Mental health problems are the major cause of disability among adolescents. Personalized prevention may help to mitigate the development of mental health problems, but no tools are available to identify individuals at risk before they require mental health care.

We identified children without mental health problems at baseline but with six different clinically relevant problems at 1- or 2-year follow-up in the Adolescent Brain Cognitive Development (ABCD) study. We used machine learning analysis to predict the development of these mental health problems with the use of demographic, symptom and neuroimaging data in a discovery (N = 3236) and validation (N = 3851) sample. The discovery sample (N = 168–513 per group) consisted of participants with MRI data and were matched with healthy controls on age, sex, IQ, and parental education level. The validation sample (N = 84–231) consisted of participants without MRI data.

Subclinical symptoms at 9–10 years of age could accurately predict the development of six different mental health problems before the age of 12 in the discovery and validation sample (AUCs = 0.71–0.90). The additive value of neuroimaging in the discovery sample was limited. Multiclass prediction of the six groups showed considerable misclassification, but subclinical symptoms could accurately differentiate between the development of externalizing and internalizing problems (AUC = 0.79).

These results suggest that machine learning models can predict conversion to mental health problems during a critical period in childhood using subclinical symptoms. These models enable the personalization of preventative interventions for children at increased risk, which may reduce the incidence of mental health problems.

Severe fatigue following COVID-19 is a debilitating symptom in adolescents for which no treatment exists currently.

The aim of this study was to determine the effectiveness and feasibility of cognitive behavioural therapy (CBT) for severe fatigue following COVID-19 in adolescents.

A serial single-case observational design was used. Eligible patients were ≥12 and <18 years old, severely fatigued and ≥6 months post-COVID-19. Five patients, consecutively referred by a paediatrician, were included. The primary outcome was a change in fatigue severity, assessed with the fatigue severity subscale of the Checklist Individual Strength, 12 weeks after the start of CBT, tested with a permutation distancing two-phase A-B test. Secondary outcomes were the presence of severe fatigue, difficulty concentrating and impaired physical functioning directly post-CBT as determined with questionnaires using validated cut-off scores. Also, the frequency of post-exertional malaise (PEM) and absence from school directly post-CBT determined with self-report items were evaluated.

All five included patients completed CBT. Twelve weeks after starting CBT for severe post-COVID-19 fatigue, three out of five patients showed a significant reduction in fatigue severity. After CBT, all five patients were no longer severely fatigued. Also, four out of five patients were no longer physically impaired and improved regarding PEM following CBT. All five patients reported no school absence post-CBT and no difficulties concentrating.

This study provides a first indication for the effectiveness and feasibility of CBT among adolescents with post-COVID-19 fatigue.

Adolescence marks a critical transition period, with significant mental health challenges including anxiety and depression symptoms that affect long-term happiness. There has been a lack of research exploring the factors mediating adolescent happiness.

To investigate the mediating effects of anxiety and depression on adolescent happiness, as well as the contributions of sociodemographic factors.

We recruited 392 adolescents. Anxiety symptoms, depression symptoms and happiness were assessed by the seven-item Generalized Anxiety Disorder scale, nine-item Patient Health Questionnaire and single-item happiness scale, respectively. Self-administered questionnaires were used to collect sociodemographic information.

Spearman correlation analysis showed significant negative correlations of happiness with anxiety (r = −0.37, P < 0.0001) and depression (r = −0.47, P < 0.0001). Positive predictors of happiness included quality of parents’ marriage (β = 0.12, P = 0.006), regular physical exercise (β = 0.13, P = 0.006) and regular diet (β = 0.10, P = 0.03). Mediation analysis indicated that depressive symptoms (estimate = 0.50, 95% CI: 0.25 to 0.80) and anxiety symptoms (estimate = 0.32, 95% CI: 0.12 to 0.57) partially mediated the relationship between regular exercise and happiness, whereas depressive symptoms completely mediated the relationship between anxiety symptoms and happiness (estimate = −0.14, 95% CI: −0.20 to −0.08).

The findings of this study highlight the intricate interplay of mental health issues, lifestyle factors and adolescent happiness and emphasise the need for comprehensive interventions focusing on enhancing physical activity and addressing psychological health to foster happiness among adolescents.

Developing integrated mental health services focused on the needs of children and young people is a key policy goal in England. The THRIVE Framework and its implementation programme, i-THRIVE, are widely used in England. This study examines experiences of staff using i-THRIVE, estimates its effectiveness, and assesses how local system working relationships influence programme success.

This evaluation uses a quasi-experimental design (10 implementation and 10 comparison sites.) Measurements included staff surveys and assessment of ‘THRIVE-like’ features of each site. Additional site-level characteristics were collected from health system reports. The effect of i-THRIVE was evaluated using a four-group propensity-score-weighted difference-in-differences model; the moderating effect of system working relationships was evaluated with a difference-in-difference-in-differences model.

Implementation site staff were more likely to report using THRIVE and more knowledgeable of THRIVE principles than comparison site staff. The mean improvement of fidelity scores among i-THRIVE sites was 16.7, and 8.8 among comparison sites; the weighted model did not find a statistically significant difference. However, results show that strong working relationships in the local system significantly enhance the effectiveness of i-THRIVE. Sites with highly effective working relationships showed a notable improvement in ‘THRIVE-like’ features, with an average increase of 16.41 points (95% confidence interval: 1.69–31.13, P-value: 0.031) over comparison sites. Sites with ineffective working relationships did not benefit from i-THRIVE (−2.76, 95% confidence interval: − 18.25–12.73, P-value: 0.708).

The findings underscore the importance of working relationship effectiveness in the successful adoption and implementation of multi-agency health policies like i-THRIVE.

Digital addiction among adolescents is an escalating concern with profound psychological implications, yet validated tools to measure it and studies exploring its relationship remain limited.

To validate the Bangla Digital Addiction Scale for Teenagers (Bangla DAST) and identify factors of digital addiction among Bangladeshi adolescents.

Using a two-stage stratified cluster sampling method, data from 1496 adolescents in Bangladesh were collected and analysed using non-parametric tests, Spearman correlations and multiple regression models.

The two-factor structure, encompassing attachment to digital devices (Factor 1) and compulsive use in different places (Factor 2) was supported by confirmatory factor analysis (comparative fit index 0.97, Tucker–Lewis index 0.95, root mean square error of approximation 0.06 [90% CI: 0.056–0.07] and standardised root mean square residual 0.048). McDonald’s omega was 0.81 for the total scale, 0.77 for Factor 1 and 0.63 for Factor 2. Convergent validity was supported by significant associations between digital addiction and psychological symptoms. Factors of digital addiction included age (b = 0.517, P = 0.020), academic grade (b = 0.737, P = 0.021), depression (b = 0.334, P < 0.001), anxiety (b = 0.400, P < 0.001) and insomnia (b = 0.504, P < 0.001). In contrast, female gender (b = −1.250, P = 0.001), not sleeping alone (b = −0.846, P = 0.029) and reduced smartphone usage (b = −1.895, P < 0.001) were associated with lower digital addiction scores. The model accounted for 23.1% of the variance in digital addiction.

The Bangla DAST appears to be a psychometrically valid and reliable tool and can be used for further studies assessing digital addiction among Bangladeshi adolescents. The study highlights the need for targeted preventive measures, particularly focusing on at-risk groups.

Suicidal ideation and behaviours are common among adolescents, posing significant challenges. Parents have a protective role in mitigating this risk, yet they often feel ill-equipped to support their adolescents, and their specific support needs are not well understood.

To explore the lived experiences of parents with suicidal adolescents and identify their support needs in the context of a therapist-assisted online parenting programme.

Semi-structured interviews were conducted with three stakeholder groups based in Australia: nine parents with lived experience caring for a suicidal adolescent, five young people who experienced suicidality during adolescence and five clinical/research experts in youth mental health/suicide prevention. Inductive thematic analysis was used to analyse and interpret findings.

Three key themes highlight the experience of parenting a suicidal adolescent: the traumatising emotional experience, uncertainty and parent empowerment. Six themes described parents’ support needs: validation and support, practical and tailored strategies, rebuilding the parent–adolescent relationship, parental self-care, flexible and accessible modes of delivery, and understanding non-suicidal self-injury.

Findings highlight key themes of parenting a suicidal adolescent and parental support needs. An online parenting programme could offer parents flexible access to evidence-based parenting strategies. Yet, a purely digital approach may not address the complexities of the parent-adolescent dynamic and provide adequate tailoring. As such, a hybrid approach incorporating therapist support can provide parents with both the compassionate support and practical guidance they seek.

The high level of psychological distress in young people is a growing concern. However, there are few national surveys that describe the trajectories of mental health and wellbeing through adolescence into early adulthood. Further, existing research has largely focused exclusively on mental ill-health, with little focus on positive mental health. This study provides the first national profile of the mental health and wellbeing of Australians aged 12–25 years.

Participants completed the National Youth Mental Health survey in 2018 (n1 = 3832), 2020 (n2 = 974) or 2022 (n3 = 961). We applied Keyes’ Complete Mental Health (CMH) framework to derive categories of mental health and wellbeing, and examine rates of CMH over time, by age and gender.

While approximately half of those surveyed reported flourishing (high wellbeing without mental illness), rates of flourishing declined between 2018 and 2022. Rates of flourishing generally decreased with age, and flourishing was more prevalent amongst males than females.

The findings provide a unique contrast of youth mental health pre-, during and post- the COVID-19 pandemic. While rates of psychological distress are consistently high, the proportion of youth reporting flourishing highlights the need to consider all aspects of psychological functioning to accurately understand and respond to the mental health needs of young people.

Smartphone apps combined with psychological interventions may be beneficial for increasing adherence to treatment tasks and augmenting outcomes. Yet, there is limited research on the acceptability and feasibility of adjunctive smartphone apps with psychological therapies for adolescents engaging in self-harm and suicidal behaviours. This study aimed to evaluate the acceptability and feasibility of integrating the Dialectical Behaviour Therapy (DBT) Coach app as an adjunct to a comprehensive DBT programme. The study also aimed to explore statistical trends of the potential relationship between the DBT Coach app and symptom reduction, including self-harm, borderline personality disorder symptoms, emotion dysregulation, and DBT skill use, to inform future study design. A mixed-method design was used to evaluate the acceptability and feasibility of the app and clinician’s portal from the perspective of adolescent and clinician participants. Thematic analysis was used to analyse qualitative data. Results indicated varied experiences of acceptability and feasibility of the DBT Coach app and portal as an adjunct to DBT. Thematic analysis generated four over-arching themes and ten subthemes. The regression analysis provided statistical trends regarding potential relationships between app use and clinical outcomes, which would be helpful to explore in future research. Findings suggest that the app and portal were acceptable and feasible for the most part, with some barriers and challenges identified. Implications of this study are discussed.

1. (1) To learn about the acceptability and feasibility of using a smartphone application as an adjunct to a DBT skills group within a comprehensive DBT programme for adolescents.

2. (2) To explore whether there is a relationship between app use and clinical outcome at the end of the group intervention.

3. (3) To learn about the experiences of adolescents and clinicians using the smartphone app as an adjunct to the DBT skills group.

While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.

A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.

(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79–5.98, p < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16–1.74, p < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01–1.53, p = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.

IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.