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Additional file 2: Authors’ background and training.

Additional file 3: COREQ (COnsolidated criteria for REporting Qualitative research) Checklist.

Additional file 1: Qualitative Guidelines.

Supplemental Material, sj-pdf-1-ccp-10.1177_13591045211063494 for The experience of receiving a diagnosis of depression in adolescence: A pilot qualitative study in Brazil by Anna Viduani, Benetti Silvia, Sandra Petresco, Jader Piccin, Bruna Velazquez, Helen L Fisher, Valeria Mondelli, Brandon A Kohrt and Christian Kieling in Clinical Child Psychology and Psychiatry

Adolescence is a developmental period marked by multiple biopsychosocial changes. Receiving a diagnosis of depression can have an important impact in the lives of adolescents, making it relevant to investigate how they tackle, aspire meaning to and understand mental health diagnoses. This study explored the adolescents’ reactions to receiving a clinical diagnosis of Major Depressive Disorder during a research protocol in Brazil. Using a qualitative design, eight Brazilian adolescents were interviewed twice: immediately after a psychiatric assessment and two weeks after. Interviews were designed to explore the subjective experience of depressive symptoms and impacts in the adolescents’ lives and their experience of receiving the diagnosis. Interviews were analyzed using Framework Analysis.Three themes and two subthemes were generated. Depression was described as an experience marked by negative emotions, but most adolescents reported struggling with the idea that negative emotions would equate their experience with a disorder. The diagnosis was seen as a reification of an abnormal status, highlighting the role of stigma in their views. They also pondered on the process of disclosing the diagnosis to others.Adolescents’ reports highlighted the different aspects of the experience, therefore shedding light on the multiple sensemaking processes that happen when the interviewed adolescents receive a diagnosis of depression.

Adolescents comprise one fourth of the world’s population, with about 90% of them living in low- and middleincome countries (LMICs). The incidence of depression markedly increases during adolescence, making the disorder a leading cause of disease-related disability in this age group. However, most research on adolescent depression has been performed in high-income countries (HICs). To ascertain the extent to which this disparity operates in neuroimaging research, a systematic review of the literature was performed. A total of 148 studies were identified, with neuroimaging data available for 4,729 adolescents with depression. When stratified by income group, 122 (82%) studies originated from HICs, while 26 (18%) were conducted in LMICs, for a total of 3,705 and 1,024 adolescents with depression respectively. A positive Spearman rank correlation was observed between country per capita income and sample size (rs=0.673, p = 0.023). Our results support the previous reports showing a large disparity between the number of studies and the adolescent population per world region. Future research comparing neuroimaging findings across populations from HICs and LMICs may provide unique insights to enhance our understanding of the neurobiological processes underlying the development of depression.

Supplemental Material, sj-pdf-1-jbd-10.1177_0165025420979357 for This is what loneliness looks like: A mixed-methods study of loneliness in adolescence and young adulthood by Timothy Matthews, Helen L. Fisher, Bridget T. Bryan, Andrea Danese, Terrie E. Moffitt, Pamela Qualter, Lily Verity and Louise Arseneault in International Journal of Behavioral Development

Objective: Prediction models have become frequent in the medical literature, but most published studies are conducted in a single setting. Heterogeneity between development and validation samples has been posited as a major obstacle for the generalization of models. We aimed to develop a multivariable prognostic model using sociodemographic variables easily obtainable from adolescents at age 15 to predict a depressive disorder diagnosis at age 18 and to evaluate its generalizability in 2 samples from diverse socioeconomic and cultural settings. Method: Data from the 1993 Pelotas Birth Cohort were used to develop the prediction model, and its generalizability was evaluated in 2 representative cohort studies: the Environmental Risk (E-Risk) Longitudinal Twin Study and the Dunedin Multidisciplinary Health and Development Study. Results: At age 15, 2,192 adolescents with no evidence of current or previous depression were included (44.6% male). The apparent C-statistic of the models derived in Pelotas ranged from 0.76 to 0.79, and the model obtained from a penalized logistic regression was selected for subsequent external evaluation. Major discrepancies between the samples were identified, impacting the external prognostic performance of the model (Dunedin and E-Risk C-statistics of 0.63 and 0.59, respectively). The implementation of recommended strategies to account for this heterogeneity among samples improved the model’s calibration in both samples. Conclusion: An adolescent depression risk score comprising easily obtainable predictors was developed with good prognostic performance in a Brazilian sample. Heterogeneity among settings was not trivial, but strategies to deal with sample diversity were identified as pivotal for providing better risk stratification across samples. Future efforts should focus on developing better methodological approaches for incorporating heterogeneity in prognostic research.

Although children who are exposed to victimisation (including abuse, neglect, domestic violence and bullying) have an increased risk of later psychopathology and functional impairment, not all go on to develop these outcomes. Risk calculators that generate individualised probabilities of a victimised child developing future psychopathology and poor functioning have the potential to help practitioners identify the most vulnerable children and efficiently target preventive interventions. This study explored the views of young people and practitioners regarding the acceptability and feasibility of potentially using a risk calculator to predict victimised children���s individual risk of poor outcomes. Young people (n = 6) with lived experience of childhood victimisation took part in two focus groups. Health and social care practitioners (n = 13) were interviewed individually. Focus groups and interviews were audio-recorded, transcribed and thematically analysed. Ten themes were identified, organised according to the three main topics of discussion: (i) identifying risk (risk factors, current practice, accuracy, implementation, response); (ii) protective factors and prevention (individual, environment, preventative intervention); and (iii) communication of research (stakeholders, methods). Risk calculators have the potential to enhance health and social care practice in the United Kingdom, but we highlight key factors that require consideration for successful implementation.

Highlights • Childhood victimization predicted elevated levels of CRP at age 18. • The association between child victimization and CRP levels was specific to females. • Latent genetic influences on CRP levels did not explain the association in females., Objective Childhood victimization is an important risk factor for later immune-related disorders. Previous evidence has demonstrated that childhood victimization is associated with elevated levels of inflammation biomarkers measured decades after exposure. However, it is unclear whether this association is (1) already detectable in young people, (2) different in males and females, and (3) confounded by genetic liability to inflammation. Here we sought to address these questions. Method Participants were 2232 children followed from birth to age 18 years as part of the Environmental Risk (E-Risk) Longitudinal Twin Study. Childhood victimization was measured prospectively from birth to age 12 years. Inflammation was measured through C-reactive protein (CRP) levels in dried blood spots at age 18 years. Latent genetic liability for high inflammation levels was assessed through a twin-based method. Results Greater exposure to childhood victimization was associated with higher CRP levels at age 18 (serum-equivalent means were 0.65 in non-victimized Study members, 0.74 in those exposed to one victimization type, and 0.81 in those exposed to poly-victimization; p = 0.018). However, this association was driven by a significant association in females (serum-equivalent means were 0.75 in non-victimized females, 0.87 in those exposed to one type of victimization, and 1.19 in those exposed to poly-victimization; p = 0.010), while no significant association was observed in males (p = 0.19). Victimized females showed elevated CRP levels independent of latent genetic influence, as well as childhood socioeconomic status, and waist-hip ratio and body temperature at the time of CRP assessment. Conclusion Childhood victimization is associated with elevated CRP levels in young women, independent of latent genetic influences and other key risk factors. These results strengthen causal inference about the effects of childhood victimization on inflammation levels in females by accounting for potential genetic confounding.