SOME ADOLESCENTS DO NOT GET ENOUGH VITAMIN D

CHICAGO—Some African American adolescents who live in cities have low levels of vitamin D, according to an article in the June issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to information in the article, vitamin D is crucial for calcium absorption and bone growth during childhood and adolescence. Studies have shown that vitamin D deficiency is an unrecognized and common health problem among young adults, elderly persons, and youths.

Catherine M. Gordon, M.D., M.Sc., of Children's Hospital Boston, and colleagues investigated the prevalence of vitamin D deficiency among 307 healthy adolescents (aged 11 to 18 years) recruited at an annual physical examination (between July 1, 2001 and June 30, 2003) to undergo a blood test and nutrition and activity assessment.

The researchers found that 74 patients (24.1 percent) were vitamin D deficient, of whom 14 (4.6 percent) were severely vitamin D deficient. Using a broader definition of vitamin D deficiency, 129 patients (42 percent) were vitamin D insufficient. The researchers also found that season, ethnicity, milk and juice consumption, body mass index, and physical activity were significant predictors of vitamin D insufficiency.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 7, 2004
To contact corresponding author Peter C. Scheidt, M.D., M.P.H., call Bob Bock at 301/496-5133. To contact editorialist James A. Mercy, Ph.D., call Gail Hayes at 770/488-4902.

FREQUENCY OF VIOLENT BEHAVIOR AMONG YOUTHS SIMILAR IN DIFFERENT COUNTRIES

CHICAGO—Adolescents from five different countries had similar frequencies of violence-related behaviors, including fighting and weapon carrying, according to an article in the June issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to information in the article, aggressive and violent behavior is a significant public health problem worldwide. The authors write: "In the United States, physical assault is the sixth leading cause of nonfatal injury in 15- to 19-year-olds and the seventh leading cause in 10- to 14-year-olds. Furthermore, homicide is the second leading cause of death in 15- to 19-year-olds and the fourth leading cause in 10- to 14-year-olds." Violence-related deaths among youths seem to be increasing, the article states.

Eleanor Smith-Khuri, M.D., of the National Institutes of Health, Bethesda, Md., and colleagues compared the frequency of violent behaviors among adolescents in five countries based on information from the World Health Organization's cross-national study of Health Behaviour in School-aged Children (HBSC), which surveyed health risk behaviors and lifestyles in young adolescents in developed countries. The HBSC survey data were obtained from adolescents aged 11.5, 13.5, and 15.5 years living in Ireland, Israel, Portugal, Sweden and the United States during the 1997-1998 academic year. The survey was administered to 10,610 boys and 11,530 girls.

The researchers found that though the majority of adolescents did not fight or carry weapons, the reported frequency of fighting (average, approximately 40 percent), weapon carrying (average, approximately 10 percent) and fighting injuries (average, approximately 15 percent) were similar among youths from all five countries. However, bullying frequency varied widely between countries, ranging from 14.8 percent in Sweden to 42.9 percent in Israel for adolescents who bullied once or more per school term.

The researchers write, "These violence-related behaviors often occurred together in adolescents cross-nationally. A large proportion of adolescents who fought also bullied and vice versa; the percentages of those both bullying and fighting were 29.5 percent in Israel, 22.1 percent in the United States, 17.8 percent in Portugal, and 15.9 percent in Ireland. This percentage dropped to 9.8 percent in Sweden, but this value was still relatively high considering that only 14.8 percent of Swedish youths engaged in any bullying at all."

The researchers conclude that "Engaging in at least an occasional fight was so frequent, particularly in boys but also in girls, and was so consistent across countries that it might not be considered abnormal or alarming. In contrast, frequent fighting and frequent bullying were relatively rare behaviors, as were fighting injuries or weapon carrying at any frequency. We found that adolescents who fight are more likely to be boys in a lower grade (6th grade vs. 10th) who currently smoke, have been drunk, and dislike school."

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To contact Emma Glasson, B.Psych., B.Sc. (Hons), Ph.D., e-mail emma.glasson{at}health.wa.gov.au

AUSTRALIAN STUDY EXAMINES ASSOCIATION BETWEEN AUTISM DISORDERS AND OBSTETRIC AND PERINATAL RISK FACTORS

CHICAGO—Mothers of children diagnosed with autism are more likely to be older and to have experienced obstetric difficulties during pregnancy, labor and delivery, but these complications are likely related to underlying genetic factors, according to an article in the June issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to information in the article, autism is believed to have a genetic basis, although some studies suggest that prenatal factors may play a role in this developmental disorder characterized by severely impaired social functioning and communication. Autism has a prevalence of about 10 to 20 per 10,000 individuals, and is usually diagnosed between the ages of 3 to 4 years, when certain developmental milestones are not met.

Emma J. Glasson, B.Psych., B.Sc. (Hons), Ph.D., of the University of Western Australia, Crawley, and colleagues examined the association between obstetric factors during pregnancy and birth, and autism spectrum disorders. The researchers studied obstetric information in the Maternal and Child Health Research Database of Western Australia for mothers who gave birth between 1980 and 1995, and whose children were diagnosed with autism spectrum disorders by 1999. The authors reviewed the medical information for children diagnosed with autism (n=465), siblings of children with autism disorders (n=481), and a random, population-based control group of children without autism (n=1,313), and compared obstetric information for the mothers of these groups.

The researchers report, "Compared with control subjects, cases had significantly older parents and were more likely to be firstborn. Case mothers had greater frequencies of threatened abortion, epidural caudal anesthesia use, labor induction, and a labor duration of less than one hour. Cases were more likely to have experienced fetal distress, been delivered by an elective or emergency cesarean section, and had an Apgar score of less than 6 at one minute [after birth]."

The researchers also found that the siblings of children with autism were more similar to their siblings than to the control group in terms of their profile of complications during pregnancy and birth.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 7, 2004
To contact Laura Mufson, Ph.D., call Dacia Morris at 212/543-5421.

SCHOOL-BASED INTERPERSONAL PSYCHOTHERAPY SEEMS TO BE EFFECTIVE FOR TREATING DEPRESSED ADOLESCENTS

CHICAGO—Adolescents who received interpersonal psychotherapy for depression at school-based health clinics had fewer symptoms of depression after 12 to 16 weeks than their peers who received other kinds of psychotherapy at school, according to an article in the June issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Adolescent depression is a common disorder, affecting 1.6 percent to 8.9 percent of adolescents annually, but fewer than three of ten adolescents with mental health problems in the United States receive mental health services, the article states. Recently, school-based health clinics have become an important treatment setting for adolescents with mental health, and general medical problems. Interpersonal psychotherapy focuses on current problems and helps the patient improve interpersonal relationships and reduce depressive symptoms.

Laura Mufson, Ph.D., of New York State Psychiatric Institute, New York, and colleagues assessed the effectiveness of interpersonal psychotherapy (IPT-A) for depressed adolescents compared to treatment as usual (TAU) for depressed adolescents at school-based mental health clinics.

The researchers studied 63 depressed adolescents at five school-based mental health clinics in New York City. The average age of the adolescents was 15.1 years, 84 percent were female, and 71 percent were Hispanic. Thirty-four adolescents were assigned to receive IPT-A (12 sessions over a 12- to 16-week period) and 29 were assigned to receive TAU at their school-based health clinics. TAU consisted of whatever psychological treatment the adolescents would have received had the study not been in place (generally, supportive, individual counseling).

"Adolescents treated with IPT-A compared with TAU showed greater symptom reduction and improvement in overall functioning," write the authors. The IPT-A group had fewer clinician-reported symptoms of depression, significantly better social functioning, greater clinical improvement and greater decrease in clinical severity of depression than adolescents treated with TAU.