Christian Kieling

Christian Kieling
Universidade Federal do Rio Grande do Sul | UFRGS · Departamento de Psiquiatria e Medicina Legal

MD-PhD

About

178
Publications
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19,608
Citations
Additional affiliations
August 2015 - present
Universidade Federal do Rio Grande do Sul
Position
  • Professor (Assistant)

Publications

Publications (178)
Article
The Identifying Depression Early in Adolescence Risk Score (IDEA-RS) has been externally assessed in samples from four continents, but North America is lacking. Our aim here was to evaluate the performance of the IDEA-RS in predicting future onset of Major Depressive Disorder (MDD) in an adolescent population-based sample in the United States of Am...
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Background There is a lack of research on the adolescent experience of depression in low- and middle-income countries. Criteria derived from research conducted primarily among adult Western populations inform current diagnostic standards for depression. These clinical categories are often used without exploration of their relevance to adolescent ex...
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Study Objectives Major Depressive Disorder (MDD) in adolescence is associated with irregularities in circadian rhythms and sleep. The characterization of such impairment may be critical to design effective interventions to prevent development of depression among adolescents. This study aimed to examine self-reported and actimetry-based circadian rh...
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Background Inflammation-related proteins constitute a promising avenue in studying biological correlates of major depressive disorder (MDD). However, MDD is a heterogeneous condition – a crucial aspect to be considered in association studies. We examined whether inflammatory proteins are associated with categorical diagnosis, a dimensional total su...
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Aim: Identifying predictors for future onset of depression is crucial to effectively developing preventive interventions. We conducted a systematic review and meta-analysis to identify risk factors for first-onset depression among adolescents and young people. Methods: We searched MEDLINE (Ovid), PsycINFO, Cochrane Database, Web of Science, Lila...
Article
A handling procedure of off-wrist episodes in actimetry time series of motor activity is presented using two records (regular vs. irregular sleep-wake cycle and daytime activity) of 14 consecutive days sampled in 1-minute epochs. We generated single missing value (NA) intervals of 1 h, 2 h, 4 h, 6 h, 12 h, and 24 h as well as random NA episodes fol...
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Background There have been significant challenges in understanding functional brain connectivity associated with adolescent depression, including the need for a more comprehensive approach to defining risk, the lack of representation of participants from low- and middle-income countries, and the need for network-based approaches to model connectivi...
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There is growing policy, practice, and research interest in reducing the treatment gap for adolescent depression in low- and middle-income countries, where 90% of the world's adolescents live. Despite increased efforts for adolescent depression services in these settings, there is a risk that services will not be utilized if initiatives are not cul...
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Receiving a diagnosis of depression can have an important impact on the lives of adolescents. However, there is limited information about how youth tackle, attribute meaning to and understand mental health diagnoses. The aim of this study was to explore adolescents’ initial reactions after receiving a clinical diagnosis of Major Depressive Disorder...
Article
Aim: Depression is one of the most common mental illnesses globally and a leading cause of disability. It is often established by late adolescence and thus identifying which adolescents are most at risk is crucial to enable early intervention to prevent depression onset. We have previously developed a risk calculator to stratify which adolescents...
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Background: The mental disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were depressive disorders, anxiety disorders, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, eating disorders, idiopathic developmental intellectual disabili...
Article
Inflammation is associated with poor physical and mental health including major depressive disorder (MDD). Moreover, there is evidence that childhood adversity – a risk factor for MDD – becomes biologically embedded via elevated inflammation. However, the risk of developing MDD arises from multiple sources and yet there has been little investigatio...
Article
Purpose of review: The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structu...
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Calls for refining the understanding of depression beyond diagnostic criteria have been growing in recent years. We examined the prevalence and relevance of DSM and non-DSM depressive symptoms in two Brazilian school-based adolescent samples with two commonly used scales, the Patient Health Questionnaire (PHQ-A) and the Mood and Feelings Questionna...
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Purpose The goal of this study was to explore the perspectives of different stakeholders regarding the experiences of adolescent depression in Porto Alegre, Brazil. Methods We conducted 54 key-informant interviews with adolescents, parents, social workers, health workers, educators, and policy makers and two focus group discussions with 5 adolesce...
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Introduction Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the development of major depressive disorder (MDD) in adulthood. Less work has focused on the role of the HPA axis in depression in adolescence and young adulthood globally. The aim of this study was to conduct a systematic review and meta-analysis of...
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Extensive research suggests a role for the innate immune system in the pathogenesis of depression, but most of the studies are conducted in adult populations, in high-income countries and mainly focus on the study of inflammatory proteins alone, which provides only a limited understanding of the immune pathways involved in the development of depres...
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Background: Neuroimaging studies on adolescents at risk for depression have relied on a single risk factor and focused on adolescents in high-income countries. Using a composite risk score, this study aims to examine neural activity and connectivity associated with risk and presence of depression in adolescents in Brazil. Methods: Depression ris...
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Background: The characterization of adolescents at high risk for developing depression has traditionally relied on the presence or absence of single risk factors. More recently, the use of composite risk scores combining information from multiple variables has gained attention in prognostic research in the field of mental health. We previously deve...
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Background : We aimed to examine the occurrence of major depressive disorder (MDD) in a population-based youth sample, assessing both categorical and dimensional presentations of the disorder and its clinical and sociodemographic correlates. Methods : We analyzed cross-sectional data from the latest assessment of the 1993 Pelotas Birth Cohort (n =...
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Background & Aims Diet quality has been inversely associated with depression, but less is known about its association with anxiety and about the mechanisms involved in the association between diet and mental health. This study aimed to assess the associations of diet quality with major depressive disorder (MDD) and generalized anxiety disorder (GAD...
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Introduction Although the aetiology and pathophysiology of depression are multifactorial, to date most studies have examined either biological or environmental mechanisms without looking at the integration of both; with most studies conducted in high-income countries (HICs). Therefore, we conducted a systematic review of worldwide studies investiga...
Article
Knowledge about early risk factors for major depressive disorder (MDD) is critical to identify those who are at high risk. A multivariable model to predict adolescents’ individual risk of future MDD has recently been developed however its performance in a UK sample was far from perfect. Given the potential role of air pollution in the aetiology of...
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Several stressors associated with the coronavirus disease 2019 (COVID-19) are expected to affect the mental health of global populations: the effects of physical distancing, quarantine, and social isolation; the emotional suffering of health and other frontline workers; neuropsychiatric sequelae in those affected by the virus; the impact to familie...
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The burden of adolescent depression is high in low- and middle-income countries (LMICs), yet research into prevention is lacking. Development and validation of models to predict individualized risk of depression among adolescents in LMICs is rare but crucial to ensure appropriate targeting of preventive interventions. We assessed the ability of a m...
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Adolescents comprise one fourth of the world's population, with about 90% of them living in low- and middle-income countries (LMICs). The incidence of depression markedly increases during adolescence, making the disorder a leading cause of disease-related disability in this age group. However, most research on adolescent depression has been perform...
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Background Adolescence represents a vulnerable period for the onset of depression. Globally, there is a need to better understand risk factors for adolescent depression to inform policies for effective prevention initiatives. Methods A Delphi consensus study was conducted on risk factors, early signs, and detection strategies for adolescent depres...
Article
A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed a consensus-based standard set of outcomes for anxiety and depression in adults (including the Patient Health Questionnaire-9, the Generalised An...
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Depression commonly emerges in adolescence and is a major public health issue in low- and middle-income countries where 90% of the world's adolescents live. Thus efforts to prevent depression onset are crucial in countries like Nigeria, where two-thirds of the population are aged under 24. Therefore, we tested the ability of a prediction model deve...
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In a seminal review article on borderline personality disorder (BPD) for the American Journal of Psychiatry, John Gunderson once made the allusion that "borderline personality disorder is to psychiatry what psychiatry is to medicine," suggesting that the condition is frequently neglected, even among mental health professionals and researchers.1 For...
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Introduction Globally, depression is a leading cause of disability among adolescents, and suicide rates are increasing among youth. Treatment alone is insufficient to address the issue. Early identification and prevention efforts are necessary to reduce morbidity and mortality. The Identifying Depression Early in Adolescence (IDEA) consortium is de...
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With the seminal discovery of somatic cell reprogramming with defined genetic factors, it is now a routine laboratory procedure to reprogram somatic cells to generate patient-specific induced pluripotent stem cells (iPSCs) [1] Patient-specific iPSCs can be differentiated to generate mature neurons as well as three-dimensional brain organoids that s...
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Background Better understanding of the heterogeneity of treatment responses could help to improve care for adolescents with depression. We analysed data from a clinical trial to assess whether specific symptom clusters responded differently to various treatments. Methods For this secondary analysis, we used data from the Treatment for Adolescents...
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Selective serotonin reuptake inhibitors (SSRI) have been claimed to negatively affect the thyroid function, albeit the evidence is controversial. We searched for studies that measured parameters of thyroid function (TSH, T4, Free T4, or T3) before and after a course of SSRI treatment in euthyroid patients with major depressive disorder. Electronic...
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Objective: Prediction models have become frequent in the medical literature, but most published studies are conducted in a single setting. Heterogeneity between development and validation samples has been posited as a major obstacle for the generalization of models. We aimed to develop a multivariable prognostic model using sociodemographic variab...
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Objectives The purpose of this study was to evaluate the agreement and risk factors for underestimation and overestimation between nutritional status and self‐perceived body image and to assess the prevalence and associated factors for dissatisfaction with body weight among Brazilian adolescents. Methods Students aged 12–17 years participating in...
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Objective: To assess the prevalence of some mental disorders and suicide risk, and the association between them in youths. Methods: Data from the 1993 Pelotas Birth Cohort (Brazil) was used. The prevalence of mental disorders at 22 years [major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), attentio...
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Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians spec...
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Objective: Suicide is the third leading cause of death among Brazilians aged 10 to 24 years. We aimed to review and describe the research output on suicide in children and adolescents in Brazil and to identify strengths and gaps in this literature. Methods: PubMed/MEDLINE was searched for studies on suicide of children and adolescents (aged 0-19...
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Objective: To test the feasibility and to present preliminary results of a neuroimaging protocol to evaluate adolescent depression in a middle-income setting. Methods: We assessed psychotropic medication-free adolescents (age range 14-16 years) with a diagnosis of major depressive disorder (MDD). Participants underwent a comprehensive clinical e...
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Objective: To investigate the effect of relatively younger age on attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis. Method: This study included participants of three community-based cohorts in Brazil: 1993 Pelotas Cohort (N = 5,249), 2004 Pelotas Cohort (N = 4,231),...
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Background: Depression is a leading contributor to disability-adjusted life-years because of early onset and chronicity throughout the lifecycle. It is crucial to identify early predictors of depression among adolescents and young people to effectively target prevention. A gap in the literature is a comprehensive systematic review of predictors of...
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A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample - ERRATUM - A. Caye, J. Agnew-Blais, L. Arseneault, H. Gonçalves, C. Kieling, K. Langley, A. M. B. Menezes, T. E. Moffitt, I. C. Passos, T. B. Rocha, M. H. Sibley, J. M. Swanson, A. Thapar, F...
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Aim Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD). Methods Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC – UK, 5113 participants, followed fro...
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Background Emotional disorders are risk factors for atherosclerosis and consequent cardiovascular disease. However, it is not clear whether emotional symptoms (ESs) have direct effects on cardiovascular disease. The aim of the present study is to investigate the effects of early ESs on carotid atherosclerosis in young adults. Methods and Results W...
Data
Table S1. Unweighted and Weighted Means for Covariates and Standardized Mean Difserences (SMD) According to SDQ Group at 15 Years‐old: The Pelotas Birth Cohort Table S2. Unweighted and Weighted Means for Covariates and Standardized Mean Differences (SMD) According to SDQ Group at 15 Years‐Old: The Pelotas Birth Cohort Figure S1. Relative influenc...
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Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions. Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. Design, setting, and participants: This study used deidentified aggregated data including 13 812 location-years of...
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IMPORTANCE Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS This study used deidentified aggregated data including 13 812 location-years of vit...
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Introduction The Internet has seen rapid growth in the number of websites focusing on mental health content. Considering the increased need for access to accurate information about mental health treatment, it is important to understand the promotion of this information online. Objective To analyze BuzzFeed’s Mental Health Week (BFMHW) interactions...
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Objectives: The purpose of this study was to evaluate the agreement and risk factors for underestimation and overestimation between nutritional status and self-perceived body image and to assess the prevalence and associated factors for dissatisfaction with body weight among Brazilian adolescents. Methods: Students aged 12-17 years participating...
Article
Unlike most leading causes of death in the United States, suicide rates have not declined during the past 50 years.1 Among young people the situation is even more dramatic, because suicide rates are rising,2 and suicide is now the second cause of death in 15- to 29-year-olds globally.3 It has been suggested that descriptions of suicide in the media...