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March 2006

Cephalon drug a victim of ADHD debate: experts

Cephalon Inc.'s experimental drug to treat attention deficit hyperactivity disorder may have fallen victim more to the timing of its audition than the quality of its performance, some experts say. Last week, a panel of advisers to the U.S. Food and Drug Administration voted 12 to 1 against approving the drug, Sparlon, amid concern it might cause a potentially fatal skin allergy called Stevens Johnson Syndrome. In a 950-person trial, one patient developed a blistering rash, from which he recovered, but the panelists felt the risk was too great to recommend approval of Sparlon without further safety studies. That will likely delay the drug's journey to the market by as much as two years, which some experts say is less a reflection of the drug's relative risk as of heightened concern among regulators about drug safety in general and ADHD drugs in particular.

Several panels have convened recently to examine the cardiovascular and psychiatric risks associated with drugs such as Novartis AG's Ritalin, Shire Plc's Adderall, Johnson & Johnson's Concerta, and Eli Lilly & Co.'s Strattera. "If the Sparlon hearing had happened three months ago, the panel wouldn't have gone this way," said Dr. F. Xavier Castellanos, professor of child and adolescent psychiatry at New York University School of Medicine and author of "Stimulant Drugs and ADHD: Basic and Clinical Neuroscience." The panel that vetted Sparlon was made up mainly of psychiatrists. The lone dermatologist on the panel was Dr. Michael Bigby, associate professor of dermatology at Harvard Medical School. He voted in favor of the drug, and other dermatologists say they would have voted the same way. "The FDA has come under fire and gotten more conservative," said Dr. Doris Day, assistant professor of dermatology at New York University School of Medicine. "There are so many drugs out there that can cause Stevens Johnson Syndrome, and at a higher level than this one."

According to the Drug Eruption Reference Manual, Stevens Johnson Syndrome has been associated with roughly 100 drugs, including almost all antibiotics, many epilepsy drugs, and even common painkillers such as aspirin and codeine. While the risk of Stevens Johnson Syndrome in the Sparlon trial was one case in nearly 1,000, the risk of serious skin rash, including Stevens Johnson Syndrome, for children taking Lamictal, GlaxoSmithKline's drug to treat epilepsy and bipolar disorder, is eight in 1,000. "We are concerned that the FDA panel took an overly myopic view and may be setting a double standard for new ADHD drugs, as existing drugs have potentially dangerous side effects," CIBC World Markets analyst Bret Holley wrote in a report.

Patients taking Adderall are warned of potential serious side effects such as sudden cardiac death, but the drug has also been associated with serious skin reactions. A spokeswoman for the FDA said the cases of Stevens Johnson Syndrome with Adderall are more difficult to interpret than the one emerging from the Sparlon trial as millions of patients have been prescribed Adderall. "Nevertheless," she said, "we are considering how they might be noted in the labeling."

ADHD is characterized by crippling levels of impulsivity, lack of focus and hyperactivity. Every month, 2 million prescriptions are written for children and 1 million for adults. Sparlon is a higher-dose version of Cephalon's sleep disorder drug Provigil, which has been prescribed to more than 36,000 children and adolescents with no reports of skin reactions. On Tuesday, the FDA granted Cephalon an additional six months of market exclusivity for Provigil based on data showing the drug was safe and effective in children. Panelists were concerned, however, that the higher dose of the drug might be responsible for having caused the skin reaction, despite Bigby's assertion that the skin condition was unlikely to be dose-related. "It really makes me wonder if that was the right panel," said Day. "If you're going to have a panel evaluate a side effect of a drug, it should include a significant number of people from that specialty."

Still smarting from the furor over the withdrawn painkiller Vioxx, the FDA has become increasingly risk-averse, some experts say, which could inhibit drug development and research. "The fact of the matter is, there's no free lunch," said Dr. Jean-Claude Bystryn, professor of dermatology at New York University School of Medicine. "If you want new drugs, you have to pay a price. And sometimes drugs can give you reactions that you don't want."

Toni Clarke
30 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-30T133315Z_01_N29322949_RTRUKOC_0_US-CEPHALON.xml
 

Ulster's obese kids 'will die before parents'

Pressure was growing today on TV chiefs to ban the promotion of foods high in fat, sugar and salt - as consumer chiefs here warned that obese Ulster children will die before their parents if the issue is not tackled urgently. Ofcom launched a 10-week consultation today into TV advertising of food and drink to children. The broadcasting regulator was asked by the Government to consider proposals for strengthening its rules on the television advertising of food and drink to children that was high in fat, sugar and salt.

It comes just weeks after the Belfast Telegraph revealed more than 1,200 Primary One pupils in Northern Ireland are obese. The Consumer Council here said that today's launch of the consultation was "only a start". But the Northern Ireland Chest, Heart and Stroke Association criticised Ofcom for "dismissing the option of a 9pm watershed for the advertising of foods high in fat, sugar and salt". It said cutting out the advertising of these foods between those hours would leave only a small proportion exposed to the junk food message. Dr Sinead Furey, Senior Consumer Affairs Officer at the Consumer Council said: "In Northern Ireland, a third of boys and a quarter of girls aged 12 are overweight or obese. "These children will die before their parents if the problem is not tackled urgently. "As part of the solution, Ofcom must consider introducing a watershed for food advertising to children and young people. "Promotion of food products high in fat, sugar or salt should be banned or restricted immediately before, during and after children's programmes and programmes likely to appeal to children."

Nigel Gould
29 March 2006

http://www.belfasttelegraph.co.uk/news/story.jsp?story=684489
 

High IQ kids have distinct pattern of brain development

Intelligence may have more to do with how the brain develops during adolescence than its overall size, researchers said on Wednesday. Using magnetic resonance imaging, scientists at the National Institutes of Health (NIH) in Bethesda, Maryland have shown that the brains of children with high IQs show a distinct pattern of development.

The cortex, or outer mantle of the brain, starts out thinner and thickens more rapidly in very intelligent children. It peaks around 11 or 12 years old before thinning rapidly in the late teens. "We found that the cortex showed a different pattern of development," Philip Shaw, lead author of the research published in the journal Nature, said in an interview. Youngsters with average IQs had a thicker cortex to start with and peaked earlier before gradual thinning began.

Shaw added that the changes were subtle and what is driving them is a mystery. Why children have a thicker or thinner cortex initially is also not known. "Brainy children are not cleverer solely by virtue of having more or less grey matter at any one age," said Judith Rapoport, a co-author of the study. "Rather IQ is related to the dynamics of cortex maturation," she added in a statement.

The scientists discovered the association between intelligence and brain development by taking MRI scans of 307 healthy children and teenagers, aged 5-19, over 2-year intervals as they grew up. They compared the scans to see how they related to the children's IQ. Very intelligent youngsters had scores of 121-145 while high IQs were between 109-120 and average between 83-108.

The smartest youngsters showed the highest rate of change in the scans. The scientists believe the longer thickening time in the very brainy children might indicate a longer period for the development of high-level cognitive circuits in the brain. The researchers added that the thinning phase could involve a "use it or lose it" pruning, or killing off, of brain cells and their connections as the brain matures and becomes more efficient. "That might be happening more efficiently in the most intelligent children," said Shaw. "People with very agile minds tend to have a very agile cortex."

Patricia Reaney
29 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-29T172251Z_01_L29760301_RTRUKOC_0_US-SCIENCE-INTELLIGENCE.xml
 

Adolescent Bullies Move to the Internet

An alarming number of adolescents report being bullied via the Internet and other electronic mediums, says a University of Wisconsin-Eau Claire assistant professor of criminal justice who has been researching cyberbullying for several years. "Technology allows kids to take harassment to another level," said Dr. Justin Patchin. "It differs from traditional bullying because victims can't get away from it. In the past, if you were bullied at school, you could get away from it at home. Now the bully can come into your home and even your bedroom. There's no escape."

In two Web-based surveys, more than one-third of the adolescent respondents reported being the victims of cyberbullying, said Patchin, who conducted the surveys with Dr. Sameer Hinduja, assistant professor of criminal justice at Florida Atlantic University. Most respondents reported being bullied in chat rooms, text messages and e-mail, Patchin said. "As an adult, we might delete or ignore harassing messages," Patchin said. "But to an adolescent, reputation is everything. With one keystroke, the whole school can get a message. It's devastating to them because social acceptance is critical to their self-esteem."

Patchin and Hinduja define cyberbullying as willful and repeated harm inflicted through the medium of electronic text. Computers with Internet access and cellular phones are typical ways through which bullying occurs. Their research began in 2003 when they posted a survey on a Web site popular with teens. Hundreds of adolescents responded, with many sharing their cyberbullying experiences, Patchin said, noting that most said they didn't tell their parents about the bullying. "Parents often don't know what to do," Patchin said. "Many adolescents are savvier with technology than their parents so parents aren't sure what their kids do online. Many kids have computers in their bedrooms, making it hard for parents to monitor online activity."

Patchin and Hinduja created the "Cyberbullying Prevention and Response Seminar for Parents and School Personnel" to help parents and school officials better understand cyberbullying, the technology used by offenders and strategies for addressing online abuse. The first seminar is slated for April 8 in Florida. An article by researchers titled, "Bullies Move Beyond the Schoolyard: A Preliminary Look at Cyberbullying," has appeared in the journal Youth Violence and Juvenile Justice.

28 March 2006

http://www.axcessnews.com/modules/wfsection/article.php?articleid=8884

Fish oil helps unruly youths, study finds

Unruly teenagers' behaviour could be dramatically improved by taking a simple fish oil supplement, research suggests. A group of 25 youngsters with severe attention deficit-hyperactivity disorder (ADHD) were given a combination of omega-3 fish oil and omega-6 evening primrose oil for three months. When they were assessed again their behaviour had significantly improved.

The trial was run by Durham County Council's senior education psychologist, Dr Madeleine Portwood, who described the results as "stunning". Before the trial started, 94 per cent of the subjects, aged 12 to 15, had a "moderate" or "severe" rating for ADHD. The same proportion also had a high rating for inattention and 89 per cent had a severe impulsivity rating.

After they had taken the fish oil supplements for three months, severe ADHD and severe impulsivity were cut to 28 per cent. Severe inattention fell to just 17 per cent among the group studied. Dr Portwood said the trials had involved a group of students with persistent behavioural problems and a high risk of being excluded from school. "By taking the fatty acid supplement, those aspects of their behaviour which put them at risk of exclusion improved dramatically," she said.

Lyndsay Moss
28 March 2006

http://news.scotsman.com/health.cfm?id=476782006
 

Australia: ADHD children 'suffer strokes'

CHILDREN as young as five have suffered strokes, heart attacks and hallucinations after taking drugs to treat attention deficit hyperactivity disorder (ADHD). Almost 400 serious adverse reactions to the two most used ADHD drugs, Ritalin and Dexamphetamine, had been reported to the Therapeutic Goods Administration (TGA), The Australian reported today.

Almost 60 of the adverse reaction reports dating back to 1980, obtained under freedom of information laws, involved children under the age of 10, the newspaper said. Cases included the sudden death of a seven-year-old and a five-year-old who suffered a stroke. children also experienced heart palpitations and shortness of breath. Hair loss, muscle spasms, severe abdominal pain, depression and paranoia were also reported.

The TGA said it has asked pharmaceutical companies to provide updated information about cardiovascular side effects involving ADHD medication. "The TGA is currently reviewing this new information," A TGA spokeswoman said. The newspaper said prescriptions for Ritalin increased tenfold after the drug was listed on the Pharmaceutical Benefits Scheme last August. More than 5800 prescriptions were written for Ritalin in January compared with 523 last August.

27 March 2006

http://www.theaustralian.news.com.au/common/story_page/0,5744,18616044%255E1702,00.html
 

Alcohol's role in suicide 'even bigger'

Alcohol plays a much bigger role in suicide among young people in Ireland than previously thought, the results of a new study suggest. The study looked at people who had died as a result of suicide or an accident in three counties and found that a significant number had consumed alcohol in the hours before their death.

Researchers with the HSE North East Area looked at all suicide and accident-related deaths that took place in Cavan, Louth and Monaghan in 2001 and 2002. Altogether, 129 deaths were included in the study. Blood alcohol levels were available in 80% of these cases. "Although it is known that alcohol is associated with a high proportion of fatal accidents and suicides, little information is available in Ireland on blood alcohol concentrations of those who died", the researchers noted.

Of the 129 deaths, 55 were as a result of a road traffic accident, 31 were due to suicide, while the remainder were due to a variety of other causes, including substance misuse, house fires and farm accidents. Among those who had died as a result of road traffic accidents, 40% had alcohol detected in their blood samples. These blood alcohol levels ranged from 16mg/100 ml to 325mg/100ml. The legal driving limit in Ireland is currently 80mg/100mls.

Factors associated with a positive blood alcohol concentration among these victims included being a young adult and for the accident to have occurred at night time. All of the drivers killed who tested positive for alcohol meanwhile were male. The study found that among those who had committed suicide, 55% had alcohol in their blood. The average blood alcohol concentration was 157mg/100mls. Those under the age of 30 were 'significantly more likely' to have any alcohol in their blood and to be above the 80mg/100mls limit, compared to those over the age of 30.

"The data suggests that alcohol plays a far bigger role in suicide among young persons in Ireland than was previously thought. Many factors contribute to suicide. However alcohol is clearly playing a major role, particularly among the young", the researchers said. Among the remaining 43 deaths studied, seven were children. However among the adults tested for alcohol, 58% were positive. The average blood alcohol concentration was 260mgs/100mls. The researchers found that none of those who had died as a result of a farm accidents had alcohol in their blood. However the average blood alcohol concentration for those who had died as a result of a house fire was 225mgs/100mls.

According to the researchers, their findings highlight the high level of alcohol consumption in those who have died from accidents or suicide. Furthermore, they believe similar results would be found elsewhere in the country, as the level of alcohol consumption in the these three counties is similar to the national average. "This study has highlighted the huge contribution alcohol makes to accidental deaths and to suicides...Without political leadership at the highest level, similar to that shown in the fight against tobacco-related illness, alcohol will continue to be responsible for the unnecessary deaths of many more people in the years to come", the researchers added.

The study was carried out by a team in the HSE North East Area's Department of Public Health. Details are published in the Irish Medical Journal.

Deborah Condon
24 March 2006

http://www.irishhealth.com/?level=4&id=9211

Cephalon ADHD drug effective but not safe: pane

Cephalon Inc.'s Provigil drug is not safe enough to win approval for treating attention deficit hyperactivity disorder (ADHD) in children and teenagers, even though data showed it worked, a U.S. advisory panel said on Thursday. The Food and Drug Administration group of outside experts said it was most concerned about the risk of skin rashes that can lead to hospitalization and called on the drug maker to conduct more clinical trials. "I think we're dealing with some fuzzy information," said panel chairman Wayne Goodman, a psychiatrist at the University of Florida, adding that more patients needed to be studied before approval. "I don't want to do that experiment in the post-marketing arena," Goodman said.

Provigil is already approved to treat sleep disorders, but Cephalon is seeking to sell it under the name Sparlon for children and teenagers with ADHD. The ADHD version of the drug, known generically as modafinil, would be smaller and come in a wider range of doses. The FDA granted conditional approval for ADHD in October 2005, but sought expert advice over lingering concerns about rashes as well as mania, aggression and other possible psychiatric effects. "They'd have to do a lot more work to show a reason for it to be marketed" if the skin risk showed up in future studies, FDA's Director of Psychiatry Products Thomas Laughren told reporters after the meeting.

Even if the wider use is approved, another FDA official said he was "virtually certain" Sparlon would come with the strongest warning possible. "It at least gets a black box," Dr. Robert Temple, head of the FDA's Office of Medical Policy, said, referring to the bold graphic warnings put on some drug labels. The FDA will make the final decision, but usually follows panel recommendations.

The panel's decision is the latest setback for Cephalon, which has faced hurdles with its experimental sleep disorder drug Nuvigil as well as the Vivitrol alcoholism treatment it is developing with Alkermes Inc.. The panelists concerns focused on a seven-year-old Asian boy with possible Stevens Johnson Syndrome. A blistering rash associated with the syndrome had spread across his body during a trial, but could not be clearly linked to the drug. "You know reasonably well that if you get a case of Stevens Johnson Syndrome it's probably the drug," FDA's Temple said.

Cephalon officials said the concern was unexpected. "We were surprised by the degree to which this relatively benign case led to such apparent turmoil in the minds of the committee today," said Dr. Paul Blake, executive vice president of Cephalon's medical and regulatory operations. The FDA panel seems to be "caught up in heightened concern about safety issues, made more complicated by dealing with children and adolescents, where the emotions are even higher than with adults," Blake said in a conference call. The drug maker adjusted its financial outlook after the meeting, lowering its 2006 sales guidance and other estimates.

Cowen and Co. analyst Eric Schmidt said the panel's 12-1 vote against the drug's safety was "definitely disappointing." Thursday's vote follows the action of another FDA panel that called on Wednesday for all ADHD drugs to include new information about psychiatric and heart risks although data are still unclear. Safety concerns also kept some panelists from supporting Sparlon when other therapies are already available. "This is a medication that looks likely to be slightly less effective than the other options available," panelist Dr. Marsha Rappley of Michigan State University added.

Cephalon, which saw its shares halted on Nasdaq pending the panel vote, said it expects a final FDA decision by late May.

Susan Heavey
23 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-24T005454Z_01_N23259349_RTRUKOC_0_US-CEPHALON-ADHD.xml
 

Ecstasy-related memory impairment can be permanent

Taking the drug Ecstasy can impair memory and learning, but giving up the drug can stop the slide in mental capacity, a new study shows. However, researchers also found evidence that in heavy Ecstasy users, the effects on memory may persist even after they quit. "The message should be loud and clear that if you're using a lot, you're not going to recover learning and memory," Dr. Konstantine K. Zakzanis of the University of Toronto at Scarborough, the study's lead author, told Reuters Health.

Zakzanis and his colleagues had previously shown that people who used Ecstasy, also known by the chemical name MDMA, experienced a decline in their memory over a one-year period. The 15 study participants' reported using the drug from 3 to 225 times over the course of the year.

The researchers looked at the same 15 people after another year had passed. Seven were still using the drug, while eight had become abstinent. The researchers evaluated their memory and learning using three tests, including the Rivermead Behavioral Memory Test, which is designed to evaluate everyday memory function. In all of the former users who had been abstinent for at least 32 weeks, test scores improved compared with their scores one year previously. However, some individuals' scores stayed the same. Current users showed continued decline, with more frequent and longer-term use of the drug tied to greater loss of memory and learning function.

The worst impairments were seen in episodic memory, meaning the sort of memory a person uses while watching a news story on television and then trying to describe it to another person later. "The general conclusions that one can make are that if you stop using, your memory won't get worse," Zakzanis said. "Depending on how much you've used, your memory may or may not recover." Zakzanis pointed out that damage to memory and learning is just one harmful aspect of Ecstasy use, which also has been tied to depression.

SOURCE: Neurology 2006; 66:740-741.

Anne Harding
22 March 2006

NEW YORK (Reuters Health)

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-22T173255Z_01_COL263112_RTRUKOC_0_US-ECSTASY-PERMANENT.xml

US panel backs new warnings on ADHD drugs

U.S. advisers on Wednesday called for new information about psychiatric and heart risks on the labels of attention deficit drugs but stopped short of recommending the strongest possible warning, saying they did not want to frighten patients or parents from effective treatment. The panel of pediatric experts reviewed reports of heart problems and psychotic behavior such as hallucinations in children who took the medicines, which include Novartis AG's Ritalin and Shire Plc's Adderall.

Patients, parents and doctors should know about the reports even though it is unclear if the drugs contributed to the problems, panel members said. They declined to recommend the "black box" warning - the strongest for prescription drugs - that a different advisory panel narrowly endorsed last month. "You have overwhelming evidence of efficacy with two rare adverse events ... A black box would scare many patients away from treatment," said panel chairman Dr. Robert Nelson, a critical care specialist at The Children's Hospital of Philadelphia.

The Food and Drug Administration will consider both panels' recommendations before making a final labeling decision. Dr. Robert Temple, director of the FDA's medical policy office, said officials likely would follow the pediatric panel's recommendations for explaining risks to children but were still mulling what to say about the dangers for adults.

Millions take prescription drugs to treat attention deficit hyperactivity disorder, or ADHD. The condition causes trouble with focus as well as hyperactivity and impulsiveness. Symptoms can be so disabling that they interfere with school or work and personal relationships. Other ADHD drugs include Johnson & Johnson's Concerta, Novartis's Focalin, GlaxoSmithKline Plc's Dexedrine and Eli Lilly and Co.'s Strattera.

Critics say the drugs are over-prescribed to people who do not need them. The recent safety concerns have added to the controversy. FDA reviewers have been working for months to analyze reports of sudden deaths, heart attacks and strokes as well as psychotic behavior such as hallucinations. FDA staff said they were struck by reports of several children under age 10 who were taking the drugs and mistakenly thought they saw or felt bugs, snakes and worms crawling on them. The hallucinations and other psychotic episodes most often occurred in patients without any known risks factors for such behavior, FDA staff said.

Panel members said they thought those problems should be highlighted on the ADHD drug labels and described in a patient-friendly guide handed out with prescriptions. Cardiac problems also should be noted, panel members said, but stressed they are most likely to be seen in children with a history of heart problems or in adults. "In the general run-of-the-mill kid, I think (ADHD drugs) are well-tolerated. I don't think there's much risk at all if they don't have a heart condition," said Dr. John Moore, a panel member and pediatric cardiologist at Mattel Children's Hospital at UCLA in Los Angeles.

Last month, a different FDA panel of drug safety experts voted 8-7 to recommend a black box warning about the potential for cardiac complications. Adderall already carries a black box warning that misuse could lead to cardiovascular problems, and Strattera has one cautioning that children and teens who take it could have suicidal thoughts. Makers of the ADHD drugs said they would work with the FDA to make sure risks were communicated adequately. "We are supportive of the suggestion that they made ... of having some type of heightened awareness around potential adverse events," Shire spokesman Matthew Cabrey said.

Lisa Richwine
22 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-23T030106Z_01_N22223575_RTRUKOC_0_US-ATTENTION.xml
 

Treating mom's depression may help children: study

Curing depression in mothers can also rid their children of problems such as anxiety and aggressive behavior, a study said on Tuesday. "The bottom-line message is: Mothers who are depressed, go get treated for your depression. It will help not only you, but your child," said A. John Rush of the University of Texas Southwestern Medical Center in Dallas, a co-author of the study. A parent's depression is known to put stress on the entire family, often causing children to develop their own mental health problems, said the study published in this week's Journal of the American Medical Association.

The study looked at 151 mothers who were treated across the country, and one child in each of their families between 2001 and 2004. It found that one third of the children of mothers who were successfully treated with medication saw their problems disappear. When mothers were not successfully treated, the rates of problems in the children rose. "To our knowledge, this is the first published study to document prospectively the relation between remission of a mother's depression and her child's clinical state. "These findings ... suggest that an environmental influence (the impact of maternal depression remission) had a measurable impact on the child's psychopathology," the study said. "Our studies suggest that a reduction in stress associated with maternal remission may reverse the long-standing symptoms in children who are likely to be genetically vulnerable" to problems of their own, it added.

Women were the targets of the study because the rate of depression is higher in women than men, particularly in women of childbearing age, the study said.

21 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-21T151127Z_01_N20265643_RTRUKOC_0_US-DEPRESSION.xml
 

Study: More children on anti-psychotics

Soaring numbers of American children are being prescribed antipsychotic drugs -- in many cases, for attention deficit disorder or other behavioral problems for which these medications have not been shown to work, a study found. The annual number of children prescribed antipsychotic drugs jumped fivefold between 1995 and 2002, to an estimated 2.5 million, the study said. That is an increase from 8.6 in 1,000 children in the mid-1990s to nearly 40 in 1,000. But more than half of the prescriptions were for attention deficit and other nonpsychotic conditions, the researchers said.

The findings are worrisome ''because it looks like these medications are being used for large numbers of children in a setting where we don't know if they work," said lead author Dr. William Cooper, a pediatrician at Vanderbilt Children's Hospital. The increasing use of antipsychotics since the mid-1990s corresponds with the introduction of costly and heavily marketed medications such as Zyprexa and Risperdal.

The packaging information for both says their safety and effectiveness in children have not been established. Antipsychotics are intended for use against schizophrenia, among other psychotic illnesses. Attention deficit disorder is sometimes accompanied by temper outbursts and other disruptive behavior. As a result, some doctors prescribe antipsychotics to these children to calm them down -- a strategy some doctors and parents say works.

Lindsey Tanner
17 March 2006

http://www.boston.com/news/nation/articles/2006/03/17/study_more_children_on_antipsychotics/
 

Children who do not get enough sleep are more likely to be obese

The less children sleep the fatter they become, researchers have found. Hectic parental lifestyles and lax bedtimes for their offspring may be driving the explosion in child obesity.

A study of 422 children between five and 10 found one in five of the boys and one in four of the girls was overweight or obese. On average the children slept for 12 to 13 hours a night. But those who slept for 10.5 to 11.5 hours had a 40 per cent increased risk of becoming overweight or obese. In those who slept for eight to 10 hours a night, the risk was increased more than threefold.

The findings are published in the International Journal of Obesity today. The researchers from Laval University in Quebec say the recognised risk factors of watching TV for long periods, physical inactivity and parental obesity applied to the children in the study. But the effect of lack of sleep was independent of these. "These findings are important because sleep duration is a potentially modifiable risk factor that could be important to consider in the prevention and treatment of obesity,'' they say.

The researchers describe their findings as "provocative" given that the best way of keeping weight down is to increase activity. "It is somewhat paradoxical that sleeping may be associated with leanness. Although recommendations to get a better night's sleep and more exercise might seem to be at odds with each other from the perspective of energy expenditure and energy balance, these simple goals may become part of our future approach to combating obesity.'' Separate laboratory studies have shown short sleep duration is associated with lower levels of leptin and increased levels of ghrelin - a hormone that plays a key role in hunger and appetite. Changes in the two hormones caused by lack of sleep could alter food intake and explain why individuals affected put on weight, the researchers say. The results suggest a "dose-response" relationship between lack of sleep and overweight, with children sleeping the least being at greatest risk of growing fat.

Previous studies have suggested there may be an "ideal zone" of sleep duration and that those who sleep longer or shorter suffer adverse effects on their energy balance. The researchers say: "Reduction in sleeping hours has become a hallmark of our society. If the findings prove to be reproducible and generalisable ... we could add sleep duration to the environmental factors that are prevalent in our society and that contribute to ... obesity."

The proportion of school-age children in Europe who are obese has risen almost 50 per cent since the late 1990s and will nearly double to 6.4 million by 2010. The number who are overweight is expected to grow by 1.3 million a year to 26 million across the EU in four years, more than a third of the child population, according to the International Association for the Study of Obesity. More than a million children in Europe are thought to have high blood pressure or high cholesterol, putting them at risk of heart disease, and 1.4 million may have early stages of liver disorder, the association says, and 20,000 children are suffering "adult onset" or type-2 diabetes, not previously seen in children.

Jeremy Laurance
17 March 2006

http://news.independent.co.uk/uk/health_medical/article351824.ece
 

Teenage Depression Can Be Enduring, but Is More Often Short-Lived

Teenage depression is widespread and can become a life-long illness, but is more often transitory, said UCLA Psychology Professor Constance Hammen, who has discussed her research at an invited address at the American Psychological Society's annual convention in Los Angeles. "Adolescent depression can be as high as 20 percent or higher," said Hammen, who has studied depression for more than 30 years. "While these numbers are alarming, and depression can be impairing, most of the depressions will be short-lived and most of these kids will not go on to have further depression. "Many things can make teenagers depressed, but in about 60 percent of the cases, the depression does not foretell future depression. Of those who have adolescent depression, perhaps 40 percent will have recurring depression, and many of those will likely be life-long."

Hammen has been conducting a long-term study over the last 10 years of 800 families with children now in their 20s, along with Patricia Brennan from Emory University in Atlanta. The subjects are among 7,000 families in Australia who have been studied since the children were five years old by researchers from the University of Queensland. About half of the children in the current study who showed depression by age 15 had recurring depression by age 20, and those who did have a distinctive profile, Hammen and Brennan found. Their preliminary analysis indicates the adolescents who showed depression by age 15 and again between 15 and 20 also had anxiety disorders and poor social relationships such as fewer friends or more conflict in their relationships.

"We have found that the risk for recurring depression occurs in the kids who had early depression and social difficulties," Hammen said. "Kids depressed by 15 who function normally in social relationships did not go on to have depression by 20. Poor social functioning by age 15, such as not having stable friendships, looks like a risk factor for recurring depression. "The kids with depression at both 15 and 20 have a very high rate before age 15 of fears, phobias, anxiety, and panic reactions," she said. "In many cases, they were showing anxious, fearful and distressed symptoms as early as age five."

Twenty percent of the children of depressed mothers developed depression by age 15, a rate of depression twice as high as that of the children of non-depressed mothers. Girls were more than twice as likely as boys to show depression at both ages 15 and 20, Hammen said. Parents commonly do not see depression in their children, she said. "Parents often don't pick up on inner despair or distress, and notice depression mainly as irritability or loss of enjoyment of activities their kids used to enjoy," Hammen said. "If it goes on for a month, I think the parent should pay more attention and not just dismiss the behavior as part of adolescence."

"Most of the time when children are depressed, there's something wrong in their lives, and the situation that's causing the depression needs to be addressed," Hammen said. "Kids often get depressed because bad things happen to them that they don't have the coping skills to deal with." Women are especially at increased risk for depression from stress factors, particularly interpersonal stress, such as poor relationships marked by as conflicts.

"Most depression, particularly for women, is triggered by negative social connections, such as relationship problems, arguments, break-ups, and not having close friends," Hammen said. Interpersonal stress plays a large role in women's depression, Hammen has found.

Not all depression is alike, Hammen said, noting it can be mild or severe, a single episode or recurring. Major episodes of depression last for at least two weeks, with impairment in performing daily activities, and a combination of symptoms such as a depressed mood, loss of enjoyment in previously pleasurable activities, changes in appetite, changes in sleep patterns, loss of motivation and energy, difficulty concentrating, and negative thoughts about themselves and the future, including suicidal thoughts.

People who are depressed often select themselves into stressful environments, or contribute to such environments through difficult relationships with romantic partners or families, that may result in chronic or recurring depression for themselves, Hammen said. Hammen has studied depression in adolescents and adults, and has studied children of depressed mothers. Depressed mothers often themselves had mothers who were depressed. Her research is funded by the National Institute of Mental Health.

"By age 15, the children of depressed mothers had a higher risk of depression, but the risk for depression is not just from genetics," Hammen said. "The risk is from a cascade of events that occur in depressed families, environmental and psychological factors that are the determinants of whether the kids become depressed. "If the mother is depressed and had stressful family factors like a bad marriage, then the child is more likely to have social and interpersonal problems and more likely to have stressful life events associated with depression."

In the Australia study, Hammen is testing whether it makes a difference when in the child's life the mother was depressed and whether the mother's depression was severe or mild. Mild depression does not have much impact on the child unless it is chronic, she said. Hammen and Brennan plan to study the link between maternal depression and youth depression, as well as interpersonal problems such as domestic violence and early pregnancy.
 

Hammen has debunked myths about depression, including this one: "A lot of people think depression stems from a weakness in character, and that you should just keep a stiff upper lip," Hammen said. "It's a myth. People cannot simply will depression away. It can be a serious impairment, and may require treatment. It's not a weakness of will."

UCLA
15 March 2006

http://www.emaxhealth.com/22/4955.html

DHHS advises parents to talk with children about inhalants

The Maine Department of Health and Human Services’ Office of Substance Abuse Services (OSA), along with the Maine Inhalant Prevention Task Force, as part of National Inhalants and Poisons Awareness Week, March 19-25, reminds parents to talk to children about the dangers of inhalants — the poisonous solvents and gases under most kitchen sinks, in garages and on office desks.

Wherever they’re found, they produce vapors that more and more kids are using to get high, become stimulated, or lose consciousness. “Many adults in our communities have a basic understanding of what alcohol abuse looks like, or what to look for with marijuana use, but they have no idea what inhalant abuse ‘looks’ like,” said Dalene Dutton, community coordinator for Five Town Communities That Care. “The signs may be right in front of them, and the inhalants readily available, but they just don’t see it. I hope that through education we can raise awareness and begin to really address this serious issue in our communities.”

The issue of inhalants needs to be on parents’ radar, as one time use can cause brain damage and can lead to death even at the trial stage. While young people may have difficulty getting illegal drugs or alcohol, there are more than 1,400 common items that can be inhaled or “huffed,” including many that can be easily accessed at home, work or school. The products being used as inhalants are safely used by millions of people every day — but can be deadly when misused as drugs. “Inhalant abuse continues to be a serious and insidious problem among our youth,” said Don Carson, LADC, outpatient substance abuse counselor. “After several years of declining use in Aroostook County, we have seen an increase recently among our eighth graders. We need to be eternally vigilant and keep inhalant abuse ‘on the radar’ for parents, teachers, and other professionals servicing youth.”

According to results of the 2004 Maine Youth Drug and Alcohol Use Survey (MYDAUS) administered by OSA, Maine students grades six through 12 ranked inhalants fourth in the most frequently used drugs in Maine. “Research has shown us that not only are inhalants toxic, but there is clear evidence that early use of inhalants may set the very young up for major problems in later life,” said Kim Johnson, director of OSA. “Parents who suspect their children are using inhalants should be alert for changes in their attitudes and interests.”

Other changes to watch for include: a decline in school performance, a disoriented/dazed appearance, slurred speech, and chemical odors on a child’s clothes, breath or backpack. In addition, adults should look for red spots or sores around the nose and/or mouth, complaints of headaches, empty lighters, spray cans, or household containers or rags or plastic bags with chemical odors.

OSA, in partnership with the New England Inhalant Abuse Prevention Coalition, formed the Maine Inhalant Prevention Task Force to identify the nature of the inhalant problem in Maine and recommend model prevention practices designed to reduce inhalant abuse. For parents and caregivers, tips and the latest information about inhalants can be found at OSA’s Information and Resource Center online at maineosa.org and inhalants.org.

14 March 2006

http://waldo.villagesoup.com/government/story.cfm?storyID=69255

Marijuana again tied to memory problems

People who regularly smoke marijuana may find their memories growing hazy over time, a study published Monday suggests. In a study of long-term and shorter-term marijuana users, researchers in Greece found that both groups performed more poorly on tests of memory, attention and other cognitive abilities than a comparison group who'd only occasionally used the drug. Long-term users - who'd smoked four or more joints per week for at least 10 years - showed the greatest deficits.

The findings, published in the journal Neurology, add to the conflicting body of research on the effects of marijuana on the brain. While many studies have suggested that long-time pot smoking dulls memory, attention span and mental acuity, some have found no large differences in these skills between marijuana users and non-users. One recent analysis of 15 studies found only minor effects on memory among long-time pot users, and no clear effect on attention, language, reasoning and a number of other cognitive functions. One problem is that it's difficult for studies such as the current one to establish a definite cause-and-effect relationship between marijuana and intellectual deficits, Dr. Lambros Messinis, the study's lead author, told Reuters Health.

Though the researchers accounted for a number of variables -- like education, use of other drugs and the presence of clinical depression -- it's tough to control for all the factors that could make heavy marijuana users different from other people, according to Messinis. Still, he and his colleagues say, their findings are in line with certain past studies linking heavy, long-term pot smoking to "subtle" deficits in intellectual abilities.

The study included 40 marijuana users ages 17 to 49 who were in a drug abuse treatment program; all had used the drug frequently for at least five years, but half -- those considered long-term users -- had smoked for 10 years or more. They were compared with 24 adults the same age who had used pot no more than 20 times in their lives.

Overall, both long- and shorter-term marijuana users performed more poorly on tests of memory, attention and mental-processing speed. The proportion of study participants deemed "impaired," according to the researchers, was highest in the long-term group and lowest in the comparison group.

Long-time pot users showed the greatest problems on tests where they were asked to learn and remember a series of words. They were "significantly" below the published norms for these tests, according to Messinis and his colleagues. It's not yet clear whether the intellectual deficits linked to marijuana are lasting, Messinis said, but research "generally supports" the notion that these problems are reversible after longer periods of abstinence. People in his study were required to have been abstinent only for the 24 hours before taking the tests.

Another unknown, according to Messinis, is whether marijuana use at a young age may affect the brain differently than use during adulthood. Knowledge in this area, he said, is still "poor."

SOURCE: Neurology,
March 14, 2006.

Amy Norton
14 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-13T225125Z_01_YUE382230_RTRUKOC_0_US-MARIJUANA-MEMORY.xml

Sleep and adolescent health

Insomnia, found to be prevalent among teens, appears to increase the risks of ADHD-like symptoms, psychiatric disorders and other health problems, according to a study by researchers at RTI International. “We found insomnia to be common and chronic among adolescents,” said Eric Johnson, Ph.D, RTI’s principal researcher for the study. “That’s a significant concern. Insomnia isn’t just about a lack of sleep; it reduces teens’ cognitive function and performance and indicates an increased risk for depression and substance abuse.”

The research funded by a grant from the National Institutes of Health and published in the February issue of the journal Pediatrics is one of the first studies of the lifetime prevalence of insomnia among adolescents. Almost 11 percent of the more than 1,000 13- to 16-year-olds studied suffered from insomnia, with the onset typically starting around 11 years of age.

According to the authors, the prevalence of insomnia in teens combined with an increased need for sleep and the other physical, social and emotional changes that accompany puberty pose a significant threat to adolescent health and well-being. “As adults and parents we often don’t understand teenagers’ propensity to stay up late and sleep until afternoon or for sleeping longer than adults,” Johnson said. “It’s not because they’re lazy. Adolescents actually require more sleep than children or adults, and without it they are at risk of serious health effects."

After beginning menstruation, girls were found to be more than twice as likely as boys to develop insomnia, which parallels a higher prevalence of insomnia in adult women compared to adult men. The majority of teens, 88 percent, who reported having ever suffered from insomnia continued to suffer from symptoms of insomnia at the time of the study, signaling a potentially chronic disorder. The study also found that more than half of the teens who suffered from insomnia also suffered from a psychiatric disorder. “Given the high prevalence of insomnia among adolescents and its impact on daytime functioning and increased risk for the onset of other psychiatric disorders, we may need to rethink how we respond to the needs of teens and the schedules we set for them,” Johnson said. “Treatment and prevention of insomnia need to be important priorities in adolescent health.”

http://www.newswise.com/articles/view/518137/

Switch to diet soda may help teens shed pounds

A new study shows that adolescents who regularly consume sugar-sweetened soda have no trouble switching to sugar-free soda if provided the opportunity -- and making the switch may lead to weight loss, especially among heavier teens. The role of sugar-sweetened beverages in promoting obesity is hotly debated. With this study, "we think there now is a very strong case that sugar-sweetened beverages are playing a strong role in weight gain among adolescents," Dr. David S. Ludwig from Children's Hospital Boston noted in an interview with Reuters Health.

The findings also provide additional support for the American Academy of Pediatrics recommendations to limit intake of sugar-sweetened beverages, Ludwig and colleagues note in the journal Pediatrics. The study involved 103 high school students who regularly drink sugar-sweetened beverages. For 25 weeks, 53 of the teens in the intervention group were provided with a variety of alternative beverages that did not contain sugar such as bottled water and diet beverages including soft drinks, iced teas, lemonades and punches. The beverages were delivered right to the teen's homes. The other 50 "control" teens received no intervention.

All of the teenagers completed the study. Consumption of sugar-sweetened beverages fell by 82 percent in the intervention group but did not change in the control group. "With this simple intervention, we could basically eliminate sugar-sweetened beverages from the diet," Ludwig said.

The teens who substituted sugar-packed drinks for diet drinks lost weight, especially the ones who were overweight to start. According to Ludwig, "in the heaviest third, body weight decreased significantly and substantially. The effect approached 1 pound per month." "If that persisted, it could play a very large role in either excessive weight gain if drinking sugar-sweetened beverages or markedly to weight loss if drinking sugar-free beverages," he added.

Summing up, Ludwig concluded that "this very simple intervention is feasible and not only changed behavior but also influenced body weight."

SOURCE: Pediatrics, March 2006.
9 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-09T202808Z_01_COL972851_RTRUKOC_0_US-DIET-SODA.xml
 

New HIV/AIDS cases on the rise in women and girls

Women and girls - get out your red ribbons. March 10th is National Women and Girls HIV/AIDS Awareness Day.

As of 2004, 27 percent of new AIDS cases in the United States were in women -- and women of color, especially African American women, made up the majority of these new cases, according to the US Centers for Disease and Prevention. To raise awareness of this growing problem in the U.S. and globally, March 10th will mark the first National Women and Girls HIV/AIDS Awareness Day, Dr. Anthony S. Fauci announced in a statement.

In the early days of the AIDS pandemic, fewer women were infected with HIV, Dr. Fauci, Director of the National Institutes of Allergy and Infectious Diseases continued. However, as of 2005, 46 percent of adults living with HIV/AIDS throughout the world were women. These 17.5 million women represent 1 million more cases than reported in 2003. And, according to the World Health Organization's UNAIDS, the "vase majority" of women became infected through heterosexual intercourse.

Along with African American and Hispanic women, who represented approximately 83 percent of new U.S. cases between 2001 and 2004, younger women are "particularly vulnerable." During this time period 38 percent of new cases in individuals under age 25 were in females, compared with 27 percent among those 25 years or older.

HIV infection is also different in women than in men - women become infected more easily and develop different types of complications, such as recurrent vaginal infections, Dr. Fauci explained. Women also tend to seek treatment at a later stage of infection and experience disease progression when they have lower levels of virus than their male counterparts. In addition, drug metabolism is different in women, which may affect how they respond to HIV antiretroviral drugs.

March 10th will be a day of recognition of these disturbing trends. Along with raising awareness, "new ways of thinking" are need, Dr. Fauci points out. Increased gender-based education and empowerment of women are needed, so they can take control of their lives, particularly in the areas of health and sexual relationships.

The NIAID supports research through the Women's Interagency HIV Study and other clinical research networks - and more participation by women in clinical trials is needed to better understand gender-based differences.

The development of vaginal gel microbicides, a method of prevention that women can control, is the focus of several clinical trials. Because in many cultures women cannot refuse sex or demand the use of a condom, for fear of violence or other negative consequences, female-controlled methods of prevention are sorely needed.

9 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-09T173707Z_01_COL963194_RTRUKOC_0_US-AIDS-CASES.xml

Depressed girls at risk of partner abuse as adults

Young women with a history of depression in adolescence are more likely than their peers to become victims of abuse from a boyfriend or husband, new research suggests.

In a study that followed students at 132 U.S. high schools and middle schools, researchers found that girls who had depression symptoms as teens were nearly twice as likely to suffer moderate to severe partner violence by early adulthood. Moderate to severe abuse was defined as being hit, slapped, kicked or injured by a husband or boyfriend.

Depression is one of the well-recognized consequences of relationship violence. But much less is known about whether early depression makes some women vulnerable to becoming victims, according to the researchers, led by Jocelyn Lehrer of the University of California San Francisco.

The current findings suggest this may be the case, they report in the March issue of the Archives of Pediatrics & Adolescent Medicine.

Young women who had significant depression symptoms as teenagers were 86 percent more likely than their non-depressed peers to report serious partner violence 5 years later. This association still held after a number of potential risk factors, such as race, parents' education and history of childhood abuse from a caregiver, were taken into account.

There are several reasons that early depression might make young women either more likely to start a relationship with a "high-risk" partner or less likely to leave after the abuse starts, Lehrer told Reuters Health. For example, depressed teens and adults seem to often gravitate toward others with similar symptoms, including in dating and marriage. And among men, depression has been linked to a greater risk of abusive behavior.

Women with a history of depression may also be less likely to leave an abusive relationship -- being perhaps more dependent, emotionally or financially, on their partners than are other women.

In the study, Lehrer and her colleagues focused on 1,659 female students who were in a steady relationship during the study's third wave of interviews -- when the women were 21 years old, on average. All had been assessed for depression symptoms in the second round of interviews, when they were about 16 years old. "High" symptom levels were considered suggestive of clinical depression.

Overall, 20.0 percent of young women who had high symptom levels in adolescence went on to be hit, slapped or kicked by a partner, compared with 8.5 percent of those without depression symptoms as teens. "The study findings suggest that depression or elevated depressive symptoms during adolescence may, at the very least, be a red flag or marker for girls' increased risk of experiencing violence by a relationship partner during young adulthood," Lehrer said.

Further research, she noted, is needed to establish whether depression directly contributes to a girls' risk of future abuse. If it does, partner violence could be added to the list of possible consequences of teen depression -- which, Lehrer noted, includes substance abuse, self-injury and suicide.

SOURCE: Archives of Pediatrics & Adolescent Medicine, March 2006.

Amy Norton
7 March 2006

http://today.reuters.com/news/newsArticle.aspx?type=healthNews&storyID=2006-03-07T170944Z_01_COL761768_RTRUKOC_0_US-DEPRESSED-ABUSE.xml

TV ruled out as cause of child hyperactivity problems

Young children do not develop hyperactivity and attention problems by spending hours in front of television sets, according to psychologists. The finding overturns research that suggested prolonged television viewing among children could lead to a range of behavioural problems, such as attention deficit hyperactivity disorder (ADHD).

Concerns over the possible role of television in the development of ADHD prompted speculation that flickering screens or the fast pace of programmes might be to blame, but the study published yesterday in the journal Pediatrics found no evidence of a link. "We're not saying television viewing is good, but what this suggests is that ADHD has a genetic and neurological basis, and has nothing to do with television," said Dr Tara Stevens, an educational psychologist at Texas Tech University. The study followed two groups of 2,500 children whose television viewing habits were recorded over a two-year period, from the moment they left nursery school at age five to their first year in primary school. The researchers found that the number of hours of television the children watched had no bearing on their risk of having ADHD later.

The finding contradicts a 2004 study which found that seven-year-olds were 10% more likely to have attention problems for every hour of television they watched between ages one and three. "This takes the pressure off parents who have hyperactive children and think television may have been to blame. There are a lot of different factors involved but television is not one of them," Dr Stevens said. "It's important to realise that this existed long before television, but it was given a variety of different names."

Writing in the journal, the psychologists said: "Researchers have learned that much of child development is reciprocal, with characteristics of a child influencing the way that child is parented in addition to parenting influencing characteristics of a child ... It may be that exhausted parents of very active and inattentive children resort to using the television as a 'babysitter' more commonly than do parents of less active and more attentive children."

Studies by the Medical Research Council found last year that children who tend to "miss" things in their left field of vision were more prone to ADHD, suggesting the cause lies with brain function. It is estimated that between 3% and 7% of children are diagnosed with ADHD before the age of seven, and although the hyperactivity tends to subside, many experience inattentiveness into adulthood.

Ian Sample, science correspondent
7 March 2006

http://www.guardian.co.uk/medicine/story/0,,1725191,00.html
 

Antidepressants linked to suicide risk in youth

Antidepressants appear to double the risk of suicidal thoughts and actions in children who take them, US regulators said in a study outlining the methodology used for a 2004 report that led to warnings on drugs including Eli Lilly & Co.'s Prozac and GlaxoSmithKline's Paxil. The Food and Drug Administration first presented the findings, detailed yesterday in the Archives of General Psychiatry, to an advisory panel in September 2004. The agency followed with a requirement that makers of antidepressants warn patients and doctors.

The warning led to a 20 percent drop in antidepressant prescriptions for children between March 2004 and June 2005, according to Psychiatric News, the newspaper of the American Psychiatric Association.
6 March 2006

http://www.boston.com/news/nation/washington/articles/2006/03/07/antidepressants_linked_to_suicide_risk_in_youth/
 

The social challenges of youth

The road to adulthood often is strewn with thorny social issues that, handled improperly or ignored, can leave a child with a painful, even deadly, sting, scientists say.

During the teen years, matters of the heart may matter more than most parents realize, research suggests. What adults often dismiss as teenage 'infatuation' or 'puppy love' may in fact represent intensely real and powerful emotions that some adolescents may find too much to handle, specialists say.

'Very often, children with poor self-esteem end up in bad relationships or sexual relationships,' says Dr. Norma Clarke, assistant professor of psychiatry and behavioral sciences at the Baylor College of Medicine in Houston. 'Some relationships may be so intense and so necessary to children that they harm themselves when the relationship ends.' She`s seen a breakup lead to suicide attempts, self-cutting and alcohol and drug abuse. In fact, an Oregon study found an argument with that special someone is the second most common reason adolescents try to kill themselves.

Intensely involved teens may 'act out' in secret, so parents should be on the lookout for signs of trouble that may require their intervention, advised Clark, who also is medical director of the Adolescent Treatment Program at The Menninger Clinic.

These include:

• Spending all free time with the love interest at the expense of seeing other friends;
• Crying frequently and wanting to be left alone;
• Seeing someone with an age gap of more than three years;
• Constantly talking on the telephone or 'chatting' on the Internet -- where chat rooms are particularly dangerous hiding places for child predators.

Parents noting problematic behavior should:

• Talk to their teenager. 'Remind your child that it is not a good idea to get too involved with just one person. They should keep their friends, and they shouldn`t put all their eggs in one basket,' Clarke recommended.
• Establish rules of engagement compatible with the family`s morals and values. 'It is OK to say, `You will not have sex when you are 15,`' Clarke advised.
• Monitor their child`s Internet use, checking frequently visited sites.

'Parents tend not to talk to kids about relationships or sexual behavior,' Clarke said. 'They may be embarrassed about sex, so their kids get all their information from their peers. I don`t think parents realize the impact they have on their teenager`s behavior.'

The impact carries over to helping children deal with a variety of life`s disappointments, be it failed relationships, failing grades or failing to make the team, said educator Janice Patterson of the University of Alabama in Birmingham. 'Never make them feel like victims by adopting a `poor you` approach,' she advised. 'Acknowledge that it`s a difficult situation, but that you have confidence in the child and that he or she will find a way to resolve the problem (and) be happy again.'

Parental support is particularly important for children with special needs, such as those with attention deficit/hyperactivity disorder, whose symptoms of inattention, hyperactivity, aggression or uncontrolled emotions may make it difficult to form friendships, said Sylvie Mrug, a UAB psychologist.

To help such children socialize, parents should 'find structured peer activities that emphasize cooperation rather than competitiveness in areas the child enjoys, such as the Scouts, sports teams that aren`t too competitive or art classes,' she said. 'Make the adult leader aware if the child needs frequent redirections or coaching.'

Moms and dads might want to organize play dates but should include only one invited guest and make plans for structured activities. 'Also, discuss and role-play basic social skills such as conversations, making invitations over the phone or conflict resolution,' Mrug said.

Lidia Wasowicz
7 Mar 2006

http://news.monstersandcritics.com/lifestyle/consumerhealth/article_1135090.php/Ped_Med_The_social_challenges_of_youth
 

London is world's cocaine capital

Tumbling prices and the lack of stigma attached to the drug have led to soaring use at every level of society By Sophie Goodchild, Chief Reporter Published: 05 March 2006 Cocaine is replacing ecstasy as the drug of choice on the club scene for the first time, with record numbers of young people snorting the powder for as little as £30 a gram.

Now widely affordable, cocaine has soared in popularity among the Ibiza set with more than three-quarters saying they have taken the drug, compared with only half last year. In contrast, there has only been a small percentage rise in the number of users of ecstasy, which once dominated the club scene.

The cost of cocaine has nearly halved over the past decade, which has also given rise to an alarming trend in bingeing on the drug. Nearly one in 10 people in their twenties who go to clubs admit to taking two grams in a session - the equivalent of 40 lines.

These figures are based on a survey of more than 2,000 regular club-goers across the country, ranging from students to civil servants, carried out by the magazine Mixmag, seen as the clubbers' Bible.

They demonstrate that the drug is no longer used just by overpaid footballers and celebrities, but now touches every section of UK society. An investigation by The Independent on Sunday has found that dealers are openly selling it almost anywhere in London, from pubs to restaurant toilets.

London is now the cocaine capital of the world, according to experts. A UN report revealed last week that one in 50 people have used cocaine in Britain - a higher figure than anywhere else in the world, including countries such as the US.

There is huge concern among ministers and teachers about teenagers becoming hooked on the drug. In one case, four teenage girls were expelled from a school in West Sussex for snorting the drug in the toilets before lessons. Police gave two a warning after being alerted by staff at Holy Trinity School in Gossops Green, Crawley.

In response to the explosion in cocaine use, Scotland Yard has taken the unprecedented step of using undercover officers to pose as drug suppliers in a bid to target recreational users. Clubs, keen to avoid getting labelled as magnets for drug users, have introduced special amnesty bins in a bid to encourage people to hand over their drugs, without fear of police action, before a night out.

Nick Stevenson from Mixmag said that the fact cocaine was almost half the price it was nearly a decade ago was a major factor in its popularity among people, law-abiding in every other aspect of their lives. "This not some dirty subculture. Our readers are everyone who likes music, from students to civil servants," he said. "There is no longer the stigma there might have been with the drug and the price means it's not just the preserve of rock stars."

Drugs education charities are warning that urgent action is needed so that recreational users are made aware of the dangers. Cocaine is a class A drug that can cause anxiety, a rise in blood pressure and heart problems, as well as long-term addiction. Tony D'Agostino, from the group Conference on Crack and Cocaine (Coca), said one alarming trend was for people to convert cocaine into crack using baking powder, a process known as "washing up". "Cocaine is now literally everywhere and more needs to be done so that users can get support," he said.

The Mixmag survey, regarded as a reliable indicator of drug trends by police and lawyers, also found that ketamine and Viagra were increasing in popularity. More than a third of young people said they had used ketamine in the past month and nearly a quarter had used Viagra as a stimulant.

COKE UK

• 750,000 PEOPLE IN the United Kingdom are estimated to use cocaine annually, according to Home Office figures.
• £30 IS THE average price for a gram of cocaine on the street. That's down £30 in five years, according to a survey by dance music magazine Mixmag.
• 100 PEOPLE DIE in Britain every year as a direct result of cocaine use.
• £200bn IS THE estimated annual value of the world market for cocaine.
• 25% OF HEART attacks among those aged between 18 and 45 in the UK are attributed to the use of cocaine.
• 20,000 TONS OF cocaine were seized by UK Customs officers during 2004.
• 20 LINES of cocaine are what users will "chop" from each gram. A third of users will go through a gram in one session, according to the Mixmag survey.

http://news.independent.co.uk/uk/crime/article349325.ece
 

Smoking tied to risk of depression

The likelihood of suffering major depression seems to be increased among smokers, especially those who smoke heavily, study findings suggest. Researchers in Norway who followed a population-based group of adults for 11 years found that those who smoked were more likely than non-smokers to become depressed, and the risk climbed in tandem with the number of cigarettes smokers puffed each day.

Heavy smokers -- those who burned through more than 20 cigarettes a day -- were four times more likely than people who'd never smoked to develop depression. A number of factors the researchers considered -- including physical health, exercise and stressful life events -- failed to explain the link between smoking and later depression. This suggests, they say, that smoking may directly contribute to the development of the mood disorder.

For instance, nicotine may over time change brain levels of the emotion-related chemical serotonin, which appears to be reduced in people with depression, the study's lead author, Dr. Ole Klungsoyr, told Reuters Health. Klungsoyr and colleagues at the University of Oslo report their findings in the American Journal of Epidemiology.

A number of studies have found that smokers have higher-than-average rates of depression, but an unanswered question has been which comes first. People who are under chronic stress or who are prone to depressive symptoms, for example, may be particularly likely to take up smoking.

The current study, however, found no evidence that past depression symptoms were strongly linked to subsequent smoking. Only 15 percent of depression cases arose before study participants started smoking, the researchers report. Their findings are based on interviews, conducted 11 years apart, with 1,190 men and women age 18 and older. All participants answered questions about their lifestyle and mental health, and were assessed for clinical depression at both time points.

Overall, the risk of developing depression by the second interview climbed along with the number of cigarettes a smoker had each day. Potential explanations like physical health problems or greater stress among smokers did not change the relationship between smoking and depression.

It's possible, Klungsoyr said, that other factors the study could not consider -- like personality traits that make a person prone to both depression and smoking -- are responsible. More studies are needed to replicate the current findings, he added. But in the meantime, Klungsoyr said, the possible connection to depression offers yet another reason to quit or never take up smoking. "It is one more argument on an already very long list," he noted.

SOURCE: American Journal of Epidemiology
1 March 2006.

http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2006-03-03T142028Z_01_COL351603_RTRUKOC_0_US-SMOKING-DEPRESSION.xml
 

After-school time not a prime time for teen sex

Though parents may worry about what their kids are doing after school, a new study suggests that teenagers do not often use their unsupervised afternoons to have sex.

In a study that followed 106 teenage girls for more than two years, researchers found that the teens were more than twice as likely to report having sex in the evening compared with afternoons. And girls were less likely to have sex on school-day afternoons than on weekends. Anyway, in general, personal and relationship factors were more important than mere opportunity in teenagers' decisions to have sex, according to findings published in the Journal of Adolescent Health.

It's been argued that unsupervised after-school hours were largely responsible for the increases in teen sex, pregnancy and sexually transmitted diseases seen in recent decades, according to Dr. J. Dennis Fortenberry, the lead author of the new study. But this is the first study to follow teenagers over time and look specifically at the correlation between time of day and sexual activity, said Fortenberry, a professor of adolescent medicine at Indiana University School of Medicine in Indianapolis.

The study included girls 14 to 18 years of age who completed periodic questionnaires and kept daily diaries on their relationships, mood, sexual interest and other issues. Overall, Fortenberry and his colleagues found, less than one-third of the sexual encounters the girls reported happened on weekday afternoons. Unmonitored after-school time appeared not to be a major contributor to teens' sexual behavior, Fortenberry told Reuters Health.

Instead, girls tended to have sex or not have sex based on the ups and downs of their relationship with their boyfriend, or based on whether they "had a good day or a bad day emotionally," he said

Parents' supervision did matter, the study found. Teens who said their parents monitored them closely were even less likely than their peers to have sex during after-school hours. However, a parent's watchful eye did not seem to keep girls from having sex in the evenings. The findings, according to Fortenberry, point to the complexity of teenagers' sexual behavior -- and suggest that no single action, such as keeping kids in after-school activities, will prevent them from having sex.

Public health efforts that "hit one thing" in order to alter teenagers' sexual behavior, he said, are unlikely to be enough - nor is a single "birds-and-bees talk" with a parent.

SOURCE: Journal of Adolescent Health
March 2006.

http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyid=2006-03-03T142128Z_01_COL351653_RTRUKOC_0_US-TEEN-SEX.xml

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