September 2007

IRELAND

Support group: One fifth child sex victims abused by women

 Up to one fifth of victims of child sex abuse may have suffered at the hands of a female, a leading support group revealed today.

The Cari Foundation brought experts together in Dublin to discuss women sex offenders - what they claim is the last taboo.

Majella Ryan, Cari national clinical director, said female child sex abuse was widely under-reported. "It's a very small proportion of cases but it is significant enough and we would probably see a slight increase if we were talking more about this and it became more widely recognised," she said. "It would then be easier for victims to come forward and disclose the abuse and easier for professionals to deal with them."

Ms Ryan said there was very little research into the number of female sex abusers in Ireland. She noted in the early 1980s there were less than 100 cases of child abuse reported but that has grown to more than 1,000 as the subject was discussed. Ms Ryan said while it was difficult to secure convictions against men for abusing youngsters prosecutions against women would be even harder because of society.

According to the Sexual Abuse and Violence in Ireland report from 2002, 7% of child sex abuses are perpetrated by females. Cari, Ireland's leading voluntary provider of psychotherapy to children, families and groups affected by child sexual abuse, held a conference on the subject in Dublin. They called for a review of the way female offenders are assessed and treatment. Cari said more intervention and therapy alternatives should be adopted.

Cari said although society has begun to recognise child sex abuse is widespread, the possibility that sex abuse of children could be perpetrated by women is hardly acknowledged. The group said there are relatively few female abusers but also warned the level of abuse is likely to be hugely under-reported.

Cari said with abuse by women being perceived as very rare, and women, particularly mothers, seen as generally good, young victims may think they bear even greater guilt and shame for the abuse.

27 September 2007

http://www.online.ie/News/News.aspx?newsId=892401

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Young children losing the habit of reading with their parents

Children of primary school age spend more time on their own or playing with friends than they do in the company of their parents, according to research published today. Even mealtimes are squeezed into as little time as possible so that children can leave the table and watch television or play with their toys.

A survey of more than 1,800 parents also revealed that they spend more time reading on their own than they do reading with their parents. The survey, commissioned by Booktime, a programme set up to encourage parents to spend more time reading aloud to their children, paints a picture of a "loner" generation which spends more time in front of a television set than on any other activity. On average, it says that children aged four to nine year spend 7 hours, 46 minutes a week watching television – more than twice as long as they spend sharing a book with an adult.

They spend 43 minutes a day on mealtimes – breakfast, lunch and dinner – but 18 per cent said that their children spent a total of just 17 minutes eating the three meals. And they do not hang around to do chores such as washing up, the report says. "It may be the rise of the 'whatever' generation or the fact that these children are too busy watching TV and playing, but it appears that helping mum and dad with simple chores comes bottom of the activity league for primary school children. Thirty-eight per cent of parents state that their children do not do any household chores.

"Primary school aged children spend the majority of their leisure time either alone or with friends rather than with family."

Over a year, the figures mean the average child will spend 16 days, 19 hours and 49 minutes in front of a television set; 15 days, 11 hours and 10 minutes playing outside; 15 days, 3 hours and 57 minutes playing with toys and 13 days, 3 hours and 16 minutes playing with friends.

Only 7 days, 9 hours and 40 minutes will be spent reading with an adult. In most cases, it is the mother who takes the lead in reading to her children – with 73 per cent of youngsters saying she was the main reader in the family compared with just 16 per cent who said their fathers took the lead role.

Sue Palmer, the author of Toxic Childhood: How The Modern World Is Damaging Our Children... And What We Can Do About it, said: "When parents are frantically juggling work and domestic responsibilities, children often rely on the TV for company. But what they really need is real-life contact with the loving adults in their lives – sharing and talking about a book together is a lovely way to provide this contact."

The research coincides with the launch by Booktime – set up through a partnership between the education publishing company Pearson and the independent charity Booktrust – under which every five-year-old will receive a free copy of a book upon arrival at reception class. The book is Funnybones by Allan Ahlberg, who has waived all royalties on the book for the scheme.

The survey did also find, though, that a growing number of would-be mothers are reading to their children in the womb (8 per cent compared to 5 per cent a year ago). And it found that the richer the father is, the more likely he is to read to his children. Twenty-one per cent of those on incomes of more than £50,000 a year read to their children, compared to just under 10 per cent of those earning less than £10,000.

Richard Garner
26 September 2007

http://news.independent.co.uk/education/article2998920.ece

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'Give more autistic children Prozac' says expert

More autistic children in the UK should be given drugs like Prozac to control their symptoms, an expert said today. Professor Eric Hollander said a class of drugs known as selective serotonin reuptake inhibitors (SSRIs) had been shown to reduce anxiety and disruptive behaviours.

SSRIs are a class of drugs that treat depression but can also be prescribed for other conditions such panic attacks, obsessive compulsive disorder and anxiety.

About 37 per cent of children with autism in the United States are taking SSRIs but Prof Hollander said the figure was a "lot less" in the UK. "I do think that many of these individuals can benefit from this type of treatment," he said. "It really should be considered as part of an overall treatment package."

Prof Hollander, who is chairman of psychiatry at the Mount Sinai School of Medicine in New York, said UK clinicians may "not be comfortable" using these types of medicines, but trials suggested there were benefits of intervening at a young age. He said those with autism seemed to do well on low doses of Prozac and showed improvement in just a short period of time, perhaps just three or four weeks.

They displayed fewer "endless ritual" behaviours, less anxiety and better social interaction, he went on.

The Best Treatments website is more cautious about the benefits of prozac on autistic children. However it says that doctors have been known to prescribe Prozac if an autistic child also has depression or anxiety or does the same actions over and over again. It adds that boosting levels of serotonin have been shown to improve mood and social interaction.

The Mount Sinai School where Prof Hollander works is a shareholder in the company Neuropharm. It is developing Prozac for use in autistic children. In 2006, Neuropharm acquired the rights to develop fluoxetine (the generic name for Prozac) for use in autism from the Mount Sinai School. Prof Hollander was granted Orphan Drug Designation for the drug in 1999, according to the firm's website. The Orphan Drug Act offers companies incentives to develop drugs for the treatment of people with rare disorders.

21 September 2007

http://www.dailymail.co.uk/pages/live/articles/health/womenfamily.html?in_article_id=483126&in_page_id=1774&ICO=HEALTH&ICL=TOPART

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Bipolar Disorder Diagnoses Spike in Youth

The diagnosis of bipolar disorder in people under 20 astonishingly increased 40-fold between 1994 and 1995 and 2002 and 2003, according to a study reported in this month's issue of Archives of General Psychiatry, the leading scientific journal in our field.

The Archives was not the first to report this story. Time magazine, always quick to spot a trend, was there first with a cover story on the subject in 2002 called "Young and Bipolar." It began with: "It used to be called manic depression. Now, this volatile form of mental illness is increasingly showing up in children and teenagers." But is it? Perhaps the illness is being recognized where it was missed before. Alternatively, perhaps it is being overdiagnosed in kids who do not truly have bipolar disorder, but, instead, only have symptoms reminiscent of the illness.

Take Benny, for example (name changed for confidentiality). This 9-year-old was diagnosed with bipolar disorder in an outpatient setting based on things like constant irritability, being easily bored, sleeping less than usual and being bossy with people. A systematic psychiatric evaluation revealed that, while he met the criteria for attention deficit hyperactivity disorder, and oppositional defiant disorder, Benny did not meet the strict criteria for bipolar disorder.

The Nature of the Bipolar Beast
So, what exactly is bipolar disorder? Here is the simple version: The term refers to two poles of mood – the low end, which is depression, and the high end, which, when severe, is called mania, and when milder, is called hypomania. Some people with bipolar disorder love their hypomanias; the episodes can have them feeling elated and important, with a high energy level.

Manic episodes, on the other hand, typically veer out of control. These episodes are defined by thoughts that race so fast they cannot be reined in and by grandiose ideas, such as thinking God has chosen you to save the world. Manic moods can be highly irritable, and can shift dramatically at the slightest provocation.

To put these shifts into perspective, imagine listening to your iPod. Imagine you are in your 40s, and you typically listen to it at a normal volume. Your experience would be analogous to a normal mood. If the volume is turned way down, it becomes much less interesting, which is analogous to depression. If a good song comes on, and you turn the volume up, it becomes more fun and exciting, which is like the experience of hypomania. But, if you turn it up to the maximum, it becomes painful and unbearable, which is like what happens in the brain during mania.

Now for the complicated part: There are also bipolar mood states, called mixed states, where elements of the high and the low poles are mixed together at the same time. Among the most common of these is the combination of the high energy state of mania with the low mood of depression. This can manifest as agitation, with patients wanting to hit, throw or break things, or as intense anger, leading to shouting matches with whomever is within earshot.

Pity the Child
Some kids fulfill all the standard criteria for bipolar disorder. The controversy that exists in the diagnosis of bipolar disorder in children and adolescents surrounds the issue of how to categorize those who are disturbed, but in a way that does not conform to the classic bipolar picture.

In some, the problem is that their abnormal moods are primarily irritable, and they never get the elation that is most typical of the illness. Others may experience elation, but only for hours at a time, rather than the four days required for hypomania, or the seven for mania. In still other patients, the issue is distinguishing the impulsivity and agitation of bipolar disorder from disruptive behavioral disorders, such as those mentioned earlier: attention deficit hyperactivity disorder, and oppositional defiant disorder.

Ellen Leibenluft, a psychiatrist at the National Institute of Mental Health in Bethesda, Md., refers to this gray-area group as having "severe mood dysregulation," rather than bipolar disorder. In last month's American Journal of Psychiatry, she and her colleagues compared rates of bipolar disorder in parents of children with bipolar disorder, and parents of children with severe mood dysregulation. The rate in the former group was 18 times higher than that in the latter, suggesting that severe mood dysregulation may be a different animal than bipolar disorder.

What do children look like before they develop bipolar disorder? Liebenluft and colleagues reported last year that very few children with severe mood dysregulation develop bipolar disorder.

Our group at Johns Hopkins is part of a larger study examining adolescents whose parents have bipolar disorder, to determine whether there is a set of symptoms or illnesses that distinguish them, and whether there are factors or behaviors, such as drug and alcohol use, for example, that put them at greater risk of eventually developing bipolar disorder themselves. Researchers will likely study this group's DNA to try to correlate genetic risk factors with patterns in the manifestation of illness.

The increase in the diagnosis of bipolar disorder in youth has, of course, led to increased prescribing of relevant medications, such as mood stabilizers and neuroleptics, for this group. Another challenge we face is that little data currently exists on the effectiveness of these drugs in this age group.

One project, the Treatment of Early Age Mania study, being conducted at Johns Hopkins and other sites, including Washington University in St. Louis, is trying to help rectify this. The group aims to assess which medications are most effective in manic patients from age 6 to 15. Their results should help us toward an increased level of confidence in prescribing decisions.

James Potash
19 September 2007

http://abcnews.go.com/Health/Depression/story?id=3624718&page=1

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Fathers afraid 'sex talk' will ruin quality time with children

Fathers are refusing to talk to their children about sex because they fear it may ruin the small amount of time they have with their offspring, according to a helpline for parents.

The absence of guidance from fathers, especially for boys, could be contributing to the problem of teenage pregnancies in Britain and sexually transmitted diseases.

Parentline Plus says that calls to its free helpline over the last few years have revealed that fathers are ducking out of difficult conversations with their sons and daughters, leaving the task to the child's mother or school.

Fathers are afraid having a 'sex talk' with their sons will ruin their quality time. As a result, the helpline is launching a campaign this week to persuade reluctant fathers to do their bit to curbe teen pregnancies and recommends they use 'light-hearted' stories about their own adolescence to get their point across.

The helpline conducted the research on why fathers were so eager to avoid telling children about the facts of life.

The most common reason cited by fathers was their concern that such a conversation would ruin the time they spent with their children in the evenings and weekend.  The problem was particularly acute among divorced or separated fathers, who often have only a few hours each week or once a fortnight with their children.

These fathers would rather avoid dealing with tricky subjects that could lead to defensiveness or an argument.

Sue Ormesher, of Parentline Plus, said: 'We know from other research teenagers who talk to their parents about sex are more likely to delay having intercourse, have fewer partners and are more likely use contraception.

'We need to engage with fathers more in his process and encourage them to talk to their children.'

Duncan Robertson
17 September

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=482201&in_page_id=1770

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Youths see little risk in trying meth

Despite methamphetamine's addictive and sometimes deadly effects, one in three youths sees little or no risk in trying the illegal drug, a new survey finds.
Nearly one in four youths believes meth "makes you feel euphoric or happy" or helps you lose weight, and the same number said it would be "very" or "somewhat easy" to obtain meth, according to a first-ever national use and attitudes survey about the drug released Tuesday.

And yet, in a finding that might be of comfort to parents, three out of four youths said they are strongly opposed to using meth.

The survey of 2,602 students age 12-17 was done by The Meth Project, a non-profit Palo Alto, Calif.-based project that aims to reduce first time meth users through advertising campaigns. About one in six youths has either a friend or a family member who has used or been treated for meth addiction, the survey found.

"For kids, meth is death," said Julie Gerberding, director of the Centers for Disease Control and Prevention. She said meth is often a factor in preventable, deadly accidents such as automobile collisions involving kids.

The project, which has run an intensive anti-meth campaign in Montana since 2005, found that meth use among youths in that state has dropped 50%. "Advertising works," Gerberding told a news conference on Capitol Hill. Gerberding said the same kinds of advertising that sells toothpaste "helps motivate kids not to use this drug." The project is running similar campaigns in Arizona, Illinois and Idaho.

Other findings in the survey:

• One in 10 youths says someone had offered or tried to get them to use meth.

• Three out of four youths are strongly opposed to using meth.

• Fifty-five percent of say they have never discussed meth with their parents.

GfK Roper Public Affairs and Media conducted the survey March 16 through June 6 of 2,602 students aged 12-17 at 43 randomly selected high schools across the U.S. The margin of error is plus or minus 2 percentage points.

Pamela Brogan
19 September 2007

http://www.usatoday.com/news/health/2007-09-18-meth-survey_N.htm

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Majority of suicides caused by depression
Males four times more likely to kill themselves

Abuse. Loneliness. A stressful episode. The unexpected loss of a loved one.
Any of those and other strong physical or emotional factors could trigger suicidal thoughts, especially in already depressed people who don't seek help either because they don't know better or are afraid to admit they need it.

"It's sort of a worldwide phenomenon," said Dr. Nancy Pena, Santa Clara County's mental health director. "In many cultures, personal distress and personal suffering, especially if it's of the mind and the emotions, is not considered a legitimate illness, and there are expectations that people should take care of these problems by themselves and not seek help. I think particularly in Western culture, where there is more emphasis on self-sufficiency and independence, people think that it's a sign of weakness to show that they have emotional problems and are suffering in some way. People think that they should snap out of it and that it is all in their mind and they should be able to fix it."

Each year, 30,000 people fail to "fix it" and end up killing themselves. More than 90 percent of them have mental illnesses – usually depression – that could have been treated, experts say. There are biological reasons why people experience depression and significant evidence that biochemical imbalances exist in people's brains.

Fortunately, suicide rates have been declining since 1997 due to an increase in the recognition of warning signs, an awareness of prevention measures, more people seeking and having access to treatment, and a plethora of antidepressants on the market, said Dr. Mark J. Goldblatt, assistant clinical professor of psychiatry at Harvard University and president of the New England Chapter of the American Foundation for Suicide Prevention.
"We know that both drugs and psychotherapy in combination is the best treatment," Goldblatt said. "Once the depression is treated, suicide usually resolves itself."  

"And while not all depression requires medication, Pena said, "it certainly does indicate that it's not just people's thought process; it actually does affect ourselves physically."

Suicide and depression cut across all ethnic groups, Goldblatt said. Elderly Caucasian males, however, have the highest suicide rates. Older adults in general are prone to suicide because they often are isolated, experts say.

While women attempt suicide more often, males are four times more likely to kill themselves, according to the American Foundation for Suicide Prevention.

"Attempts are cries for help. They want someone to give them attention," said Amanda Freeman, manager of San Mateo County's Crisis Center, a program run by the private nonprofit Youth and Family Enrichment Services.

While adults often show outward or behavioral signs of depression, youth do not. But changes in a youth's clothing fashion or music style could mean a shift in how he or she is feeling on the inside, Freeman said.

"Situational depression related to emotional situations in kids' lives becomes very sort of amplified for young people and they really oftentimes don't have the ability to see that things won't be the same tomorrow or next week," Pena said.

In many suicides, a precipitating event was devastating to an individual – the loss of a job, or of a loved one. While life-altering events likely aren't the sole cause of suicide, they could be exacerbated by drugs or alcohol, according to many experts.

Other risk factors include previous suicide attempts and a family history of suicide. People who are widowed or divorced, particularly if they live alone, have a higher rate of suicide than those in other sociological groups.

Those who know someone who died by suicide are more likely to attempt or complete suicide.

Trends for some groups
Though the overall suicide rate has been falling nationwide, the numbers are climbing for some groups.

According to a report released Sept. 6 by the U.S. Centers for Disease Control and Prevention, the suicide rate for children and young adults grew 8 percent in 2004.

"This is the biggest annual increase that we've seen in 15 years. We don't yet know if this is a short-lived increase or if it's the beginning of a trend," said Dr. Ileana Arias, director of CDC's National Center for Injury Prevention and Control. "Either way, it's a harsh reminder that suicide, and suicide attempts, are affecting too many youth and young adults. We need to make sure suicide-prevention efforts are continuous and reaching children and young adults."

The report didn't speculate on the reasons behind the increase, but it coincides with a drop in the use of antidepressant drugs by young people after the Food and Drug Administration announced it would require antidepressant makers to place a "black box" label warning that the drugs increase the risk of suicidal thoughts and behaviors in children and adolescents, the Wall Street Journal reported.

There also has been a spike in the rate of military people who kill themselves. In an Aug. 16 news article, the Associated Press reported that Army soldiers in 2006 committed suicide at the highest rate in 26 years. The Army attributes that to repeated and longer deployments, which puts increasing pressure on relationships and military families. There were 99 Army suicides last year – nearly half of them soldiers who hadn't reached their 25th birthdays, about a third of them while serving in Iraq or Afghanistan.

Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, told a Pentagon press conference the primary reason for suicide is "failed intimate relationships, failed marriages."

Members of the military may have undiagnosed depression when they return from the war, Goldblatt said, adding that many suffer from post-traumatic stress disorder, which can occur following a traumatic event.

"Depression and mental illness strike any number of people," said Dr. Rona Hu, an assistant professor of psychiatry at the Stanford University School of Medicine, where she is also medical director of the acute psychiatric inpatient unit. "You're not a bad person because you're affected by it," she said.

While depression and suicide can affect anyone, Hu said Asians also are at high risk. "There is truth to the idea that Asians are less likely to go for help, and less likely to comply with treatment recommendations," Hu said.

And the figures are overwhelming in some Asian countries. Japan has the second-highest suicide rate in the industrialized world 25.5 per 100,000 people in 2003. Russia has the highest rate – 38.7 percent – according to World Health Organization statistics. In a personal or business failing, Asians often feel the only alternative is suicide, Hu said. "In Asian culture, there is a saying, 'death before dishonor,'" Hu adds. "In Asian society, there's such an emphasis on saving face. Seeking help seems like a moral failing."

Over the years, Hu has treated many Asian patients and said that on the surface, they are compliant. "Even if they're not taking the medications (I have prescribed), they won't tell me. With depression, there is a sense of shame, a stigma."

Something to take seriously
According to the American Foundation for Suicide Prevention, every 16 minutes someone in the United States dies by suicide, leaving others to try and make sense of it.

Goldblatt and other experts urge people to seek help if they or someone they know is contemplating suicide. "People should take it seriously when their loved ones talk about wanting to die," Goldblatt said. "These illnesses are treatable."

Hu agrees that if suicide is more openly discussed, more people might seek treatment, which could eventually lead to fewer people taking their lives. "Depression and suicide affect so many people. It's so stigmatized, but yet so common. If we all could come together and talk about it, we could help each other," Hu said.

Jamie Casini
14 September 2007

http://www.insidebayarea.com/ci_6891830?source=most_emailed

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