Division of Clinical Child and Adolescent Psychology, University of Bern, Bern, Switzerland
Division of Clinical Child and Adolescent Psychology, University of Bern, Bern, Switzerland.
BMJ Open. 2024 Nov 14;14(11):e084821. doi: 10.1136/bmjopen-2024-084821.
Adolescent mental health is a global public health challenge as most cases remain undetected and untreated, and consequently, have a high likelihood of persistence or recurrence. It is critical to improve early detection of mental disorders and to target individuals experiencing subclinical symptoms. However, most indicated prevention approaches have been developed for risk syndromes of specific mental disorders. This contradicts the increasing recognition of emerging psychopathology as a complex system characterised by rapid shifts in subclinical symptoms, cutting across diagnostic categories and interacting with each other over time. Therefore, this study aims to examine the dynamic course, pattern and network of subclinical symptoms and transdiagnostic mechanisms over time.
The EMERGE-study is a prospective, naturalistic, 1-year follow-up study. A general population sample of 1196 adolescents will be recruited. Inclusion criteria are age between 11 and 17 years, German language skills, main residency in Switzerland and access to internet. Individuals will be excluded if they have a current or lifetime axis I mental disorder. Assessments of subclinical symptoms of several mental disorders and potential transdiagnostic mechanisms will be conducted at baseline and at 3-month, 6-month, 9-month and 12-month follow-up. Structural equation modelling will be used to estimate the homotypic and heterotypic patterns of subclinical symptoms and the associations with transdiagnostic mechanisms. Latent growth mixture modelling and growth mixture survival analysis will be carried out to identify subclasses of individuals with different trajectories of subclinical symptoms that may be predictive of an onset of a mental disorder. Network analysis will be applied to assess the centrality of subclinical symptoms and how networks of emerging psychopathology change over time.
Ethical approval was obtained from the Bern Cantonal Ethics Committee (ID 2020-02108). All findings will be disseminated by publication in peer-reviewed scientific journals and by presentation of the results to conferences and stakeholder organisation events.
青少年心理健康是一个全球性的公共卫生挑战，因为大多数病例未被发现和治疗，因此很有可能持续或复发。改善精神障碍的早期发现，并针对出现亚临床症状的个体是至关重要的。然而，大多数有针对性的预防方法都是针对特定精神障碍的风险综合征开发的。这与越来越多的认识相矛盾，即新兴精神病理学是一个复杂的系统，其特点是亚临床症状迅速变化，跨越诊断类别，并随时间相互作用。因此，本研究旨在考察亚临床症状和跨诊断机制随时间的动态过程、模式和网络。
EMERGE 研究是一项前瞻性、自然主义、为期 1 年的随访研究。将招募 1196 名青少年的一般人群样本。纳入标准为年龄在 11 至 17 岁之间、具有德语语言技能、主要居住在瑞士并能上网。如果个体当前或一生中存在任何轴 I 精神障碍，则将被排除在外。将在基线和 3 个月、6 个月、9 个月和 12 个月随访时评估几种精神障碍的亚临床症状和潜在的跨诊断机制。结构方程模型将用于估计亚临床症状的同型和异型模式，以及与跨诊断机制的关联。潜在增长混合模型和增长混合生存分析将用于识别具有不同亚临床症状轨迹的个体亚类，这些轨迹可能预示着精神障碍的发生。网络分析将用于评估亚临床症状的中心性以及新兴精神病理学网络如何随时间变化。
伯尔尼州伦理委员会（ID 2020-02108）已批准该研究。所有发现都将通过在同行评议的科学期刊上发表和在会议和利益相关者组织活动上展示结果来传播。
