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Chapter 3 - Risk Factors for Childhood Psychopathology

Published online by Cambridge University Press:  10 October 2025

Shermin Imran
Affiliation:
Greater Manchester NHS Foundation Trust
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Summary

A survey found that 1 in 6 (16%) of children aged between 5 and 16 years has a probable mental illness. Furthermore, research has shown that most of these disorders have their origins in childhood, even if they are typically diagnosed in adulthood. Childhood represents a critical period of physical, cognitive, psychological, behavioural and social transformation. Identifying risk and protective factors that alter the typical developmental trajectory could have long-term educational, social, societal and economic implications. This chapter will address what is meant by the term risk factor and how these can be identified, provide examples of risk factors thought to be important in child and adolescent psychiatry. It concludes with some case vignettes to highlight the importance of taking a developmental biopsychosocial approach to identifying risk, considering predisposing, precipitating, perpetuating and protective factors.

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Publisher: Cambridge University Press
Print publication year: 2025

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References

NHS Digital. Mental Health of Children and Young People in England, 2020: Wave 1 follow up to the 2017 survey. NHS Digital, 2020.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):593602.CrossRefGoogle ScholarPubMed
Paus, T, Keshavan, M, Giedd, JN. Why Do Many Psychiatric Disorders Emerge During Adolescence? Nat Rev Neurosci. 2008 Nov 12;9(12):947–57.CrossRefGoogle ScholarPubMed
Engel, GL. The Need for a New Medical Model: A Challenge for Biomedicine. Science. 1977 April 8;196(4286):129–36.CrossRefGoogle Scholar
Laver-Bradbury, C, Thompson, MJJ, Gale, C, Hooper, CM. (eds.). Child and Adolescent Mental Health: Theory and Practice. 3rd ed. CRC Press, 2021. https://doi.org/10.4324/9781003083139.CrossRefGoogle Scholar
Pettersson, E, Lichtenstein, P, Larsson, H, et al. Genetic Influences on Eight Psychiatric Disorders Based on Family Data of 4 408 646 Full and Half-siblings, and Genetic Data of 333 748 Cases and Controls. Psychol Med. 2019 May 1;49(7):1166–73.Google ScholarPubMed
Schneider, M, Debbané, M, Bassett, AS, et al. Psychiatric Disorders from Childhood to Adulthood in 22q11.2 Deletion Syndrome: Results from the International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome. Am J Psychiatry. 2014;171(6):627–39.CrossRefGoogle Scholar
Chawner, SJRA, Owen, MJ, Holmans, P, et al. Genotype–Phenotype Associations in Children with Copy Number Variants Associated with High Neuropsychiatric Risk in the UK (IMAGINE-ID): A Case-Control Cohort Study. Lancet Psychiatry. 2019 Jun 1;6(6):493505.CrossRefGoogle ScholarPubMed
Cross-Disorder Group of the Psychiatric Genomics Consortium, Hong Lee, S, Ripke, S, et al. Genetic Relationship Between Five Psychiatric Disorders Estimated from Genome-Wide SNPs. Nat Genet. 2013;45(9):984–94.Google Scholar
Arango, C, Dragioti, E, Solmi, M, et al. Risk and Protective Factors for Mental Disorders beyond Genetics: An Evidence-Based Atlas. World Psychiatry. 2021 Oct 1;20(3):417–36.CrossRefGoogle ScholarPubMed
Kim, JH, Kim, JY, Lee, J, et al. Environmental Risk Factors, Protective Factors, and Peripheral Biomarkers for ADHD: An Umbrella Review. Lancet Psychiatry. 2020 Nov 1;7(11):955–70.CrossRefGoogle ScholarPubMed
Jones, KL, Smith, DW. Recognition of the Fetal Alcohol Syndrome in Early Infancy. Lancet. 1973 Nov 3;302(7836):9991001.CrossRefGoogle ScholarPubMed
Aiton, N. Neglect of Fetal Alcohol Spectrum Disorder Must End. BMJ. 2021 Dec 6;375:n2969.CrossRefGoogle ScholarPubMed
Mattson, SN, Bernes, GA, Doyle, LR. Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated with Prenatal Alcohol Exposure. Alcohol Clin Exp Res. 2019 Jun 1;43(6):1046–62.CrossRefGoogle ScholarPubMed
Mukherjee, RAS, Cook, PA, Norgate, SH, Price, AD. Neurodevelopmental Outcomes in Individuals with Fetal Alcohol Spectrum Disorder (FASD) with and Without Exposure to Neglect: Clinical Cohort Data from a National FASD Diagnostic Clinic. Alcohol. 2019 May 1;76:2328.CrossRefGoogle ScholarPubMed
Ross, EJ, Graham, DL, Money, KM, Stanwood, GD. Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn. Neuropsychopharmacology. 2015 Jan 1;40(1):61.CrossRefGoogle Scholar
Lavebratt, C, Yang, LL, Giacobini, MB, et al. Early Exposure to Antibiotic Drugs and Risk for Psychiatric Disorders: A Population-Based Study. Transl Psychiatry. 2019 Nov 26;9(1):317.CrossRefGoogle ScholarPubMed
Liew, Z, Ritz, B, Rebordosa, C, Lee, PC, Olsen, J. Acetaminophen Use During Pregnancy, Behavioral Problems, and Hyperkinetic Disorders. JAMA Pediatr. 2014;168(4):313–20.Google ScholarPubMed
Christensen, J, Pedersen, L, Sun, Y, Dreier, JW, Brikell, I, Dalsgaard, S. Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs with Risk for Attention-Deficit/Hyperactivity Disorder in Offspring. JAMA Netw Open. 2019 Jan 4;2(1):e186606.CrossRefGoogle ScholarPubMed
Christensen, J, Grnøborg, TK, Srøensen, MJ, et al. Prenatal Valproate Exposure and Risk of Autism Spectrum Disorders and Childhood Autism. JAMA. 2013 Apr 24;309(16):1696–703.CrossRefGoogle ScholarPubMed
Liu, X, Agerbo, E, Ingstrup, KG, et al. Antidepressant Use During Pregnancy and Psychiatric Disorders in Offspring: Danish Nationwide Register Based Cohort Study. BMJ. 2017 Sep 6;358:j3668.Google ScholarPubMed
Hysing, M, Elgen, I, Gillberg, C, Lie, SA, Lundervold, AJ. Chronic Physical Illness and Mental Health in Children. Results from a Large-Scale Population Study. J Child Psychol Psychiatry. 2007 Aug;48(8):785–92.CrossRefGoogle ScholarPubMed
Dobbie, M, Mellor, D. Chronic Illness and Its Impact: Considerations for Psychologists. Psychol Health Med. 2008 Oct;13(5):583–90.CrossRefGoogle ScholarPubMed
Ferro, MA, Lipman, EL, Van Lieshout, RJ, et al. Cohort Profile: Multimorbidity in Children and Youth Across the Life-course (MY LIFE) Study. J Can Acad Child Adolesc Psychiatry. 2021;30(2):104–15.Google ScholarPubMed
Merikangas, KR, Calkins, ME, Burstein, M, et al. Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study. Pediatrics. 2015 Apr 1;135(4):e927–38.CrossRefGoogle ScholarPubMed
Carney, R, Imran, S, Law, H, Folstad, S, Parker, S. Evaluation of the Physical Health of Adolescent In-patients in Generic and Secure Services: Retrospective Case-Note Review. BJPsych Bull. 2020 Jun;44(3):95102.CrossRefGoogle ScholarPubMed
Köhler-Forsberg, O, Petersen, L, Gasse, C, et al. A Nationwide Study in Denmark of the Association Between Treated Infections and the Subsequent Risk of Treated Mental Disorders in Children and Adolescents. JAMA Psychiatry. 2019 Mar 1;76(3):271–79.CrossRefGoogle ScholarPubMed
Buchberger, B, Huppertz, H, Krabbe, L, Lux, B, Mattivi, JT, Siafarikas, A. Symptoms of Depression and Anxiety in Youth with Type 1 Diabetes: A Systematic Review and Meta-analysis. Psychoneuroendocrinology. 2016 Aug 1;70:7084.CrossRefGoogle ScholarPubMed
Quilter, MC, Hiraki, LT, Korczak, DJ. Depressive and Anxiety Symptom Prevalence in Childhood-Onset Systemic Lupus Erythematosus: A Systematic Review. Lupus. 2019 Jun 1;28(7):878–87.CrossRefGoogle ScholarPubMed
Kayser, MS, Dalmau, J. Anti-NMDA Receptor Encephalitis in Psychiatry. Curr Psychiatry Rev. 2011 Aug 29;7(3):189.CrossRefGoogle ScholarPubMed
Friedman, MJ, Sharieff, GQ. Seizures in Children. Pediatr Clin North Am. 2006 Apr;53(2):257–77.CrossRefGoogle ScholarPubMed
Bertelsen, EN, Larsen, JT, Petersen, L, Christensen, J, Dalsgaard, S. Childhood Epilepsy, Febrile Seizures, and Subsequent Risk of ADHD. Pediatrics. 2016 Aug 1;138(2):20154654. https://doi.org/10.1542/peds.2015-4654. Epub 2016 Jul 13. PMID: 27412639.CrossRefGoogle ScholarPubMed
Gaitatzis, A, Trimble, MR, Sander, JW. The Psychiatric Comorbidity of Epilepsy. Acta Neurol Scand. 2004 Oct 1;110(4):207–20.CrossRefGoogle ScholarPubMed
Gillberg, C, Lundström, S, Fernell, E, Nilsson, G, Neville, B. Febrile Seizures and Epilepsy: Association with Autism and Other Neurodevelopmental Disorders in the Child and Adolescent Twin Study in Sweden. Pediatr Neurol. 2017 Sep 1;74:8086.e2.CrossRefGoogle ScholarPubMed
Vestergaard, M, Pedersen, CB, Christensen, J, Madsen, KM, Olsen, J, Mortensen, PB. Febrile Seizures and Risk of Schizophrenia. Schizophr Res. 2005 Mar 1;73(2–3):343–49.CrossRefGoogle ScholarPubMed
Dreier, JW, Li, J, Sun, Y, Christensen, J. Evaluation of Long-Term Risk of Epilepsy, Psychiatric Disorders, and Mortality Among Children with Recurrent Febrile Seizures: A National Cohort Study in Denmark. JAMA Pediatr. 2019 Dec 1;173(12):1164–70.CrossRefGoogle ScholarPubMed
Gerring, JP, Brady, KD, Chen, A, et al. Premorbid Prevalence of ADHD and Development of Secondary ADHD After Closed Head Injury. J Am Acad Child Adolesc Psychiatry. 1998 Jun 1;37(6):647–54.CrossRefGoogle ScholarPubMed
Max, JE, Koele, SL, Smith, WL, et al. Psychiatric Disorders in Children and Adolescents After Severe Traumatic Brain Injury: A Controlled Study. J Am Acad Child Adolesc Psychiatry. 1998;37(8):832–40.Google ScholarPubMed
Koenen, KC, Moffitt, TE, Roberts, AL, et al. Article Childhood IQ and Adult Mental Disorders: A Test of the Cognitive Reserve Hypothesis. Am J Psychiatry. 2009;166(1):5057.CrossRefGoogle ScholarPubMed
Emerson, E, Hatton, C. The Mental Health of Children and Adolescents with Learning Disabilities in Britain. Br J Psychiatry. 2007 Dec; 191:493–99. https://doi.org/10.1192/bjp.bp.107.038729.CrossRefGoogle ScholarPubMed
Gilissen, C, Hehir-Kwa, JY, Thung, DT, et al. Genome Sequencing Identifies Major Causes of Severe Intellectual Disability. Nature. 2014;511(7509):344–47.CrossRefGoogle ScholarPubMed
Yew, SGK, O’Kearney, R. Emotional and Behavioural Outcomes Later in Childhood and Adolescence for Children with Specific Language Impairments: Meta-analyses of Controlled Prospective Studies. J Child Psychol Psychiatry. 2013 May;54(5):516–24.CrossRefGoogle ScholarPubMed
Toseeb, U, Oginni, OA, Dale, PS. Developmental Language Disorder and Psychopathology: Disentangling Shared Genetic and Environmental Influences. J Learn Disabil. 2022 May–Jun;55(3):185–99. https://doi.org/10.1177/00222194211019961.CrossRefGoogle ScholarPubMed
Newbury, DF, Gibson, JL, Conti-Ramsden, G, Pickles, A, Durkin, K, Toseeb, U. Using Polygenic Profiles to Predict Variation in Language and Psychosocial Outcomes in Early and Middle Childhood. J Speech, Lang Hear Res. 2019 Aug 19;62(9):3381–96.CrossRefGoogle ScholarPubMed
Emerson, E. Mothers of Children and Adolescents with Intellectual Disability: Social and Economic Situation, Mental Health Status, and the Self-Assessed Social and Psychological Impact of the Child’s Difficulties. J Intellect Disabil Res. 2003 May;47(4–5):385–99.CrossRefGoogle ScholarPubMed
Emerson, E, McCulloch, A, Graham, H, Blacher, J, Llwellyn, GM, Hatton, C. Socioeconomic Circumstances and Risk of Psychiatric Disorders Among Parents of Children with Early Cognitive Delay. Am J Intellect Dev Disabil. 2010 Jan;115(1):3042.CrossRefGoogle ScholarPubMed
Baker, K, Devine, RT, Ng-Cordell, E, Raymond, FL, Hughes, C. Childhood Intellectual Disability and Parents’ Mental Health: Integrating Social, Psychological and Genetic Influences. Br J Psychiatry. 2021 Jun 1;218(6):315–22.CrossRefGoogle ScholarPubMed
Winters, KC, Tanner-Smith, EE, Bresani, E, Meyers, K. Current Advances in the Treatment of Adolescent Drug Use. Adolesc Health Med Ther. 2014 Nov 20;5:199210.Google Scholar
Bukstein, OG, Brent, OA, Perper, JA, et al. Risk Factors for Completed Suicide Among Adolescents with a Lifetime History of Substance Abuse: A Case‐Control Study. Acta Psychiatr Scand. 1993;88(6):403–08.CrossRefGoogle ScholarPubMed
O’Neil, KA, Conner, BT, Kendall, PC. Internalizing Disorders and Substance Use Disorders in Youth: Comorbidity, Risk, Temporal Order, and Implications for Intervention. Clin Psychol Rev. 2011 Feb 1;31(1):104–12.Google ScholarPubMed
Wilens, TE, Martelon, M, Joshi, G, et al. Does ADHD Predict Substance-Use Disorders? A 10-Year Follow-Up Study of Young Adults with ADHD. J Am Acad Child Adolesc Psychiatry. 2011 Jun;50(6):543–53.CrossRefGoogle ScholarPubMed
Arseneault, L, Cannon, M, Witton, J, Murray, RM. Causal Association Between Cannabis and Psychosis: Examination of the Evidence. Br J Psychiatry. 2004 Feb;184:110–17.CrossRefGoogle ScholarPubMed
Large, M, Sharma, S, Compton, MT, Slade, T, Nielssen, O. Cannabis Use and Earlier Onset of Psychosis: A Systematic Meta-analysis. Arch Gen Psychiatry. 2011 Jun;68(6):555–61.CrossRefGoogle ScholarPubMed
Clark, LA, Watson, D. Tripartite Model of Anxiety and Depression: Psychometric Evidence and Taxonomic Implications. J Abnorm Psychol. 1991;100(3):316–36.CrossRefGoogle ScholarPubMed
Wills, TA, Windle, M, Cleary, SD. Temperament and Novelty Seeking in Adolescent Substance Use: Convergence of Dimensions of Temperament with Constructs from Cloninger’s Theory. J Pers Soc Psychol. 1998;74(2):387406.CrossRefGoogle ScholarPubMed
Rettew, DC, McKee, L. Temperament and Its Role in Developmental Psychopathology. Harv Rev Psychiatry. 2005 Jan;13(1):1427.CrossRefGoogle ScholarPubMed
Bulik, CM, Sullivan, PF, Weltzin, TE, Kaye, WH. Temperament in Eating Disorders. Int J Eat Disord. 1995;17(3):251–61.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Vitousek, K, Manke, F. Personality Variables and Disorders in Anorexia Nervosa and Bulimia Nervosa. J Abnorm Psychol. 1994;103(1):137–47.CrossRefGoogle ScholarPubMed
Bowlby, J. (1969). Attachment and Loss. Vol. 1: Attachment. Attachment and Loss. New York: Basic BooksGoogle Scholar
Ainsworth, MDS, Blehar, MC, Waters, E, Wall, SN. Patterns of Attachment: A Psychological Study of the Strange Situation. 1st ed. New York: Psychology Press, 1979.Google Scholar
Main, M., Solomon, J. Procedures for Identifying Infants as Disorganized/Disoriented During the Ainsworth Strange Situation. In Greenberg, MT, Cicchetti, D, Cummings, EM (ed.), Attachment in the Preschool Years: Theory, Research, and Intervention. The University of Chicago Press, 1990, 121–60.Google Scholar
Madigan, S, Brumariu, LE, Villani, V, Atkinson, L, Lyons-Ruth, K. Representational and Questionnaire Measures of Attachment: A Meta-analysis of Relations to Child Internalizing and Externalizing Problems. Psychol Bull. 2016 Apr 1;142(4):367–99.CrossRefGoogle ScholarPubMed
Weissman, MM, Feder, A, Pilowsky, DJ, et al. Depressed Mothers Coming to Primary Care: Maternal Reports of Problems with Their Children. J Affect Disord. 2004;78(2):93100.CrossRefGoogle ScholarPubMed
Tully, EC, Iacono, WG, McGue, M. An Adoption Study of Parental Depression As an Environmental Liability for Adolescent Depression and Childhood Disruptive Disorders. Am J Psychiatry. 2008 Sep;165(9):1148–54.CrossRefGoogle Scholar
Brophy, S, Todd, C, Rahman, MA, Kennedy, N, Rice, F. Timing of Parental Depression on Risk of Child Depression and Poor Educational Outcomes: A Population Based Routine Data Cohort Study from Born in Wales, UK. PLoS One. 2021 Nov 1;16(11):e0258966.CrossRefGoogle ScholarPubMed
Ramchandani, P, Stein, A, Evans, J, O’Connor, TG. Paternal Depression in the Postnatal Period and Child Development: A Prospective Population Study. Lancet. 2005 Jun 25;365(9478):2201–05.CrossRefGoogle ScholarPubMed
Harold, GT, Sellers, R. Annual Research Review: Interparental Conflict and Youth Psychopathology: An Evidence Review and Practice Focused Update. J Child Psychol Psychiatry Allied Discip. 2018 Apr 1;59(4):374402.CrossRefGoogle ScholarPubMed
Buist, KL, Deković, M, Prinzie, P. Sibling Relationship Quality and Psychopathology of Children and Adolescents: A Meta-analysis. Clin Psychol Rev. 2013 Feb 1;33(1):97106.CrossRefGoogle ScholarPubMed
Kidger, J, Araya, R, Donovan, J, Gunnell, D. The Effect of the School Environment on the Emotional Health of Adolescents: A Systematic Review. Pediatrics. 2012 May;129(5):925–49.CrossRefGoogle ScholarPubMed
Arseneault, L, Bowes, L, Shakoor, S. Bullying Victimization in Youths and Mental Health Problems: ‘Much Ado About Nothing’? Psychol Med. 2010 May;40(5):717–29.CrossRefGoogle ScholarPubMed
Eccles, JS, Roeser, RW. Schools As Developmental Contexts During Adolescence. J Res Adolesc. 2011 Mar;21(1):225–41.CrossRefGoogle Scholar
Moak, ZB, Agrawal, A. The Association Between Perceived Interpersonal Social Support and Physical and Mental Health: Results from the National Epidemiological Survey on Alcohol and Related Conditions. J Public Health (Oxf). 2010 Jun;32(2):191201.CrossRefGoogle ScholarPubMed
Jewett, R, Sabiston, CM, Brunet, J, O’Loughlin, EK, Scarapicchia, T, O’Loughlin, J. School Sport Participation During Adolescence and Mental Health in Early Adulthood. J Adolesc Health. 2014 Nov 1;55(5):640–44.CrossRefGoogle ScholarPubMed
Oberle, E, Ji, XR, Guhn, M, Schonert-Reichl, KA, Gadermann, AM. Benefits of Extracurricular Participation in Early Adolescence: Associations with Peer Belonging and Mental Health. J Youth Adolesc. 2019 Nov 1;48(11):2255–70.CrossRefGoogle ScholarPubMed
Webster, D, Dunne, L, Hunter, R. Association Between Social Networks and Subjective Well-Being in Adolescents: A Systematic Review. Youth & Society. 2020 May 14;53(2):175210. https://doi.org/10.1177/0044118X20919589.CrossRefGoogle Scholar
Wilksch, SM, O’Shea, A, Ho, P, Byrne, S, Wade, TD. The Relationship Between Social Media Use and Disordered Eating in Young Adolescents. Int J Eat Disord. 2020 Jan 1;53(1):96106.CrossRefGoogle ScholarPubMed
Dyson, MP, Hartling, L, Shulhan, J, et al. A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts. PLoS One. 2016 May 18;11(5):e0155813.CrossRefGoogle ScholarPubMed
Marchant, A, Hawton, K, Stewart, A, et al. A Systematic Review of the Relationship Between Internet Use, Self-Harm and Suicidal Behaviour in Young People: The Good, the Bad and the Unknown. PLoS One. 2017 Aug 1;12(8).CrossRefGoogle Scholar
Best, P, Manktelow, R, Taylor, B. Online Communication, Social Media and Adolescent Wellbeing: A Systematic Narrative Review. Child Youth Serv Rev. 2014;41:2736.CrossRefGoogle Scholar
Robinson, P, Turk, D, Jilka, S, Cella, M. Measuring Attitudes Towards Mental Health Using Social Media: Investigating Stigma and Trivialisation. Soc Psychiatry Psychiatr Epidemiol. 2019 Jan 28;54(1):51.CrossRefGoogle ScholarPubMed
Teicher, MH, Andersen, SL, Polcari, A, Anderson, CM, Navalta, CP. Developmental Neurobiology of Childhood Stress and Trauma. Psychiatr Clin North Am. 2002;25(2):397426.CrossRefGoogle ScholarPubMed
Teicher, MH, Samson, JA, Anderson, CM, Ohashi, K. The Effects of Childhood Maltreatment on Brain Structure, Function and Connectivity. Nat Rev Neurosci. 2016 Sep 19;17(10):652–66.CrossRefGoogle ScholarPubMed
Hughes, K, Ford, K, Bellis, MA, Glendinning, F, Harrison, E, Passmore, J. Health and Financial Costs of Adverse Childhood Experiences in 28 European Countries: A Systematic Review and Meta-analysis. Lancet Public Heal. 2021 Nov 1;6(11):e848–57.Google ScholarPubMed
UNHCR. UNHCR Global Report [Internet]. UNHCR, 2018. Available from: https://www.unhcr.org/publications/fundraising/5e4ff98f7/unhcr-global-report-2018.html (cited 26 January 2022).Google Scholar
Blackmore, R, Gray, KM, Boyle, JA, et al. Systematic Review and Meta-analysis: The Prevalence of Mental Illness in Child and Adolescent Refugees and Asylum Seekers. J Am Acad Child Adolesc Psychiatry. 2020 Jun 1;59(6):705–14.CrossRefGoogle ScholarPubMed
Corona Maioli, S, Bhabha, J, Wickramage, K, et al. International Migration of Unaccompanied Minors: Trends, Health Risks, and Legal Protection. Lancet Child Adolesc Heal. 2021 Dec 1;5(12):882–95.Google ScholarPubMed
Morrison Gutman, L, Joshi, H, Parsonage, M, Schoon, I. Children of the New Century: Mental Health Findings from the Millennium Cohort Study. Centre for Mental Health, 2015 Nov. Available from: https://www.centreformentalhealth.org.uk/publications/children-new-century/.Google Scholar
Bignall, T, Jeraj, S, Helsby, E, Butt, J. Racial Disparities in Mental Health: Literature and Evidence Review. Race Equality Commission, 2019. Available from: https://raceequalityfoundation.org.uk/wp-content/uploads/2022/10/mental-health-report-v5-2.pdf (accessed 4 April 2025).Google Scholar
Memon, A, Taylor, K, Mohebati, LM, et al. Perceived Barriers to Accessing Mental Health Services Among Black and Minority Ethnic (BME) Communities: A Qualitative Study in Southeast England. BMJ Open. 2016 Nov 1;6(11). doi.org/10.1136/bmjopen-2016-012337.CrossRefGoogle ScholarPubMed
Viner, R, Russell, S, Saulle, R, et al. School Closures During Social Lockdown and Mental Health, Health Behaviors, and Well-being Among Children and Adolescents During the First COVID-19 Wave: A Systematic Review. JAMA Pediatr. 2022 Apr 1;176(4):400409.CrossRefGoogle ScholarPubMed
Bowyer-Crane, C, Bonetti, S, Compton, S, Nielsen, D, D’apice, K, Tracey, L. The Impact of Covid-19 on School Starters: Interim Briefing 1: Parent and School Concerns About Children Starting School. Education Endowment Fund UK, 2021. Available from: https://files.eric.ed.gov/fulltext/ED620337.pdf.Google Scholar
Solmi, F, Downs, JL, Nicholls, DE. COVID-19 and Eating Disorders in Young People. Lancet Child Adolesc Heal. 2021 May 1;5(5):316–18.Google ScholarPubMed
Adegboye, D, Williams, F, Collishaw, S, et al. Understanding Why the COVID-19 Pandemic-Related Lockdown Increases Mental Health Difficulties in Vulnerable Young Children. JCPP Adv. 2021 Apr 1;1(1). https://doi.org/10.1111/jcv2.12005.CrossRefGoogle ScholarPubMed

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