We need rapid clinical translation!

Psychiatric disorders are developmental disorders. About 75% of individuals with mental illness experience their first symptoms before the age of 25 years. Among adolescents, more than 50% experience episodes of mental ill-health. Accordingly, nationally representative surveys estimate the life-time prevalence for any mental health disorder in this age group at around 45%, with a world-wide pooled point prevalence of 13%. These numbers indicate that currently about 96 million adolescents worldwide are affected by mental health problems. Affective disorders (i.e., depression and anxiety) are most common among adolescents and frequently comorbid. In 2014, an estimated 2.8 million adolescents in the United States experienced at least one major depressive episode, representing 11.4% of the underage U.S. population. Representative data from European countries illustrate similar rates among adolescents (7.1%–19.4%) with regional differences. Psychiatric disorders present a major burden for the individual and our society, placing them distant first in the global burden of disease statistics. 

Still, this is not reflected in our global efforts, aiming to increase the understanding of clinical entities early in life, ultimately reducing their harm and societal costs. Identifying those at risk for the development of psychopathology and providing early intervention are the two incremental tasks, we as a field are facing. Importantly, not all patients with psychiatric disorders receive help and only a minority of those presenting in the professional health care system benefit from the treatment options currently available. The research to clinical practice gab in child and adolescent psychiatry is significant - although we know about other treatment options, these are only implemented in clinical care years later. By systematically monitoring the existing evidence for innovative treatment approaches and writing comprehensive reviews we aim to speed up clinical translation.

Examples of our efforts to close the science to practice gap in child and adolescent psychiatry:

• Vöckel J, Markser A, Wege L, Wunram HL, Sigrist C, Koenig J. Pharmacological Anti-Inflammatory Treatment in Children and Adolescents with Depressive Symptoms: A Systematic-Review and Meta-Analysis. European Neuropsychopharmacology, 2024: 78:16-29, DOI: 10.1016/j.euroneuro.2023.09.006 [PubMed]
• Sigrist C, Torki B, Bolz LO, Jeglorz T, Bolz A, Koenig J. Transcutaneous Auricular Vagus Nerve Stimulation in Pediatric Patients – A Systematic Review of Clinical Treatment Protocols and Stimulation Parameters. Neuromodulation, 2023: 26(3): 507-517, DOI: 10.1016/j.neurom.2022.07.007 [PubMed]
• Vöckel J, Spitznagel N, Markser A, Sigrist C, Koenig J. A paucity of evidence in youth: The curious case of transcranial direct current stimulation for depression. Asian J Psychiatr 2024; 91:103838. DOI: 10.1016/j.ajp.2023.103838 [PubMed]
• Sigrist C, Vöckel J, MacMaster FP, Farzan F, Croarkin PE, Galletly C, Kaess M, Bender S, Koenig J. Transcranial magnetic stimulation in the treatment of adolescent depression –A systematic review and meta-analysis of aggregated and individual patient data from uncontrolled studies. European Child & Adolescent Psychiatry, 2022; 31(1): 1501-1525; DOI: 10.1007/s00787-022-02021-7 [PubMed]