Publications by authors named "Helen Keeley"

41 Publications

Excessive and pathological Internet use - Risk-behavior or psychopathology?

Addict Behav 2021 12 9;123:107045. Epub 2021 Jul 9.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden.

Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as "psychopathology" or "risk-behavior". A representative, cross-sectional sample of 11.110 students from 10 European Union countries was analyzed. Structural equation models, including the factors "risk-behavior" and "psychopathology" and the variables excessive and pathological Internet use, were tested against each other. "Risk-behavior" was operationalized by several risk-behaviors (e.g. drug abuse, truancy, etc). "Psychopathology" included measures of several mental disorders (e.g. depression, hyperactivity, etc). Excessive Internet use was assessed as the duration and frequency of Internet use. Pathological Internet use was assessed with the Young Diagnostic Questionnaire (i.e., presence of addiction criteria). Excessive Internet use loaded on "risk-behavior" (λ = 0.484, p < .001) and on "psychopathology" (λ = 0.071, p < .007). Pathological Internet use loaded on "risk-behavior" (λ = 0.333, p < .001) and on "psychopathology" (λ = 0.852, p < .001). Chi-square tests determined that the loadings of excessive Internet use (χ (1) = 81.98, p < .001) were significantly stronger on "risk-behavior" than "psychopathology". Vice versa, pathological Internet use loaded significantly stronger on "psychopathology" (χ (1) = 107.10, p < .001). The results indicate that pathological Internet use should rather be considered as psychopathology. Excessive Internet use on the other hand, should be classified as adolescent risk-behavior.
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http://dx.doi.org/10.1016/j.addbeh.2021.107045DOI Listing
December 2021

Risk and protective factors for psychotic experiences in adolescence: a population-based study.

Psychol Med 2021 05 6;51(7):1220-1228. Epub 2020 Feb 6.

Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.

Background: Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of psychiatric disorders. The aims of this study were to examine associations between PEs and a range of factors including psychopathology, adversity and lifestyle, and to investigate mediating effects of coping style and parental support on associations between adversity and PEs in a general population adolescent sample.

Method: Cross-sectional data were drawn from the Irish centre of the Saving and Empowering Young Lives in Europe study. Students completed a self-report questionnaire and 973 adolescents, of whom 522 (53.6%) were boys, participated. PEs were assessed using the 7-item Adolescent Psychotic Symptom Screener.

Results: Of the total sample, 81 (8.7%) of the sample were found to be at risk of PEs. In multivariate analysis, associations were found between PEs and number of adverse events reported (OR 4.48, CI 1.41-14.25; p < 0.011), maladaptive/pathological internet use (OR 2.70, CI 1.30-5.58; p = 0.007), alcohol intoxication (OR 2.12, CI 1.10-4.12; p = 0.025) and anxiety symptoms (OR 4.03, CI 1.57-10.33; p = 0.004). There were small mediating effects of parental supervision, parental support and maladaptive coping on associations between adversity and PEs.

Conclusion: We have identified potential risk factors for PEs from multiple domains including adversity, mental health and lifestyle factors. The mediating effect of parental support on associations between adversity and PEs suggests that poor family relationships may account for some of this mechanism. These findings can inform the development of interventions for adolescents at risk.
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http://dx.doi.org/10.1017/S0033291719004136DOI Listing
May 2021

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.

J Adolesc Health 2020 02 31;66(2):195-201. Epub 2019 Oct 31.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Purpose: Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

Methods: Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

Results: The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

Conclusions: The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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http://dx.doi.org/10.1016/j.jadohealth.2019.08.018DOI Listing
February 2020

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.

J Adolesc Health 2020 02 31;66(2):195-201. Epub 2019 Oct 31.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Purpose: Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

Methods: Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

Results: The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

Conclusions: The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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http://dx.doi.org/10.1016/j.jadohealth.2019.08.018DOI Listing
February 2020

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.

J Adolesc Health 2020 02 31;66(2):195-201. Epub 2019 Oct 31.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Purpose: Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

Methods: Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

Results: The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

Conclusions: The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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http://dx.doi.org/10.1016/j.jadohealth.2019.08.018DOI Listing
February 2020

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.

J Adolesc Health 2020 02 31;66(2):195-201. Epub 2019 Oct 31.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Purpose: Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

Methods: Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

Results: The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

Conclusions: The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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http://dx.doi.org/10.1016/j.jadohealth.2019.08.018DOI Listing
February 2020

Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.

J Adolesc Health 2020 02 31;66(2):195-201. Epub 2019 Oct 31.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

Purpose: Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample.

Methods: Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel.

Results: The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB.

Conclusions: The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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http://dx.doi.org/10.1016/j.jadohealth.2019.08.018DOI Listing
February 2020

Physical activity in European adolescents and associations with anxiety, depression and well-being.

Eur Child Adolesc Psychiatry 2017 Jan 9;26(1):111-122. Epub 2016 Jun 9.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

In this cross-sectional study, physical activity, sport participation and associations with well-being, anxiety and depressive symptoms were examined in a large representative sample of European adolescents. A school-based survey was completed by 11,110 adolescents from ten European countries who took part in the SEYLE (Saving and Empowering Young Lives in Europe) study. The questionnaire included items assessing physical activity, sport participation and validated instruments assessing well-being (WHO-5), depressive symptoms (BDI-II) and anxiety (SAS). Multi-level mixed effects linear regression was used to examine associations between physical activity/sport participation and mental health measures. A minority of the sample (17.9 % of boys and 10.7 % of girls; p < 0.0005) reported sufficient activity based on WHO guidelines (60 min + daily). The mean number of days of at least 60 min of moderate-to-vigorous activity in the past 2 weeks was 7.5 ± 4.4 among boys and 5.9 days ± 4.3 among girls. Frequency of activity was positively correlated with well-being and negatively correlated with both anxiety and depressive symptoms, up to a threshold of moderate frequency of activity. In a multi-level mixed effects model more frequent physical activity and participation in sport were both found to independently contribute to greater well-being and lower levels of anxiety and depressive symptoms in both sexes. Increasing activity levels and sports participation among the least active young people should be a target of community and school-based interventions to promote well-being. There does not appear to be an additional benefit to mental health associated with meeting the WHO-recommended levels of activity.
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http://dx.doi.org/10.1007/s00787-016-0875-9DOI Listing
January 2017

Physical activity in European adolescents and associations with anxiety, depression and well-being.

Eur Child Adolesc Psychiatry 2017 Jan 9;26(1):111-122. Epub 2016 Jun 9.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden.

In this cross-sectional study, physical activity, sport participation and associations with well-being, anxiety and depressive symptoms were examined in a large representative sample of European adolescents. A school-based survey was completed by 11,110 adolescents from ten European countries who took part in the SEYLE (Saving and Empowering Young Lives in Europe) study. The questionnaire included items assessing physical activity, sport participation and validated instruments assessing well-being (WHO-5), depressive symptoms (BDI-II) and anxiety (SAS). Multi-level mixed effects linear regression was used to examine associations between physical activity/sport participation and mental health measures. A minority of the sample (17.9 % of boys and 10.7 % of girls; p < 0.0005) reported sufficient activity based on WHO guidelines (60 min + daily). The mean number of days of at least 60 min of moderate-to-vigorous activity in the past 2 weeks was 7.5 ± 4.4 among boys and 5.9 days ± 4.3 among girls. Frequency of activity was positively correlated with well-being and negatively correlated with both anxiety and depressive symptoms, up to a threshold of moderate frequency of activity. In a multi-level mixed effects model more frequent physical activity and participation in sport were both found to independently contribute to greater well-being and lower levels of anxiety and depressive symptoms in both sexes. Increasing activity levels and sports participation among the least active young people should be a target of community and school-based interventions to promote well-being. There does not appear to be an additional benefit to mental health associated with meeting the WHO-recommended levels of activity.
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http://dx.doi.org/10.1007/s00787-016-0875-9DOI Listing
January 2017

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

The association between parental and adolescent substance misuse: findings from the Irish CASE study.

Ir J Psychol Med 2015 Mar;32(1):107-116

National Suicide Research Foundation, University College Cork, Ireland.

Background: Self-report data from 2716 adolescents aged 15-17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Methods: Data were collected using the 'Lifestyle and Coping Questionnaire' which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Results: Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent's psychological characteristics.

Conclusions: This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.
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http://dx.doi.org/10.1017/ipm.2014.87DOI Listing
March 2015

Risk-behaviour screening for identifying adolescents with mental health problems in Europe.

Eur Child Adolesc Psychiatry 2014 Jul 19;23(7):611-20. Epub 2013 Nov 19.

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany,

Indicated prevention of mental illness is an important public health concern among youth. The aim of this study was to establish a European school-based professional screening among adolescents, which included variables on both a broad range of risk-behaviours and psychopathology; and to investigate the indicative value of adolescent risk-behaviour and self-reported psychopathology on help-seeking and psychological problems that required subsequent mental healthcare. A two-stage professional screening approach was developed and performed within the multi-centre study "Saving and Empowering Young Lives in Europe" (SEYLE). The first stage of screening comprised a self-report questionnaire on a representative sample of 3,070 adolescents from 11 European countries. In the second stage, students deemed at-risk for mental health problems were evaluated using a semi-structured clinical interview performed by healthcare professionals. 61 % of participants (n = 1,865) were identified as being at-risk in stage one. In stage two, 384 participants (12.5 % of the original sample) were found to require subsequent mental healthcare during semi-structured, clinical assessment. Among those, 18.5 % of pupils were identified due to screening for psychopathology alone; 29.4 % due to screening for risk-behaviours alone; and 52.1 % by a combination of both. Young age and peer victimization increased help-seeking, while very low body mass index, depression, suicidal behaviour and substance abuse were the best predictors of referral to mental healthcare. Screening of risk-behaviours significantly increased the number of detected students requiring subsequent mental healthcare. Screening of risk-behaviours added significant value in identifying the significant amount of European pupils with mental health problems. Therefore, attention to adolescent risk-behaviours in addition to psychopathology is critical in facilitating prevention and early intervention. Identifying factors that increase compliance to clinical interviews are crucial in improving screening procedures.
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http://dx.doi.org/10.1007/s00787-013-0490-yDOI Listing
July 2014

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries.

J Child Psychol Psychiatry 2014 Apr 12;55(4):337-48. Epub 2013 Nov 12.

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.

Objectives: To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries.

Methods: Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed.

Results: Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment.

Conclusion: These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
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http://dx.doi.org/10.1111/jcpp.12166DOI Listing
April 2014

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries.

J Child Psychol Psychiatry 2014 Apr 12;55(4):337-48. Epub 2013 Nov 12.

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.

Objectives: To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries.

Methods: Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed.

Results: Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment.

Conclusion: These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
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http://dx.doi.org/10.1111/jcpp.12166DOI Listing
April 2014

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries.

J Child Psychol Psychiatry 2014 Apr 12;55(4):337-48. Epub 2013 Nov 12.

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.

Objectives: To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries.

Methods: Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed.

Results: Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment.

Conclusion: These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
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http://dx.doi.org/10.1111/jcpp.12166DOI Listing
April 2014

Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries.

J Child Psychol Psychiatry 2014 Apr 12;55(4):337-48. Epub 2013 Nov 12.

Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.

Objectives: To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries.

Methods: Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed.

Results: Overall lifetime prevalence of D-SIB was 27.6%; 19.7% reported occasional D-SIB and 7.8% repetitive D-SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D-SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D-SIB. There was a strong association of D-SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D-SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D-SIB ever received medical treatment.

Conclusion: These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
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http://dx.doi.org/10.1111/jcpp.12166DOI Listing
April 2014

Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality.

Am J Psychiatry 2013 Jul;170(7):734-41

Department of Psychiatry, Royal College of Surgeons, Ireland.

Objective: Using longitudinal and prospective measures, the authors assessed the relationship between childhood trauma and psychotic experiences, addressing the following questions: 1) Does exposure to trauma predict incident psychotic experiences? 2) Does cessation of trauma predict cessation of psychotic experiences? 3) What is the direction of the relationship between childhood trauma and psychotic experiences?

Method: This was a nationally representative prospective cohort study of 1,112 school-based adolescents 13-16 years of age, assessed at baseline and at 3-month and 12-month follow-ups for childhood trauma (physical assault and bullying) and psychotic experiences.

Results: A bidirectional relationship was observed between childhood trauma and psychosis, with trauma predicting psychotic experiences over time and vice versa. However, even after accounting for this bidirectional relationship with a number of strict adjustments (only newly incident psychotic experiences occurring over the course of the study following exposure to traumatic experiences were examined), trauma was strongly predictive of psychotic experiences. A dose-response relationship was observed between severity of bullying and risk for psychotic experiences. Moreover, cessation of trauma predicted cessation of psychotic experiences, with the incidence of psychotic experiences decreasing significantly in individuals whose exposure to trauma ceased over the course of the study.

Conclusions: After a series of conservative adjustments, the authors found that exposure to childhood trauma predicted newly incident psychotic experiences. The study also provides the first direct evidence that cessation of traumatic experiences leads to a reduced incidence of psychotic experiences.
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http://dx.doi.org/10.1176/appi.ajp.2012.12091169DOI Listing
July 2013

Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality.

Am J Psychiatry 2013 Jul;170(7):734-41

Department of Psychiatry, Royal College of Surgeons, Ireland.

Objective: Using longitudinal and prospective measures, the authors assessed the relationship between childhood trauma and psychotic experiences, addressing the following questions: 1) Does exposure to trauma predict incident psychotic experiences? 2) Does cessation of trauma predict cessation of psychotic experiences? 3) What is the direction of the relationship between childhood trauma and psychotic experiences?

Method: This was a nationally representative prospective cohort study of 1,112 school-based adolescents 13-16 years of age, assessed at baseline and at 3-month and 12-month follow-ups for childhood trauma (physical assault and bullying) and psychotic experiences.

Results: A bidirectional relationship was observed between childhood trauma and psychosis, with trauma predicting psychotic experiences over time and vice versa. However, even after accounting for this bidirectional relationship with a number of strict adjustments (only newly incident psychotic experiences occurring over the course of the study following exposure to traumatic experiences were examined), trauma was strongly predictive of psychotic experiences. A dose-response relationship was observed between severity of bullying and risk for psychotic experiences. Moreover, cessation of trauma predicted cessation of psychotic experiences, with the incidence of psychotic experiences decreasing significantly in individuals whose exposure to trauma ceased over the course of the study.

Conclusions: After a series of conservative adjustments, the authors found that exposure to childhood trauma predicted newly incident psychotic experiences. The study also provides the first direct evidence that cessation of traumatic experiences leads to a reduced incidence of psychotic experiences.
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http://dx.doi.org/10.1176/appi.ajp.2012.12091169DOI Listing
July 2013

Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality.

Am J Psychiatry 2013 Jul;170(7):734-41

Department of Psychiatry, Royal College of Surgeons, Ireland.

Objective: Using longitudinal and prospective measures, the authors assessed the relationship between childhood trauma and psychotic experiences, addressing the following questions: 1) Does exposure to trauma predict incident psychotic experiences? 2) Does cessation of trauma predict cessation of psychotic experiences? 3) What is the direction of the relationship between childhood trauma and psychotic experiences?

Method: This was a nationally representative prospective cohort study of 1,112 school-based adolescents 13-16 years of age, assessed at baseline and at 3-month and 12-month follow-ups for childhood trauma (physical assault and bullying) and psychotic experiences.

Results: A bidirectional relationship was observed between childhood trauma and psychosis, with trauma predicting psychotic experiences over time and vice versa. However, even after accounting for this bidirectional relationship with a number of strict adjustments (only newly incident psychotic experiences occurring over the course of the study following exposure to traumatic experiences were examined), trauma was strongly predictive of psychotic experiences. A dose-response relationship was observed between severity of bullying and risk for psychotic experiences. Moreover, cessation of trauma predicted cessation of psychotic experiences, with the incidence of psychotic experiences decreasing significantly in individuals whose exposure to trauma ceased over the course of the study.

Conclusions: After a series of conservative adjustments, the authors found that exposure to childhood trauma predicted newly incident psychotic experiences. The study also provides the first direct evidence that cessation of traumatic experiences leads to a reduced incidence of psychotic experiences.
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http://dx.doi.org/10.1176/appi.ajp.2012.12091169DOI Listing
July 2013

Childhood trauma and psychosis in a prospective cohort study: cause, effect, and directionality.

Am J Psychiatry 2013 Jul;170(7):734-41

Department of Psychiatry, Royal College of Surgeons, Ireland.

Objective: Using longitudinal and prospective measures, the authors assessed the relationship between childhood trauma and psychotic experiences, addressing the following questions: 1) Does exposure to trauma predict incident psychotic experiences? 2) Does cessation of trauma predict cessation of psychotic experiences? 3) What is the direction of the relationship between childhood trauma and psychotic experiences?

Method: This was a nationally representative prospective cohort study of 1,112 school-based adolescents 13-16 years of age, assessed at baseline and at 3-month and 12-month follow-ups for childhood trauma (physical assault and bullying) and psychotic experiences.

Results: A bidirectional relationship was observed between childhood trauma and psychosis, with trauma predicting psychotic experiences over time and vice versa. However, even after accounting for this bidirectional relationship with a number of strict adjustments (only newly incident psychotic experiences occurring over the course of the study following exposure to traumatic experiences were examined), trauma was strongly predictive of psychotic experiences. A dose-response relationship was observed between severity of bullying and risk for psychotic experiences. Moreover, cessation of trauma predicted cessation of psychotic experiences, with the incidence of psychotic experiences decreasing significantly in individuals whose exposure to trauma ceased over the course of the study.

Conclusions: After a series of conservative adjustments, the authors found that exposure to childhood trauma predicted newly incident psychotic experiences. The study also provides the first direct evidence that cessation of traumatic experiences leads to a reduced incidence of psychotic experiences.
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http://dx.doi.org/10.1176/appi.ajp.2012.12091169DOI Listing
July 2013

Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies.

Br J Psychiatry 2012 Jul 12;201(1):26-32. Epub 2012 Apr 12.

Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland.

Background: Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.

Aims: To investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.

Method: Data from four population studies were used: two early adolescence studies (ages 11-13 years) and two mid-adolescence studies (ages 13-16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11-16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11-15 years.

Results: Younger adolescents had a higher prevalence (21-23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.

Conclusions: Psychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
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http://dx.doi.org/10.1192/bjp.bp.111.101543DOI Listing
July 2012

Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies.

Br J Psychiatry 2012 Jul 12;201(1):26-32. Epub 2012 Apr 12.

Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland.

Background: Epidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.

Aims: To investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.

Method: Data from four population studies were used: two early adolescence studies (ages 11-13 years) and two mid-adolescence studies (ages 13-16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11-16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11-15 years.

Results: Younger adolescents had a higher prevalence (21-23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.

Conclusions: Psychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.
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http://dx.doi.org/10.1192/bjp.bp.111.101543DOI Listing
July 2012

Development of a nano-electrospray MSn method for the analysis of serotonin and related compounds in urine using a LTQ-orbitrap mass spectrometer.

Talanta 2012 Feb 27;90:1-11. Epub 2011 Dec 27.

Team Elucidate, Department of Chemistry, Cork Institute of Technology, Cork, Ireland.

Serotonin, its key metabolite hydroxyindole acetic acid (5-HIAA) and dopamine have been shown to be potential biomarkers whose levels in serum and urine can be correlated with certain psychiatric and physiological disorders and illness, including depression, schizophrenia, anxiety and dementia. Recently we have published elsewhere that 5-HIAA has been identified as a potential biomarker for Attention Deficit Hyperactivity/Hyperkinetic Disorder (AD-HKD). This study describes a versatile and validated method for the analysis of these three compounds in urine using a nanoelectrospray-MS(n) method interfaced with an LTQ Orbitrap mass spectrometer. No chromatographic separation is required prior to nanoelectrospray infusion. Good linear calibrations were obtained for analytes in urine (with serotonin and dopamine giving R(2)=0.9999 and 5-HIAA having a lower R(2) value of 0.9955). Acceptable intraday repeatability was achieved for all analytes with RSD values (n=5) ranging from 4.4% to 6.2% (57, 65 and 52 nmol/L for serotonin, dopamine and 5-HIAA respectively) to 2.1-8.1% (2837, 3268, 2618 nmol/L for serotonin, dopamine and 5-HIAA respectively). Excellent limits of detection (LOD) and limits of quantitation (LOQ) were achieved with spiked samples for all compounds; with LODs of 9-12.9 nmol/L and LOQs of 27.2-57.7 nmol/L for analytes in urine. An appropriate sample clean-up procedure for urine was developed to ensure highest recovery and reproducibility on analysis.
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http://dx.doi.org/10.1016/j.talanta.2011.11.085DOI Listing
February 2012

Reprint of: bullying victimisation, self harm and associated factors in Irish adolescent boys.

Soc Sci Med 2012 Feb 7;74(4):490-7. Epub 2011 Dec 7.

National Suicide Research Foundation, 1 Perrott Avenue, College Road, Cork, Ireland.

School bullying victimisation is associated with poor mental health and self harm. However, little is known about the lifestyle factors and negative life events associated with victimisation, or the factors associated with self harm among boys who experience bullying. The objectives of the study were to examine the prevalence of bullying in Irish adolescent boys, the association between bullying and a broad range of risk factors among boys, and factors associated with self harm among bullied boys and their non-bullied peers. Analyses were based on the data of the Irish centre of the Child and Adolescent Self Harm in Europe (CASE) study (boys n = 1870). Information was obtained on demographic factors, school bullying, deliberate self harm and psychological and lifestyle factors including negative life events. In total 363 boys (19.4%) reported having been a victim of school bullying at some point in their lives. The odds ratio of lifetime self harm was four times higher for boys who had been bullied than those without this experience. The factors that remained in the multivariate logistic regression model for lifetime history of bullying victimisation among boys were serious physical abuse and self esteem. Factors associated with self harm among bullied boys included psychological factors, problems with schoolwork, worries about sexual orientation and physical abuse, while family support was protective against self harm. Our findings highlight the mental health problems associated with victimisation, underlining the importance of anti-bullying policies in schools. Factors associated with self harm among boys who have been bullied should be taken into account in the identification of boys at risk of self harm.
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http://dx.doi.org/10.1016/j.socscimed.2011.12.001DOI Listing
February 2012

Development of an LC-MS/MS method for the analysis of serotonin and related compounds in urine and the identification of a potential biomarker for attention deficit hyperactivity/hyperkinetic disorder.

Anal Bioanal Chem 2011 Nov 25;401(8):2481-93. Epub 2011 Aug 25.

Team Elucidate, Department of Chemistry, Cork Institute of Technology, Cork, Ireland.

Serotonin is a major neurotransmitter and affects various functions both in the brain and in the rest of the body. It has been demonstrated that altered serotinergic function is implicated in various psychiatric disorders including depression and schizophrenia. Serotonin has also been implicated along with dopamine in attention deficit-hyperkinetic disorder (AD-HKD). This study provides a versatile validated method for the analysis of serotonin, hydroxyindole acetic acid and dopamine in urine using LC-MS/MS. This method was then used to quantify these analytes in a test group of 17 children diagnosed with severe AD-HKD. This group was compared to a matched control group to investigate the possibility that one of these compounds may be a potential biomarker for this condition. The developed method provided good linear calibration curves for the multiplex assay of analytes in urine (0.05-3.27 nmol/L; R(2) ≥ 0.9977). Acceptable inter-day repeatability was achieved for all analytes with RSD values (n = 9) ranging from 1.1% to 9.3% over a concentration range of 0.11-3.27 μmol/L in urine. Excellent limits of detection (LOD) and limits of quantitation (LOQ) were achieved with LODs of 8.8-18.2 nmol/L and the LOQs of 29.4-55.7 nmol/L for analytes in urine. Recoveries were in the ranges of 98-104%, 100-106% and 91-107% for serotonin, 5-HIAA and dopamine, respectively. An appropriate sample clean-up procedure for urine was developed to ensure efficient recovery and reproducibility on analysis. Evaluation of matrix effects was also carried out and the influence of ion suppression on analytical results reported. Confirmatory analysis was carried out on a linear trap quadrupole-Orbitrap mass spectrometer to obtain high mass accuracy data of the target analytes in the clinical samples.
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http://dx.doi.org/10.1007/s00216-011-5322-7DOI Listing
November 2011
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