Dr. Mohammad SI Mullick

02/05/2025

Valbenazine Significantly Improves Tardive Dyskinesia in Older Adults Over Long-Term

Adults ages 65 and older with tardive dyskinesia (TD) given valbenazine for up to 48 weeks experienced substantial and sustained improvements in symptoms while maintaining psychiatric stability, according to a post-hoc analysis of two clinical trials.
The researchers wrote that valbenazine may be well suited for older patients with TD because it requires no titration to reach an effective, tolerable dose and is available as a sprinkle formulation that can be mixed with soft foods.They undertook the study to address the “relative paucity of information on valbenazine efficacy and safety in relation to increasing age” among individuals 65 and older.

Sajatovic and colleagues pooled data from 304 individuals (55 of whom were 65 or older) who had participated in one of two 48-week studies of valbenazine—one an open-label study and the other a blinded-dosing study comparing 40 mg or 80 mg dosing. Participants were assessed with two clinician-rated assessments, the Abnormal Involuntary Movement Scale (AIMS) and Clinical Global Impression of Change-Tardive Dyskinesia (CGI-TD), at baseline and at various points over 48 weeks.

Overall, 40% of older participants experienced a meaningful response to valbenazine (≥50% improvement in AIMS) at eight weeks, which rose to 65% at 24 weeks and 82% at 48 weeks; the improvements in older adults were comparable to those seen in younger participants. Similar strong and comparable improvements were seen with CGI-TD scores; in fact, at week 48, older adults were significantly more likely to have a CGI-TD score ≤2 than younger participants (93% versus 77% respectively).

There was no statistical difference in the prevalence of adverse events between younger and older participants, though a significantly higher percentage of older participants discontinued medication due to an adverse event compared with the younger subgroup (26% versus 13%, respectively). The most common adverse events were urinary tract infection, drowsiness, and headache.

The researchers wrote that this article reports on data indicating that once-daily valbenazine is effective and well-tolerated in the ≥65-year age group. Given the projected rates of population aging in the U.S. and globally, along with the increased risk of TD with older age and historic under representation of adults aged ≥65 years in clinical trials, these results address an important gap in TD research.

For more information, see the article:
Goldberg JF. Tardive Dyskinesia: Assessing and Treating a Debilitating Side Effect of Prolonged Antipsychotic Exposure. Psychiatric News 2025;56(3):https://doi.org/10.1176/appi.pn.2021.3.10

18/01/2025

Su***de Risk Among Patients With Depression Highest First Three Days After Discharge

Patients with depression who have been discharged from psychiatric hospitals have the highest risk of dying by su***de in the first three days after discharge, with some risk factors increasing that risk further, according to a recent published article in JAMA Psychiatry.

Aaltonen and colleagues reported that of all people dying by su***de, more than half had depression, and approximately 40% had been recently hospitalized. Therefore, people hospitalized for depression are at significant risk of su***de following their discharge. “Such a population with a distinct high-risk period in contact with psychiatric care forms a prioritizable target for selective su***de prevention,” they wrote.

The researchers used data from Finnish registers such as the Care Register for Health Care and Statistics Finland, which included information on hospital admissions, discharges, diagnoses, and causes of death. They identified all psychiatric hospitalizations for depression among participants aged 18 years and older from 1996 to 2017; patients with comorbid major psychotic disorder or bipolar disorder were excluded. Each patient was followed for up to two years after discharge. For those with multiple hospitalizations, each discharge marked the beginning of a new follow-up period.
A total of 193,197 hospitalizations occurred during the study period among 91,161 participants (56.2% female; mean age 44 years). A total of 1,219 men and 757 women died by su***de during the study period. Additional findings included the following:

•During the first three days after discharge, the su***de incidence rate was 6,062 per 100,000 person-years. The authors noted that this rate exceeded the rate within the general population in Finland by 330-fold.

•The su***de rate remained high throughout the first week after discharge (3,884 per 100,000 person-years on days four to seven), but then fell steadily, dropping to 478 per 100,000 person-years after one year.

•Individuals who were admitted to the hospital due to a su***de attempt by firearm or hanging had the highest risk of death by su***de in the first three days after discharge. Other factors associated with immediate su***de risk included severe or psychotic depression, severe illness with impaired function, a history of attempted su***de, male s*x, and age 40 and above.

•Some factors showed temporal trends. Having a higher household disposable income was associated with immediate su***de risk after discharge, but later it was associated with a lower risk compared with those with lower income. Individuals hospitalized with comorbid alcohol use disorder had a lower immediate su***de risk than those without, but then a higher risk over time.

“Although we found a decreasing trend over time, the high-risk post-discharge period still requires intensified attention,” the authors wrote. “Continuity of care and access to enhanced psychiatric outpatient care within days of discharge should be imperative.”

See the Article:
Aaltonen K, Sund R, Hakulinen C, Pirkola S, Isometsä E. Variations in Su***de Risk and Risk Factors After Hospitalization for Depression in Finland, 1996-2017. JAMA Psychiatry. 2024;81(5):506–515. doi:10.1001/jamapsychiatry.2023.5512.

10/01/2025

Mirtazapine and Vitamin B6 May Be Best Options for Antipsychotic-Induced Akathisia

Akathisia—a feeling of restlessness is often accompanied by movements like rocking or pacing—is a common side effect of antipsychotic medications. A meta-analysis report suggests that biperiden, mirtazapine, and vitamin B6 are the three most effective treatment options for antipsychotic-induced akathisia.

Gerolymos and colleagues compiled data from 15 randomized clinical trials testing potential pharmacotherapies for akathisia in people taking antipsychotics. The combined data included 492 patients, 324 of whom received an active drug and 168 received placebo. Ten medications were evaluated: biperiden, clonazepam, cyproheptadine, mianserin, mirtazapine, propranolol, trazodone, valproate, vitamin B6, and zolmitriptan.

The researchers noted that clinicians should be prudent about interpreting their results due to the small sample size, but offered the following findings:
• Six medications were found to be effective. They were the following, in decreasing order of strength: mirtazapine, biperiden, vitamin B6, mianserin, trazodone, and propranolol.
• Cyproheptadine may also be potentially effective, but there was not enough evidence to make a firm conclusion.
• Clonazepam, valproate, and zolmitriptan did not show effectiveness and are not recommended.

The authors wrote that Mirtazapine consistently ranked first in both the main analysis and all subgroup analyses. However, mirtazapine may be poorly tolerated due to its sedative effects and the potential for weight gain. Rather, they suggested that vitamin B6 may be the best option in terms of risk-benefit ratio, as it is very well tolerated. However, for patients with akathisia who also have depressive symptoms and insomnia, mirtazapine may be preferred.
The researchers also cautioned that “trazodone should be avoided in men who have specific hematologic or neurologic diseases (such as sickle cell anemia, multiple myeloma, leukemia, hypercoagulable states, or autonomic nervous system disorders) or in men with anatomical deformations of the pen*s.”

See the Article
Gerolymos C, Barazer R, Yon DK, Loundou A, Boyer L, Fond G. Drug Efficacy in the Treatment of Antipsychotic-Induced Akathisia: A Systematic Review and Network Meta-Analysis. JAMA Netw Open. 2024;7(3): e241527. doi:10.1001/jamanetworkopen.2024.1527.

07/01/2025

New Schizophrenia Drug Shows Marked Effect on Cognitive Deficits

Individuals with schizophrenia and cognitive deficits who were treated with the combination of xanomeline and trospium chloride showed clinically significant improvements in cognition compared with those receiving placebo, according to a recent published article. The results, pooled from two Phase 3 clinical trials, replicate cognitive benefits seen in smaller studies.
Xanomeline/trospium chloride was approved for use by the U.S. Food and Drug Administration (with the brand name Cobenfy) in September 2024 for the treatment of schizophrenia in adults. Cognitive deficits are a stubborn feature in many cases of schizophrenia that significantly affect long-term trajectory and daily functioning.

Lead researchers said “Collectively, the xanomeline/trospium clinical studies reflect the first time a monotherapy for the treatment of schizophrenia has shown a replicable cognitive benefit,”.

Across the two trials, 357 patients with acute schizophrenia were randomly assigned to receive oral xanomeline/trospium or placebo twice daily for five weeks. Most participants assigned to xanomeline/trospium were taking the maximum dosage of 125 mg/30 mg twice daily at week 5, with the remainder taking an intermediate dosage of 100 mg/20 mg. Participants completed a computerized assessment of four key cognitive domains (executive function, visual memory, sustained attention, and verbal recall and recognition) at baseline, week 3, and week 5. Overall, 137 participants had significant cognitive deficits at baseline. Among patients with cognitive impairment, those receiving xanomeline/trospium showed a significantly larger improvement in their cognitive scores from baseline to week 5 than the placebo group, with a calculated effect size of 0.54 (indicating a moderate level of improvement). The largest difference in performance between the xanomeline/trospium and placebo groups observed at week 5 was for verbal recall and recognition.The effect remained significant after accounting for changes in positive and negative symptoms—suggesting that the effect on cognition is independent of improvement in psychotic symptoms. As with previous studies, there was no evidence of cognitive benefit for xanomeline/trospium when analyzing the full sample of 357 participants.

Cobenfy is the first drug approved for schizophrenia that does not act on dopamine (D2) receptors in the brain; rather it targets muscarinic acetylcholine receptors in areas of the brain more central to the cognitive and behavioral symptoms of schizophrenia.

See that article:
Horan WP, Sauder C, Ramsay IS, Yohn SE, Keefe RSE, Davis VJ, Paul SM, Brannan SK .The Impact of Xanomeline and Trospium Chloride on Cognitive Impairment in Acute Schizophrenia: Replication in Pooled Data From Two Phase 3 Trials. Am J Psychiatry 2024. https://doi.org/10.1176/appi.ajp.20240076.

18/10/2023

Don’t Shut Down Conversations When Youth Present With ‘Trending’ Disorders, Psychiatrist Says

Youth increasingly rely on social media to diagnose themselves with a variety of psychiatric illnesses—a trend that has been met with more than a few raised eyebrows.

In a short Article, Rettew described how he works with youth with so-called “trending presentations” and cautions against the dangers of oversimplifying such cases.

• Ask patients direct questions about whether they have a specific diagnosis in mind, as well as the research that led them to this conclusion: “[I]t is common for my new patients to get a little sheepish when disclosing the source of their investigations, as most commonly the ideas come from social media platforms such as YouTube or TikTok rather than the medical textbooks that used to make medical students wonder about being stricken with lots of exotic ailments,” he described.

• Reject the tendency to dismiss or deny the patient’s narrative “because it does not fit our current scientific or political perspective”: “Science has shown us repeatedly that virtually everything when it comes to mental functioning—from common personality traits to psychopathology to gender typical behavior—comes from a complicated mash-up of mutually interacting genetic and environmental factors. These environmental contributors include things such as peers and media influences, and their presence in the mix should not immediately disqualify someone’s history as undeserving.”

• The more complicated a clinical situation appears, the more important it is to stick to the basics: Establish good rapport with the patient, be thorough, validate while maintaining some skepticism, and give yourself time to conceptualize, he said. “[I]n so doing, we may find that those supposed trending presentations are an accurate description of symptoms that have been long experienced and suppressed by the individual until they are living in an environment supportive enough for their expression. … Or maybe we find out that, indeed, someone really has been heavily influenced by what they have heard from a peer or seen on a social media video as part of developmentally appropriate needs to feel connected socially and developmentally appropriate introspection at this age about their identity,” he wrote.

The author concluded, “Rigid and oversimplistic thinking often fails us and our patients by closing conversations before they ever truly open. The pathways through which our patients find their way to our office are incredibly rich and diverse. We lump them into convenient boxes at our peril, virtually begging our patients to reveal to us the deficiencies of our mental shortcuts.”

See the article:
Rettew DC. Internet Inspired Self Diagnosis: A New Phenomenon Calling for An Old Approach. J Am Acad Child Adolesc Psychiatry 2023. http//doi.org./10.1016/j.jaac:2023.08.017.

08/08/2023

FDA Approves First Oral Medication for Postpartum Depression

The U.S. Food and Drug Administration (FDA) on Friday approved Zurzuvae (zuranolone), the first oral medication for the treatment of postpartum depression in adults. Zuranolone acts on similar receptors in the brain as the intravenous medication brexanolone, which was the first postpartum depression medication to receive FDA approval in 2019. Zuranolone and brexanolone are both manufactured by Sage Therapeutics.

Clinical trial data show the pill works quickly, beginning to ease depression in as little as three days, significantly faster than general antidepressants, which can take two weeks or longer to have an effect.

The efficacy of Zurzuvae was demonstrated in two randomized, double-blind, placebo-controlled trials—196 women aged 18 to 45 with severe postpartum depression were assigned to take either zuranolone (50 mg) or placebo pills daily for 14 days. Those in the zuranolone group experienced significantly greater improvements in their depressive symptoms than those taking placebo pills, and the improvements were maintained one month after the last zuranolone dose. Similar outcomes were reported in the other trial, where women with postpartum depression also received another formulation of zuranaolone (equivalent to 40 mg of Zurzuvae) or placebo for 14 days.

The recommended dose for Zurzuvae is 50 mg daily for 14 days. The medication is to be taken in the evening with fat-containing food.

See the article:
Deligiannidis KM,Meltzer-Brody, Maximos B,et al. Zuranolone for the Treatment of Postpartum Depression. Am J Psychiatry 2023

Objective: Postpartum depression (PPD) is a common perinatal complication with adverse maternal and infant outcomes. This study investigated the efficacy and safety of zuranolone, a positive allosteric modulator of synaptic and extrasynaptic GABAA receptors and neuroactive steroid, as an oral, once-...

05/04/2023

Study Supports Repetitive TMS for Patients With Treatment-Resistant Depression

About 1 in 4 people with treatment-resistant depression may achieve remission with repetitive transcranial magnetic stimulation (rTMS), according to data collected from patients at five hospitals in France. In their study, Bouaziz and colleagues showed that patients with more severe symptoms at baseline experienced greater improvements following rTMS on average.

The study encompasses a large variety of stimulation settings and comorbidities, reflecting usual clinical practice. Thus, this study is intended to guide psychiatrists in real-life practice, as a complement to [randomized, controlled trials] with strict inclusion criteria.

The researchers collected data from 435 adults who were treated with rTMS at one of five French University Hospitals between January 2015 and December 2020. The patients had a diagnosis of either unipolar or bipolar depression and had not responded to at least two trials of antidepressants. Many of these patients had psychiatric or other medical comorbidities; the only patients excluded from the study were those who had metallic implants, had nonstabilized epilepsy, and/or were pregnant. The rTMS protocols at the hospitals varied; the number of sessions ranged from 10 to 28 and the total delivered pulses per session ranged from 360 to 2,000.

They compared patients’ Montgomery–Åsberg Depression Rating Scale (MADRS) scores at baseline with those following the completion of rTMS. Overall, MADRS scores decreased by about 9.5 points, which represented a 33% reduction from baseline levels. In addition, 22.8% of the patients achieved remission (defined as a MADRS score of 10 or less).
Bouaziz and colleagues next looked at factors that might influence a patient’s response to rTMS. They found that patients with more severe baseline depression had greater MADRS improvements following rTMS on average, whereas patients with milder depression were more likely to achieve remission. Patients who did not have psychiatric comorbidities and those who were not taking lithium showed greater symptom improvement than those who did meet these criteria; however, neither the presence of comorbidities nor use of lithium impacted remission rate.

See the article:
Bouaziz N, Laidi C, Bulteau S, Berjamin C, et al.Real world transcranial magnetic stimulation for major depression: A multisite, naturalistic, retrospective study-.Journal of Affective Dis 2023;326:26-35. https://doi.org/10.1016/j.jad.2023.01.070.

27/10/2022

Telepsychiatry Creates Opportunities To Increase Access To Treatment, Flexibility, Convenience Of Routine Care And The Potential Of Increased Privacy

Blanco and colleagues assert in a viewpoint that Telepsychiatry creates opportunities to increase access to treatment, flexibility, convenience of routine care and the potential of increased privacy. The authors outline some of the choices that will have to be made as telepsychiatry continues to expand and will have far-reaching implications for multiple stakeholders including, among others, regulators, payers, clinicians, health care systems, and patients.

See the article:
Blanco C, Wall MM, Olfson M. Implications of Telepsychiatry for Cost, Quality, and Equity of Mental Health Care. JAMA Psychiatry. Published online October 19, 2022. doi:10.1001/jamapsychiatry.2022.3330

25/07/2022

Concept of 'Preaddiction' Could Lead to Early Intervention for Possible Substance Use Disorder

About 20 years ago, diabetes care changed when an organized effort was made to identify patients at risk of diabetes earlier and connect them with treatment. A similar strategy could be used within the substance use disorder (SUD) field by using the term “preaddiction,” advised by McLellan et al in a viewpoint article.
“Addiction is the most severe form of a full spectrum of substance use disorders,” the authors wrote. “It has been the almost exclusive focus of U.S. clinical and policy efforts. However, serious addiction only results after years of unhealthy substance misuse that could be identified and managed much earlier.”

The transition from using a substance to developing a substance use disorder is usually slow and variable, the authors wrote. “[T]he DSM-5 uses 11 equally weighted symptoms of impaired control to define SUDs along a three-stage severity continuum,” they continued. Severe SUDs, commonly referred to as addiction, are defined by six or more symptoms and found in only 4% to 5% of adults, while mild to moderate SUDs are defined by two to five symptoms and found in about 13% of adults. “However, treatment efforts and public health policies have focused almost exclusively on those with serious, usually chronic addictions, virtually ignoring the much larger population with early-stage SUDs,” the authors wrote.

When faced with a similar problem, the American Diabetes Association suggested the term prediabetes in 2001, defined by elevated scores on two laboratory tests (impaired glucose tolerance and impaired fasting glucose). Advertising campaigns that followed to raise public awareness and partnerships with insurers led to the creation of new medications, testing, and interventions. If a similar approach were taken in the SUD field using the term preaddiction, McLellan, Koob, and Volkow wrote, it would require a similarly integrated effort in three areas, including the following:
• Establish measures to define and detect preaddiction: DSM-5 diagnoses are reliable and could be implemented in clinical settings to define preaddiction.
• Identify effective interventions: Screening, brief interventions, referrals to treatment, and a computerized version of cognitive-behavioral therapy could potentially be used as preaddiction interventions. However, the authors also pointed out the need for a broader range of medication treatments and social support.
• Advocate and educate: Few in the public or even in medical practice know how to recognize or what to do when an individual begins to transition to an SUD, and procedures for screening and tracking early-stage SUDs must be taught in medical or nursing schools and properly reimbursed.

The authors acknowledged that some may be concerned that the term preaddiction could intensify stigma, yet they contend that it is exactly the right term to use for two reasons. First, preaddiction refers to the disease, not the individual. “Second, the term addiction is well understood by clinicians and patients as a serious condition to be avoided,” the authors wrote. “Thus, preaddiction has inherent motivational properties that convey the need for clinical action and patient change—just as prediabetes and precancerous currently do.”

See the article:
McLellan AT, Koob GF, Volkow ND. Preaddiction—A Missing Concept for Treating Substance Use Disorders. JAMA Psychiatry. Published online July 06, 2022. doi:10.1001/jamapsychiatry.2022.1652

For more information visit https://www.drmsimullick.com

11/06/2022

Most Males Who Die by Su***de Have No Known Mental Health Conditions

The majority of boys and men who die by su***de have no known mental health conditions, a recent study has found.

Fowler and colleagues analyzed data from the CDC’s National Violent Death Reporting System (NVDRS) for 70,376 males aged 10 years and older who died by su***de between 2016 and 2018. The researchers looked at data from four age groups: adolescents (aged 10 to 17 years), young adults (aged 18 to 34 years), middle-aged adults (aged 35 to 64 years), and older adults (aged 65 years and older). They used the NVDRS definition of a diagnosed mental health problem to determine if males who had died by su***de during the study period had any known mental health conditions. The NVDRS defines “diagnosed mental health problems” as diagnosed disorders and syndromes listed in DSM-5 except for alcohol and other substance use disorders. The definition also includes a history of treatment for a mental health problem, even if the nature of the problem is unclear in the person’s records (for example, the records say the person “was being treated for various psychiatric problems”).

Overall, 60% of males who died by su***de had no known mental health conditions. Across all age groups, firearm su***des were more common among males without known mental health conditions compared with males who had known mental health conditions. Between 32% and 40% of all young and middle-aged adults in the study had a history of problematic substance use. Between 43% and 48% of all young and middle-aged adults tested positive for alcohol at the time of their death.

Relationship problems were common among males who died by su***de, especially among adolescents, young adults, and middle-aged adults with no known mental health conditions. Intimate partner problems were significantly more common for young and middle-aged adults with no known mental health conditions, and family problems were the most common type of problem for adolescents with or without known mental health conditions. Arguments were common across age groups and were significantly more prevalent among young and middle-aged adults without known mental health conditions, particularly among those who died by su***de during an argument.

The authors concluded that su***de prevention initiatives for males might benefit from comprehensive approaches focusing on age-specific stressors reported in this study in addition to standard psychiatric markers.

See the article:
Fowler KA, Kaplan MS, Stone DM, Zhou H, Stevens MR, Simon TR. Su***de Among Males Across the Lifespan: An Analysis of Differences by Known Mental Health Status. Am J Prevent Med 2022.;000(000):1−4 DOI: https://doi.org/10.1016/j.amepre.2022.02.021.

27/05/2022

Study Examines Patient Recovery 10 Years After First-Episode Psychosis

Nearly a third of patients with first-episode psychosis (FEP) had recovered at 10-year follow-up based on a standard clinical definition of recovery, according to a 10-year-follow up study. Recovery rates were higher still among FEP patients who had been diagnosed with bipolar spectrum disorder, with 50% meeting the criteria for recovery. Researchers commented that clinicians must communicate this to patients receiving a psychosis diagnosis as it can contribute to increased hope of recovery and reduced pessimism and stigma, ultimately promoting chances of recovery.
The study involved patients who had recently experienced a first episode of psychosis between 2004 and 2012 and were recruited for the Thematically Organized Psychosis (TOP) study. As part of the TOP study, patients who met DSM-IV criteria for schizophrenia or bipolar spectrum disorder were evaluated at one- and 10-year follow-ups.
The researchers used a standard clinical definition of recovery focusing on remission of psychotic symptoms and adequate functioning to evaluate 142 patients from the TOP study. Psychotic symptom remission was defined as a score of 3 or less on measures of positive, negative, and disorganized symptoms using the Positive and Negative Symptom Scale (PANSS). Adequate functioning was defined as full-time occupational functioning in terms of work, study, or other (for example, full-time child rearing); social functioning (for example, meeting a friend at least once weekly); and independent living (for example, residing in an unsupervised home and maintaining activities of daily living). They also included 117 age- and gender-matched healthy controls for comparison on measures of functioning.
Of the 142 patients in the analysis, 31.7% met the criteria for clinical recovery at the 10-year follow-up, with 59.9% achieving psychotic symptom remission for at least 12 months and 32.4% achieving adequate functioning. The clinical recovery rate was significantly higher among patients with a bipolar spectrum diagnosis (50.0%) compared with those with a schizophrenia spectrum diagnosis (22.9%). Among the healthy controls, 18.8% did not meet the standard criteria for adequate functioning, “suggesting that these criteria are too strict,” the authors wrote.
When the researchers adjusted the criteria for adequate functioning (for example, part-time instead of full-time work/study/other and having a close friend or confidant instead of weekly contact), they found that the recovery rate in the group of patients increased to 40.8%.
The researchers concluded that their findings suggest that clinical recovery is common in FEP, although more in bipolar than in schizophrenia spectrum disorders, also when altering the recovery criteria. increase in recovery rates with looser criteria illustrates how recovery rates are partially dependent on how they are defined. This knowledge allows for meaningful conversations with patients about the many forms that recovery can take. The authors also noted that because most of the patients were in remission, treatment should focus early on regaining functioning and employment.

See the article:
Gina Åsbø, Torill Ueland, Beathe Haatveit, Thomas Bjella, Camilla Bärthel Flaaten, Kristin Fjelnseth Wold, Line Widing, Magnus Johan Engen, Siv Hege Lyngstad, Erlend Gardsjord, Kristin Lie Romm, Ingrid Melle, Carmen Simonsen, The Time is Ripe for a Consensus Definition of Clinical Recovery in First-episode Psychosis: Suggestions Based on a 10-Year Follow-up Study, Schizophrenia Bulletin, 2022;, sbac035 https://doi.org/10.1093/schbul/sbac035

16/02/2022

Children, Youth With More Screen Time Appear To Have Had Increased Risk For Poor Mental Health During COVID-19 Pandemic, Study Indicates

A study sought to examine potential associations between specific forms of screen use and symptoms of depression, anxiety, conduct problems, irritability, hyperactivity and inattention among 2,026 children and youth aged 2 to 18 years in Ontario, Canada, between May 2020 and April 2021. The finding indicates that children and youth with more screen time had increased risk for poor mental health during the COVID-19 pandemic.

See the article:
Li X, Vanderloo LM, Keown-Stoneman CDG, et al. Screen Use and Mental Health Symptoms in Canadian Children and Youth During the COVID-19 Pandemic. JAMA Netw Open. 2021;4(12):e2140875. doi:10.1001/jamanetworkopen.2021.40875