Background. Bullying is a major school problem. Victims of bullying often experience low self-esteem, whereas social skills are positively associated with the level of self-esteem. This research examined whether the victim’s condition impacted their social skills and self-esteem. Methods. International school students in Thailand aged 13 to 18 years old completed the Olweus bullying questionnaire, social capital questionnaire (SC), social skills questionnaire (SS), adolescent discrimination index (ADDI), and the Rosenberg self-esteem scale (RSES). Moderation analyses and visual presentations were carried out using IBM SPSS ver. 22 and PROCESS, ver. 4.0. Results. A total of 102 students participated (63% female). The mean age of the participants was 16.57 (SD = 1.42). The number of victims was 16 (15.7%), the mean (SD) for the SC, SS, ADDI, and RSES was 7.82 (2.37), 44.45 (9.40), 12.33 (9.82), and 27.85 (5.31), respectively. As predicted, those with high social skills reported greater self-esteem when they had never been bullied. The moderation effect was significant: B = 0.458, standard error = 0.203, 95% CI = −0.836 to −0.054. Additionally, the ADDI and SC were found to predict self-esteem. Conclusions. The significant moderation effect suggests the importance of identifying the victim’s condition when the association between social skills and self-esteem is not observed (as expected) among school adolescents. A longitudinal study to confirm the causal relationship should be encouraged. Further research on providing appropriate interventions along with social skill training for the victim group is warranted.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic is a global health crisis that has impacted daily life due to the policies created to contain the outbreak. Recent studies showed that medical students, a high-stress population, experienced deteriorated mental well-being during the pandemic. The aim of the present study was to assess stress and the need for support among Thai medical students during the COVID-19 pandemic, as a multicenter study.Methods: The present study was a cross-sectional questionnaire-based study which collected data from second through sixth year medical students. Data was collected during the pandemic from multiple medical schools spanning all six regions of Thailand. Questionnaires included: demographic data; the Thai version of the Perceived Stress Scale-10 (T-PSS-10) assessing stress level and the sources of stress; and the received supports from medical schools, the satisfaction with the supports, and the further necessary needs.Results: There were 1,395 medical students who responded to the questionnaires. Mean T-PSS-10 score was 17.8. Most of the sources of stress were related to the changing of teaching and evaluation system. Students residing in larger medical schools were significantly more satisfied with received support and tended to gain greater support than those in medium and small sized schools. Stress-relieving activities arrangement was considered the most sought after additional support by students.Conclusion: Medical student stress levels were higher during the pandemic compared to pre-pandemic levels. Stress relieving activities, availability and access to mental health resources, and other strategies to reduce stress among medical students are urgently needed.

Numerous factors are proposed to affect high school students’ academic achievement; however, these factors may not reveal all possible causal relationships. This study conducted path analysis to examine the direct and indirect effects of interpersonal relationships, life satisfaction, self-esteem, anxiety, and depression on the academic achievement of senior high school students. Two hundred and eighty-five students from five schools in Chiang Mai, Thailand, aged 14–19 years, were included for data analysis. The fit indices of all models were in agreement with the empirical data. Anxiety levels had a significantly positive direct effect on achievement, whereas depression had a negative direct effect on achievement. Additionally, self-esteem, life satisfaction, and interpersonal relationships had negative indirect effects on depression and anxiety. A program that stimulates the optimal and appropriate level of anxiety may be useful. An appropriate level of anxiety appeared positively related to academic achievement, but a high level of anxiety relatively influenced the incidence of depression. Thus, encouraging self-esteem, interpersonal relationships, and life satisfaction can promote academic ability and decrease the risk of depression. Further well-designed and large sample-size studies should be conducted to confirm these findings. The interplay of all studied factors may account for the variation in academic achievement, depression, and anxiety of 11.60%, 42.80%, and 17.60%, respectively.

The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children’s difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children’s difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.

In China, preschool teachers significantly influence the development of young children aged 3–6 years. Understanding their mental health and its associated factors is imperative to informing policies, optimizing their mental well-being, and supporting their job performance. This study aimed to investigate the factors contributing to anxiety symptoms among preschool teachers. A sample of 393 Chinese preschool teachers (279 women, 114 men), aged 21–56, completed online questionnaires collecting their sociodemographic and work-related information and assessing anxiety symptoms, interpersonal difficulties, personality traits, perceived stress, resilience, and inner strength. Pearson correlation and multiple linear regression analyses identified significant predictors of anxiety symptoms. The prevalence of anxiety symptoms among the studied cohort was found to be 12.2%. Statistically significant factors that positively correlated with anxiety symptoms included objective work-related stress (B = 0.149, p < 0.001), interpersonal difficulties (B = 0.921, p < 0.001), perceived stress (B = 0.108, p = 0.001), and neuroticism (B = 0.071, p = 0.002). These findings highlight the urgent need for measures to reduce work-related stress and anxiety. However, when negative mental health factors were included, the effect of positive psychological factors became nullified. Positive mental health might have a moderating role in a negative mental health outcome such as anxiety. Therefore, further research is required to understand the impact of positive mental health factors more clearly.

To evaluate the efficacy, acceptability, and safety of escitalopram for pediatric major depressive disorder (MDD) through a systematic review and meta-analysis. We searched Cochrane CENTRAL, CINAHL, PubMed, ClinicalTrials.gov, and Scopus (January 2001– October 2025) for randomized controlled trials comparing escitalopram with placebo in children and adolescents (ages 6–17) with MDD. The primary outcome was the change in the Children’s Depression Rating Scale-Revised (CDRS-R). Secondary outcomes included Clinical Global Impressions scores, response rates, and discontinuation rates. Two reviewers independently assessed the risk of bias using Cochrane tools. Random-effects meta-analysis was performed; certainty was evaluated using GRADE. Three RCTs (664 participants) were identified: two acute trials (Wagner 2006, n=268; Emslie 2009, n=316) and one continuation trial (Saito 2023, n=80). Meta-analysis of acute trials included 572 participants (completion rates 81–82%). Escitalopram demonstrated small and borderline statistically significant improvements versus placebo: CDRS-R (weighted mean difference [WMD]=−2.46, 95% CI: −4.83 to −0.09, I²=0%; low certainty); CGI-Severity (WMD=−0.35, 95% CI: −0.57 to −0.12); CGAS (WMD=2.56, 95% CI: 0.37 to 4.75); non-response rates (relative risk=0.84, 95% CI: 0.72 to 0.98; number needed to treat=11). Overall discontinuation (RR=1.37, 95% CI: 0.97 to 1.93) and discontinuation due to adverse events (RR=1.88, 95% CI: 0.44 to 8.03) did not differ significantly (low to very low certainty). Continuation treatment did not significantly prevent relapse (p=0.051). Universal industry sponsorship, high placebo response (52–53% by CGI-I ≤2 in original publications), mixed trial results, limited evidence for children ages 6–11, and lack of independent replication. Escitalopram demonstrates small and borderline statistically significant efficacy for adolescent MDD (aged 12–17 years). Short-term tolerability is acceptable; however, no definitive conclusion on long-term safety can be drawn, and evidence is insufficient to support use in children aged 6–11 years. It may be considered when fluoxetine is unsuitable, combined with psychosocial interventions and close monitoring. Further independent studies are needed. PROSPERO CRD42019141268. Depression is common in children and teenagers, affecting about 3-6% of young people. It can seriously impact their school, friendships, and family life, and increase the risk of suicide. Doctors sometimes prescribe escitalopram (an antidepressant medication) for teenagers with depression, but we need clearer evidence about how well it works and whether it is safe. We searched research databases for all high-quality studies that tested escitalopram in young people with depression. We found three studies involving 664 children and teenagers and combined their results to understand the overall benefits and risks. Escitalopram showed a small and statistically borderline benefit for teenagers (ages 12-17) with depression compared to a placebo (sugar pill). For every 11 teenagers treated with escitalopram, one additional person improved because of the medication. Side effects were similar to those of the placebo. However, all three studies were funded by the drug manufacturer, and many teenagers improved even with placebo pills, which means we should interpret these results carefully. Escitalopram may help some teenagers with depression, particularly when other treatments like another antidepressant called fluoxetine are not suitable. However, the benefits are modest. Young people taking escitalopram should also receive counseling or therapy and be closely monitored by their doctor for side effects and suicidal thoughts.