Listen30 February
Explaining Boys' Language
Delay
...
Testosterone exposure doubles risk of
having impaired language
Many new mothers wonder why their toddler sons don’t speak as well – or as quickly – as other children. A new Australian has an answer: Blame it on testosterone.
Researchers from the University of Western Australia studied testosterone in newborns and found that boys who are exposed to high levels of testosterone before birth are at a doubled risk of having impaired language development compared to females.
The scientists found that testosterone had the opposite effect on girls: increased levels of testosterone before birth actually lowered a girl’s risk for language delay.
About 12% of toddlers suffer language delays, and boys are at greater risk because they develop at a slower rate, says lead author Dr. Andrew Whitehouse, a professor of psychology at the University of Western Australia, in a press release. The team’s findings give a biological explanation for this, he says.
In the study, the researchers looked at the umbilical cord blood of 767 infants and measured how much testosterone the infants were exposed to during an important phase of brain development. Then, the researchers evaluated the children’s language skills when they were 1, 2 and 3 years of age.
The team found that little boys with high levels of testosterone in the blood were 2-3 times more likely to experience language delay. The authors say that male fetuses have 10 times the levels of testosterone compared to female fetuses. They think that significantly higher levels interfere with young boys’ abilities to speak.
This study is the first large study to look at umbilical cord blood and language delay in the first three years of a child’s life.
This observational study was published in the Journal of Child Psychology and Psychiatry.
Nicole McEwen
26 January 2012
___
27 January
Genetic variation increases
risk of metabolic side effects in children on some antipsychotics
...
Associated with increased blood
pressure and elevated blood sugar levels
Researchers have found a genetic variation predisposing children to six-times greater risk of developing metabolic syndrome when taking second-generation anti-psychotic medications. Metabolic syndrome is a cluster of conditions that are risk factors for cardiovascular disease. The study showed a close association with two conditions in particular: high blood pressure and elevated fasting blood sugar levels, which is a precursor to diabetes. The research is published today in the medical research journal Translational Psychiatry.
"This is the first report of an underlying biological factor predisposing children to complications associated with second-generation anti-psychotic medication use," says Dr Dina Panagiotopoulos, study co-author, clinician scientist at the Child & Family Research Institute (CFRI), pediatric endocrinologist at BC Children's Hospital, and assistant professor, Department of Pediatrics, University of British Columbia (UBC).
"It's concerning because these children take medications to treat a chronic disease – mental illness – and then develop risk factors for a second chronic disease," says Dr. Angela Devlin, study co-author, CFRI scientist and assistant professor in the UBC Department of Pediatrics.
Second-generation anti-psychotics are prescribed to approximately 5500 children and youth in British Columbia for psychotic disorders, mood and anxiety disorders, attention deficit hyperactivity disorder, autism spectrum disorders, adjustment disorders and substance abuse. Of these medications, the two most commonly prescribed in B.C. are quetiapine (Seroquel®) and risperidone (Risperdal®).
For the study, researchers assessed 209 children who were inpatients between April 2008 and June 2011 at the Child & Adolescent Psychiatry Department at BC Children's Hospital, an agency of the Provincial Health Services Authority. Their average age was 13 years, and 105 of the children were treated with second-generation anti-psychotics while 112 did not use these drugs. DNA analysis showed that eight per cent of children from both groups had a genetic variation called C677T on the MTHFR gene. Children with the MTHFR C677T variant who used these medications were six-times more likely to have metabolic syndrome.
The researchers targeted the MTHFR C677T variant because it is known to be associated with metabolic syndrome in adults who have schizophrenia, and with cardiovascular disease in adults who don't have psychiatric illness.
Dr. Devlin and Dr. Panagiotopoulos say their discovery is an important step to preventing and managing metabolic complications associated with second-generation antipsychotic medications. It is critical to reduce these risks in childhood because adults with mental illness have a 19 per cent increased mortality rate that is largely due to cardiovascular disease risk.
The MTHFR gene is involved in metabolizing the B-vitamin folate.
"We now plan to assess B vitamin status and dietary intake in children who take these medications to gain a better understanding of this association," says Dr. Panagiotopoulos.
This study was funded by CFRI and the Canadian Diabetes Association.
Press release: EurekAlert
24 January 2012
http://www.eurekalert.org/pub_releases/2012-01/cfr-gvi012412.php
___
25 January
Adopting a Healthy Diet May Help ADHD
When drug therapy fails to control attention-deficit/hyperactivity disorder (ADHD) or is unacceptable, adopting a "healthy" diet, eliminating items known to predispose to ADHD, and adding omega-3 fatty acid supplementation may be worth trying, new research suggests.
"The recent increase of interest in this form of therapy for ADHD, and especially in the use of omega supplements, significance of iron deficiency, and the avoidance of the 'Western pattern' diet, make the discussion timely," the authors write.
Many parents and physicians continue to be interested in how diet and dietary changes, particularly parents wanting to find an alternative to stimulant medication or a complementary therapy. Nevertheless, it remains a "controversial" topic, the authors note.
For their review, J. Gordon Millichap, MD, and Michelle M. Yee, CPNP, from Children’s Memorial Hospital in Chicago, Illinois, searched PubMed for relevant studies on the role of diet and dietary supplements for the treatment of children with ADHD.
They note that their recommendations on diet and dietary supplements are based on a critical review of the data and their own experience in a neurology clinic for children and adolescents with ADHD.
The study was published on January 9 in Pediatrics.
Elimination Diets Not Advisable
Perhaps the "most promising and practical" complementary or alternative treatment, write Dr. Millichap and Ms. Yee, is adopting a "healthy" dietary pattern, omitting items shown to predispose to ADHD or to make the condition worse. These items include fast foods, red meat, processed meat, potato chips, high-fat dairy foods, and soft drinks.
They point to a "provocative" study published last year, which found a link between ADHD in adolescents and a "Western-style" dietary pattern that was high in fat, refined sugars, and sodium and low in fiber, folate, and omega-3 fatty acids (Howard et al, J Atten Disord. 2011;15:403-411). ADHD was not associated with a "healthy" dietary pattern rich in fish, vegetables, fruit, legumes, and whole-grain foods.
Adopting a healthy dietary pattern "may offer an alternative method of treatment of ADHD and less reliance on medications," the authors of the current study write.
They also note that although many parents report worsening of hyperactivity symptoms after consumption of foods and drinks containing sugar or aspartame – and isolated reports support the parents' observations – most controlled studies have failed to find a significant harmful effect of sugar or aspartame, the authors note.
Additionally, they say that the elimination of sugar and aspartame and adapting additive-free diets are complicated, disruptive, and often impractical; such measures are indicated only in select cases.
Fatty Acid Supplements May Be Helpful
Low levels of long-chain polyunsaturated fatty acids (PUFA) have been reported in the plasma and red cells of children with ADHD in comparison with their ADHD-free peers, Dr. Millichap and Ms. Yee note. Some studies have demonstrated a reduction in ADHD symptoms with PUFA supplementation, although no definitive conclusions can be drawn.
However, the authors note that "on the basis of reports of efficacy and safety, we use doses of 300 to 600 mg/day of omega-3, and 30 to 60 mg/day of omega-6 fatty acids, continued for 2 or 3 months, or longer if indicated."
"As initial or add-on therapy, we have occasional reports of improved school grades and lessening of symptoms of ADHD, without occurrence of adverse effects. Most parents are enthusiastic about trying the diet supplements, despite our explanation of only possible benefit and lack of proof of efficacy," they note.
They also note that iron and zinc supplementation is advisable when there is a known deficiency in these minerals, and this may "enhance the effectiveness" of stimulant therapy.
Dr. Millichap and Ms. Yee have disclosed no relevant financial relationships.
Pediatrics.
9 January 2012
http://www.medscape.com/viewarticle/756957?src=mpnews&spon=9
___
23 January
TORONTO
Government Announces Support for New Child
and Youth Advocacy Centre
Today, the Honourable Rob Nicholson, P.C., Q.C., M.P. for Niagara Falls,
Minister of Justice and Attorney General of Canada, announced federal
government funding for Toronto's first Child and Youth Advocacy Centre
(CYAC).
This project brings together Boost, a Toronto based agency committed to
eliminating abuse and violence of children, youth and their families;
police; the Crown prosecutor's office; health authorities; and child
welfare agencies, to serve young victims of crime and young witnesses to
serious crime.
"Our government remains unwavering in our commitment to protecting
Canadians, particularly those most vulnerable, such as young victims of
crime," said Minister Nicholson. "We commend Boost Child Abuse
Prevention & Intervention for their ongoing services and support to
children, youth and their families and we are pleased to play a part in
supporting this Centre."
Boost will be funded to plan, facilitate and develop a Child and Youth
Advocacy Centre that will aim to minimize the trauma of being a child
victim of crime or witness to crime. A CYAC is a place where a team of
professionals work in a child-friendly setting to help a child or youth
victim or witness navigate the criminal justice system.
"The CYAC will be a strong and effective partnership of all of the key
organizations that assist child and youth victims of abuse," said Karyn
Kennedy, Executive Director of Boost. "Bringing all of these services
together in one location will significantly improve our ability to
respond effectively to children, youth and their families when abuse is
reported."
The $278,865 in federal funding over two years comes from the $5.25
million in funding over five years that was announced on October 7,
2010, and is made available through the Victims Fund at the Department
of Justice Canada. In 2007, the Government announced the Federal Victims
Strategy and committed $52 million over four years to respond to the
needs of victims of crime. In Budget 2011, the Government announced $26
million in renewed funding over the next two years to continue the
Federal Victims Strategy.
Internet:
www.canada.justice.gc.ca (Version francaise disponible)
BACKGROUNDER: CHILD ADVOCACY CENTRES
A Child Advocacy Centre (CAC) adopts a seamless, coordinated and
collaborative approach to addressing the needs of child and youth
victims of crime and their families. A CAC seeks to minimize
system-induced trauma by providing a child-friendly setting for a young
victim or witness and his or her family. A CAC is designed to support a
child's healing and assist them in recovering from abuse.
Professional services offered by CACs include coordinated interviews by
law enforcement and child protection, examination of the child or youth
by a medical professional and trauma counselling. One goal of a CAC is
to minimize the number of interviews and questions directed at a child
or youth, thereby minimizing any additional system-induced trauma.
CACs help children and their families navigate the justice system in a
number of ways. These include providing a child or youth with a safe and
comfortable environment in which to be interviewed by criminal justice
professionals, minimizing the number of interviews and ultimately
leading to better communication between agencies supporting young
victims. CACs may also provide education and training to justice
professionals on best practices for interviewing child victims and
witnesses. As an example, interviews recorded by video are an effective
method for gathering valuable information to help both children and the
justice system.
Research in the United States has shown that investigations conducted by
CACs are cost-effective and expedite decisions to lay criminal charges
by prosecutors. Parents whose children receive services from CACs were
more satisfied with the investigation process and interview procedures
than parents who did not receive services from CACs. In addition, those
children who attended CACs were generally satisfied with the
investigation and were more likely to state they were not scared during
the forensic process compared to children who did not attend CACs. CACs
have also been shown to increase collaboration between the agencies
charged with protecting children and youth, and law enforcement agencies
responsible for investigating criminal activity.
Press release: marketwire
Source: Department of Justice Canada
20 January 2012
http://www.marketwatch.com/story/government-announces-support-for-new-child-and-youth-advocacy-centre-2012-01-20
___
20 January
CANADA
Report calls for improved
coordination of community programs
for children and youth with disabilities
Community organizations are coming together today to discuss findings from a new report that suggest better coordination across the sector could improve social interaction and development for youth and children with disabilities. The report reiterates the need for children and youth with disabilities and their families to have a sense of community and suggests that while there are numerous programs available across the country, they are challenging to access and navigate.
Sally Jordan, caregiver to a 22 year-old a nephew living with a disability, echoes the findings of the project. "It's extremely important for my nephew to participate in activities in the community so that he doesn't feel isolated, but finding information on what is available is a big challenge. Often I can only find programs and service through word-of-mouth. It would be great to have a reliable and accessible source of information where I can find everything in one place."
Lead author, Dr. Anne Snowdon, will present findings and recommendations from the national Human Resources and Skills Development Canada-funded discussion document, Strengthening Communities for Canadian Children with Disabilities, at The Sandbox Project Conference 2012, urging key stakeholders to create community environments that strengthen social development for children and youth who face significant challenges due to disability.
"Through this initiative, we found that children and youth with disabilities and their families need and want to connect and engage with their communities in a meaningful, accessible, and accommodating way that enables social interaction and development ," said Dr. Snowdon, the lead author behind the project. "As a result, we have been able to identify opportunities to strengthen these community environments, and can now develop and disseminate tools and resources needed to foster supportive communities, so that the needs of this population can be better met."
The project was implemented in three pilot communities across Canada (Toronto, ON; Regina, SK; and Fredericton, NB) and examined their respective capacities for supporting the social development and well-being of children and youth with disabilities. Three main recommendations have been proposed in response to the findings, including:
•Develop coordinated web-based navigation tools for
families that can create a 'single online reference' resource for
accessing community programs, services, and professional care.
•Develop integration-focused programs and services that will allow for
children and youth with disabilities and their families to feel part of
their community.
•Augment the social networks of children and youth with special needs
using social networking tools to strengthen current and future community
programs to actively engage and include children and youth with special
needs as active members of their community.
"The project recommendations are a step in the right direction, and
provide an opportunity to engage and connect service providers and
families in new and different ways to work together towards meeting
common goals," says Jennifer Goosens of Special Olympics Canada. "We can
enhance the support we provide to children and youth with disabilities,
as well as their families, by working together."
The Strengthening Communities for Canadian Children with Disabilities project was produced through the collaboration of a number of key stakeholder organizations, including: Special Olympics Canada, Community Living and Holland Bloorview.
About The Sandbox Project
The Sandbox Project was created to improve the health of Canada's
children and youth. The goal of The Sandbox Project is to make
measurable progress against international health indicators within the
next five years, with a particular focus on improving health outcomes
for Canadian children with respect to injury prevention, obesity, mental
health, and the environment. Working directly with parents, business,
health industry leaders, governments and non-governmental organizations,
The Sandbox Project seeks to raise awareness, pursue research, and
collaborate to develop solutions and better public policy.
For more information on The Sandbox Project, visit: www.sandboxproject.ca
Press release: Canada Newswire
19 January 2012
http://www.digitaljournal.com/pr/554064
___
18 January
PHILIPPINES
Department, World Vision to promote children’s welfare
To promote children’s welfare by further enhancing the functionality of the local council for the protection of children (LCPC) in the communities, the Department of the Interior and Local Government (DILG) and the World Vision Development Foundation inked a memorandum of agreement over the weekend.
DILG Secretary Jesse Robredo and World Vision executive director Elnora Avarientos signed the memorandum of agreement that aims to pursue a capacity building and participation program that will enhance the effectiveness and functionality of the LCPC.
The signing ceremony was held at the DILG Central Office building in Quezon City, witnessed by DILG Undersecretary Austere Panadero, National Barangay Operations Office Director Virgilio Castro, and World Vision Public Engagement director Filomena Portales.
World Vision is a child-focused, development, relief and advocacy organization dedicated to alleviating the plight of children, families and communities, particularly those in depressed areas and depressed and disaster-affected communities nationwide.
Robredo said that the DILG and World Vision share the same vision of promoting the best interest of children by creating an environment that is caring and safe for children to develop their full potential.
“To help us achieve this objective, we need to ensure the effectiveness and functionality of our LCPCs in order to have a caring environment for children and uphold their welfare,” he said.
Article 87 of Presidential Decree No. 603 of the Child and Youth Welfare Code, as well as Section 15 of Republic Act 9344 or the Juvenile Justice and Welfare Act of 2006, mandate the establishment of the LCPCs down to the barangay level.
Records from the NBOO show that at present, there are 5,169 LCPCs (37 provinces, 66 cities, 307 municipalities and 4,759 barangays) with ideal functionality that work for the advancement of children’s rights and welfare at the local level.
Under the project, World Vision shall collaborate with the DILG on the development and execution of a Barangay Council for the Protection of Children training program in World Vision- assisted areas, as well as coordinate and assist the Department in all activities required in the implementation of the project, including logistical and technical support.
It shall also identify its staff and partners who will undergo the BCPC training of trainers, and share in the LCPC/BCPC training costs where it operates through its Area Development Programs.
On the other hand, the DILG is tasked to develop a program of activities and provide resource persons in the conduct of LCPC capability training activities for World Vision staff and partners, and work with World Vision in the monitoring of BCPC in areas where the organization has programs.
“We welcome the partnership and support of World Vision in this effort of ensuring the well-being of our children,” Robredo said. (DILG/RJB/JCP-PIA NCR)
Press release: PIA
17 January 2012
http://www.pia.gov.ph/?m=1&t=1&id=72672
___
16 January
AUSTRALIA
The Gillard Labor Government today launched a new website to tackle cyberbullying and help more young people stay safe online.
The Easy Guide to Socialising Online website has been developed in partnership with industry and young people to help parents, children and educators combat cyberbullying and inappropriate content online.
The Easy Guide website is part of the Government’s $125.8 million Cybersafety Plan and has been developed following advice from the Government’s Youth Advisory Group on Cybersafety.
The new website provides cybersafety information for 26 social networking sites, search engines and online games, and gives step by step instructions on how to report cyberbullying, abuse and inappropriate content on these sites.
It also provides clear information for parents, educators and young people on how to adjust safety and privacy settings on websites as well as tips on how to stay safe when using any social media site.
Members of the Government’s Consultative Working Group on Cybersafety (CWG), including Facebook, Google, Microsoft, NineMSN, Yahoo!7 and the Interactive Games and Entertainment Association worked closely with the Government to develop the Easy Guide website.
Cyberbullying is a serious matter which is why the Government has listened to young people and produced the new guide to staying safe online.
The Government’s Cybersafety Plan involves a number of important initiatives including the Easy Guide to combat online risks to children.
The Cybersmart website www.cybersmart.gov.aulaunched two years ago, has received well over a million visits and provides access to KidsHelpline for confidential online counselling.
It also provides access to the Government’s Cybersafety Help Button which is a ‘one stop shop’ for practical information and tips on how to deal with cyberbullying, unwanted contact and offensive or illegal content.
Since its launch 12 months ago, the Help Button has been downloaded on more than 300,000 computers across Australia.
The Cybersafety Help Button can be downloaded at www.dbcde.gov.au/helpbutton.
The new Easy Guide website address is www.dbcde.gov.au/easyguideand it can also be accessed via the Cybersafety Help Button.
For further tips on cybersecurity and safety are available at www.staysmartonline.gov.au
Press release: Advert.co.uk
15 January 2012
http://www.vadvert.co.uk/government/20704-helping-australians-just-say-no-to-cyber-bullying.html
___
13 January
HAITI
Most Vulnerable Must Not Be
Forgotten in Haiti
...
Two years after the earthquake in
Haiti the most vulnerable are still at risk, if aid wanes.
At least half of the over 220,000 casualties of the earthquake in Haiti on January 12, 2010, were children. Many of those who have survived the turmoil of the past two years have been abandoned by families no longer able to provide for them due to poverty and impossible living conditions. Girls, in particular, face sexual violence in makeshift camps. Over 500,000 people still living in camps endure worsening conditions as donor funding and interest in Haiti’s reconstruction wanes. Plan International, SOS Children’s Villages and World Vision call on the European Union (EU) to consider the protection of children and the economic and social support for their families in Haiti a top priority.
In January 2010, over 2 million people were affected by the devastating earthquake in Haiti, leaving many homeless. One and a half million were children. Although the number of Haitians living in camps has decreased by 66 percent from a July 2010 peak of 1.5 million, those left in the camps are the most vulnerable to new natural disasters such as hurricanes and floods, as well as economic hardship. Children and adolescents are exposed to malnutrition and violence; they report of physical and sexual abuse, of broken homes and parents who are not able to find work. The greatest child protection risks witnessed in Plan’s operational areas have been in the crowded and unsanitary camps. Girls and women, especially, have been exposed to violence when simply walking to and from washroom facilities. According to World Vision research, over half of the children registered at official border check points last year were travelling in dangerous conditions (without documents, hidden in vehicles, or clearly handled by smugglers). Many of these children are at risk of sexual or labor exploitation.
Helmut Kutin, President of SOS Children’s Villages, states: “The conditions are catastrophic: measures to ensure children’s rights are respected should be enforced as soon as possible. Those of us who have committed ourselves to helping the people of Haiti must make good on our promises, even if true consolidation is still years away.”
According to the UN Office for the Coordination of Humanitarian Affairs, $231 million is required for 2012 to address immediate unmet necessities and to carry out longer-term projects. In 2011, half of the financial needs were not met. Although the EU has given strong support to Haiti in the past, it must now continue to prioritize Haiti, and rise to the level of other world leaders. Aid initiatives have contributed to erasing the devastation left by the earthquake in Haiti; many children have benefited from these services. Yet reconstruction on this scale is an exceedingly complex and time consuming process, even more so when a country has a long history of permanent political, social and economic crisis.
Plan, SOS Children’s Villages and World Vision have implemented measures to protect children and adolescents in child-friendly spaces, through emotional and psychosocial support, reunification of separated children with their families, and child-trafficking prevention. Children in Haiti have received food, medical care and shelter. Massive investment, however, is required to assist the Government of Haiti in fulfilling its responsibility and taking leadership on shelter, healthcare, education and economic growth.
As Plan’s director in Haiti, John Chaloner, confirms: “Haiti is a very young nation with around half of its population aged under 18. There are many vulnerable young people at risk if we allow this to become simply 2010’s forgotten crisis.”
Therefore full social protection should be prioritized, in particular for Haitian girls, including safe, quality education, economic opportunities for young people, campaigns targeting child rights, gender-based violence, youth pregnancy and work rights. $7.3 million alone will be required to ensure an enrolment of 80 percent of the children between four and 14 years of age who live in temporary camps and shelter.
Jean Claude Mukadi, World Vision Haiti’s National Director, says: “I envision a Haiti where children and youth are given the opportunity to dream and to have hope for the future; where they are loved, cared for, protected, and where they are provided with the opportunity to express themselves and to participate in the reconstruction of their country.”
Plan, SOS Children’s Villages and World Vision therefore call on the EU to allocate necessary funds to the long-term reconstruction of Haiti, and particularly the protection of children.
Press release SOS-USA
11 January 2012
http://www.sos-usa.org/newsroom/press-releases/Pages/Most-vulnerable-must-not-be-forgotten.aspx
___
11 January
Are Governments Doing Enough
to Protect Kids?
No. Canada Can Do Better, Say Paediatricans
Canada's provincial and territorial governments could be doing more to protect and promote the health and well-being of Canada's children and youth, according to a report released today by the Canadian Paediatric Society (CPS).
The fourth edition of Are We Doing Enough? A status report on Canadian public policy and child and youth health examines how effectively governments use legislation and programming in areas such as injury prevention, disease prevention and health promotion. It also assesses the federal government in key areas.
"Since we last published our report in 2009, there have been too few improvements across all provinces and territories. In fact, Canadian children and youth may be losing ground when it comes to public policy," said Dr. Andrew Lynk, CPS Vice-President and Chair of the Action Committee for Children and Teens. "There continues to be a piecemeal approach to keeping children and youth healthy and safe in Canada-and it's putting kids at risk."
As government attention turns to the economy, there is mounting evidence to show that investing early in child health and development is a strong driver of economic growth and helps to ensure a fiscally healthy nation.
"Canada lags far behind most wealthy western nations and is ranked last in terms of support for family policy and early child development," said Dr. Jean-Yves Frappier, CPS President. "Government-led health promotion strategies have proven protective and preventive powers-to save lives, and to prevent injury, disability and disease. The CPS strongly encourages all levels of government to take action on the recommendations in this report."
The interval between reports allows time for policy changes to take place, and in some areas improvements have been made. Provinces and territories continue to strengthen anti-smoking laws, and many have introduced policies to improve the mental health of children and youth and to pull them out of poverty. But there is still much more to be done.
Among the new key issues evaluated in this year's report are newborn hearing screening and an enhanced 18-month well-baby visit.
The Canadian Paediatric Society (www.cps.ca) is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,000 paediatricians, paediatric subspecialists and other child health professionals across Canada.
SOURCE: Canadian Paediatric Society
Press release: marketwire
10 January 2012
___
9 January
Brain Changes Found in Youth with Schizophrenia, Psychosis
Children and adolescents with first-episode psychosis who are later diagnosed with schizophrenia show significant changes in specific brain volumes, new research suggests.
In a magnetic resonance imaging (MRI) study of more than 100 young people in Spain, those who were diagnosed with schizophrenia or other psychoses showed a greater loss of brain gray matter (GM) volume and a greater increase in cerebrospinal fluid (CSF) volumes in the frontal lobe after 2 years than did their healthy peers.
Progressive brain changes were also more significant in the participants with schizophrenia than in those with bipolar disorder (BD).
"These changes… after onset of psychotic symptoms may be related to markers of poorer prognosis," write lead author Celso Arango, MD, PhD, from the Hospital General Universitario Gregorio Maranon in Madrid, Spain, and colleagues.
"To develop therapeutic strategies to counteract these pathologic progressive brain changes, future studies should focus on their neurobiological underpinnings," they add.
The study is published in the January issue of the Archives of General Psychiatry.
Volumes and Clinical Outcomes
For this analysis, the investigators evaluated data from 110 pediatric patients between the ages of 7 and 17 years who participated in the Child and Adolescent First-Episode Psychosis Study (CAFEPS) between March 2003 and November 2005 and compared the data with 98 matched healthy control participants.
Of these participants, 61 of the first-episode psychosis patients (74% boys; mean age, 15.5 years) and 70 of the healthy control participants (67% boys; mean age, 15.3 years) underwent MRI at baseline and at a 2 year follow-up visit.
The primary outcome measures were GM and CSF volumes in the total brain and in the frontal, temporal, and parietal lobes.
Results showed that at the end of the 2-year follow-up period, 25 of the first-episode psychosis patients were diagnosed with schizophrenia, 16 with BD, and 20 with "other psychoses," using the Spanish version of the Kiddie-Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version.
The participants who were diagnosed with schizophrenia showed significantly greater GM volume loss from baseline to the end of the 2-year follow-up period compared with their healthy peers in both the left (-3.3 cm vs -0.6 cm; P = .004) and right (-3.7 cm vs -0.8 cm; P = .005) frontal lobes, left parietal lobe (-4.3 cm vs -2.2 cm, P = .04), and the total brain (-37.1 cm vs -14.5 cm, P = .001).
Those with schizophrenia also had a significantly greater CSF volume increase in the left frontal lobe than did the healthy control participants (6.7 cm vs 2.4 cm; P = .006).
"Greater left frontal GM volume loss was related to more weeks of hospitalization, whereas severity of negative symptoms correlated with CSF increase in patients with schizophrenia," report the investigators.
More Research Needed
The patients diagnosed with "other psychosis," compared with the healthy control participants, had significantly greater GM volume loss in the whole brain (P < .001), in the frontal lobes bilaterally (P < .05), and in the left pariental lobes (P < .01), as well as greater increases in CSF volume in the frontal lobes (left, P < .001; right, P < .05).
The pediatric patients with BD had no significant differences in either GM or CSF volumes compared with the healthy participants.
The researchers note that these results correspond with past studies that found that early-onset psychosis may be "a progressive neurodevelopmental disorder with both early and late neurodevelopmental abnormalities."
"The correlates of volume change at a cellular level and the study of risk genes involved in circuitries associated with different psychoses and their relationship to developmental trajectories may be promising areas of research," conclude the investigators.
The study was supported by several organizations, and the study authors report several financial relationships, all of which are listed in the original article.
Arch Gen Psychiatry. 2012;69:16-26
6 January 2012
http://www.medscape.com/viewarticle/756475
