The period of childhood and adolescence represents a critical stage for psychological development, with mental health during formative years exerting a profound impact on an individual's lifelong health and social development. In recent years, the prevalence of mental disorders among children and adolescents in China has continued to rise; however, the utilization rate of mental health services remains significantly low, highlighting a prominent contradiction of high demand and low uptake. The current service system faces multiple challenges: widespread lack of public mental health knowledge, particularly among parents; significant disparities in service accessibility between urban and rural areas, with severe resource shortages in rural regions; stigma that hinders help-seeking behavior; and an insufficient number of professionals, coupled with an urgent need for capacity enhancement, particularly a severe shortage of child psychiatrists. Moving forward, development should focus on four key areas: (1) establishing a multi-tiered service network that encompasses prevention, screening, intervention, and rehabilitation, while strengthening collaborative mechanisms among families, schools, and communities; (2) enhancing the construction of professional talent teams and conducting cultural competence training; (3) shifting the service model from a treatment-focused approach to a prevention-prioritized one, emphasizing early identification and health promotion; and (4) fully leveraging technological means to develop digital mental health services, thereby improving accessibility and precision of services. Only through systematic policy support, cross-departmental resource integration, and innovative social concepts can we build a child- and adolescent-centered, accessible, effective, and friendly mental health service system that supports high-quality population development.

Neurodevelopmental disorders are a group of conditions that originate in early childhood and affect cognitive, language, motor, and social functions. They include intellectual developmental disorder, autism spectrum disorder, attention deficit hyperactivity disorder, and others. The release of ICD-11 CDDR has provided a new framework and guidance for the diagnosis, classification, and clinical management of neurodevelopmental disorders. This expert review focuses on the classification of neurodevelopmental disorders under the ICD-11 CDDR framework, diagnostic procedures, multidisciplinary collaboration models, and intervention principles, aiming to serve as a reference for relevant professionals.

This article examines the clinical application of the ICD-11 Clinical Descriptions and Diagnostic Requirements (CDDR) for Mental, Behavioural and Neurodevelopmental Disorders in the diagnosis and assessment of mood disorders in children and adolescents. It systematically reviews key updates in the ICD-11 CDDR, including shifts in classification from a categorical to a spectrum-based approach, refined diagnostic criteria for depressive and bipolar disorders, and the introduction of Disruptive Mood Dysregulation Disorder (DMDD). Emphasis is placed on the importance of adopting a developmental perspectives, clarifying symptom definitions, and differentiating between chronic irritability and episodic mood episodes. A structured clinical assessment and diagnostic workflow is proposed to enhance diagnostic accuracy and support targeted interventions. The article concludes with recommendations for training, localized research, and clinical integration to facilitate the effective implementation of ICD-11 CDDR in China.

Psychological distress in children and adolescents often manifests as somatic symptoms. Both young patients and their parents tend to overfocus on physical complaints while neglecting the core role of psychosocial factors in the onset and progression of these symptoms. This misattribution not only delays the timing of treatment but also leads to adverse consequences: on one hand, it may result in the decline of social functioning such as school refusal and withdrawal of interpersonal functions; on the other hand, family members may be skeptical about the effectiveness of psychiatric or mental health assessments and thus continue to seek examinations for ruling out physical organic lesions, and excessive examinations will increase the economic burden. From the medical perspective, medical institutions such as community health service centers and pediatric departments currently have a low recognition rate of such diseases. There is no unified treatment plan for psychosomatic diseases, and the interval from the onset of symptoms to the initiation of treatment is relatively long. Therefore, this article aims to raise awareness among medical workers, especially those in primary medical institutions, to promote early detection, timely diagnosis, and effective intervention for pediatric psychosomatic disorders.

To explore the network structures of anxiety and depressive emotions among early adolescent elementary school students and to examine gender differences in these structures.

In April 2025, a cluster sampling method was employed to select 1182 students in grades 4~6 from two elementary schools in Nanjing and Huai'an. Depression, anxiety, smartphone addiction, and emotion regulation strategies were assessed using the DSRSC, SCARED, SAS-SV, and ERQ scales. Gender differences were analyzed via t-tests. Core and bridging nodes were identified through regularized partial correlation networks, with stability and gender differences evaluated using Bootstrap sampling and network comparison tests.

Girls scored significantly higher than boys on both anxiety and depression measures (P＜0.001). Network analysis revealed that generalized anxiety had the highest centrality (strength=1.870, 95%CI: 1.214~2.681), while smartphone addiction exhibited the strongest bridging effect (bridge expected influence=0.638, 95%CI: 0.538~0.736). Gender difference analysis indicated stronger depression-social anxiety connections in girls (P=0.003), while boys exhibited stronger links between generalized anxiety and separation anxiety (P=0.047) and between cognitive reappraisal and expressive inhibition (P=0.042). Regarding bridge expected influence, boys exhibited the highest effect for smartphone addiction (bridge expected influence=0.669, 95%CI: 0.531~0.777), while girls showed the highest effect for depression (bridge expected influence=0.723, 95%CI: 0.594~0.866).

This study highlights the critical need for early adolescent interventions to address the central role of generalized anxiety and its bridging link to smartphone addiction. Concurrently, prevention strategies should be gender-tailored: focusing on externalizing behavioral issues in boys and internalizing emotional problems such as depression in girls.

To explore the characteristics of childhood trauma experiences, implicit memory, and explicit memory in first-degree relatives (parents) of children with comorbid attention deficit hyperactivity disorder (ADHD), in order to provide insight into the disorder's neuropsychological pathogenesis and inform family-based psychological interventions.

A total of 88 children with ADHD (disease group) who attended the outpatient department of Fouth People’s Hospital of Hefei from July 2022 to February 2024, along with their first-degree relatives, were selected, of which 31 were classified as the comorbidity subgroup. Additionally, 30 healthy children (matched in age, gender, and intelligence) from a primary and secondary school in Hefei, together with their first-degree relatives, were chosen as a healthy control group. The Chinese version of the Swanson Nolan and Pelham Version IV Scale (SNAP-IV) was used to assess the severity of ADHD symptoms in children. The Childhood Trauma Questionnaire-Short Form (CTQ-SF) was employed to evaluate the childhood trauma experiences of the relatives. The lexical perceptual speed test task and lexical recognition task were respectively adopted to measure the implicit memory and explicit memory of the relatives. Analysis of variance (ANOVA) and Pearson correlation analysis were applied for data analyses.

The comorbidity rate of ADHD in the disease group was 27.23% (31/88). The SNAP-IV score of children in the comorbidity subgroup (49.00±12.02) was significantly higher than that in the non-comorbidity subgroup (41.61±10.06) and the healthy control group (13.43±6.89). The total CTQ-SF score of parents in the comorbidity subgroup (45.81±7.96) was higher than that of the non-comorbidity subgroup (40.28±7.78) and the healthy control group (37.03±5.34). Specifically, the scores of emotional abuse and sexual abuse factors in parents of the comorbidity subgroup were higher than those of the other two groups; the score of physical neglect factor was higher than that of the non-comorbidity subgroup; and the scores of emotional neglect and physical abuse dimensions were higher than those of the healthy control group (all P＜0.05). The explicit reaction time in parents of the comorbidity subgroup [(1059.63±122.01) ms] was longer than that of the non-comorbidity subgroup [(928.43±118.17)] ms and the healthy control group [(928.37±202.88) ms], while the accuracy of implicit memory [(20.75±15.16)%] was lower than that of the non-comorbidity subgroup [(58.10±33.18)%] and the healthy control group [(83.61±20.53)%] (all P＜0.001). The accuracy of implicit memory in parents of the comorbidity subgroup was negatively correlated with the total CTQ-SF score (r=-0.506), sexual abuse score (r=-0.422), and physical neglect score (r=-0.479), whereas there was no significant correlation between explicit memory and childhood trauma (P＞0.05).

First-degree relatives of children with comormid ADHD have more severe childhood trauma experiences and deficits in implicit and explicit memory functions. Furthermore, the childhood trauma experiences of relatives are closely associated with implicit memory impairment. This suggests that the early-life trauma of parents may indirectly increase the risk of comorbidities in children with ADHD by affecting memory function, which can provide a target for family psychological intervention for ADHD.

To examine the effects of overweight/obesity on sleep-related breathing disorders, cardiovascular risk characteristics, and their interrelationships in adolescents with bipolar disorder (BD).

A cross-sectional study was conducted on 44 BD patients aged 12–18 years from the People's Hospital of Xinjiang Uygur Autonomous Region between June 2024 to June 2025. According to the Chinese screening standard for overweight and obesity in school-age children and adolescents, the patients were divided into an overweight/obesity BD group (n=23) and a normal-weight BD group (n=21). Demographic data, clinical course, and objective sleep parameters were collected via overnight polysomnography (PSG). Cardiovascular indicators were measured simultaneously. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and Pearson and Spearman correlation analyses were employed to examine the related factors.

The overweight/obesity group had a longer disease duration, higher systolic blood pressure (SBP), lower sleep efficiency (SE), and significantly higher obstructive apnea-hypopnea index (OAHI) and subjective sleep quality scores compared to the normal-weight group (all P＜0.05). Logistic regression analysis indicated that SE (OR=0.867, 95%CI: 0.765~0.982), OAHI (OR=1.374, 95%CI: 1.017~1.858), SBP (OR=1.190, 95%CI: 1.066~1.328), and PSQI sleep quality score (OR=2.280, 95%CI: 1.041~4.994) were influencing factors for overweight/obesity status. Multivariate analysis further confirmed that SE (OR=0.826, 95%CI: 0.699~0.976, P=0.025) and SBP (OR=1.254, 95%CI: 1.075~1.461, P=0.004) were independent predictors of overweight/obesity status. Correlation analysis revealed that BMI was negatively correlated with SE (r=−0.334, P=0.027) and positively correlated with OAHI (ρ=0.436, P=0.003) and SBP (r =0.467, P＜0.01).

Overweight/obese adolescents with BD exhibit more severe sleep-related breathing disorders and cardiovascular risks. Sleep efficiency and SBP are independent predictors of overweight/obesity status. Comprehensive management of body weight, sleep, and blood pressure should be emphasized in clinical practice to improve patient prognosis.

To explore the relationship between family function and the severity of depression, and analyze the chain mediation effect of resilience and negative coping in this relationship.

A total of 200 adolescents with depression were recruited from Tianjin Anding Hospital, and standard questionnaires were administered for each participant. The family function, resilience, coping style, and depression were assessed by Adaptation Partnership Growth Affection Resolve, Resilience Scale for Chinese Adolescents, Simplified Coping Style Questionnaire, and Beck Depression Inventory-II, respectively. Bootstrap analysis was performed in this study for mediation analysis.

Family function was significantly and positively correlated with resilience (r=0.632, P＜0.001) and significantly and negatively correlated with negative coping and depression (r=-0.561 and -0.570, respectively, P＜0.001). Resilience was significantly and negatively correlated with negative coping and depression (r=-0.666 and -0.641, respectively, P＜0.001). Negative coping was significantly and positively correlated with depression (r=0.972, P＜0.001). Family function was a direct predictor of depression (β=-0.570, P＜0.001) as well as an indirect predictor through the mediating effects of resilience (β=-1.449, 95%CI: -2.161~-0.819) and negative coping (β=-1.273, 95%CI: -4.916~-2.074). Family function was a direct predictor of depression (β=-0.570, P＜0.001) as well as an indirect predictor through the mediating effects of resilience (β=-1.449, 95%CI: -2.161~-0.819), negative coping (β=-1.273, 95%CI: -4.916~-2.074), and the sequential mediation between resilience and negative coping (β=-0.047, 95%CI: -0.209~-0.077).

Family function can directly predict the severity of depression, and can also exert an indirect effect on depression severity through the chain mediation pathway of resilience and negative coping.

Depressive disorder in children and adolescents represents a growing public health concern, with its prevalence rising annually. Characterized by complex etiologies and significant functional impairment, untreated depression in this population can lead to chronic mental health issues in adulthood, presenting substantial challenges to both clinical services and public health systems. While the causes are often understood within a biopsychosocial framework, the unique developmental stage of childhood and adolescence introduces specific risk factors distinct from those seen in adults. This article reviews the multifactorial etiology of pediatric and adolescent depression, aiming to inform early screening and precision prevention efforts, and to guide developmentally appropriate intervention and treatment strategies.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood, primarily characterized by inattention, impulsivity, and hyperactivity. With an estimated prevalence of approximately 8.0%, ADHD often persists into adulthood. Traditional explanations of its pathophysiological mechanisms mainly focus on abnormalities in the dopamine and norepinephrine pathways in the brain. However, a growing body of research is expanding the perspective to the microbiota-gut-brain axis (MGBA), revealing that the gut microbiota is involved in the pathogenesis and development of ADHD through neural, endocrine, and immune pathways. This article reviews recent advances in the understanding of the characteristics of the gut microbiota in children with ADHD, the MGBA pathways involved, and related intervention studies, aiming to provide insights for understanding the mechanisms of the gut-brain axis in ADHD and developing precise intervention strategies.

Depression disorder, as one of the main factors causing disability worldwide, has long been confronted with key challenges in clinical treatment, such as low response rates to therapeutic drugs and significant side effects. Against this backdrop, repetitive transcranial magnetic stimulation (rTMS), as a non-invasive treatment technique, has demonstrated unique advantages in the treatment of depression. At its core, rTMS utilizes electromagnetic pulses to regulate the activity of neurons in the cerebral cortex, avoiding the systemic effects brought by drug metabolism. Although existing research has systematically evaluated treatment regimens with different stimulation parameters, current clinical applications still face predicaments such as insufficient mechanism explanation and unclear molecular pathways underlying neural plasticity changes. Exosomes, as a crucial messenger for intercellular information transmission, have seen a highly significant association between the specific miRNA spectra that they carry and the synaptic remodeling process confirmed by multiple studies in recent years. This natural information transmission system may help explain the sustained neuroplastic changes induced by rTMS. This article reviews clinical advances in rTMS for depression treatment and the role of exosomes in the disease, and further explores the potential mechanism of their interaction, with the aim of providing a new perspective for the treatment of depression.

The prevalence of major depressive disorder (MDD) among adolescents has been rising steadily, making it a serious public health issue that affects young people's psychological well-being and social functioning. Although traditional treatments such as pharmacotherapy and psychotherapy have demonstrated certain efficacy, they are often limited by delayed onset of action, poor adherence, and potential side effects. In recent years, transcranial alternating current stimulation (tACS), a novel non-invasive neuromodulation technique, has shown promising progress in the treatment of adult depressive disorders. This review summarizes the potential applications of tACS in adolescent MDD, with a focus on its clinical evidence and parameter mechanisms. Building on findings and insights from adult studies, it further proposes future research directions, aiming to provide new theoretical and practical perspectives for the intervention of adolescent depressive disorders.