CHD is the most common congenital anomaly worldwide. Advances in paediatric cardiology and cardiac surgery have transformed survival, shifting attention towards long-term psychosocial adaptation, neurodevelopment, quality of life, and relational well-being for children and their families.

This narrative review examines the psychosocial, developmental, familial, and relational dimensions of childhood CHD. Literature was identified through PubMed, Scopus, and Google Scholar, with thematic synthesis of evidence relating to psychosocial adaptation, parental mental health, neurodevelopment, resilience, belonging, peer relationships, and models of family- and relationship-centred care.

Childhood CHD is associated with repeated hospitalisation, developmental disruption, emotional distress, and lifelong uncertainty, with psychosocial effects extending beyond the child to parents, siblings, grandparents, peers, schools, and healthcare professionals. Families frequently experience anxiety, depression, chronic vigilance, and posttraumatic stress symptoms, while children and adolescents face challenges related to identity, belonging, and social participation. Supportive relationships, multidisciplinary psychosocial care, educational integration, peer support, and developmentally informed interventions may strengthen resilience and improve long-term adaptation. Patients with advanced heart failure requiring ventricular assist devices or heart transplantation, and their families experience additional uncertainty and psychological burden that warrant dedicated psychosocial support.

Psychosocial outcomes in CHD are shaped not only by medical care but also by the quality of the relationships surrounding the child. Relationship-centred care builds upon established family-centred care by recognising the broader relational ecosystem that influences development, resilience, participation, and quality of life. Future paediatric cardiology care should integrate longitudinal psychosocial, developmental, educational, and relational support alongside advances in medical treatment.

Gene-environment correlations (rGEs) are often observed for psychiatric traits, including externalizing problems. Some researchers believe rGEs reflect the effects of offspring genotype on psychosocial environments. Others consider rGEs to be a nuisance, reflecting effects of confounders, such as population stratification, assortative mating, or parental genotypes. Our study aims to examine whether rGEs persist when confounding effects are controlled for in a family-based design.

We examined rGEs between a polygenic score (PGS) for externalizing problems and adolescent psychosocial environments (parent- and child-reported parental relationships, delinquent peer affiliation, and school connectedness) in the National Longitudinal Study of Adolescent to Adult Health. We estimated rGEs within 777 families (1,589 twins/full-siblings) and also at the population-level using 7,635 unrelated individuals.

rGEs were observed with parental relationships, delinquent peer affiliation, and school connectedness in the population sample. In family-based analyses, rGEs with parental relationships persisted at the within-family level. However, rGE with delinquent peer affiliation was attenuated and non-significant at the within-family level, suggesting the presence of confounding. Analyses regarding school connectedness were inconclusive.

While PGSs are often associated with psychosocial environments, some of these associations may be subject to substantial confounding. Our findings highlight the importance of testing rGE while controlling for potential confounds in large population-based studies.

Worldwide, the increasing trend of young people experiencing mental health challenges constitutes a major public health concern. There is a need for preventive and mental health-promoting initiatives targeting youths. This study examines the effectiveness of headspace Denmark – a nationwide counseling service for 12- to 25-year-olds – at 6-month follow-up.

The study was a quasi-experimental trial. 12- to 25-year-olds who had participated in counseling sessions in headspace were matched with a comparable control group, using propensity score matching. Survey data, collected at baseline and at 6-month follow-up, were linked to national register data. Outcome measures were well-being, loneliness, self-efficacy, life satisfaction, and health-related quality of life. Linear regression was used to test differences between the two groups. Subgroup analyses were conducted. Post-hoc Population Attributable Fractions (PAFs) were estimated to describe the effect sizes at the population level.

The inclusion period was 14.5 months from September 2022. Follow-up data were collected until mid-August 2024. The number of participants in the intervention group was 1,362. In the control group was 3,192. A statistically significant difference between the groups was observed for well-being at 6-month follow-up (Cohen’s D = 0.11; p = 0.018). The estimated PAF was 4%, assuming a prevalence of low well-being in the target group of 70% and the intervention reaching 80% of the target group.

headspace had an effect on participants’ well-being. Based on the estimated PAF, headspace can play a crucial role in early health promotion and disease prevention among young people in Denmark.

Non-suicidal self-injury (NSSI) is a prevalent behavioural health concern during adolescence and has been consistently linked to emotionally invalidating interpersonal environments.

This study tested whether distress tolerance and negative urgency prospectively explained the link between invalidating environments and adolescent NSSI.

The study used a 2-wave longitudinal design with a 6-month interval; 300 Iranian adolescents (70% female, aged 13–17 years) participated.

Cross-lagged panel modelling showed that invalidating environments at wave 1 predicted higher NSSI at wave 2, when we controlled for baseline NSSI, and were associated with increases in negative urgency. Although both negative urgency and distress tolerance were related to later NSSI, only negative urgency significantly mediated this relationship; distress tolerance and the hypothesised serial pathway did not show significant associations. Sensitivity analyses indicated developmental differences across age groups.

The findings highlight impulsive response under distress as a central mechanism linking environmental invalidation to adolescent NSSI and identify negative urgency as a key intervention target.

Depression and anxiety disorders and symptoms are among the leading causes of disability and global disease burden in young people. Scalable, unified interventions are required to address subthreshold emotional symptoms in adolescents as a preventive strategy. This study evaluated the effectiveness of a transdiagnostic treatment for adolescents with subthreshold emotional symptoms.

A multicenter, two-arm, randomized controlled trial was conducted. The Unified Protocol for Adolescents (UP-A) was compared with an active control consisting of protocolized progressive relaxation. A total of 676 adolescents (72.6% female; Mage = 13.77; SD = 1.39; range = 12–18 years) participated in the study. Primary outcomes were self-reported depressive and anxiety symptoms at postintervention, 6 months, and 12 months. The trial is registered with ClinicalTrials.gov (NCT05322642).

Three hundred seventy-eight participants were allocated to the UP-A group and 298 to the control group. Adherence was high in both conditions (≈78% attended >70% of sessions). Both interventions showed significant reductions in depressive and anxiety symptoms over time, with no significant between-group differences. At 12 months, the UP-A group showed marginally lower depressive symptoms and neuroticism. Significant treatment effects favoring the UP-A were observed for hyperactivity, conduct problems, and total mental health difficulties. Improvements were maintained across most outcomes at both follow-ups.

The comparable improvements observed across both conditions suggest that structured, group-based school interventions may help reduce emotional symptoms in adolescents with subthreshold presentations, rather than reflecting the superiority of a specific protocol. These findings support their potential for broad dissemination within stepped-care frameworks and for enhancing accessibility and real-world effectiveness of evidence-based treatments.

Adverse health behaviors, such as physical inactivity and smoking, constitute a potential pathway connecting loneliness to poor mental and physical health. No prior study has investigated the dynamic interplay between loneliness and a broad range of health behaviors across the first half of life.

We used data from a Norwegian population-based cohort study (n = 3,072) spanning 28 years from adolescence to midlife. Applying a propensity score-based causal inference approach, we examined bidirectional prospective associations between loneliness and health behaviors, comprising alcohol use, body mass index (BMI), smoking, and physical exercise.

Loneliness in adolescence was associated with lowered physical exercise (mean difference: −14.13 minutes/week, 95% CI: −26.54 to −1.72), and loneliness during young adulthood was linked to increased BMI (0.37 points, 0.12–0.63). In the reverse direction, moderate alcohol use (−0.07 SD, −0.13 to −0.01 and − 0.19 SD, −0.33 to −0.05), smoking (−0.12 SD, −0.23 to −0.01), and moderate physical exercise (−0.16 SD, −0.26 to −0.07 and − 0.07 SD, −0.14 to −0.01) during adolescence and emerging adulthood were linked to reduced loneliness. All other associations were consistent with a null effect.

Our results provide limited support for the causal effects of loneliness on health behaviors across the first half of life. By contrast, findings in the reverse direction suggest that health behaviors in young people – whether health-promoting or risky – are socially embedded and may facilitate socializing. To tackle youth loneliness, public health policies should promote equitable access to health-promoting behaviors.

Early adolescence marks a critical period for the onset of psychiatric symptoms, with 50% of mental disorders emerging before age 18. Recent evidence points to individuals being born preterm and/or with low birth weight (henceforth, PTB) having an increased risk of developing mental disorders in adolescence. Surprisingly, existing early detection and intervention strategies in adolescence are not tailored to PTB needs and profiles. The previous use of several disorder-specific instruments complicates unified, efficient screening.

We analyzed data on the frequency of experiencing mental health challenges from 225 adolescents aged 10-14 years (M = 12.03 years) who were born very PTB (M = 28.03 weeks, M = 999.62 g) to test the applicability of the diagnostic system for mental disorders for children and adolescents – III (DISYPS-III) to PTB adolescents.

A confirmatory factor analysis replicated the DISYPS-III’s factorial structure and internal consistency for 10- to 14-year-old PTB adolescents. Overall, PTB adolescents reported significantly more mental health challenges than the DISYPS-III community norm sample. The instrument’s transdiagnostic scales provided a better relative fit to these challenges compared to the disorder-specific scales. Results also replicated specific findings of mental health challenges from other PTB cohorts and countries, such as a higher number of comorbidities in adolescents officially diagnosed with the inattentive presentation (ADD) of ADHD.

These findings of an elevated psychological burden suggest a need for structured PTB screening of long-term mental health outcomes in adolescence that also includes 10-year-old PTB individuals, with the DISYPS-III being a suitable screening instrument.

Alcohol, nicotine, and cannabis use problems have a poorer prognosis when they co-occur with internalizing distress (INT). One hypothesis to account for the association between INT and alcohol and substance use problems (SUP) is that people engage in heavy substance use to reduce aversive affective states characteristic of INT (e.g. affective reinforcement). Whether INT operates as a cause or a shared liability with SUP (e.g. shared genetic and environmental risk) over and above an alternative cause (e.g. externalizing problems, EXT) remains unclear.

We tested INT as a developmental pathway for SUP by applying a prospective, co-twin control approach to the Minnesota Twin and Family Study sample (n = 1881 twin pairs). A multilevel modeling framework was used to estimate the between-twin pair effect and the within-twin pair effect of INT over and above EXT on separate SUP outcomes (i.e. alcohol, nicotine, and cannabis use problems) from adolescence (age 14) to young adulthood (age 29).

We failed to detect any non-familial causal effects of INT on SUPs. Instead, their associations were due to common genetic and shared environmental influences. In contrast, EXT had consistent non-familial causal influences on alcohol and cannabis use in adolescence and young adulthood.

The link between INT and SUPs is primarily due to shared, familial influences while EXT likely serves as a unique determinant, with elevated EXT increasing selection into situations that pose SUP risk (e.g. peer environments that normalize and sustain heavy use) over and above common genetic influences.