Inflammation and immune system pathways as biological signatures of adolescent depression-the IDEA-RiSCo study.

The biological mechanisms underlying the onset of major depressive disorder (MDD) have predominantly been studied in adult populations from high-income countries, despite the onset of depression typically occurring in adolescence and the majority of the world's adolescents living in low- and middle-income countries (LMIC). Taking advantage of a unique adolescent sample in an LMIC (Brazil), this study aimed to identify biological pathways characterizing the presence and increased risk of depression in adolescence, and sex-specific differences in such biological signatures. We collected blood samples from a risk-stratified cohort of 150 Brazilian adolescents (aged 14-16 years old) comprising 50 adolescents with MDD, 50 adolescents at high risk of developing MDD but without current MDD, and 50 adolescents at low risk of developing MDD and without MDD (25 females and 25 males in each group). We conducted RNA-Seq and pathway analysis on whole blood. Inflammatory-related biological pathways, such as role of hypercytokinemia/hyperchemokinemia in the pathogenesis of influenza (z-score = 3.464, p < 0.001), interferon signaling (z-score = 2.464, p < 0.001), interferon alpha/beta signaling (z-score = 3.873, p < 0.001), and complement signaling (z-score = 2, p = 0.002) were upregulated in adolescents with MDD compared with adolescents without MDD independently from their level of risk. The up-regulation of such inflammation-related pathways was observed in females but not in males. Inflammatory-related pathways involved in the production of cytokines and in interferon and complement signaling were identified as key indicators of adolescent depression, and this effect was present only in females.

Unraveling the Concept of Childhood Adversity in Psychosis Research: A Systematic Review.

BACKGROUND: During the last decades, an abundance of studies has investigated childhood adversity in relation to psychosis. This systematic review critically examines the methodologies employed to investigate childhood adversity in psychosis over the past decade, including operational definitions, measurement tools and characteristics, and psychometric properties of instruments used in these studies. STUDY DESIGN: This systematic review followed the PRISMA guidelines (registration number CRD42022307096), and the search used the following electronic databases: PsychINFO, SCOPUS, Web of Science, African Index Medicus (AIM), LILACS, CINAHL, EMBASE, and MEDLINE. The search included variations and combinations of the terms targeting childhood adversity and psychosis. STUDY RESULTS: Out of 585 identified studies published between 2010 and 2023, 341 employed a validated instrument to investigate childhood adversity. Our findings show "childhood trauma" being the most frequently examined construct, followed by "child maltreatment" or "child abuse." The short version of the Childhood Trauma Questionnaire was the dominant instrument. Physical abuse, emotional abuse, and sexual abuse were most frequently investigated, and indeed the field appears generally to focus on child abuse and neglect over other adversities. Significant psychometric heterogeneity was observed in the selection and summarization of instrument items, with only 59% of studies documenting original psychometric validation and 22% reporting reliability in their datasets. CONCLUSION: This review highlights substantial methodological heterogeneity in the field, pointing out biases in the research on childhood adversity and psychosis. These findings underline the need for standardized definitions and high-quality measurement tools to enhance the validity of future research in this area.

Air and Noise Pollution Exposure in Early Life and Mental Health From Adolescence to Young Adulthood.

Importance: Growing evidence associates air pollution exposure with various psychiatric disorders. However, the importance of early-life (eg, prenatal) air pollution exposure to mental health during youth is poorly understood, and few longitudinal studies have investigated the association of noise pollution with youth mental health. Objectives: To examine the longitudinal associations of air and noise pollution exposure in pregnancy, childhood, and adolescence with psychotic experiences, depression, and anxiety in youths from ages 13 to 24 years. Design, Setting, and Participants: This cohort study used data from the Avon Longitudinal Study of Parents and Children, an ongoing longitudinal birth cohort founded in 1991 through 1993 in Southwest England, United Kingdom. The cohort includes over 14 000 infants with due dates between April 1, 1991, and December 31, 1992, who were subsequently followed up into adulthood. Data were analyzed October 29, 2021, to March 11, 2024. Exposures: A novel linkage (completed in 2020) was performed to link high-resolution (100 m2) estimates of nitrogen dioxide (NO2), fine particulate matter under 2.5 µm (PM2.5), and noise pollution to home addresses from pregnancy to 12 years of age. Main outcomes and measures: Psychotic experiences, depression, and anxiety were measured at ages 13, 18, and 24 years. Logistic regression models controlled for key individual-, family-, and area-level confounders. Results: This cohort study included 9065 participants who had any mental health data, of whom (with sample size varying by parameter) 51.4% (4657 of 9051) were female, 19.5% (1544 of 7910) reported psychotic experiences, 11.4% (947 of 8344) reported depression, and 9.7% (811 of 8398) reported anxiety. Mean (SD) age at follow-up was 24.5 (0.8) years. After covariate adjustment, IQR increases (0.72 µg/m3) in PM2.5 levels during pregnancy (adjusted odds ratio [AOR], 1.11 [95% CI, 1.04-1.19]; P = .002) and during childhood (AOR, 1.09 [95% CI, 1.00-1.10]; P = .04) were associated with elevated odds for psychotic experiences. Pregnancy PM2.5 exposure was also associated with depression (AOR, 1.10 [95% CI, 1.02-1.18]; P = .01). Higher noise pollution exposure in childhood (AOR, 1.19 [95% CI, 1.03-1.38]; P = .02) and adolescence (AOR, 1.22 [95% CI, 1.02-1.45]; P = .03) was associated with elevated odds for anxiety. Conclusions and Relevance: In this longitudinal cohort study, early-life air and noise pollution exposure were prospectively associated with 3 common mental health problems from adolescence to young adulthood. There was a degree of specificity in terms of pollutant-timing-outcome associations. Interventions to reduce air and noise pollution exposure (eg, clean air zones) could potentially improve population mental health. Replication using quasi-experimental designs is now needed to shed further light on the underlying causes of these associations.

Association of early-life exposure to air and noise pollution with youth mental health: findings from the ALSPAC cohort.

BACKGROUND: Increasing evidence suggests that air pollution exposure contributes to the development of mental health problems, including psychosis and depression. However, little is known about the importance of early-life exposure, nor the potential role of noise pollution, a correlate of air pollution. We examined the association of exposure to air and noise pollution from pregnancy to age 12 years with three mental health problems assessed at ages 12, 18, and 24 years. METHODS: Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC), which tracks the development of about 14 000 babies who had expected delivery dates between April 1, 1991, and Dec 31, 1992, in Avon, UK. This was linked with novel data on nitrogen dioxide, PM2·5, and noise pollution in pregnancy, childhood (ages 1-9 years), and adolescence (ages 10-12 years). Psychotic experiences, depression, and anxiety were measured at ages 12, 18, and 24 years. Logistic regression models were controlled for individual-level, family-level, and area-level confounders, and e-values were calculated to estimate residual confounding. FINDINGS: Participants exposed to higher PM2.5, particularly during pregnancy, had greater odds for psychotic experiences (adjusted odds ratio 1·17 [95% CI 1·05-1·30]) and depression (1·11 [1·01-1·22]). There was little evidence associating nitrogen dioxide or noise pollution with psychotic experiences or depression. Conversely, higher nitrogen dioxide (but not PM2·5) exposure in pregnancy (1·16 [1·01-1·33]), and higher noise pollution in childhood (1·20 [1·06-1·37]) and adolescence (1·17 [1·02-1·35]), were associated with greater odds for anxiety. INTERPRETATION: Our study builds on evidence linking air pollution to psychosis and depression and provides rare longitudinal evidence linking noise pollution to anxiety. Our findings indicate that air pollution exposure earlier in development (eg, during pregnancy) might be particularly important, and suggest a degree of specificity in terms of pollutant-outcome associations. If causal, our findings suggest that interventions to reduce air pollution would improve global mental health. FUNDING: Wellcome Trust, UK Medical Research Council-Wellcome, and University of Bristol.

The relationship between type, timing and duration of exposure to adverse childhood experiences and adolescent self-harm and depression: findings from three UK prospective population-based cohorts.

BACKGROUND: Adverse childhood experiences (ACEs) are well-established risk factors for self-harm and depression. However, despite their high comorbidity, there has been little focus on the impact of developmental timing and the duration of exposure to ACEs on co-occurring self-harm and depression. METHODS: Data were utilised from over 22,000 children and adolescents participating in three UK cohorts, followed up longitudinally for 14-18 years: the Avon Longitudinal Study of Parents and Children (ALSPAC), the Millennium Cohort Study (MCS) and the Environmental Risk (E-Risk) Longitudinal Twin Study. Multinomial logistic regression models estimated associations between each ACE type and a four-category outcome: no self-harm or depression, self-harm alone, depression alone and self-harm with co-occurring depression. A structured life course modelling approach was used to examine whether the accumulation (duration) of exposure to each ACE, or a critical period (timing of ACEs) had the strongest effects on self-harm and depression in adolescence. RESULTS: The majority of ACEs were associated with co-occurring self-harm and depression, with consistent findings across cohorts. The importance of timing and duration of ACEs differed across ACEs and across cohorts. For parental mental health problems, longer duration of exposure was strongly associated with co-occurring self-harm and depression in both ALSPAC (adjusted OR: 1.18, 95% CI: 1.10-1.25) and MCS (1.18, 1.11-1.26) cohorts. For other ACEs in ALSPAC, exposure in middle childhood was most strongly associated with co-occurring self-harm and depression, and ACE occurrence in early childhood and adolescence was more important in the MCS. CONCLUSIONS: Efforts to mitigate the impact of ACEs should start in early life with continued support throughout childhood, to prevent long-term exposure to ACEs contributing to risk of self-harm and depression in adolescence.

Automatic detection of expressed emotion from Five-Minute Speech Samples: Challenges and opportunities.

Research into clinical applications of speech-based emotion recognition (SER) technologies has been steadily increasing over the past few years. One such potential application is the automatic recognition of expressed emotion (EE) components within family environments. The identification of EE is highly important as they have been linked with a range of adverse life events. Manual coding of these events requires time-consuming specialist training, amplifying the need for automated approaches. Herein we describe an automated machine learning approach for determining the degree of warmth, a key component of EE, from acoustic and text natural language features. Our dataset of 52 recorded interviews is taken from recordings, collected over 20 years ago, from a nationally representative birth cohort of British twin children, and was manually coded for EE by two researchers (inter-rater reliability 0.84-0.90). We demonstrate that the degree of warmth can be predicted with an F1-score of 64.7% despite working with audio recordings of highly variable quality. Our highly promising results suggest that machine learning may be able to assist in the coding of EE in the near future.

The general factor of psychopathology (p): Choosing among competing models and interpreting p.

Over the past 10 years, the general factor of psychopathology, p, has attracted interest and scrutiny. We review the history of the idea that all mental disorders share something in common, p; how we arrived at this idea; and how it became conflated with a statistical representation, the Bi-Factor Model. We then leverage the Environmental Risk (E-Risk) longitudinal twin study to examine the properties and nomological network of different statistical representations of p. We find that p performed similarly regardless of how it was modelled, suggesting that if the sample and content are the same the resulting p factor will be similar. We suggest that the meaning of p is not to be found by dueling over statistical models but by conducting well-specified criterion-validation studies and developing new measurement approaches. We outline new directions to refresh research efforts to uncover what all mental disorders have in common.

Social isolation, loneliness, and inflammation: A multi-cohort investigation in early and mid-adulthood.

Social isolation and loneliness have been associated with poor health and increased risk for mortality, and inflammation might explain this link. We used data from the Danish TRIAGE Study of acutely admitted medical patients (N = 6,144, mean age 60 years), and from two population-representative birth cohorts: the New Zealand Dunedin Longitudinal Study (N = 881, age 45) and the UK Environmental Risk (E-Risk) Longitudinal Twin Study (N = 1448, age 18), to investigate associations of social isolation with three markers of systemic inflammation: C-reactive protein (CRP), interleukin-6 (IL-6), and a newer inflammation marker, soluble urokinase plasminogen activator receptor (suPAR), which is thought to index systemic chronic inflammation. In the TRIAGE Study, socially isolated patients (those living alone) had significantly higher median levels of suPAR (but not CRP or IL-6) compared with patients not living by themselves. Social isolation prospectively measured in childhood was longitudinally associated with higher CRP, IL-6, and suPAR levels in adulthood (at age 45 in the Dunedin Study and age 18 in the E-Risk Study), but only suPAR remained associated after controlling for covariates. Dunedin Study participants who reported loneliness at age 38 or age 45 had elevated suPAR at age 45. In contrast, E-Risk Study participants reporting loneliness at age 18 did not show any elevated markers of inflammation. In conclusion, social isolation was robustly associated with increased inflammation in adulthood, both in medical patients and in the general population. It was associated in particular with systemic chronic inflammation, evident from the consistently stronger associations with suPAR than other inflammation biomarkers.

Cannabis use as a potential mediator between childhood adversity and first-episode psychosis: results from the EU-GEI case-control study.

BACKGROUND: Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis. METHODS: Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0-11 years), and late (12-17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use. RESULTS: The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord. CONCLUSIONS: Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.

Editorial: Salutogenic mental health science-A phoenix rising from the pathogenic ashes of psychiatry?

As highlighted by several of the papers featured in this current issue of the Journal, psychiatric research and practice is dominated by a pathogenic focus on understanding the origins of mental ill-health and developing interventions to prevent or treat psychopathology. The World Health Organization has called for a paradigm shift to move away from the almost exclusive focus on the absence of illness towards the promotion of mental, physical and social well-being among those with or at risk of psychiatric disorders. Adoption of a salutogenic approach, which focuses on factors and interventions that promote positive health and improve quality of life, has been heralded as the transformation psychiatry requires to achieve this ambitious aim. Looking forward, salutogenic mental health science should harness the power of longitudinal data and analytical techniques, centre lived experience expertise, and take heed of the cautionary tales of its pathogenic predecessor.

Integrating a virtual reality relaxation clinic within acute psychiatric services: A pilot study.

People with acute psychiatric conditions experience heightened stress, which is associated with worsened symptoms and increased violence on psychiatric wards. Traditional stress management techniques can be challenging for patients. Virtual reality (VR) relaxation appears promising to reduce stress; however, research on VR for psychiatric wards is limited. This mixed-methods study investigated feasibility and acceptability of integrating a VR relaxation clinic within acute psychiatric services. The study evaluated a VR relaxation session for inpatients and outpatients with acute psychiatric conditions (N = 42) and therapists' (N = 6) experience facilitating VR sessions for patients. Self-report assessments of psychological wellbeing were completed by patients pre- and post-VR. Patients and therapists provided qualitative feedback. The number of violent incidents and restrictive practices on the wards in the 12 weeks before VR implementation was compared to the first 12 weeks of VR. Post-VR, there were statistically significant increases in patients' relaxation, happiness, and connectedness to nature, and decreases in stress, anxiety, and sadness. Qualitative findings indicate patients found sessions enjoyable, relaxing, and helpful. Therapists provided positive feedback but highlighted practical challenges. Violent incidents and restrictive practices halved during VR implementation. VR relaxation appears feasible and acceptable in acute services. Larger studies should evaluate potential impact on psychiatric wards.

Assessing Mood With the Identifying Depression Early in Adolescence Chatbot (IDEABot): Development and Implementation Study.

BACKGROUND: Mental health status assessment is mostly limited to clinical or research settings, but recent technological advances provide new opportunities for measurement using more ecological approaches. Leveraging apps already in use by individuals on their smartphones, such as chatbots, could be a useful approach to capture subjective reports of mood in the moment. OBJECTIVE: This study aimed to describe the development and implementation of the Identifying Depression Early in Adolescence Chatbot (IDEABot), a WhatsApp-based tool designed for collecting intensive longitudinal data on adolescents' mood. METHODS: The IDEABot was developed to collect data from Brazilian adolescents via WhatsApp as part of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study. It supports the administration and collection of self-reported structured items or questionnaires and audio responses. The development explored WhatsApp's default features, such as emojis and recorded audio messages, and focused on scripting relevant and acceptable conversations. The IDEABot supports 5 types of interactions: textual and audio questions, administration of a version of the Short Mood and Feelings Questionnaire, unprompted interactions, and a snooze function. Six adolescents (n=4, 67% male participants and n=2, 33% female participants) aged 16 to 18 years tested the initial version of the IDEABot and were engaged to codevelop the final version of the app. The IDEABot was subsequently used for data collection in the second- and third-year follow-ups of the IDEA-RiSCo study. RESULTS: The adolescents assessed the initial version of the IDEABot as enjoyable and made suggestions for improvements that were subsequently implemented. The IDEABot's final version follows a structured script with the choice of answer based on exact text matches throughout 15 days. The implementation of the IDEABot in 2 waves of the IDEA-RiSCo sample (140 and 132 eligible adolescents in the second- and third-year follow-ups, respectively) evidenced adequate engagement indicators, with good acceptance for using the tool (113/140, 80.7% and 122/132, 92.4% for second- and third-year follow-up use, respectively), low attrition (only 1/113, 0.9% and 1/122, 0.8%, respectively, failed to engage in the protocol after initial interaction), and high compliance in terms of the proportion of responses in relation to the total number of elicited prompts (12.8, SD 3.5; 91% out of 14 possible interactions and 10.57, SD 3.4; 76% out of 14 possible interactions, respectively). CONCLUSIONS: The IDEABot is a frugal app that leverages an existing app already in daily use by our target population. It follows a simple rule-based approach that can be easily tested and implemented in diverse settings and possibly diminishes the burden of intensive data collection for participants by repurposing WhatsApp. In this context, the IDEABot appears as an acceptable and potentially scalable tool for gathering momentary information that can enhance our understanding of mood fluctuations and development.

Towards a youth mental health paradigm: a perspective and roadmap.

Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.

Associations between air pollution and mental health service use in dementia: a retrospective cohort study.

BACKGROUND: Little is known about the role of air pollution in how people with dementia use mental health services. OBJECTIVE: We examined longitudinal associations between air pollution exposure and mental health service use in people with dementia. METHODS: In 5024 people aged 65 years or older with dementia in South London, high resolution estimates of nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. Associations between air pollution and Community Mental Health Team (CMHT) events (recorded over 9 years) were examined using negative binomial regression models. Cognitive function was measured using the Mini Mental State Examination (MMSE) and health and social functioning was measured using the Health of the Nation Outcomes Scale (HoNOS65+). Associations between air pollution and both MMSE and HoNOS65+ scores were assessed using linear regression models. FINDINGS: In the first year of follow-up, increased exposure to all air pollutants was associated with an increase in the use of CMHTs in a dose-response manner. These associations were strongest when we compared the highest air pollution quartile (quartile 4: Q4) with the lowest quartile (Q1) (eg, NO2: adjusted incidence rate ratio (aIRR) 1.27, 95% CI 1.11 to 1.45, p<0.001). Dose-response patterns between PM2.5 and CMHT events remained at 5 and 9 years. Associations were strongest for patients with vascular dementia. NO2 levels were linked with poor functional status, but not cognitive function. CONCLUSIONS: Residential air pollution exposure is associated with increased CMHT usage among people with dementia. CLINICAL IMPLICATIONS: Efforts to reduce pollutant exposures in urban settings might reduce the use of mental health services in people with dementia, freeing up resources in already considerably stretched psychiatric services.

A magnetic resonance imaging-based morphometric and structural covariance network study of Brazilian adolescents stratified by depression risk

Objectives: To explore differences in regional cortical morphometric structure between adolescents at risk for depression or with current depression. Methods: We analyzed cross-sectional structural neuroimaging data from a sample of 150 Brazilian adolescents classified as low-risk (LR) (n=50) or high-risk (HR) for depression (n=50) or with current depression (n=50) through a vertex-based approach with measurements of cortical volume (CV), surface area (SA), and cortical thickness (CT). Differences between groups in subcortical volume and in the organization of networks of structural covariance were also explored. Results: No significant differences in brain structure between groups were observed in whole-brain vertex-wise CV, SA, or CT. Also, no significant differences in subcortical volume were observed between risk groups. In relation to the structural covariance network, there was an indication of an increase in the hippocampus betweenness centrality index in the HR group network compared to the LR and current depression group networks. However, this result was only statistically significant when applying false discovery rate correction for nodes within the affective network. Conclusion: In an adolescent sample recruited using an empirically based composite risk score, no major differences in brain structure were detected according to the risk and presence of depression.

Parental bonding style and illness severity in a longitudinal study of individuals with first episode psychosis.

A parenting style with high amounts of control combined with low caring or nurturing behaviour has been reported in association with mental disorders including schizophrenia. However, the association of parenting style with illness severity in individuals with schizophrenia has never been evaluated retrospectively or over a longitudinal time course. In a subset (n = 84) of the participants included in the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses)-10 study, we evaluated participants' perceptions of their own parents' bonding style at the time of their first episode of psychosis using the parental bonding instrument (PBI). We then examined the association between different bonding styles, illness course and severity, and global functioning over a 10-year follow-up. Participants who perceived that their fathers had a more caring and less controlling parenting style showed better functioning at follow-up. However, in contrast to previous research, participants who reported having been subject to uncaring and controlling parenting styles were not found to have a notably worse course of illness or symptom severity over the follow-up period. These results indicate that more optimal parental bonding styles may be associated with better overall functioning in individuals with psychosis but not with other measures of illness outcome.

Sex-specific inflammatory markers of risk and presence of depression in adolescents.

BACKGROUND: Associations between inflammatory markers and depression are reported among adults; however, less is known in adolescent depression in particular whether these associations are sex-specific. We aimed to identify inflammatory markers of increased risk and presence of depression in adolescence and their association with severity of depressive symptoms in the entire cohort and separately in boys and girls. METHODS: We measured serum cytokines using a Meso Scale Discovery electrochemiluminescence V-PLEX assay in a cohort of 150 adolescents stratified for risk/presence of depression. Risk group and sex-specific differences in inflammatory markers were assessed with 2-way mixed ANOVA, and sex-moderated associations between inflammatory markers and the severity of depressive symptoms were assessed with moderated multiple hierarchical regression analyses. RESULTS: We found a significant interaction between biological sex and the risk group, where boys showed higher interleukin (IL)-2 levels among the depressed group compared with the low-risk group. The severity of depressive symptoms was associated with elevated levels of IL-2 in boys, and of IL-6 in girls. There was a significant moderating effect of sex on the relationship between IL-2 and the severity of depressive symptoms but not for IL-6. LIMITATIONS: The cross-sectional design means that we cannot be certain about the direction of the associations. CONCLUSIONS: Our findings suggest sex-specific associations between inflammatory markers and the development of adolescent depression, where IL-2 may increase risk for depression and severity of depressive symptoms in boys, but not in girls. However, IL-6 may increase risk for more severe depressive symptoms in girls.

The developmental interplay between the p-factor of psychopathology and the g-factor of intelligence from age 7 through 16 years.

Intelligence and mental health are the core pillars of individual adaptation, growth, and opportunity. Here, we charted across childhood and adolescence the developmental interplay between the p-factor of psychopathology, which captures the experience of symptoms across the spectrum of psychiatric disorders, and the g-factor of general intelligence that describes the ability to think, reason, and learn.Our preregistered analyses included 7,433 twin pairs from the Twins Early Development Study (TEDS), who were born 1994 to 1996 in England and Wales. At the ages 7, 9, 12, and 16 years, the twins completed two to four intelligence tests, and multi-informant measures (i.e., self-, parent- and teacher-rated) of psychopathology were collected.Independent of their cross-sectional correlations, p- and g-factors were linked by consistent, bidirectional, and negative cross-lagged paths across childhood and adolescence (from -.07 to -.13 with 95% CIs from -.03 to -.15). The cross-lagged paths from intelligence to psychopathology were largely due to genetic influences, but the paths from psychopathology to intelligence were driven by environmental factors, and increasingly so with age.Our findings suggest that intelligence and psychopathology are developmentally intertwined due to fluctuating etiological processes. Understanding the interplay of g- and p-factors is key for improving children's developmental outcomes.

Air quality and mental health: evidence, challenges and future directions.

BACKGROUND: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. AIMS: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. METHOD: Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. RESULTS: There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action. CONCLUSIONS: There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course.