographic characteristics, associated with compromised physical or mental HRQOL among young men. Hence, preventive programs should aim to preserve or re-establish normal weight. The self-appraised positive mental well-being of obese men noted here, which possibly reflects a response shift, might complicate such efforts. [ABSTRACT FROM AUTHOR]