Pediatr. praxi. 2025;26(6):375-379 | DOI: 10.36290/ped.2025.072

Culmination of a quarter-century of converging epidemics in child and adolescent physical and mental health deterioration

MUDr. Jakub Figueroa, MUDr. Jiří Podlipný, Ph.D.

Psychiatrická klinika, Fakultní nemocnice Plzeň a Lékařská fakulta v Plzni, Univerzita Karlova, Plzeň

Over roughly 25 years, children and adolescents have faced converging adverse trends in mental and physical health. Population-based surveys indicate declining well-being and rising anxiety/depressive symptoms-especially among girls-while objective indicators show increased pediatric emergency visits for suicidality, greater service use for eating disorders, and higher incidence of self-harm. In the Czech Republic, harms related to alcohol and nicotine products persist, alongside rising childhood overweight/obesity. These phenomena share common biological and behavioral pathways-including stress-related hypothalamic-pituitary-adrenal (HPA) axis dysregulation and low-grade inflammation, microbiota-gut-brain interactions, and modifiable lifestyle factors (insufficient/irregular sleep, low physical activity, suboptimal diet, and impaired social connectedness/role fulfillment). This narrative review: summarizes epidemiological evidence from the past quarter-century, links it to shared risks and mechanisms, and proposes a pragmatic, feasible framework for collaboration between pediatric primary care and child & adolescent psychiatry. Within the ongoing psychiatrization debate, we argue that clinical decisions should be anchored in objective indicators and an integrated shared-care model.

Keywords: pediatric population, mental health, obesity, eating disorders, self-harm, prevention, primary care.

Accepted: December 10, 2025; Published: December 15, 2025  Show citation