JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. the Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 7, 2007)
SURVEY ESTIMATES MORE THAN 4 PERCENT OF U.S. ADULTS HAVE SOME FORM OF BIPOLAR DISORDER
MORE THAN 10 PERCENT OF ADULTS ABUSE OR BECOME DEPENDENT ON DRUGS DURING THEIR LIFETIME
TRAUMATIC EVENTS, BUT NOT POST-TRAUMATIC STRESS DISORDER, COMMON IN CHILDHOOD
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 7, 2007)
FREQUENT TELEVISION VIEWING DURING ADOLESCENCE ASSOCIATED WITH RISK OF ATTENTION AND LEARNING DIFFICULTIES
STUDY ANALYZES TELEVISION, DVD AND VIDEO VIEWING IN CHILDREN YOUNGER THAN 2 YEARS
CIGARETTE MARKETING PRACTICES IN RETAIL STORES ASSOCIATED WITH TEEN SMOKING HABITS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact Kathleen R. Merikangas, Ph.D., call Colleen Labbe at 301-443-4536.
SURVEY ESTIMATES MORE THAN 4 PERCENT OF U.S. ADULTS HAVE SOME FORM OF BIPOLAR DISORDER
CHICAGO—Approximately 4.4 percent of U.S. adults may have some form of bipolar disorder during some point in their lifetime, including about 2.4 percent with a "sub-threshold" condition, according to an article in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Individuals with bipolar disorder tend to fluctuate between periods of mania—an inappropriately elevated mood, characterized by impulsive behavior and an increased activity level—and periods of depression. They are at increased risk of suicide and other medical problems, such as cardiovascular disease, according to background information in the article. Previously, researchers estimated that about 1 percent of adults had bipolar disorder. But evidence indicates that current diagnostic criteria may be too narrow to effectively detect bipolar disorder in the general population, and that a broader definition of bipolar spectrum disorder would identify many more individuals with bipolar symptoms, the authors note.
Kathleen R. Merikangas, Ph.D., National Institute of Mental Health, Bethesda, Md., and colleagues estimated the national prevalence of bipolar disorder using data from 9,282 individuals chosen to represent the general population. The researchers conducted interviews between February 2001 and April 2003 to assess the presence of bipolar disorder and other psychiatric conditions. Participants were classified as having bipolar disorder I, characterized by at least one episode of mania and one of depression; bipolar disorder II, requiring an episode of depression plus hypomania, a milder form of mania that does not require hospitalization; and a milder, sub-threshold bipolar disorder that involves hypomania with or without depression, otherwise classified as bipolar disorder "not otherwise specified" in the current diagnostic nomenclature of the American Psychiatric Association.
The study found that:
- A total of 1.0 percent of participants had bipolar disorder I and 1.1 percent had bipolar disorder II in their lifetimes; in the previous 12 months, 0.6 percent had bipolar disorder I, 0.8 percent bipolar disorder II and 1.4 percent sub-threshold manifestations of bipolar disorder.
- Symptoms began at age 18.2 years for bipolar disorder I, 20.3 years for bipolar disorder II and 22.2 years for sub-threshold bipolar disorder.
- 95.8 to 97.7 percent of those with bipolar disorder and 88.4 percent of those with sub-threshold bipolar disorder also had another psychiatric condition, such as an anxiety disorder or substance use disorder, which is a frequent complication of bipolar illness.
- The majority of those with lifetime bipolar disorder (80.1 percent) received treatment, including 69.3 percent of those with sub-threshold bipolar disorder; most of those people sought treatment for the depression rather than for the manic symptoms of bipolar disorder.
- However, over the previous 12 months, only 25 percent of those with bipolar disorder I, 15.4 percent with bipolar disorder II and 8.1 percent with sub-threshold bipolar disorder received appropriate medication.
"The present results reinforce the argument of other researchers that clinically significant sub-threshold bipolar disorder is as least as common as threshold bipolar disorder," the authors write. "Although most individuals with bipolar disorder receive treatment owing to co-morbid disorders, the lack of recognition of their underlying bipolarity leads to only a few receiving appropriate treatment." The findings suggest that a substantial proportion of those diagnosed with major depression may actually have a form of bipolar disorder.
More individuals with other psychiatric disorders should also be screened for bipolar disorder, the authors conclude. "Additional research is needed to resolve uncertainty regarding the most appropriate threshold and boundary distinctions for bipolar disorder. This uncertainty remains a major impediment to advancing the understanding of the bipolar disorder spectrum in the population."
(Arch Gen Psychiatry. 2007;64:543-552. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: The NCS-R is supported by a grant from the National Institute of Mental Health, with supplemental support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, a grant from the Robert Wood Johnson Foundation and the John W. Alden Trust. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact Wilson M. Compton, M.D., M.P.E., call Dorie Hightower at 301-496-1545 or Sara Rosario Wilson at 301-594-6145. To contact corresponding author Bridget F. Grant, Ph.D., Ph.D., call Ann Bradley at 301-443-0595.
MORE THAN 10 PERCENT OF ADULTS ABUSE OR BECOME DEPENDENT ON DRUGS DURING THEIR LIFETIME
CHICAGO—Approximately 10.3 percent of U.S. adults appear to have problems with drug use or abuse during their lives, including 2.6 percent who become drug dependent at some point, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Drug abuse refers to the intense desire to take drugs at the exclusion of other activities, and dependence occurs when the body becomes physically dependent on an illicit substance. Both are widespread and associated with substantial costs to society and individuals, according to background information in the article. "Although extensive data on drug use in the U.S. population have been available on an ongoing basis for adults and adolescents, epidemiologic data on the prevalence, correlates, disability, treatment and comorbidity of drug use disorders among adults are seldom collected," the authors write. "In fact, it has been more than 16 years since such detailed information on drug use disorders in the United States has been published."
Wilson M. Compton, M.D., M.P.E., of the National Institute on Drug Abuse, Bethesda, Md., and colleagues at the National Institute on Alcohol Abuse and Alcoholism used data from in-person interviews conducted in 2001 and 2002 with 43,093 adults representative of the entire U.S. population to determine the prevalence of abuse or dependence on nicotine, alcohol or one of 10 classes of other drugs: sedatives, tranquilizers, opiates [other than heroin], stimulants, hallucinogens, cannabis, cocaine, inhalants/solvents, heroin and other drugs. Participants were also assessed for other psychiatric disorders, including mood (such as depression), anxiety (such as panic disorder) and personality disorders (including obsessive-compulsive disorder). For those with drug use disorders, level of disability—how much the disorder affected their daily life—were ranked on a scale of zero to 100, with lower scores indicating more disability.
Over the previous 12 months, 1.4 percent of the participants reported that they had abused drugs and 0.6 percent reported that they were dependent on drugs, while 7.7 percent reported that they developed drug abuse and 2.6 percent drug dependence over their lifetime. Rates of abuse and dependence tended to be higher among men, Native Americans, those age 18 to 44, lower socioeconomic groups, those living in the West and those who were not married.
"With few exceptions, 12-month and lifetime drug abuse and dependence were positively and significantly related to alcohol use disorders, nicotine dependence and mood, anxiety and personality disorders," the authors write. "Associations of drug use disorders with other substance use disorders and anti-social personality disorder were diminished but remained strong when we controlled for psychiatric disorders." This indicates that common factors underlie both drug abuse and other psychiatric conditions. Drug abuse and dependence were also associated with mental, social and emotional disability.
Individuals who abused drugs began at an average age of 19.9, whereas those with drug dependence developed the condition at an average age of 21.7. About 8.1 percent of those who abused drugs and 37.9 percent of those who were dependent received treatment during their lives. "The adolescent onset of drug abuse and dependence revealed critical windows of opportunity for prevention efforts," the authors write.
"The results of this study indicate that immediate action must be taken to educate physicians, the public and policy makers about drug use disorders and their treatment and to develop programs to destigmatize the disorders, thereby reducing the personal suffering and adverse societal impact of drug use disorders in the United States," they conclude.
(Arch Gen Psychiatry. 2007;64:566-576. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported in part by the Intramural Program of the National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. The National Epidemiological Survey on Alcohol and Related Conditions is funded by the National Institute on Alcohol Abuse and Alcoholism, with supplemental support from the National Institute on Drug Abuse. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact William E. Copeland, Ph.D., call Tracey Koepke at 919-684-4148.
TRAUMATIC EVENTS, BUT NOT POST-TRAUMATIC STRESS DISORDER, COMMON IN CHILDHOOD
CHICAGO—Potentially traumatic events are common in children but do not typically result in post-traumatic stress symptoms or disorder, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Post-traumatic stress disorder (PTSD) is a unique psychiatric diagnosis because it requires an initiating event, such as war, rape, natural disaster or serious illness, according to background information in the article. In children, the list of events that could lead to PTSD includes a parent being sent to prison, sudden separation from a loved one and learning of a traumatic event occurring to a loved one.
William E. Copeland, Ph.D., and colleagues at Duke University Medical Center, Durham, N.C., conducted annual interviews with 1,420 children from age 9, 11 or 13 through age 16. Between 1993 and 2000, participants and their parents were interviewed in separate rooms and asked about traumatic events that may have occurred in the previous year. In addition, they reported any symptoms of post-traumatic stress that the children displayed, including compulsive behaviors to suppress memories, panic attacks and engaging in dangerous activities.
More than two-thirds of the children reportedly experienced at least one traumatic event by age 16, including 30.8 with exposure to one event and 37 percent to multiple events. The most common events were witnessing or learning about a trauma that affected others—known as "vicarious" events.
Of those, 13.4 percent of those developed some post-traumatic stress symptoms by age 16, but less than 0.5 percent met the criteria for PTSD. About 9.1 percent experienced painful recall, or distressing memories or images of the traumatic event, and 2.2 percent had a milder, sub-clinical form of PTSD. "Violent or sexual trauma were associated with the highest rates of symptoms," the authors write. "The post-traumatic stress symptoms were predicted by previous exposure to multiple traumas, anxiety disorders and family adversity." In addition, symptoms were more likely to occur among older children.
Children exposed to trauma had nearly double the rates of psychiatric disorders of those who were not (except for substance use disorders). "Across childhood, the children who experience trauma are often those with anxiety, depressive and disruptive behavior disorders, a finding supported in the present study," the authors write. "This likely reflects common liability conveyed from a limited set of family risk factors."
"In the general population of children, potentially traumatic events are fairly common and do not often result in post-traumatic stress symptoms, except after multiple traumas or a history of anxiety," they conclude. "The prognosis after the first lifetime trauma exposure was generally favorable. Apart from PTSD, traumatic events are related to many forms of psychopathology, with the strongest links being with anxiety and depressive disorders."
(Arch Gen Psychiatry. 2007;64:577-584. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institute of Mental Health, National Institute on Drug Abuse and the William T. Grant Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact Jeffrey G. Johnson, Ph.D., call Dacia Morris at 212-543-5421.
FREQUENT TELEVISION VIEWING DURING ADOLESCENCE ASSOCIATED WITH RISK OF ATTENTION AND LEARNING DIFFICULTIES
CHICAGO—Teenagers who watch television for three or more hours per day may have a higher risk of attention and learning difficulties in their adolescent and early adult years, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Children and teens in industrialized nations spend an average of two or more hours per day watching television, with more than 90 percent of viewing time watching entertainment and general audience programming, according to background information in the article. Researchers hypothesize that watching entertainment programming might contribute to learning problems because it takes time that might otherwise be dedicated to reading and homework, requires little intellectual effort, promotes problems with attention and contributes to disinterest in school.
Jeffrey G. Johnson, Ph.D., Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, and colleagues studied 678 families in upstate New York. Parents and children were interviewed about television habits and school problems three times between 1983 and 1993, when the children were an average of 14, 16 and 22 years old. Between 2001 and 2004, when the children in the study had reached an average age of 33, they provided information about their secondary and post-secondary education, including whether they graduated from high school or attended college.
At age 14, 225 (33.2 percent) of the teens reported that they watched three or more hours of television per day. "Television viewing time at mean age 14 years was associated with elevated risk for subsequent frequent attention difficulties, frequent failure to complete homework assignments, frequent boredom at school, failure to complete high school, poor grades, negative attitudes about school (i.e., hates school), overall academic failure in secondary school and failure to obtain post-secondary (e.g., college, university, training school) education," the authors write. "These associations remained significant after the covariates were controlled." These covariates included family characteristics and previous problems with thinking, learning and memory.
The researchers also conducted 14 analyses to investigate associations between attention and learning problems at age 14 and subsequent television habits. Only two of these analyses suggested any association, indicating that television watching contributes to learning difficulties and not vice versa. "The results suggest that although youths with attention or learning problems may spend more time watching television than do youths without these difficulties, this tendency may be unlikely to explain the preponderance of the association between television viewing and attention and learning difficulties during adolescence," they write.
Overall, the findings have important preventive implications, the authors continue. "They suggest that by encouraging youths to spend less than three hours per day watching television, parents, teachers and health care professionals may be able to help reduce the likelihood that at-risk adolescents will develop persistent attention and learning difficulties," they conclude. Future studies could investigate whether promoting other types of activities—such as athletics, music or arts— also could help reduce the risk of learning problems during the teen years.
(Arch Pediatr Adolesc Med. 2007;161:480-486. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institute of Mental Health and the National Institute on Drug Abuse. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact Frederick J. Zimmerman, Ph.D., call Joel Schwarz at 206-543-2580.
STUDY ANALYZES TELEVISION, DVD AND VIDEO VIEWING IN CHILDREN YOUNGER THAN 2 YEARS
CHICAGO—Approximately 40 percent of three-month old children and about 90 percent of children age 24 months and under regularly watch television, DVDs or videos, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
"The public health implications of early television and video viewing are potentially large. There are both theoretical and empirical reasons to believe that the effects of media exposure on children’s development are more likely to be adverse before the age of about 30 months than afterward," the authors note. Recent studies suggest that what children younger than two years watch and whether they watch it alone or with a parent may be important for their vocabulary development.
Frederick J. Zimmerman, Ph.D., of the University of Washington, Seattle, and colleagues, conducted a telephone survey of 1,009 parents of children age 2 to 24 months. The study analyzed four television and DVD content categories: children’s educational, children’s non-educational, baby DVDs/videos and grown-up television (such as talk shows or sports programming). Average daily viewing, reasons parents gave for their child’s viewing, who was present during viewing and socio-demographic factors were reported.
The median age of initiating viewing was 9 months. The average amount of viewing time for the children was 40.2 minutes per day. At 3 months of age children watched less than an hour per day and by 24 months they watched more than 1.5 hours per day. "Approximately half of the viewing was of shows that parents reported to be in the children’s educational category," the authors note. "The remaining half was approximately equally split among children’s non-educational content, baby DVDs/videos and grown-up television."
Of the reasons given by parents for allowing television and DVD/video viewing, 29 percent believe that television is educational or good for their child’s brain, 23 percent believe that it is enjoyable or relaxing for their child and 21 percent believe it gives them time to get things done while the child is entertained. Parents watched with their children more than half the time.
Researchers also reported that compared with children without siblings, children with two or more siblings were less likely to view grown-up television and watched about 18 minutes less per day in all content types.
"These results suggest that it may not only be the amount or content type that children view, but also the role of siblings in helping to process this content that may affect whether television viewing helps or hinders development," the authors conclude. In addition, "these results suggest that the widespread notion that parents turn to television only as an electronic babysitter is a misconception…Parents are clearly hungry for truly educational content for children younger than 2 years. More research is urgently required to determine whether it is realistic to produce genuinely educational content for children younger than 2 years, and if so, what it would be."
(Arch Pediatr Adolesc Med. 2007;161:473-479. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Tamaki Foundation. Dr. Zimmerman is supported by a grant from the National Institute of Mental Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 7, 2007
Media Advisory: To contact Sandy J. Slater, Ph.D., call Sherri McGinnis González at 312-996-8277. To contact editorialist Dale Kunkel, Ph.D., call Johnny Cruz at 520-621-1879.
CIGARETTE MARKETING PRACTICES IN RETAIL STORES ASSOCIATED WITH TEEN SMOKING HABITS
CHICAGO—Tobacco display advertising in retail stores appears to be associated with teens experimenting with cigarette smoking, while promotional giveaways and price breaks may be associated with the transition to regular smoking among youth, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Research has found that beginning to smoke at a young age is associated with eventually smoking more cigarettes per day and a higher risk of long-term consequences, according to background information in the article. Certain types of cigarette marketing that may appeal to young people, including advertisements that use cartoon characters, were banned as part of the 1998 Master Settlement Agreement with tobacco companies. Evidence suggests the tobacco industry may be turning to retail stores for marketing efforts. "In fact, in 2003, the tobacco industry spent $14.2 billion on retail advertising and price and other promotions, which accounts for 94 percent of all its 2003 advertising and promotional spending," the authors note.
Sandy J. Slater, Ph.D., of the Institute for Health Research and Policy, University of Illinois at Chicago, and colleagues analyzed surveys of 26,301 eighth-, 10th- and 12th-grade students collected from February 1999 to June 2003. Based on their responses, students were divided into levels of smoking uptake, which range from puffers (who have smoked once or twice) to current established smokers (who either smoked regularly at the time of the survey or smoked regularly in the past and at least occasionally during the past 30 days).
The students came from 966 communities, where the researchers then gathered cigarette marketing data, visiting up to 30 retail locations to evaluate the types and frequency of tobacco advertisements, the availability of promotions (such as coupons and gifts with purchase) and also the price of a pack of cigarettes.
Overall, 53.7 of the students had never smoked, 20.7 percent were puffers and 11.5 percent were current established smokers. "Higher levels of advertising, lower cigarette prices and greater availability of cigarette promotions were associated with smoking uptake," the authors write. "Advertising increased the likelihood of youth initiating smoking, price increased the likelihood of smoking at most levels of uptake and availability of promotions increased the likelihood that youth will move from experimentation to regular smoking."
Based on the estimates in their study, the authors predict that if stores had no advertising, there would be a relative decline of about 11 percent in puffers, whereas eliminating promotions would result in a relative decline of about 13 percent in current established smokers. "Overall, our results provide evidence that restricting point-of-sale advertising will discourage youth from trying smoking, and policies that increase cigarette prices and/or restrict price-based promotions will have a long-term positive impact by preventing youth from moving farther along the smoking uptake continuum toward regular smoking," they conclude.
(Arch Pediatr Adolesc Med. 2007;161:440-445. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention. The Monitoring the Future Survey is supported by the National Institute on Drug Abuse. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: UPDATED MARKETING REGULATIONS ARE NEEDED
"On closer scrutiny, the evidence that this new study provides about the impact of retail point-of-sale marketing techniques on youth smoking uptake is informative and insightful for understanding the environmental factors that promote tobacco use," writes Dale Kunkel, Ph.D., University of Arizona, Tucson, in an accompanying editorial. "These data provide clear lessons for how best to proceed with policies that would most effectively reduce smoking."
"If the policy goal of tobacco marketing restrictions is to focus the government’s efforts on advertising practices that increase youth smoking uptake, which over time translates into increased morbidity, then the study by Slater et. al. clearly demonstrates that it is time for some new regulations to be adopted," Dr. Kunkel writes.
"While advertisers have First Amendment rights, those privileges are always subject to restriction in the face of evidence that demonstrates a ‘compelling governmental interest’," he concludes. "Helping to protect young people from becoming addicted to tobacco clearly meets that standard."
(Arch Pediatr Adolesc Med. 2007;161:515-516. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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