PARENTS HAVE COMPLEX OPINIONS ABOUT NOTIFICATION LAWS FOR MINORS' ACCESS TO CONTRACEPTION

CHICAGO—Most parents surveyed felt laws requiring parental notification of minors requesting prescribed contraceptives were a good idea, while almost half viewed a minor's right to obtain contraceptives without parental consent as a good idea, according to an article in the February issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"Since 2000, more than a dozen states have considered repealing or modifying laws that allow minors to consent to reproductive or other health care or have considered restricting access to confidential care for minors," according to background information in the article. Although health care professionals encourage young people to include their parents in such decision making, many organizations feel legal barriers should not obstruct treatment, when considering potential health risks if patients are unable to obtain reproductive services.

Marla E. Eisenberg, Sc.D., M.P.H., from the University of Minnesota, Minneapolis, and colleagues used data from telephone surveys of 1,068 parents of children aged 13 to 17 years. Survey participants were asked whether or not they thought it was a good idea that people aged 17 years or younger could obtain contraceptive or birth control without a parent's consent. Participants were also asked if they thought a law should exist that requires parental notification when a teen requests birth control from a clinic. The majority of those surveyed were white (88.5 percent), female (67.8 percent), and aged 40 to 49 years (65.8 percent).

The researchers found that more than half (55.1 percent) of the parents thought parental notification laws (PNLs) were a good idea. However, 96.1 percent of participants anticipated at least one negative consequence resulting from such laws, like teens having more unprotected sex, and nearly half (47.6 percent) expected five or more negative consequences. For exceptions to PNLs, 85.5 percent of parents supported at least one, and 29.7 percent supported five to six, with the most commonly supported exception including cases in which an adolescent was abused or involved in incest (67.6 percent). Few parents (15.4 percent) felt teenagers would have less sex if PNLs existed, with even fewer parents (3.6 percent) believing the laws would cause teenagers to stop having sex altogether.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 7, 2005
To contact Gregory D. Zimet, Ph.D., call Mary Hardin at 317-274-7722.

PARENTS COMFORTABLE WITH THE IDEA OF VACCINATION FOR SEXUALLY TRANSMITTED INFECTIONS FOR THEIR ADOLESCENT CHILDREN

CHICAGO—Parents are generally accepting of the hypothetical scenario of vaccinating their adolescent children against infection, whether the infection is sexually transmitted or not, according to a study in the February issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Several vaccines for the prevention of sexually transmitted infections (STIs) are in development, according to background information in the article. Because an ideal STI immunization program would target young adolescents and preadolescents before they become sexually active, much of the decision-making burden would be placed on parents. It has been suggested that pediatricians may be reluctant to recommend STI vaccination in anticipation of negative parental reactions.

Gregory D. Zimet, Ph.D., from Indiana University School of Medicine, Indianapolis, and his colleagues analyzed the responses of 278 parents to questionnaires to evaluate how their willingness to vaccinate their children related to four possible variables: mode of transmission, whether the infection was sexually transmitted or not; severity of the infection, whether the infection was curable, chronic or fatal; vaccine efficacy, 50, 70 or 90 percent effective; and whether or not a behavioral method for prevention was available (for example, hand washing or condom use).

Parents were as willing to vaccinate their children against STIs as other types of infection (81.3 versus 80.0 on the study's rating scale), the researchers found. The most important determinants for parents in making their decision were the severity of the infection and the vaccine's effectiveness. Parents favored vaccines for infections that had no methods of behavioral prevention available.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 7, 2005
To contact Mark Schuster, M.D., Ph.D., call Warren Robak at 310-451-6913.

HIV-INFECTED PARENTS REPORT LIMITING PHYSICAL CONTACT WITH THEIR CHILDREN

CHICAGO—Over one-fourth of HIV-infected parents reported avoiding certain physical interactions, like hugging or kissing, with their children due to a fear of transmitting the disease or of contracting an infection from them, according to an article in the February issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Of adults receiving care for human immunodeficiency virus (HIV) in the U.S., 28 percent have children younger than 18 years old, according to background information in the article. These children, although not infected themselves, may be greatly affected by the disease. Because HIV patients can both transmit the virus and may be vulnerable to opportunistic infections (occurring in people with weakened immune systems), a fear of infection may affect parent-child interactions.

Mark A. Schuster, M.D., Ph.D., from RAND Corporation, Santa Monica, Calif., and colleagues conducted interviews with 344 parents receiving health care for HIV in the U.S. Participants were asked how much they feared getting an infection from their children and how much they feared transmitting HIV to their child. They were then asked how much these fears led them to avoid interactions with their children including cuddling or hugging, kissing on the cheek, kissing on the lips, and sharing utensils.

The researchers found that 36.1 percent of HIV-infected patients felt at least "a little" fear and 19 percent felt moderate fear of transmitting HIV to their children. Fourteen percent of parents reported at least a moderate fear and 41.7 percent reported at least "a little" fear of catching infections from their children. Of participants, 27.9 percent avoided one of four types of interaction with their children "a lot," specifically, kissing on the lips (22.2 percent), sharing utensil (17.7 percent), hugging (1.8 percent), and kissing on the cheek (1.3 percent). Nearly 40 percent of parents reported avoiding these interactions at least "a little."

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 7, 2005
To contact Peter J. Schmidt, M.D., call Jules Asher at 301-443-4536.

OVER-THE-COUNTER SUPPLEMENT APPEARS EFFECTIVE IN TREATMENT OF MIDLIFE-ONSET DEPRESSION

CHICAGO—The over-the-counter hormonal therapy known as DHEA may be an effective treatment of midlife-onset minor and major depression, according to a study in the February issue of the Archives of General Psychiatry, one of the JAMA/Archives journals. DHEA (dehydroepiandrosterone), an adrenal androgen and neurosteroid is available as a supplement in the U.S.

Complementary and alternative medicine is a multimillion dollar industry, reflecting a growing number of people who avoid traditional medication, including anti-depressants, according to information provided in the article. Alternative therapies may have potential as second- or third-line treatments but controlled evaluations of these potential therapeutic agents are needed, the study's authors suggested. DHEA has been previously reported to have antidepressant-like effects. The current study was designed to evaluate DHEA as a treatment for depression with a midlife onset.

Peter J. Schmidt, M.D., from the Behavioral Endocrinology Branch of the National Institute of Mental Health, Rockville, Md. and colleagues, evaluated 23 men and 23 women aged 45 to 65 with midlife onset major or minor depression of moderate severity. They were randomly assigned to either receive six weeks of DHEA therapy, three weeks each of two dosages, or six weeks of placebo treatment. Following the six weeks of DHEA therapy and a period of one or two weeks without any therapy, the treatment groups were reversed. The participants in the study were evaluated at three and six weeks during the treatment phases with standard measures of depression and a sexual functioning scale.

A 50 percent or greater reduction in the baseline of their score on a depression rating scale was observed in 23 patients after DHEA and in 13 patients after placebo. Six weeks of DHEA treatment was associated with significant improvements in measures of depression and sexual functioning compared to both baseline and six weeks of placebo treatment, the researchers found.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, February 7, 2005
To contact Julia Kim-Cohen, Ph.D., email: julia.kim{at}iop.kcl.ac.uk.

MOTHER'S DEPRESSION ASSOCIATED WITH INCREASED RISK OF CHILD'S ANTISOCIAL BEHAVIOR

CHICAGO—Significantly higher levels of antisocial behavior were found in seven-year-old children whose mothers were depressed during the child's first five years of life, according to an article in the February issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

"Children of depressed mothers have elevated conduct problems, presumably because maternal depression disrupts the caregiving environment," according to background information in the article. Researchers have identified three possible explanations for the association between a mother's depression and antisocial behavior (ASB) in their children: 1) depressed women are likely to have antisocial personality traits related to depression, 2) are likely to bear children with antisocial men, 3) and the children of depressed mothers may inherit a genetic predisposition for antisocial disorders.

Julia Kim-Cohen, Ph.D., from King's College London, and colleagues investigated the association between maternal depression and children's ASB. Participants were members of the Environmental Risk (E-Risk) Longitudinal Twin Study, which examined how genetic and environmental factors affected the development of 1,116 sets of twins in England and Wales. The mothers categorized the timing of their depression as: never depressed (n = 728), depressed only before twins' birth (n = 68), depressed only after twins' birth (n = 193), and depressed before and after twins' birth (n = 124). Children's ASB at ages five and seven was determined from mother and teacher reports.

The researchers found that children of mothers who were depressed during the child's first five years of life had significantly higher ASB levels at seven years of age. A mother's depression taking place after the children's birth was associated with children's ASB, although depression before the children's birth was not. Maternal depression combined with symptoms of antisocial personality disorder in mothers posed the greatest risk for children's ASB.