Population-Based Epidemiologic Research

National Institute Of Mental Health

Investigators

Linked publications & trials

Abstract

We continue to leverage the National Comorbidity Survey (NCS-A) for its rich information on risk factors to expand the scientific knowledge base that can be used to inform prevention efforts. We examined the association of cannabis use with major depression and suicidal behavior (Hinckley et al, 2023), and found that cannabis use is associated with higher odds of depression and depression severity and found that depression and cannabis use are independently associated with higher odds of suicide attempt. Findings underscore a potential link between cannabis and suicide risk and the need for research on the temporal nature of these associations, particularly as recreational cannabis legalization expands. Using a naturalistic observational design, we assessed parent responses for over 1200 youth using a CRISIS survey (CRISIS AFAR) adapted for autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). Analyses showed that the pandemic was associated with distinct patterns of symptom change among youth with ASD and NDD (Vibert et al, 2023). We identified 4 subgroups and their profiles revealed that symptom and service changes have distinct patterns of covariation among youth with ASD/NDD. Results suggested the COVID-19 pandemic impact on these groups varied, as in the general population. This study highlights the need for increased global coordination to include common assessment protocols and data structures to facilitate data sharing and analysis, in addition to longitudinal research aimed to assess and address the needs of the most vulnerable. We also used CRISIS data collected through HBN approximately 1 year after the initial pandemic to study associations between mental disorders and COVID-19 risk-mitigation practices among youth aged 5-21 (Conway et al, 2023). In this now published study, we found that youth with anxiety disorders were more likely to avoid high-risk exposure settings, and those with ADHD (combined type) were less likely to follow hygiene practices. Findings suggested that education and monitoring of risk-mitigation strategies in certain subgroups of youth may reduce risk of exposure to COVID-19 and other contagious diseases. We continued to work with CMI collaborators to study multinational survey data to assess parents'/caregivers' comfort with and preferences for pediatric mental health screening and related factors among 900 parents/caregivers (Kass et al, 2023). Despite slight variations based on country of residence, screening topic, and childs age, there was a cross-national parent/caregiver acceptability for mental health screening of their offspring, with preferences for f/u with experts who can facilitate further evaluation and treatment. This study suggests multinational interest in developing programs to detect and intervene in mental disorders in youths. In a systematic review with collaborators, we examined and cataloged scientific evidence on child and adolescent mental health in Greece, encompassing: prevalence estimates, assessment instruments, and interventions (Koumoula et al, 2023). The goal of this review was to develop a free collection of up-to-date evidence to serve as an interactive resource for clinical practice, https://rpubs.com/camhi/sysrev_table. This work may encourage similar assessments in other countries for child and adolescent mental health. With investigators at the NIMH, we studied the validity of the Ask Suicide-Screening Questions (ASQ) among black youth (Horowitz et al, 2022). We pooled data from 3 ASQ validation studies of over 1,000 pediatric medical patients aged 10-21, where participants had completed both the ASQ and the Suicidal Ideation Questionnaire. We found that there were no significant differences in ASQ psychometric properties between black and white youth, indicating that the ASQ is valid for screening black youth at risk for suicide. Future research is needed to confirm the validity of the ASQ among black youth and other racial and ethnic groups. Finally, we published an editorial discussing the widespread concern about the mental health of US youth and the need for novel approaches to estimate and track the magnitude of mental and behavioral disorders in the US and across the world (Merikangas & Salum, 2023). The most recent data on the prevalence and service patterns for the full range of mental disorders were collected nearly 20 years ago through the NCS-A study referenced above. Such information remains crucial, even though this type of research is becoming less feasible because of the high cost, sampling challenges, and rapid shifts in communication patterns through mobile technology that make household surveys increasingly obsolete. This editorial suggests a next generation of child and adolescent epidemiology that will focus on systematic data to help characterize the magnitude and impact of serious emotional disorders across development, coupled with education, intervention and prevention. Public Health Impact: Our research group continues to be at the forefront of coordinating the evidence base on epidemiology including prevalence, correlates and consequences of child and youth mental health through extensive collaborations with leaders in the field in the US, Canada, Brazil, the UK, Greece, Taiwan and China. The focus on developmental risk factors in the manifestations of emotional and behavioral conditions, which the NCS-A made possible, are critical for identifying targets for intervention and prevention of psychiatric disorders. Our studies of physical-mental comorbidity and sleep in adolescents and adults complement our family study research on the importance of physiological systems and behavioral rhythms in mental health and contribute to scientific understanding of psychiatric disorder etiology and opportunities for prevention. The CRISIS Consortium and continued collaboration with HBN will further our opportunity to conduct research aimed at reducing the adverse consequences of the COVID-19 pandemic and other influences on mental health problems among youth, which may have life-long positive benefit. Our growing collaborations with other research across the world will also facilitate our ability to identify the impact of global influences such as the COVID-19 pandemic and climate change as well as individual-level susceptibility on youth physical and mental health. Future Plans: We plan to continue our activity in the CRISIS Consortium that is now extending to broader efforts to track youth mental health through our collaborations with CMI and HBN, and parallel Brazilian, Canadian, and Swiss studies with intensive analysis of collected data on clinical features, risk factors, and impairment. We are also helping to design and implement a prospective follow-up of select HBN participants that will provide longitudinal information on patterns of symptoms, behaviors, and risk across time during development. Our team is also collaborating with the leaders of a recent nationwide study of youth in Canada, the CHSCY Canadian Health Survey of Children and Youth of more than 40,000 youth ages 7-21 across Canada. Now the data have been collected, we will consult on the priorities, analyses and interpretations of findings. We also plan to interrogate data from the PATH Study for associations between tobacco-product use (including e-cigarettes) and mental health problems. Across these rich data resources, we expect to continue publishing studies related to: 1) the intersection between physical and mental health; 2) the relationship between health behaviors such as sleep and activity and psychiatric disorders; 3) the influence of environmental and social exposures among children and youth; 4) associations between sleep, physical activity and mood disorders; and 5) subtypes of depression, mania and their core components.