Research priorities on physical-mental comorbidity in children and adolescents: an international consensus

Denan Jiang^{1

2}, Jiali Zhou¹, Yajie Zhu³, Edimansyah Abdin⁴, Tracie O Afifi⁵, Laura Helena S G Andrade⁶, Rebecca Bendayan^{7

8}, Emma E Berkelbach van der Sprenkel⁹, Ronny Bruffaerts¹⁰, Ferrán Catalá-López¹¹, Ian Colman¹², Benjamin G Druss¹³, Laura Duncan^{14

15

16}, Nuša Farič¹⁷, Erika Felix¹⁸, Holly Foster¹⁹, Shurong Lu²⁰, Hassan Mansour²¹, Ruth Ann Marrie^{22

23}, Tanya Meade²⁴, Salima Meherali²⁵, Carles Muntaner^{26

27

28

29}, Yoko Nomura^{30

31}, Junko Okuyama³², Susan J Rees³³, Graham J Reid^{34

35

36

37

38}, Janet U Schneiderman³⁹, Dan J Stein⁴⁰, Frederick W Thielen^{41

42}, Wan Yee Winnie Tso⁴³, André Oliveira Werneck⁴⁴, Xiaoyan Wu⁴⁵, Igor Rudan^{46

47}, Peige Song^{1

46}

Affiliations

¹ School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² The Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
³ School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China.
⁴ Research Division, Institute of Mental Health, Singapore.
⁵ College of Community and Global Health, Faculty of Rady Health Sciences, University of Manitoba, Winnipeg, Canada.
⁶ Núcleo de Epidemiologia Psiquiátrica (LIM 23), Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
⁷ Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁸ National Institute for Health and Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
⁹ Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.
¹⁰ Universitair Psychiatrisch Centrum KU Leuven, Center for Public Health Psychiatry, KU Leuven, WHO Collaborating Centre for Public Health Psychiatry, Belgium.
¹¹ Institute of Public Goods and Policies (IPP), Spanish National Research Council (CSIC), Madrid, Spain.
¹² School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada.
¹³ Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, USA.
¹⁴ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
¹⁵ Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
¹⁶ McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
¹⁷ The Artificial Intelligence and its Applications Institute (AIAI), University of Edinburgh, Edinburgh, UK.
¹⁸ Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, USA.
¹⁹ Department of Sociology, Texas A&M University, College Station, TX, USA.
²⁰ Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
²¹ North London Foundation NHS Trust, London, UK.
²² Departments of Medicine and Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
²³ Nova Scotia Health, Halifax, Nova Scotia, Canada.
²⁴ School of Psychology, Western Sydney University, Penrith, New South Wales, Australia.
²⁵ Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Canada.
²⁶ Bloomberg Faculty of Nursing & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
²⁷ MAP Center for Urban Health Solutions, St. Michael's Hospital, University of Toronto, Toronto, Canada.
²⁸ Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
²⁹ JHU-UPF Public Policy Center and Barcelona School of Management (BSM), Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
³⁰ Department of Psychology, Queens College and Graduate Center, The City University of New York (CUNY), New York, USA.
³¹ Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, USA.
³² Department of Human Health and Nutrition, Shokei Gakuin University, Natori, Japan.
³³ Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Australia.
³⁴ Department of Psychology, The University of Western Ontario, Canada.
³⁵ Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, Canada.
³⁶ Department of Paediatrics, Schulich School of Medicine and Dentistry, The University of Western Ontario, Canada.
³⁷ Children's Health Research Institute, Canada.
³⁸ Lawson Health Research Institute, Canada.
³⁹ University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA.
⁴⁰ SAMRC Unit on Risk & Resilience, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁴¹ Erasmus School of Health Policy & Management (ESHPM) & Erasmus Centre for Health Economics Rotterdam (EsCHER), Rotterdam, the Netherlands.
⁴² Trimbos institute, Utrecht, the Netherlands.
⁴³ Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
⁴⁴ Center for Epidemiological Research in Nutrition and Health, School of Public Health, Universidade de São Paulo, São Paulo, Brazil.
⁴⁵ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
⁴⁶ Centre for Global Health, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
⁴⁷ Nuffield Department of Primary Care Health Sciences, Oxford University, UK.

PMID: 41140459
PMCID: PMC12547249
DOI: 10.1016/j.eclinm.2025.103559

Review

Research priorities on physical-mental comorbidity in children and adolescents: an international consensus

Denan Jiang et al. EClinicalMedicine. 2025.

. 2025 Oct 9:89:103559.

doi: 10.1016/j.eclinm.2025.103559. eCollection 2025 Nov.

Authors

Affiliations

¹ School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² The Fourth Affiliated Hospital of School of Medicine, International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
³ School of Information Science and Technology, Hangzhou Normal University, Hangzhou, China.
⁴ Research Division, Institute of Mental Health, Singapore.
⁵ College of Community and Global Health, Faculty of Rady Health Sciences, University of Manitoba, Winnipeg, Canada.
⁶ Núcleo de Epidemiologia Psiquiátrica (LIM 23), Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
⁷ Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁸ National Institute for Health and Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
⁹ Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.
¹⁰ Universitair Psychiatrisch Centrum KU Leuven, Center for Public Health Psychiatry, KU Leuven, WHO Collaborating Centre for Public Health Psychiatry, Belgium.
¹¹ Institute of Public Goods and Policies (IPP), Spanish National Research Council (CSIC), Madrid, Spain.
¹² School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada.
¹³ Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, USA.
¹⁴ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
¹⁵ Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
¹⁶ McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, Ontario, Canada.
¹⁷ The Artificial Intelligence and its Applications Institute (AIAI), University of Edinburgh, Edinburgh, UK.
¹⁸ Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, USA.
¹⁹ Department of Sociology, Texas A&M University, College Station, TX, USA.
²⁰ Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
²¹ North London Foundation NHS Trust, London, UK.
²² Departments of Medicine and Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
²³ Nova Scotia Health, Halifax, Nova Scotia, Canada.
²⁴ School of Psychology, Western Sydney University, Penrith, New South Wales, Australia.
²⁵ Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Canada.
²⁶ Bloomberg Faculty of Nursing & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
²⁷ MAP Center for Urban Health Solutions, St. Michael's Hospital, University of Toronto, Toronto, Canada.
²⁸ Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
²⁹ JHU-UPF Public Policy Center and Barcelona School of Management (BSM), Universitat Pompeu Fabra, Barcelona, Catalonia, Spain.
³⁰ Department of Psychology, Queens College and Graduate Center, The City University of New York (CUNY), New York, USA.
³¹ Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York, USA.
³² Department of Human Health and Nutrition, Shokei Gakuin University, Natori, Japan.
³³ Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Australia.
³⁴ Department of Psychology, The University of Western Ontario, Canada.
³⁵ Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, Canada.
³⁶ Department of Paediatrics, Schulich School of Medicine and Dentistry, The University of Western Ontario, Canada.
³⁷ Children's Health Research Institute, Canada.
³⁸ Lawson Health Research Institute, Canada.
³⁹ University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA.
⁴⁰ SAMRC Unit on Risk & Resilience, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
⁴¹ Erasmus School of Health Policy & Management (ESHPM) & Erasmus Centre for Health Economics Rotterdam (EsCHER), Rotterdam, the Netherlands.
⁴² Trimbos institute, Utrecht, the Netherlands.
⁴³ Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
⁴⁴ Center for Epidemiological Research in Nutrition and Health, School of Public Health, Universidade de São Paulo, São Paulo, Brazil.
⁴⁵ Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
⁴⁶ Centre for Global Health, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
⁴⁷ Nuffield Department of Primary Care Health Sciences, Oxford University, UK.

PMID: 41140459
PMCID: PMC12547249
DOI: 10.1016/j.eclinm.2025.103559

Abstract

Physical-mental comorbidity in children and adolescents is an emerging global health concern, yet research remains fragmented and lacks a coordinated agenda. We conducted a global priority setting exercise using the Child Health and Nutrition Research Initiative method. A total of 134 research ideas were scored by 45 experts against five criteria: answerability, effectiveness, potential for paradigm shift, potential for translation and implementation, and impact on equity. The highest-ranked priorities focused on treatment strategies, early intervention, reducing disparities in care, and the role of schools and communities in supporting health. Comparative analyses revealed both shared and context-specific needs across income settings. This is the first global consensus on research priorities for child and adolescent physical-mental comorbidity and offers a strategic roadmap to guide future research and policy.

Keywords: Child and adolescent health; Global health; Physical-mental comorbidity; Research prioritization.

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Conflict of interest statement

Tracie O. Afifi reported receiving grants from the Canadian Institutes of Health Research (CIHR), the Communications Research Centre Canada (CRC), and the Public Health Agency of Canada (PHAC), and royalties from Elsevier for a book, outside the submitted work. Ruth Ann Marrie reported serving as a co-investigator on studies funded by Biogen Idec and Roche Canada, outside the submitted work. Dan J. Stein reported receiving consultancy honoraria from Discovery Vitality, Kanna, L’Oréal, Lundbeck, Orion, Servier, Seaport Therapeutics, Takeda, and Wellcome outside the submitted work. No other disclosures were reported.

Figures

**Fig. 1**
**Flow chart of CHNRI exercise.** RPS, research priority score; AEA-e, average expert agreement score based on information theory; HICs, high-income countries; LMICs, low- and middle-income countries; LLMs, large language models; CHNRI, Child Health and Nutrition Research Initiative; ISoGH, International Society of Global Health.

**Fig. 2**
**The geographic distribution of participating experts.** Our study involved 82 participating experts. In the research idea generation phase, 71 experts submitted research ideas as requested via Google Form. A total of 45 experts participated in the scoring phase, of these, 34 were from the original 71 who had submitted ideas, 3 only scored, and the remaining 8 were additional scoring experts from ISoGH. ISoGH, International Society of Global Health.

**Fig. 3**
**The ranking distribution of the top ten research priorities overall and across all criteria.** The numbers in the bubbles represent the rach ideas in the overall ranking or across different criteria. C, criterion; C1, answerability; C2, effectiveness; C3, potential for paradigm shift; C4, potential for translation and implementation; C5, impact on equity.

**Fig. 4**
**The three highest-ranked research ideas for each of the predefined priority-setting criterion.** C, criterion; RPS, research priority score; C1, answerability; C2, effectiveness; C3, potential for paradigm shift; C4, potential for translation and implementation; C5, impact on equity.

See this image and copyright information in PMC

References

1. Adolescent health. https://www.who.int/health-topics/adolescent-health
1. Early childhood development | UNICEF. https://www.unicef.org/early-childhood-development
1. Sawyer S.M., Afifi R.A., Bearinger L.H., et al. Adolescence: a foundation for future health. Lancet. 2012;379:1630–1640. - PubMed
1. Patton G.C., Sawyer S.M., Santelli J.S., et al. Our future: a lancet commission on adolescent health and wellbeing. Lancet. 2016;387:2423–2478. - PMC - PubMed
1. Bonnie R.J., Backes E.P., editors. The Promise of Adolescence: Realizing Opportunity for All Youth. National Academies Press; Washington, D.C.: 2019. - DOI - PubMed

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Research priorities on physical-mental comorbidity in children and adolescents: an international consensus

Affiliations

Research priorities on physical-mental comorbidity in children and adolescents: an international consensus

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources