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EXTRACTS FROM THE “OTHER” JOURNALS
RELATING TO CHILDREN, YOUTH AND FAMILIES —
IN THE FIELDS OF HEALTH,
SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE ...
June 2006
Alcohol a bigger threat to U.S. youth than drugs
Alcohol abuse by minors results in almost 3,200 deaths a year -- four times more than deaths due to all illegal drug use combined, a new study finds. Underage drinking also costs the United States $62 billion each year, the researchers found.
Despite these numbers, policymakers remain focused on the impact and prevention of drug use in minors, rather than alcohol, the study's authors said. The budget for anti-drug use by America's youth is nearly 25 times that of public funds earmarked for the prevention of alcohol use. "Alcohol-related traffic crashes, violence, teen pregnancies, STDs, burns, drownings, alcohol poisoning, property damage and other risks take a human and economic toll that's much greater than illegal drugs. Yet, we spend so much more on youth drug abuse," study author Ted Miller, director of the Pacific Institute for Research and Evaluation (PIRE), said in a prepared statement.
Miller's team at the PIRE Public Services Research Institute in Calverton, Md., found that a large number of minors are drinking great quantities of alcohol. In fact, the study showed that underage youth consume at least 16 percent of all alcohol sold in the United States, a number the researchers called conservative. The costs of underage drinking come from a variety of sources, with expenses linked to traffic accidents alone totaling roughly $13.7 billion per year. "Drinks in bars, drinks in cars, drinks stolen form Mom's liquor cabinet: The average harm from a kid's illegal drink is $3," said Miller. "That's far more than the 85-cent price tag those drinks carry. It dwarfs the 10 cents in taxes we collect or the 40 cents in profit the alcohol industry reaps," he said.
Miller said poor legal enforcement is a major factor in the underage drinking epidemic, and that stricter regulations and inspections of institutions where alcohol is sold would cut the amount of alcohol getting into minors' hands. Improvements in identification and age-verification, driving curfews, zero-tolerance laws and regulations placing liability on parents who allow underage drinking in their home would also help control the problem, he said.
The study is published in the July issue of Journal of Studies on Alcohol.
29 June 2006
http://news.yahoo.com/s/hsn/20060629/hl_hsn/alcoholabiggerthreattousyouththandrugs
Emotional factors may contribute to stuttering
Preschoolers who stutter may have more difficulty controlling their emotions than other children their age, a study has found -- suggesting that emotional factors contribute to the speech disorder. Stuttering is a common speech problem that typically becomes apparent between the ages of 2 and 5 years old. Children may repeat or draw out words or parts of words, or have difficulty beginning a word.
The exact cause of stuttering is unknown, but it probably involves a "complex interaction" between genes and environment, said Dr. Edward G. Conture, a professor of hearing and speech sciences at Vanderbilt University in Nashville and a co-author of the new study. Stuttering is believed to have a strong genetic component, as it often runs in families. But it has also long been suspected that emotional development may contribute to the disorder, Conture told Reuters Health.
In his team's study, published in the Journal of Communication Disorders, preschoolers who stuttered were typically more excitable than their peers with normal speech, and tended to have a harder time calming down or shifting their attention away from a stressful situation. The findings are based on reports from parents of 65 preschoolers who stuttered and 56 children who did not. Both groups of parents completed a standardized questionnaire on child behavior.
Three general differences between the two groups emerged, Conture said. Children who stuttered showed greater emotional "reactivity" to everyday stresses, like having a toy taken away; it took them longer to settle down once they were excited or upset; and they were less adept at shifting their attention away from the stressor, often becoming fixated on it instead. The researchers suspect that poor attentional control, leading to higher levels of emotional reactivity may contribute to the development of stuttering in children who are predisposed to the speech problem. Conture said the findings are in line with what parents often tell their child's doctor or speech therapist: that emotional outbursts or excitement seem to trigger stuttering episodes. He said parents should tell their health care provider if they notice that their child regularly has strong emotional reactions to everyday challenges or changes in their daily routine.
Parents may be able to help their child by demonstrating ways to calmly cope with stressful situations, according to Conture. He also noted that children can have difficulty controlling not only negative emotions, but excitement over positive events as well; so it may not be a good idea, he said, to tell your child about a trip to Disney World months beforehand. No one knows yet whether helping children better regulate their emotions will aid their stuttering problems, but Conture said the current findings "tell us this is something we should look at." He also emphasized that parents should not feel guilty about any role emotional control might play in stuttering. "There is no evidence that parents cause their children to stutter," Conture said.
SOURCE: Journal of Communication Disorders, June 2006,
online.
Amy Norton
28 June 2006
Activity level in kids unaffected by environment
While children vary in how active they are, they are consistent in the amount of physical activity they engage in every day, regardless of the amount of school-based physical education they receive, their daily routine, background or culture. According to British investigators, these findings imply that children's physical activity is not determined by the environment but by some internal regulator of sorts that all children share, according to their paper in the International Journal of Obesity. "There has been a lot of concern regarding the serious loss over the past decade for children to have opportunities for physical activity at school," Dr. Terry J. Wilkin told Reuters Health. "We believed that the loss of physical education would have its greatest impact on children attending school in areas of low socioeconomic status."
Wilkin and his colleagues at the Peninsula Medical School in Plymouth studied the physical activity of children ages 5 to 10 in a variety of schools. The team compared several different situations: Group 1, which included 307 children from 53 primary schools who were tested at ages 5 and 6. Group 2 included 215 children ranging in age from 7 to 11 years, selected from three schools representing high income areas and areas of lower socioeconomic status. Group 3 included 732 children attending school in Glasgow, approximately 800 km away.
The three schools in Group 2 included a private preparatory school with 9 hours per week of physical education; a village school with 2.2 hours per week of physical education, and an inner city school that had physical education only 1.8 hours per week.
Each subject wore a matchbox-size accelerometer for 7 days. The device records the time along with duration and intensity of activity, which is then downloaded into a computer at the end of the week. "Predictably, children who went to private school had a lot more physical activity during the day compared with the schools in lower socioeconomic areas," Wilkin said. "But when we looked at the activity after school, it was entirely reversed. Then when we added in-school and out-of-school activity altogether, it was exactly the same." "At the end of the week, the difference was less than 0.1 percent between groups," he added, because each child compensates by increasing activity after school.
The researchers also found that total levels of physical activity were the same on week days and weekend days. Similar findings were obtained when comparing children who walked to school with those transported by car, or when they looked at children in the Glasgow school system versus those in Plymouth.
Moreover, total physical activity scores were independent of the amount of time spent sleeping or watching TV or playing video games, the investigations note. "There was about a 4-fold variation in activity in each group," Wilkin noted, "that is, some children do four times more activity in a day than others. But the point is, the degree of variation was the same at each school, and the average for each school was the same." The researchers also found that girls were consistently less physically active than boys. "So if environmental differences do not explain this variation, there must be something else," Wilkin continued. "We called this the 'activitystat,' a kind of thermostat in the brain that sets activity levels for each particular child."
SOURCE: International Journal of Obesity, June 2006.
Karla Gale
27 June 2006
Children as young as eight self-harming
Child psychiatrist Sally Bonnar, based at the Centre for Child Health in Dundee, said today that on average around 150 children a year across Tayside were referred for specialist help because they were self-harming. The youngest child she had treated for deliberate self-harm was eight, although the numbers requiring help at such a young age were few. “These are very rare,” said Dr Bonnar. “The vast majority are 13 to 16-year-olds and more girls than boys.”
Deliberate self-harming takes a variety of forms including hanging, burning, pulling out hair, but most commonly occurs as cutting or overdosing. Locally, child and adolescent mental health services (CAMHS) have undergone major changes over the last couple of years, redesigning the service and taking on extra staff because waiting times for children seeking help were “unacceptable” with the longest waits previously around two years.
Around 40 children a week, some not even old enough to attend school, are referred to CAMHS with a variety of mental health problems and staff prioritise these cases at a weekly team meeting. Even now children can wait up to six months for help because demand for services outstrips capacity, though self-harmers now “jump the queue”. While psychologists have been recruited to the CAMHS, boosting the service available to children with general mental health problems, there has also been a turn around in the service to self-harmers with the appointments of two highly-trained specialist nurses able to respond rapidly.
The nurses are available seven days a week, with a consultant or senior specialist doctor on-call during the night. Dr Bonnar said the arrangement allowed self-harmers to “jump the queue” and be seen and assessed within hours of a referral. Prior to the introduction of the nurses to work specifically with young people who deliberately self-harm, the service was delivered by doctors engaged in a variety of other duties, who could be anywhere in Tayside and “caught up” in other problems when they were informed of a self-harm emergency.
Dr Bonnar said in the past a self-harming child admitted to A&E at Ninewells or Perth Royal Infirmary in the morning, could wait until late in the day, and after five o’clock at night, until medical staff (from CAMHS) got to see the child referred as an emergency. “Clearly that was not ideal,” said Dr Bonnar. “All the other support services have clocked off and gone home.” To better respond to the needs of children who deliberately self-harm, the specialist nurse service was established. “Our deliberate self- harm nurses can go out to A&E within two hours,” said Dr Bonnar. “Young people can be seen that day and an assessment made of their mental health needs and the nurses can either follow them up themselves or, if a young person with serious mental health problems needs a more complicated piece of work, they will get seen within the department or can be referred on appropriately, to a social worker or one of the voluntary sector agencies.”
Dr Bonnar said no clinician liked to have waiting lists for treatment but gave a reassurance that real emergencies would get a rapid response whether they were children deliberately self harming or with other mental health problems. “If a GP phones in with a real emergency, the child gets seen that day,” said Dr Bonnar. “If it’s an urgent case, it will be seen within a week. If it’s a routine case it will take on average six months.”
Marjory Inglis
26 June 2006
http://www.eveningtelegraph.co.uk/output/2006/06/26/story8484069t0.shtm
Americans' circle of close friends shrinking
Americans are more socially isolated than they were 20 years ago, separated by work, commuting and the single life, researchers reported on Friday. Nearly a quarter of people surveyed said they had "zero" close friends with whom to discuss personal matters. More than 50 percent named two or fewer confidants, most often immediate family members, the researchers said. "This is a big social change, and it indicates something that's not good for our society," said Duke University Professor Lynn Smith-Lovin, lead author on the study to be published in the American Sociological Review.
Smith-Lovin's group used data from a national survey of 1,500 American adults that has been ongoing since 1972. She said it indicated people had a surprising drop in the number of close friends since 1985. At that time, Americans most commonly said they had three close friends whom they had known for a long time, saw often, and with whom they shared a number of interests.
They were almost as likely to name four or five friends, and the relationships often sprang from their neighborhoods or communities. Ties to a close network of friends create a social safety net that is good for society, and for the individual. Research has linked social support and civic participation to a longer life, Smith-Lovin said. People were not asked why they had fewer intimate ties, but Smith-Lovin said that part of the cause could be that Americans are working more, marrying later, having fewer children, and commuting longer distances.
The data also show the social isolation trend mirrors other class divides: Non-whites and people with less education tend to have smaller social networks than white Americans and the highly educated. That means that in daily life, personal emergencies and national disasters like Hurricane Katrina, those with the fewest resources also have the fewest personal friends to call for advice and assistance. "It's one thing to know someone and exchange e-mails with them. It's another thing to say, 'Will you give me a ride out of town with all of my possessions and pets? And can I stay with you for a couple or three months?" Smith-Lovin said.
"Worrying about social isolation is not a matter of nostalgia for a warm and cuddly past. Real things are strongly connected with that," added Harvard University Public Policy Professor Robert Putnam, author of "Bowling Alone," a book on the decline of American community. He suggested flexible work schedules would allow Americans to tend both personal and professional lives.
Amanda Beck
23 June 2006
New evidence of condoms' effectiveness
A new scientific study published in June 22's issue of the New England Journal of Medicine states that proper condom use can reduce the risk of contracting HPV, a virus that can cause cervical cancer. "This is very encouraging news," said James Wagoner, President of Advocates for Youth. "This report provides further evidence that, while not absolutely foolproof, condoms are far and away the most effective prevention tool for sexually active people, including youth."
Ultra-conservatives have been waging a war on condoms for the past decade as a way to further promote abstinence-only-until- marriage programs for youth – programs that censor information about the effectiveness and health benefits of condoms. These individuals have often made a case against condoms by claiming that they provide no protection from HPV. However, this report clearly states that "consistent condom use… appears to reduce the risk of cervical and vulvovaginal HPV infection."
Yet, the war against condoms is not limited the HPV issue. In addition, ultra-conservatives in Congress and the administration forced the CDC and USAID to remove information about the health benefits of condoms from their Web sites; prohibited U.S. HIV prevention programs working overseas from promoting condom use for sexually active youth; argued at international conferences that promoting condom use encourages teens to have sex, despite overwhelming research to the contrary; and pushed the FDA for condom labeling that would emphasize condom 'failure' instead of condom effectiveness.
"It's time for a 'cease-fire' in the war on condoms," continued Wagoner. "We know that abstinence from sexual activity is the only way to remain 100 percent safe from sexually transmitted disease. But the continuing attacks on condom efficacy and the efforts to keep young people in the dark when it comes to safer sex runs counter to proven public health science and basic common sense." "Government should be in the business of providing medically accurate information to the people of this country, not using public health as a vehicle for ideological agendas," Wagoner concluded.
USNewswire
21 June 2006
http://releases.usnewswire.com/GetRelease.asp?id=67917
Fat teens' parents too busy: study
The number of hours a parent works may influence the health of their teenage children, a pilot study on adolescent obesity has warned. Presenting the results of US research to the Association for Consumer Research's Asia Pacific conference in Sydney last Friday, academics from the University of Nebraska said preliminary results suggested a link between mothers who worked long hours and overweight or obese teenagers.
Mothers who worked more than 30 hours were more inclined to turn to fast food for family meals, and teenagers left unsupervised at home were more inclined to snack in front of the TV or computer, according to Patricia Kennedy, Associate Professor of Marketing at the university's College of Business Administration. "It's the parent who's buying the type of food that . . . is available for the child while unsupervised that is the overwhelming factor," she said.
A pilot study sampling 12-to-18-year-olds across four US states surveyed students' eating habits and lifestyle, their parents' socioeconomic status, eating habits and lifestyle and schools' food, health and physical education policies. The survey found almost one in five US teenagers were either overweight or obese.
Kelly Burke
20 June 2006
Link between child abuse and schizophrenia proposed
NEW YORK (Reuters Health) -- There is strong evidence to support the theory that child abuse can cause schizophrenia, two researchers argued at medical conferences in London and Madrid last week. Paul Hammersley, of the University of Manchester, and Dr. John Read, from the University of Auckland, New Zealand, reviewed 40 studies of psychiatric patients and found that most of these individuals were sexually or physically abused as children or adults.
In a review of 13 studies of schizophrenics, they found abuse rates from a low of 51 percent to a high of 97 percent. Citing the known link between the symptoms of post-traumatic stress disorder and schizophrenia, Hammersley and Read charge that many schizophrenic symptoms may actually be caused by trauma. "I hope we soon see a more balanced and evidence-based approach to schizophrenia and people using mental health services being asked what has happened to them and being given help instead of stigmatizing labels and mood-altering drugs," Read said in a statement. "Child abuse was a reality for a large number of sufferers of psychosis," Hammersley added. "The experience of hearing voices is consistently associated with childhood trauma regardless of diagnosis or genetic pedigree."
Genes may still play a role in schizophrenia, but genes alone do not cause the illness, the researchers argue. Apart from Alzheimer's disease, not a single gene has been shown to play a key role in any mental illness, they point out. Schizophrenia is a disorder of altered emotions, thought processes, and perceptions of reality. In addition to hearing voices, schizophrenics may suffer hallucinations and delusions and have difficulty with memory and intellectual functioning.
Symptoms of the disorder are most apt to appear in the late teens and 20s. Hammersley and Read think all patients seen in the mental health arena should be asked about whether they have suffered any kind of abuse in their lifetime. They also think antipsychotic drugs should not be automatically doled out; rather these individuals should be offered psychological therapies more often. "What is important about all this," Hammersley told Reuters Health, "is whether or not mental health services change. Users of those services tell me over and over again, they are fed up being offered nothing but medication."
The findings were scheduled for presentation at the Institute of Psychiatry in London and the 15th ISPS Symposium for the Psychotherapy of Schizophrenia and other Psychoses in Madrid.
19 June 2006
http://www.tehrantimes.com/Description.asp?Da=6/19/2006&Cat=7&Num=6
Body image concerns tied to mood disorders in teens
In a study of adolescents who were admitted to a psychiatric hospital, those with body image concerns were more likely to suffer from symptoms of depression, anxiety, suicidal thoughts and other mental health problems than those who didn't have such concerns. Also, patients preoccupied with body shape or weight were significantly more likely to have post-traumatic stress disorder, dissociation and sexual preoccupation.
Overall, body image disorders affected one third of all of the teens evaluated, and were severe enough to cause significant distress or interfere with normal functioning, Dr. Jennifer Dyl of Brown Medical School in Providence, Rhode Island and colleagues report. "These relatively common, yet distressing and impairing body image preoccupations deserve further study in adolescents," Dyl and her team report in the journal of Child Psychiatry and Human Development.
Body dysmorphic disorder (BDD) is a medically recognized condition in which a person suffers from a disabling preoccupation with an imagined or minor flaw in his or her appearance. The condition usually first appears in early adolescence, a time when the body is undergoing major changes in appearance, Dyl and her colleagues note. To investigate the prevalence of BDD, eating disorders and other body image concerns and their association with other mental disorders, the researchers evaluated 208 boys and girls between 12 and 17 years old who were admitted to a psychiatric hospital for inpatient care.
Fourteen met the medical criteria for BDD, 8 had eating disorders, and 46 had shape or weight concerns that were clinically significant but did not meet criteria for BDD or eating disorders. Just 1 of the 14 study participants with BDD had this diagnosis noted in their medical record, Dyl and her colleagues found. Less than half of the teens with shape and weight concerns were actually overweight. "Our results underscore the importance of screening for and diagnosing BDD and other body image concerns in adolescents," Dyl and her team conclude.
SOURCE: Child Psychiatry and Human Development,
June 2006.
ADHD and medication – practical education and
information
Due to a shortage of child and adolescent psychiatrists more pediatricians and family doctors are being asked to diagnose and treat Attention Deficit Hyperactivity Disorder (ADHD) creating a need for knowledge on current research and the latest information on ADHD medication. Recently Health Canada has up-dated the prescribing information for all drugs indicated for the treatment of ADHD in adults and children.
The changes affect the Contraindications, Warnings and Precautions, Dosing recommendations, and Information for the Patient. Many parents as well as adult patients will be asking for clarification on this newly released information and will need reassurance that medication is still a safe choice. It light of this it has become even more important that physicians as well as other medical professionals working with children and adults with ADHD familiarize themselves with the latest scientific research in this area. The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) a national independent not-for-profit organization has published the first Canadian ADHD Practice Guidelines that outline proper assessment, diagnosis and treatment of ADHD through out the lifespan.
These guidelines can be accessed through the CADDRA
web site www.caddra.ca
(On this website you can also find details of a conference to be held on
June 23-25, 2006 at the Renaissance Toronto Airport Hotel.)
Press release: CNW
15 June 2006
http://www.cnw.ca/fr/releases/archive/June2006/14/c2257.html
CDC survey measures youth alcohol and drug use
among other risky behaviors
The good news is that there are fewer teenagers engaging in risky behaviors compared to 1991, according to the Results of the latest National Youth Risk Behavior Survey (YBRS) from the Centers for Disease Control and Prevention (CDC). Substance abuse was one of the many categories of behaviors measured, which also included diet, exercise, violence and sex. In a release from the CDC last week, the Center’s director of the adolescent and school health division Howell Wechsler, Ed.D, MPH commented, “The overall survey results are encouraging because they show us that persistent efforts to get young people to adopt healthier behaviors can achieve positive results.”
The survey results showed that more than 43 percent of students across the country are considered current drinkers, and over 25 percent had five or more alcoholic drinks in a row within the last 30 days. Also noted was that about one quarter of the students first drank alcohol, other than a few sips, before the age of 13. Another behavior associated with alcohol consumption is drinking and driving. Roughly ten percent of teenagers had driven a car within the last month under the influence of alcohol, which translates to millions of impaired underage drivers in just a 30-day period. Nationwide, 38.4% of students had used marijuana one or more times during their life. While current marijuana use has declined over the last six years, it is still significantly higher at over 20% in 2005 than the under 15% total in 1991. Almost nine percent of students had tried marijuana for the first time before age 13.
Director of Drug Education for Narconon Arrowhead J.T. Daily points out that, “Unfortunately, there are pro-drug groups out there that promote the use of illegal drugs, which sends a message to young people that it might be safe or okay, which is not the case.” Mr. Daily has worked with well over 100,000 students across the country in recent years and says he has to combat a lot of misinformation about these drugs. Narconon Arrowhead is one of the nation’s largest and most successful drug education and rehabilitation programs, which uses the effective drug-free approach developed by American author and humanitarian L. Ron Hubbard.
Another drug that is promoted by organizations involved in drug legalization and harm reduction is the club drug known as ecstasy (MDMA). Although ecstasy use has dramatically declined since its peak around the year 2000, according to the YRBS there are still as many students who have tried ecstasy as methamphetamine, the latter of which has become a serious problem in the U.S. over the last several years. Daily says that there are two videos available that also help to provide insight to young people. “Marijuana: The Myth” and “Ecstasy: The Real Story” are produced and distributed by a supporting group called Friends of Narconon. “The more information you can provide to students through effective drug education that communicates on their level, the more they will make the decision to stay away from these harmful substances,” he claims.
Nearly 14,000 U.S. high school students participated in the 2005 National YRBS, which is one of three Department of Health and Human Services-sponsored surveys that provide data on drug use among youth. The full 2005 Youth Risk Behavior Survey data are available at www.cdc.gov/yrbs
eMediaWire
13 June 2006
http://www.emediawire.com/releases/2006/6/emw398182.htm
Study questions if drugs raise suicide risk
A study raises questions about whether newer antidepressant drugs raise the risk of suicide as some studies have suggested by finding that suicide rates have dropped in the United States since the drugs were introduced, researchers said on Monday. In fact, the use of the new SSRI antidepressants to treat depression has saved more than 30,000 lives, according to the study published in the journal Public Library of Science Medicine. "Our findings certainly suggest that the introduction of SSRIs has contributed to reduction of suicide rates in the United States," Dr. Julio Licinio of the University of Miami said in a statement. "However, the findings do not preclude the possibility of increased risk of suicide among small populations of individuals," Licinio added.
Millions of Americans use antidepressants, which include Pfizer Inc.'s Zoloft, GlaxoSmithKline Plc's Paxil and Eli Lilly and Co.'s Prozac. Prozac, or fluoxetine, was the first SSRI, which stands for selective serotonin reuptake inhibitor. The U.S. Food and Drug Administration introduced "black box warnings" on the most popular SSRIs in 2004 after studies in the United States and Britain suggested the drugs may raise the risk of suicide in children and adults. "Although the current issue concerning antidepressants and suicidality requires further examination, we believe that many more lives have been saved than lost since the advent of these drugs," the researchers wrote.
Licinio's team studied federal data to show the U.S. suicide rate held steady for 15 years prior to the introduction of Prozac in 1988, then dropped steadily over 14 years as sales of the antidepressant rose. The research team found the strongest effect among women. Mathematical modeling of probable suicide rates from 1988 to 2002, based on pre-1988 data, suggests 33,600 fewer people have committed suicide since Prozac hit the market, Licinio said. The actual suicide rates fluctuated between 12.2 and 13.7 suicides per 100,000 people until 1988, and then gradually fell to the lowest 10.4 per 100,000 in 2000, Licinio's team reported.
During that time prescriptions of fluoxetine ballooned from about 2.5 million in 1988 to more than 33 million in 2002. "Much of the psychiatric community fears that the absence of treatment may prove more harmful to depressed individuals than the effects of the drugs themselves," said Licinio, who did the study while at the University of California Los Angeles. "Most people who commit suicide suffer from untreated depression."
Maggie Fox
12 June 2006
Tough curbs on Prozac prescribed for children
Prozac is to be licensed for treating children over eight with depression, but regulators have imposed an unprecedented restriction on its use, ordering that it may not be prescribed unless talking therapies have failed, and even then a course of the drug must be accompanied by counselling. The conditions imposed by the European licensing agency (EMEA) are likely to result in Prozac being used less to treat children. While neither Prozac nor any of the other antidepressants of its class had a licence, doctors were free to prescribe them as they liked.
Because of shortages of therapists and because they seemed a quick and easy fix, the prescribing of Prozac and other drugs known as SSRIs (selective serotonin reuptake inhibitors) to adults and children soared. The annual number of prescriptions to those under 18 leapt from 13,227 in 1995 to 27,658 in 2003. While doctors can still theoretically prescribe "off label", they are unlikely to flout the terms of the licence, which will be laid down in the Summary of Product Characteristics and written in the prescribing bible, the British National Formulary. "Prozac should only be used together with psychological therapy in patients non-responding to such therapy alone after four to six sessions," said the EMEA in its recommendation to the European commission, which will formally grant the licence. If the child does not get better in nine weeks, the drug treatment should be reconsidered, it says.
The move is unprecedented, according to Tim Kendall, joint director of the National Collaborating Centre for Mental Health, which formulated the NHS guidelines on the treatment of depression in children. "This is the first time to my knowledge that a drug has been given a licence which includes a period of psychological treatment before and during the drug treatment," he said. Eli Lilly, manufacturer of Prozac, was specifically asked to apply for a licence by the drug regulator, the Medicines and Healthcare Products Regulatory Authority (MHRA). Prozac is the only antidepressant of the SSRI class the MHRA exempted from its general ban on use in children. Analysis of trial data has shown that the risk children will become suicidal on other SSRIs is greater than the benefit they get from taking the drugs.
With a licence for use on children, Prozac will also be subject to post-licensing surveillance by the MHRA, which will look for reports of troubling side-effects. "I think the MHRA will not take their eye off the ball now," said Dr Kendall. Eli Lilly has also been instructed by the EMEA to "carry out additional studies to ensure that the safety profile of Prozac remains acceptable". The agency also wants further investigation of findings in the early animal safety studies on "sexual development, emotional behaviour and testicular toxicity".
Meanwhile nearly half the men (46%) questioned for a survey by Men's Health Forum published today said they suffered from stress on a weekly basis and two-thirds admitted to anxiety or depression. But almost a third said they would be too ashamed or embarrassed to ask for help.
Sarah Boseley
12 June 2006
http://www.guardian.co.uk/medicine/story/0,,1795476,00.html
Dancing 'calms down' unruly children
Dancing helps hyperactive children to calm down, pay attention in class and avoid getting into fights, a study has shown. Researchers encouraged energetic movement in unruly boys aged five to seven with attention deficit hyperactivity disorder (ADHD) - and found that their behaviour improved.
Professor Erna Gronlund, who led the study, said: "Boys with ADHD calmed down. Their parents and teachers reported that they did their schoolwork better. "One boy could only sit in a classroom for ten minutes previously, and after dance therapy he could attend a whole lesson. "These boys could also play with other children without getting into conflict and fighting all the time." Dance sessions started at "full throttle" with wild jumping and freely expressed movement. Then they did more controlled exercises which required listening and role playing. The research project was developed at Karlstad University and the University College of Dance in Stockholm.
John von Radowitz
12 June 2006
http://news.scotsman.com/scitech.cfm?id=861912006
High rate of self-harm seen among college students
One in six young adults have injured themselves intentionally at least once, according to the largest US survey to investigate the practice among college students. Self-injurious behavior can include scratching and pinching oneself, cutting, swallowing poison and even breaking bones. People who injure themselves say it helps relieve distress. "It's a harbinger of distress, in all likelihood, and inability to cope positively," Dr. Janis Whitlock of Cornell University in Ithaca, New York, the study's lead author, told Reuters Health. "There's a fair degree of consensus that self-injury is fundamentally self-medicative," she added, noting that injuries trigger the release of natural opiates known as endorphins, resulting in an immediate sense of calm.
Whitlock and her colleagues surveyed 2,863 students at two northeastern US universities, 17 percent of whom said they had harmed themselves intentionally at least once. While there have been numerous reports that self-injurious behavior is becoming more common, Whitlock told Reuters Health, "I don't think I expected it to be quite that high." Most of the students who reported injuring themselves -- 71 percent -- said they had done so at least twice. On average, they had injured themselves for the first time at age 15 or 16, the team reports in the medical journal Pediatrics. While 20 percent said they had injured themselves more severely than they intended and should have gotten medical help, just 3 percent of the self-injurers had told a physician. Thirty-six percent said no one knew about their self-injurious behavior.
Repeat self-injurers were more likely to be female, bisexual or unsure of their sexual orientation, and were also more likely to have been abused sexually or emotionally, Whitlock and her colleagues found. They also were more likely to have considered or attempted suicide and were more psychologically distressed. Given the reluctance of people who injure themselves to get help, the researchers write, it is "critical" for health professionals to find ways to recognize, treat and prevent self-injury. Based on the findings, they add, medical and mental health providers might make it standard practice to ask their older adolescent and young adult patients about self-injurious behaviors. Signs that a young person may be harming themselves may include dressing inappropriately for the season, for example wearing long sleeves and long pants in the summer months, and wearing adornments that cover the wrists, Whitlock said.
Parents who do discover that their child is injuring him or herself should try not to react with "horror or incredulity," she added. "For a lot of self-injurers there is a high degree of shame associated with the behavior, and that's one of the reasons why they're so secretive. Adults need to sort of be aware and know how to respond in a way that's not judgmental or reactionary."
SOURCE: Pediatrics, June 2006.
Anne Harding
8 June 2006
Aggressive teens more likely to try tobacco, pot
Among young adolescents, aggression is linked to a likelihood of experimenting with cigarettes or marijuana for the first time, while impulsivity confers a greater risk of trying alcohol, a new study shows. However, the researchers found no association between attention-deficit/hyperactivity disorder (ADHD) and substance-use initiation. Dr. Monique Ernst of the National Institute of Mental Health in Bethesda, Maryland and her colleagues sought to determine whether a psychiatric diagnosis like ADHD or behavioral measures such as level of aggression or impulsivity might influence the risk that a child would try pot, cigarettes or alcohol for the first time. They followed 78 12- to 14-year-old boys and girls, 50 of whom had been diagnosed with ADHD.
Four years after the study had begun, 37 of the participants had not tried substances, 41 had tried at least one, and 29 had experimented with more than one. Just three cases could be defined as substance abuse, as opposed to substance use. Kids who used tobacco were more aggressive and hyperactive and had more trouble with attention and learning than nonsmokers, the researchers report in the medical journal Pediatrics. Statistical analysis found that a child's level of aggressiveness was independently tied to tobacco use. Aggression also independently predicted marijuana use. The only characteristic associated with trying alcohol was impulsivity. This suggests, the investigators note, that there may be different biological factors that make a person vulnerable to starting to use a particular substance. The researchers also found that aggressive teens were more likely to use substances heavily and to try more substances. However, Ernst and her colleagues found that children with ADHD, ADHD plus conduct disorder, depression or anxiety were no more likely to try substances than their peers without a psychiatric diagnosis. The team suggests that it may make more sense to identify at-risk teens by looking at the severity of certain behavioral symptoms, rather than any particular psychiatric diagnosis. "Substance-use initiation confers vulnerability for later substance abuse, and a better understanding of its behavioral predictors can help to shape preventive measures at both the individual and societal levels," they conclude.
SOURCE: Pediatrics, June 2006.
7 June 2006
Midbrain, striatal and amygdalar dopaminergic dysfunction in ADHD Medical Studies/Trials
The brain's dopamine system, which has long been associated with reward learning and reward-related behavior, works differently in treated and untreated attention deficit hyperactivity disorder (ADHD) individuals, according to a study presented by German researchers at SNM's 53rd Annual Meeting in San Diego. "The significant difference we found between treated and untreated ADHD patients provides an important hint on the effect of the most commonly prescribed drug for this disease, which has long baffled and frustrated parents and physicians," noted Felix M Mottaghy, research fellow at University Ulm in Germany. Until this study, there has been no direct evidence pointing to the beneficial effect of methylphenidate (drugs like Ritalin) on the body's dopamine system, added the co-author of "Midbrain, Striatal and Amygdalar Dopaminergic Dysfunction in Attention Deficit Hyperactivity Disorder (ADHD)." For years, researchers have speculated that methylphenidate calms people with ADHD by amplifying the release of the neurotransmitter dopamine, improving attention and focus in those who have weak dopamine signals. "This is a very preliminary basic science study, initiated by Andrea G. Ludolph from the child and youth psychiatry department of the University Ulm; however, future studies of the dopamine system could aid differential diagnosis in hyperactive children," said Mottaghy.
The principal characteristics of ADHD are inattention, hyperactivity and impulsivity, and this condition can become apparent early in a child's life--sometimes as soon as preschool. Estimates indicate that there are as many as 2 million ADHD children (or 1 in every classroom of about 25 students) in the United States. With ADHD, there is an imbalance of several neurotransmitter systems, said Mottaghy. "The most affected seemed to be the dopaminergic system. Until now most studies focused on the so-called postsynaptic or receiving part of this system," he explained. "Our study shows that the beneficial effect of methylphenidate is received via 'normalization' of the dopamine system," he added. "We demonstrated that the brain's dopamine system--including midbrain, the striatum and the amygdala--is differentially modulated in treated and untreated ADHD patients with respect to healthy normal controls," noted Mottaghy. "Methylphenidate leads to a harmonization of the presynaptic dopaminergic neurons that could explain in part the beneficial effects of this central nervous system stimulant," he indicated.
The researchers used positron emission tomography (PET), a noninvasive brain scan, with 18F-DOPA, an imaging drug that is a precursor of dopamine. The University Ulm researchers also used statistic parametric mapping to obtain the statistical comparison of normalized and reoriented brain images, said Mottaghy. "It gives an impression of the distribution of differences within the brain comparing groups of patients or different conditions within one subject," he explained. Additional studies with more subjects need to be undertaken, said Mottaghy, including direct comparison of presynaptic and postsynaptic alterations in an age-matched patients group.
News-Medical Net
7 June 2006
http://www.news-medical.net/?id=18331
Many teenage girls feel pressured into sex: study
Teenage girls commonly have sex not because they want to, but because
they feel pressured into it - and the result may be a higher risk of
sexually transmitted diseases and pregnancy, a new study suggests.
Researchers found that among 279 teenage girls they interviewed, many
said they'd given in to unwanted sex at some point because they were
afraid their boyfriend would get angry.
The findings, published in the Archives of Pediatrics & Adolescent
Medicine, indicate that may teenagers -- both female and male --
need help in negotiating their relationships. "We need to give
guidance to teens on how to communicate with each other," said lead
study author Dr. Margaret J. Blythe, a pediatrician at the Indiana
University Medical Center in Indianapolis. That means helping girls to
take more control over their sexual activity, and boys to understand
what constitutes pressure, according to Blythe.
The importance of educating boys, she told Reuters Health, "is often the
untalked-about part."
The study included girls between the ages of 14 and 17 who were seen at
urban health clinics in Indianapolis. Over about two years, the girls
were periodically interviewed about their current relationships,
including any instances of unwanted sex over the past three months.
Specific questions included: "Would he break up with you unless you had
sex?" and "Would he get mad if you didn't want to have sex?"
In all, 41 percent said they'd had unwanted sex at some point. The most
common reason was fear that their boyfriend would become angry. Ten
percent, though, said their partner forced them have sex when they
didn't want to. About 5 percent said they'd had sex after being offered
money or gifts. Girls who reported unwanted sex also reported less
condom use, a poorer relationship quality and a higher rate of pregnancy
than their peers, the study found.
Other research has shown that unwanted sex, particularly in cases of
rape, can lead to depression, anxiety and post-traumatic stress
disorder. The current findings, Blythe and her colleagues say, point to
sexually transmitted diseases and unintended pregnancy as additional
serious consequences.
Most of the girls in the study were black and lower-income, and it's not
clear how representative the findings are of the general population. But
the results are similar to those of some past studies, according to
Blythe and her colleagues.
For example, girls who reported unwanted sex were more likely than their
peers to have a partner who smoked marijuana, and other studies have
linked drug and alcohol use to forced or unwanted sex.
Substance use can blur the line between consensual and non-consensual
sex, the researchers write, and boys who use drugs or alcohol may become
"less sensitive" to what their partners want or don't want.
SOURCE: Archives of Pediatrics & Adolescent Medicine, June 2006.
Amy Norton
6 June 2006
http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-06-06T154255Z_01_COL656420_RTRUKOC_0_US-TEENAGE-GIRLS.xml
Too strict with your children? They're 5 times as likely to be fat, says study
Children with overly strict mothers are much more likely to get fat, according to new research. The study found disciplinarian mothers ended up with six-year-olds who were nearly five times more likely to be overweight than children treated with flexibility and respect, but who were still given clear rules. Scientists said youngsters whose mothers were strict might be comfort eating due to stress. Children of neglectful and overly-lenient mothers were also twice as likely to get fat as those of the "flexible rule-setters". Researchers from the Boston University School of Medicine in the United States surveyed the relationships of four-year-olds in 872 families.
When they measured their body-mass indexes later, they found that 17 per cent of the children of strict disciplinarians were overweight. That compared with 9.9 per cent of the children of neglectful parents, 9.8 per cent of those with too-lenient parents and just 3.9 per cent of the flexible rule-setters' offspring. "The difference between the parenting groups is pretty striking," said Dr Kay Rhee, a co-author of the study into the four parenting "styles" and their effects. Another explanation might be that parents who show respect and warmth within a framework of rules help their children learn to make good decisions about food and exercise. The study, which was published in the journal Paediatrics, said: "These results provide evidence that a strict environment lacking in emotional responsiveness is associated with an increased risk of childhood [obesity]."
Rachel Williams
6 June 2006
http://news.scotsman.com/education.cfm?id=833892006
Heroin viewed as "loser drug" by youths thanks to Zurich's heroin policy
Young people in Zurich consider heroin a drug of "losers", thanks to Zurich's heroin policy of providing alternative drugs and syringe exchange programmes, according to a study that appears in Lancet. Heroin use in Zurich dropped 82 percent between 1990 and 2002, but rose more than 10 times from 1975 to 1990, researchers at the Psychiatric University Hospital in Zurich said. The reason they say is because the government introduced a new heroin policy in 1991 considered to be more liberal. "The medicalization of opiate dependence changed the image of heroin use as a rebellious act to an illness that needs therapy," Carlos Nordt and Rudolf Stohler wrote in the study. "Heroin seems to have become a 'loser drug,' with its attractiveness fading for young people."
Since 1991, the state's government has given addicts supervised access to methadone or buprenorphine, drugs that mimic some of heroin's effects. Mandatory health insurance covers treatment costs and patients can choose any doctor they want. The city has also tried to make heroin use safer by providing safe and hygienic places to inject the drug and exchanging used needles for new ones. The editors of the Lancet medical journal cited the study in calling for a new drug policy in the U.K. Though the country has also introduced needle-exchange programs, it has rejected the idea of safe injecting houses, or drug consumption rooms.
Some policy makers have criticized the Zurich
government's approach, which sometimes includes providing heroin itself,
saying it would lead to more users and longer dependence times.
"Incidence peaked in 1990 at a similar high level to that ever reported
in New South Wales, Australia, or in Italy," the authors wrote. "But
only in Zurich has a decline by a factor of four in the number of new
users of heroin been observed within a decade." The authors say that the
U.K. should permit a similar progamme to be initiated saying, "A
thorough trial of drug consumption rooms is a requirement the government
cannot afford to refuse a second time." The authors noted that "Each
year for the past decade, more people have died in the U.K. after
illegal drug use than in any other European country."
http://www.axcessnews.com/modules/wfsection/article.php?articleid=9870
Governments shy from concrete AIDS commitments
A U.N. meeting on global AIDS strategy endorsed on Friday a goal of doubling funding to fight the epidemic, but fell short of concrete commitments and shied away from frank language on sex. "More people need to know how AIDS is transmitted - and every country has an obligation to educate its citizens," first lady Laura Bush told the third and final day of the global AIDS conference that is setting guidelines for the next decade to help the 40 million people now infected. Some 25 million people have died of the disease since 1981 and it is the leading cause of death among African between 15 to 29 years. Friday's session of the conference brought together heads of state and other ministers in delegations from 151 countries. Bush as well as U.N. Secretary-General Kofi Annan struck at a squeamishness about sex that dominates diplomatic gatherings and many governments and has caused dismay among the more than 1,000 activists participating in the gathering. But British international development secretary, Hilary Benn, put the case more bluntly than any one else. "Abstinence is fine for those who are able to abstain, but human beings like to have sex and they should not die because they do have sex," he said.
The hotly fought-over final declaration, completed early on Friday after all-night talks, includes more-detailed language on prevention and the need for condoms. It has stronger language on women and girls than a declaration in 2001. But its section on empowering girls under 18, many in forced marriages, to decide over their sexuality was weaker than U.N. officials had wanted. "Commitment to women's rights have become a subject of controversy, rather than being recognized as a critical component of a pandemic that is increasingly becoming a women's issue," said Aditi Sharma of India from the South African-based ActionAid International. While the declaration is nonbinding, it serves as a guideline for many governments and activists and spurs private groups and business into action. The document says $23 billion will be needed annually by 2010 to fight AIDS, more than double the $8.3 billion currently spent. Nations pledged they would try to ensure additional resources would be available to ensure universal access to treatment by 2010. But unlike the 2001 declaration, concrete commitments and timetables for funding and programs were not included. The United States and others have objected to international financial goals, although Washington is by far the largest single contributor to prevention and treatment.
The document contains strong language on the necessity of including "vulnerable groups" in all prevention and AIDS plans -- a reference to homosexuals, prostitutes and drugs addicts using dirty needles. But as in 2001, diplomats, especially from conservative Latin American countries and Islamic ones, still refused to mention who is "vulnerable." In nearly every country in the world, AIDS untreated among these groups rapidly spreads to the general population. "Leadership means finding ways to reach out to all groups -- whether young people, sex workers, injecting drug users or men who have sex with men," Annan said. U.N. experts say the epidemic has peaked but the number of people living with HIV continues to rise, even if more slowly than before. Most Africans, some two-thirds of the 40 million infected with HIV, the virus that can lead to AIDS, die within 10 years due to lack of testing, treatment, and weak immune systems in communities where people lack food. El Salvador's President Tony Saca told reporters Latin America nations seem to have been forgotten, despite rising rates of the disease in Central America. "We're not Africa in this respect, but we could be," he said.
Evelyn Leopold
2 June 2006
Fewer young American teens drinking
The percentage of American youngsters who start drinking at an early age has declined, but youth drinking remains a serious problem, a new study shows. Researchers analyzed three large U.S. national surveys to identify trends and characteristics of teenage drinking from 1975 onward. They found that fewer eighth-graders start drinking early, but 10 percent of 9- to 10-year-olds still say they have already had a drink. In 2003, nearly 28 percent of underage drinkers had tried drinking before age 13. The trends were similar for girls and boys and among different ethnic groups. "The data indicate a worsening (drinking) situation in the 1970s, with increasing numbers of youth starting to drink in the earlier grades, followed by an improving situation in the mid-1980s, by which time the drinking age had been raised to age 21 in all 50 states," the study authors wrote in the June issue of Alcoholism: Clinical and Experimental Research.
Despite the improving situation, "12.9 percent of 12-year-olds, 23.8 percent of 13-year-olds and 36.5 percent of 14-year-olds report having initiated drinking," the study found. By the time they reach Grade 8, 40 percent of young people have started drinking. That increases to about 75 percent by the senior year of high school. Young people most often get alcohol from older peers or adults who give it to them or buy it for them. "Underage drinking is a very serious problem that creates adverse consequences for adolescents, their families, their communities and our country," study leader Vivian Faden, of the U.S. National Institute on Alcohol Abuse and Alcoholism, said in a prepared statement. She said there are no simple solutions. "Parents can promote an ongoing dialogue with their children about alcohol, be supportive, loving and involved in their children's lives," Faden suggested. All sectors of society -- including schools, communities, law agencies, government, and the health-care system -- have a role to play in "changing the existing culture around underage alcohol use," she added.
1 June 2006
http://www.lex18.com/Global/story.asp?S=4978482&nav=EQls
EU adopts new rules on children's medicine
The European Union is offering drug makers extended patents as an incentive to produce children's versions of drugs for diseases such as cancer, AIDS or psychiatric disorders. New regulations approved by the EU Parliament Thursday encourage pharmaceutical companies to develop pediatric drugs that don't have the undesirable side-effects of medicines for adults and which can be administered in smaller doses. "For some serious diseases, drugs for adults may have side effects that are particularly serious for children. We are trying to convince labs to produce children-friendly versions of drugs," said French lawmaker Francoise Grossetete, after the EU assembly approved the new rules. EU member states endorsed the rules earlier this year.
Sick children frequently have to take smaller doses of medicines designed for adults, even though their organism absorbs the drugs differently and they can suffer different side effects. Few pharmaceutical companies produce drugs aimed specifically at children because clinical trials are more difficult and take longer. The new EU regulations extend patents for children's drugs by six months, to 15 1/2 years, in an effort to give pharmaceutical companies an incentive to invest more. The European Commission said that, with the extended patent, companies could make an extra 9 million euros ($11.5 million) in sales to offset the 4 million euros ($5 million) usually spent on a clinical trial. The new regulations also cut administrative procedures in drug development.
Companies will not be obliged to develop a children's version of every drug, but they will have to conduct clinical tests and clearly indicate what effect the drug has on children, said Guenther Verheugen, Vice President of the European Commission. Currently, more than 50 percent of the medicines used to treat children in Europe have not been tested and authorized for use for children. "What we are trying to achieve is that all the medicines that we have in Europe are examined (as to) how they affect children, whether they are suitable for children or not. At the end we should know that for all existing medicines," he said. Grossetete pointed to antidepressants as an example of medicine that often has undesirable effects on children and that should be developed separately for children. The European Federation of Pharmaceutical Industries and Associations, representing leading pharmaceutical companies, welcomed the new regulations. "Our children must be able to benefit from medicines tailored to their special needs. This must be achieved by restoring a strong pharmaceutical research and development presence for Europe," said Brian Ager, director general of EFPIA.
Jan Sliva
1 June 2006
Men often victims of dating violence: study
The results of a 32-nation study of violence against dating partners among university students shows that about one third are violent with their partner and women are as likely as men to be the perpetrator. Contrary to the widely held belief that dating violence is a male crime, "women do about as much hitting of dating partners as men do," Dr. Murray A. Straus, founder and co-director of the Family Research Laboratory at the University of New Hampshire, told Reuters Health.
At first glance, this may be hard to fathom given that in 90 percent of police reports it's the male who is the aggressor. That's because only incidents involving an injury get reported, and men are more likely to cause an injury than women are, Straus explains. "Then there is the fear factor," he said: "A woman is more likely to get worried or scared when hit by a man and call the police. 'Real men' don't do that." In general, less than 1 percent of all partner violence is reported to police. According to Straus' research, the most common pattern of dating violence among young couples involves both partners hitting each other. "In every single country, it's most common that both partners are hitting, without exception," Straus said.
In the second most common scenario, the female partner is sole perpetrator of violence. "Chivalry isn't dead," Straus said. "Up to a certain point, the male will not hit back if struck by a woman because 'you don't hit women.' But if it continues, sooner or later he's likely to follow the example and hit her and that, in my opinion, is responsible for the predominance of mutual partner violence." The least common scenario is when the male partner is the only one who hits. The findings of the study also show that dominance by any partner -- female or male -- increases the odds of dating violence. This finding also goes against current beliefs. "According to the feminist theory of male violence, it's an act of male dominance intended to keep women in their place," Straus said. "What we found is that it's not male dominance -- it's any inequality. If one partner tries to run the show, regardless whether it's the male partner or the female partner, it's trouble. Dominance by the male partner is associated with increased violence and so is dominance by the female partner."
The study also confirms that rates of dating violence are very high -- typically three times higher than rates among married couples. "That's because they are younger and any kind of violence -- from slaps to murders -- are more common among young people," Straus said. Straus calls for an end to the focus on men as the only perpetrators of dating violence. He believes that the refusal to recognize that women are often the perpetrators hampers the effort to end domestic violence and ignores half of the problem, he charges. "There needs to be the same public effort to brand as terrible a woman hitting a male partner as a man hitting a female partner. In fact, we've had almost the opposite if you look at women in films and TV -- we now glorify female violence against men."
Megan Rauscher
31 May 2006
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