MINORITY BOYS APPEAR TO GET THE LEAST AMOUNT OF SLEEP AMONG 8- TO 11-YEAR-OLD CHILDREN

CHICAGO—Among children eight to eleven years old, minority boys get the least amount of sleep, according to an article in the October issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to the article, 11 percent to 12 percent of elementary school-aged children experience daytime sleepiness and 18 percent to 21 percent are fatigued during the school day. Sleepiness may impair academic performance, and lead to increased aggression and other behavioral problems, the article states.

James C. Spilsbury, Ph.D., of Case Western Reserve University, Cleveland, Ohio, and colleagues investigated sleep behavior among 755 elementary school-aged children eight to 11 years old (50 percent female). The children completed a seven-day sleep journal and answered questionnaires about their general health. Child caregivers completed health/sleep questionnaires about their children as well. The authors examined sleep duration by the children's age, sex, and ethnicity, classified as nonminority (white), or minority (African-American, Asian, Native-American, Hispanic or biracial). Thirty-five percent (267 children) of the sample were categorized as being of minority ethnicity, 88 percent of whom were African-American.

The researchers found that the average sleep duration for all children was 9.63 hours. There was a statistically significant decrease in amount of sleep with increased age and male sex. Minority boys slept significantly less than non-minority boys and minority and non-minority girls, and the shortest average sleep duration was in the oldest minority boys studied (9.28 hours vs. 9.43-9.85 hours for other age, sex and minority groups).

The researchers also found that 43 percent of 10- to 11-year-old minority boys reported less than the nine recommended hours of nightly sleep vs. 5 percent to 26 percent of children in other age, sex and minority groups. Minority children were also almost four times as likely to have a bedtime later than 11 p.m.

"Use of self-completed pediatric seven-day sleep journals provided average estimates for sleep duration consistent with current national recommendations for school-aged children," write the authors.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 4, 2004
To contact corresponding author Gideon Koren, M.D., F.A.B.M.T., F.R.C.P.C., call Laura Greer 416/813-5046.

MOTHER'S EXPOSURE TO ORGANIC SOLVENTS WHILE PREGNANT IS ASSOCIATED WITH SUBTLE EFFECTS ON CHILD'S COGNITIVE, LANGUAGE, AND BEHAVIORAL FUNCTIONING

CHICAGO—Children of mothers exposed to organic solvents during their pregnancies had lower scores on certain tests of language, behavior, and cognitive functioning, according to an article in the October issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

According to the article, organic solvents are some of the most common sources of workplace chemical exposure reported by pregnant women. Organic solvents are used in dry cleaning, manufacturing, jobs involving paints and plastic adhesives, nail salons and medical laboratories, and in many other industries. Organic solvents are toxic and can harm the central nervous system. There are also reports of women who abused organic solvents during pregnancy ("sniffers") delivering infants with developmental delay or birth defects, the article states.

Dionne Laslo-Baker, M.Sc., of The Hospital for Sick Children and the University of Toronto, Ontario, and colleagues compared the cognitive, language and motor skills and behavioral achievements of 32 children (age range, 3 to 9 years old) whose mothers were occupationally exposed to organic solvents during pregnancy to a matched control group of children whose mothers were not exposed to solvents during pregnancy.

Mothers in the exposed group reported being exposed to 78 organic solvents between one and 40 hours per week and between eight and 40 weeks of their pregnancies. Exposed mothers reported using protective equipment to limit exposure to organic solvents. The children in the two groups did not differ in birth weight, gestational age or age at achieving certain behavioral milestones, and none had major malformations or neurological deficits.

The researchers found that "After controlling for potential confounding because of maternal IQ and maternal education, children exposed in utero to organic solvents obtained lower scores on subtests of intellectual, language, motor and neurobehavioral functioning," write the researchers.

"The results of this study suggest some adverse fetal effects of occupational exposure to organic solvents during pregnancy as measured by neurocognitive, behavioral, and motor coordination measures," the authors write. "Exposed children performed at a lower level than control children in subtests that measure short-term auditory memory, general verbal information, and attention. Furthermore, children who were exposed to organic solvents in utero showed reduced ability in recalling sentences, even when their global scores were within the normal range."

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contact Jonathan R.T. Davidson, M.D., call Tracey Koepke at 919/660-1301.

ANTIDEPRESSANTS, COGNITIVE BEHAVIORAL THERAPY APPEAR EQUALLY EFFECTIVE IN TREATING SOCIAL PHOBIA

CHICAGO—The use of fluoxetine (an antidepressant) or comprehensive cognitive behavioral therapy (CCBT) were similarly effective for treating social phobia, while combining these treatments did not provide further benefit, according to an article in the October issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, as many as 14 percent of people in the United States experience social phobia, also known as social anxiety disorder. Previous studies have shown that selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral treatments (CBTs) have been effective in treating social phobia.

Jonathan R.T. Davidson, M.D., from Duke University Medical Center at Durham, N.C., and colleagues compared the efficacy of fluoxetine, CCBT, placebo, CCBT plus fluoxetine, and CCBT plus placebo in 295 patients with generalized social phobia. Of the study participants, 156 were male and 226 (76.3 percent) were white, with an average age of 37.1 years. Treatment lasted for 14 weeks, with fluoxetine and placebo administered in 10 mg/day to 60 mg/day doses. Those receiving group CCBT attended sessions one day a week for the 14 weeks. The sessions included specific social skills training (for example, how to begin a conversation with a stranger), role playing, and cognitive restructuring.

By the end of the study period, 54.2 percent of those receiving both fluoxetine and CCBT reported "very much improvement" or "much improvement" in their social phobia. Of participants taking only fluoxetine, 50.9 percent reported such progress, while 51.7 percent of participants receiving only CCBT also reported very much or much improvement. A comparable proportion (50.8 percent) of those receiving the combination of CCBT and placebo reported similar results, whereas only 31.7 percent of those who received placebo reported such improvement.

"All active treatments were superior to placebo on primary outcomes. Combined treatment did not yield any further advantage. Notwithstanding the benefits of treatment, many patients remained symptomatic after 14 weeks," the authors write.

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To contact corresponding author Brian Kirkpatrick, M.D., M.S.P.H., call Bill Seiler at 410/328-8919.

CERTAIN TYPES OF SCHIZOPHRENIA MAY BE LINKED TO SUMMER BIRTH

CHICAGO—Patients with deficit schizophrenia, a subtype of schizophrenia characterized by "negative" symptoms, such as blunted speech and expression, lack of emotional response, and apathy, are more likely to have been born in the summer months, according to an article in the October issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, winter birth was reported to be a risk factor for schizophrenia in 1929. Clinical aspects of patients with schizophrenia born in the winter include paranoia and a more benign course of illness. Additionally, the clinical features associated with winter birth are different from patients with deficit schizophrenia, defined by the presence of negative symptoms, including inability to experience pleasure, lack of interest in socializing, speech deficits, blunted emotional response, poor eye contact, and more severe course of illness. Nondeficit schizophrenia is characterized by symptoms including hallucinations, incoherent thinking, and prominent delusions.

Erick Messias, M.D., M.P.H., of The Johns Hopkins University, Baltimore, Md., and colleagues analyzed published and unpublished data from the northern hemisphere on studies of season of birth with information on schizophrenia and its subtype- deficit or nondeficit. A total of 1,594 patients were included in the nine studies examined.

"This pooled analysis of data from six countries in the northern hemisphere showed a significant association between deficit schizophrenia and summer birth," write the authors. "Information on month of birth only, as opposed to day of birth, was available across studies, and our analyses found an increase in June/July. However, it is likely that a more seasonal pattern would have been apparent with more detailed information."

"Our results support the concept of a double dissociation in deficit vs. nondeficit schizophrenia and the risk factor of season of birth, with the deficit group associated with summer birth and the nondeficit group with winter birth. This difference strongly suggests differences in etiology between the two groups," the researchers write.

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To contact Peter J. Schmidt, M.D., call NIMH Press Office at 301/443-4536.

MEDICATION-INDUCED, SHORT-TERM DECREASE IN TESTOSTERONE LEVEL HAS FEW NEGATIVE EFFECTS ON HEALTHY MEN

CHICAGO—Short-term, artificially-induced reductions in testosterone levels in healthy young men had little effect on mood or depressive symptoms, according to an article in the October issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

According to the article, levels of androgens (hormones, including testosterone) decrease with age in men, sometimes leading to hypogonadism, a condition characterized by decreased testicular functioning. Hypogonadism may also have negative effects on bone metabolism, muscle mass, and mood and behavior. Some studies have shown that the administration of androgens causes mood changes in men, and other studies, administration of testosterone produced anti-depressant-like effects in hypogonadal men. However, no studies have examined the relationship between mood and acute suppression of testosterone.

Peter J. Schmidt, M.D., of the National Institute of Mental Health, Bethesda, Md., and colleagues studied the effects of medication-induced hypogonadism in 31 healthy men (aged 23 to 46 years) by administering leuprolide acetate (a drug that lowers testosterone levels in the body) every four weeks for three months. Then, in addition to leuprolide, participants received testosterone enanthate (a testosterone replacement drug) or placebo every two weeks for one month. Participants then switched groups (those receiving testosterone enanthate received placebo and vice versa). Mood and behavior questionnaires were completed and blood samples were taken at clinic visits every two weeks throughout the study.

The researchers found that men taking leuprolide plus placebo had significantly lower blood levels of testosterone than men taking leuprolide plus testosterone, and blood levels of testosterone were higher during testosterone replacement than before beginning the study (at baseline). With the exception of hot flushes, libido and feeling emotionally charged, there were no significant differences in symptoms between the leuprolide plus placebo and the leuprolide plus testosterone groups.

The researchers write, "Few subjects in this study developed negative mood symptoms during an otherwise dramatic albeit brief (four-week) withdrawal and replacement of testosterone under double-blind conditions."