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 PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, June 4, 2007)
BENEFITS OF SCHOOL-BASED FITNESS PROGRAMS FADE AFTER SUMMER
DATING VIOLENCE AND SEXUAL ASSAULT ASSOCIATED WITH SUICIDE ATTEMPTS AMONG URBAN TEENS
STUDY EXAMINES CHARACTERISTICS OF FEMALE HIGH SCHOOL STUDENTS WHO REPORT STEROID USE
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, June 4, 2007)
LOW DOSES OF ECSTASY ASSOCIATED WITH DECLINE IN VERBAL MEMORY
GENETIC VARIATIONS MAY PREDISPOSE SOME MEN TO SUICIDAL THOUGHTS DURING SHORT-TERM TREATMENT FOR DEPRESSION
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 4, 2007
Media Advisory: To contact Aaron L. Carrel, M.D., call Aaron Conklin at 608-263-5561. To contact editorialist John Cawley, Ph.D., call Joe Schwartz at 607-254-6235.
BENEFITS OF SCHOOL-BASED FITNESS PROGRAMS FADE AFTER SUMMER
CHICAGO—A study of 17 middle school students suggests that physical fitness gains made by obese children who participated in a lifestyle-focused physical education class during the school year were lost after the three-month summer break, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Children increasingly live in an environment with reduced amounts of physical activity coupled with easy access to calories, according to background information in the article. This can result in obesity, poor cardiovascular fitness, insulin resistance, type 2 diabetes, high cholesterol and hypertension.
Aaron L. Carrel, M.D., and colleagues at the University of Wisconsin Children’s Hospital, Madison, previously conducted a randomized controlled trial in which 17 overweight children were assigned to participate in a lifestyle-focused, fitness-oriented physical education class for nine months. At the end of the trial, students in the class achieved significant improvements in cardiovascular fitness and also had reduced fasting insulin levels, which indicate a lower risk for diabetes. For the new study, the same children (average age 12)—all of whom remained at the same school and repeated the fitness class—were assessed again at the beginning and at the end of the next school year.
“Improvements seen during the nine-month school-year intervention in cardiovascular fitness, fasting insulin levels and body composition were lost during the three-month summer break,” the authors write. During the break, average fitness level as measured by maximum oxygen consumption—the amount of oxygen the body can use, with higher levels indicating better fitness—decreased by 3.2 milliliters per kilogram per minute. Percentage of body fat increased by an average of 1.3 percent, and fasting insulin levels also increased.
“Developing and evaluating interventions to influence students’ opportunities for healthful choices has been a focus of school-based health promotion research, including nutrition programs and physical education,” the authors write. “However, when interventions occur in a school-based setting, and are confined to the school year, an inherent question is one of sustainability.”
The children were not given any instructions regarding exercise over the summer, creating three months of unsupervised activity, the authors note. “These data show that in children, efforts to improve insulin sensitivity and reduce risk of type 2 diabetes mellitus and other morbidities of insulin resistance should include exercise intervention in a sustained manner to improve cardiovascular fitness throughout the year, not just during the school year,” they conclude.
(Arch Pediatr Adolesc Med. 2007;161:561-564. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by grants from Genentech Center for Clinical Research and the University of Wisconsin Sports Medicine Classic Fund. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: EFFECTIVENESS AND COST-EFFECTIVENESS DATA NEEDED ON CHILDHOOD OBESITY PROGRAMS
Although public health and medical organizations have encouraged action, more research is needed to determine what works to prevent or reduce childhood obesity, writes John Cawley, Ph.D., of Cornell University, Ithaca, N.Y., in an accompanying editorial.
“Specifically, the critical information that policymakers and educators lack is how to achieve the greatest reduction in obesity for the fixed budget they have available; in other words, how they can achieve the greatest ‘bang for the buck’,” Dr. Cawley writes. “Cost-effectiveness analysis (CEA) is the method that can answer this question because it compares various interventions in terms of their costs per unit of benefit.”
Legislators and others should be wary of acting without the results of such analyses, he continues. “While I appreciate that obesity seems to be the public health cause du jour and that there may be greater attention given to, and willingness to act on, this problem by policymakers in the near future than in the long run, there are also risks associated with rushing to implement unproven interventions.” These risks include the misallocation of resources, unintended consequences and a loss of credibility among policymakers.
(Arch Pediatr Adolesc Med. 2007;161:611-614. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: Dr. Cawley is an evaluator of the following school-based anti-obesity interventions: the Healthy Schools Program and Health Corps. 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, June 4, 2007
Media Advisory: To contact Elyse Olshen, M.D., M.P.H., call Elizabeth Streich at 212-305-6535. To contact corresponding editorialist Amy E. Bonomi, Ph.D., M.P.H., call Jeff Grabmeier at 614-292-8457.
DATING VIOLENCE AND SEXUAL ASSAULT ASSOCIATED WITH SUICIDE ATTEMPTS AMONG URBAN TEENS
CHICAGO—Recent dating violence among urban teen females and lifetime history of sexual assault among urban teen males may be associated with suicide attempts, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Suicide is the third leading cause of death in adolescents,” according to background information in the article. “In 2003, 6.5 per 100,000 U.S. teenagers aged 14 to 19 years committed suicide.” In 2005, more than 8 percent of high school students reported one or more suicide attempts in the previous year. Childhood sexual assault has been linked with depression, alcohol use and violence, making it a likely risk factor for a suicide attempt. “Dating violence has also been shown to be associated with depressive symptoms and multiple health-compromising behaviors,” the authors write.
Elyse Olshen, M.D., M.P.H., of Columbia University Medical Center, New York, and colleagues analyzed self-administered, anonymous questionnaires completed by 8,080 students (age 14 and older) from 87 New York City public high schools in 2005. The surveys measured different risk behaviors such as use of tobacco, alcohol and other drugs, unintentional injury and violence, sexual behaviors, dietary behaviors and physical activity. Students were also asked how many times they had attempted suicide, if they had experienced dating violence and if they had been sexually assaulted in the past 12 months.
Females made up 51 percent of the students and those who responded were primarily not white (40.1 percent Hispanic, 36 percent black, 16 percent Asian/other and 7.9 percent white). “Persistent sadness (feeling sad or hopeless daily for two weeks in a row during the past year) occurred in 40.2 percent of female students and 24.2 percent of male students; also, 19.9 percent of females and 10.3 percent of males reported suicidal ideation [suicidal thoughts or behaviors] or seriously considering attempting suicide in the past year.”
A lifetime history of sexual assault was reported by 9.6 percent of the females and 5.4 percent of the males in the study. In the past year, 10.6 percent of the girls and 9.5 percent of the boys reported that they had experienced dating violence and 11.7 percent of adolescent girls and 7.2 percent of adolescent boys reported that they had attempted suicide one or more times. For girls, violence in the past year was associated with suicide attempts, while lifetime history of sexual assault was not. Other significant factors influencing suicide attempts among females included sexual orientation, persistent sadness, disordered eating, feeling unsafe at school, being in a physical fight and binge drinking. For male students, lifetime history of sexual assault was associated with suicide attempts, while dating violence in the past year was not. Other factors influencing suicide attempts among boys included sexual orientation, persistent sadness, disordered eating, drug use and gun possession.
“While our study focused on public high school students in a single urban area, our results are likely generalizable to urban youth across the United States,” the authors conclude. “Questions about violence, depression, anxiety, substance abuse and suicidality are all extremely important and should be included as part of a comprehensive health assessment of adolescents. Furthermore, clinicians, educators and other professionals working with youth should be trained to routinely screen for violence victimization and should have a low threshold for referring these at-risk teenagers for mental health services.”
(Arch Pediatr Adolesc Med. 2007;161:539-545. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: PEDIATRICIANS ARE IN A PRIME POSITION TO HELP PREVENT SUICIDE ATTEMPTS AMONG MINORITY TEENS
“The study adds to a growing body of literature noting associations between the largely tolerated pandemic of violence victimization and adverse mental health in adolescents,” write Amy E. Bonomi, Ph.D., M.P.H., and Kelly Kelleher, M.D., M.P.H., of The Ohio State University, Columbus, in an accompanying editorial. “The study is unique in that it focused on black and Hispanic youth, who are traditionally underrepresented in studies of violence victimization and suicide risk.”
“As a group of professionals highly trusted and often with long-standing relationships with youth, pediatricians are in a prime position to act as leaders in implementing interventions for families and communities,” they conclude. “This community engagement will require pediatricians to become a necessary and ongoing linkage to partners outside of the office who are already addressing complex social problems with innovative programs and public health methods.”
(Arch Pediatr Adolesc Med. 2007;161:609-610. 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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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 4, 2007
Media Advisory: To contact Diane L. Elliot, M.D., call Tamara Hargens at 503-494-8653.
STUDY EXAMINES CHARACTERISTICS OF FEMALE HIGH SCHOOL STUDENTS WHO REPORT STEROID USE
CHICAGO— Steroid use among teen girls is not limited to those involved in competitive athletics and is associated with a cluster of other health-harming behaviors, including smoking and taking diet pills, according to results of a national survey published in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
In 2004, the Centers for Disease Control and Prevention reported that 7 percent of ninth-grade girls reported ever using anabolic steroids, according to background information in the article. During the 1990s, three national surveys indicated dramatic increases in the prevalence of teen girls using steroids. Previous analyses of female steroid use have focused on older women and found an association with competitive athletics and bodybuilding.
Diane L. Elliot, M.D., of the Oregon Health & Sciences University, Portland, and colleagues assessed anabolic steroid use among teen girls using a nationally representative sample of U.S. high schools completed in 2003. A total of 7,544 female students in grades nine through 12 completed the survey, which included questions about sports participation as well as steroids, ecstasy use and other illegal or unhealthy behaviors.
A total of 5.3 percent of the participants reported prior or ongoing steroid use. “Participating in team sports was negatively related to anabolic steroid use, such that those who were members of sports teams were less likely to self-report prior or ongoing anabolic steroid use,” the authors write.
“Adolescent girls reporting anabolic steroid use had significantly more other health-harming behaviors,” they continue. “They were much more likely to use other unhealthy substances, including past 30-day use of cigarettes, alcohol, marijuana and cocaine.” Young female steroid users were also more likely to:
- have had sexual intercourse before age 13
- have been pregnant
- drink and drive or have ridden with a drinking driver
- carry a weapon
- have been in a fight on school property in the past year
- have feelings of sadness or hopelessness almost every day for at least two weeks
- have attempted suicide
More than two-thirds of the teen girls surveyed reported trying to change their weight. However, those who used steroids were more likely to turn to extreme weight-loss techniques, including vomiting and laxative use. “Anabolic steroids are body-shaping agents and cause a loss in body fat and an increase in lean tissue; therefore, their association with unhealthy weight loss practices was not surprising,” the authors write.
The findings highlight important associations among girls who use steroids, the authors conclude. “Across all grades, these seem to be troubled adolescent girls with co-occurring health-compromising activities in the domains of substance use, sexual behavior, violence and mental health,” they conclude. “High-risk adolescent girls seem to have received less attention than adolescent boys, perhaps reflecting that their actions are less socially, albeit perhaps more personally, destructive. Anabolic steroid use is another marker for high-risk adolescent girls, and further study is needed to develop effective interventions for this population.”
(Arch Pediatr Adolesc Med. 2007;161:572-577. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was funded in part by a grant 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, June 4, 2007
Media Advisory: To contact Thelma Schilt, M.Sc., e-mail t.schilt{at}amc.uva.nl.
LOW DOSES OF ECSTASY ASSOCIATED WITH DECLINE IN VERBAL MEMORY
CHICAGO—Even low doses of Ecstasy may be associated with a decline in language-related memory, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Ecstasy is an illicit recreational drug popular among young people, according to background information in the article. Research in both humans and animals suggests that the drug can harm the brain. Ecstasy may damage nerve cells that respond to the hormone serotonin, which is involved in mood, thinking, learning and memory.
Thelma Schilt, M.Sc., of the Academic Medical Center of the University of Amsterdam, the Netherlands, and colleagues recruited 188 volunteers (average age 22) who had not used Ecstasy but reported that they were likely to try it soon. Within three years of the initial evaluations, which took place between April 2002 and April 2004, 58 individuals began using Ecstasy. They were compared with 60 individuals who had the same age, sex and intelligence score but who did not use Ecstasy during the follow-up period. All participants took tests that assessed various types of memory—including attention, verbal memory for words and language, and visual memory for images—at the beginning and end of the study. Verbal memory was tested by memorizing a series of 15 words and repeating them immediately and again 20 minutes later.
“At the initial examination, there were no statistically significant differences in any of the neuropsychological test scores between persistent Ecstasy-naïve subjects and future Ecstasy users,” the authors write. “However, at follow-up, change scores on immediate and delayed verbal recall and verbal recognition were significantly lower in the group of incident Ecstasy users compared with persistent Ecstasy-naïve subjects. There were no significant differences on other test scores.”
In contrast to other studies, which have suggested that Ecstasy affects women more than men, there was no difference in the drug’s effect between the sexes. Overall, test scores remained within the normal range for the general population.
The fact that Ecstasy appeared to affect only verbal memory points to specific brain areas and chemicals that may be affected by the drug, the authors note. “The main underlying factor seems to be a depletion of serotonin in Ecstasy users, a depletion that might be reversible,” they write. “Serotonin is involved in several cognitive functions but might be especially relevant to learning and memory.”
“In conclusion, our data indicate that low doses of Ecstasy are associated with decreased verbal memory function, which is suggestive for Ecstasy-induced neurotoxicity,” the authors conclude. “Further research on the long-term effects of Ecstasy as well as on the possibility of additive effects of Ecstasy use on aging of the brain is needed.”
(Arch Gen Psychiatry. 2007;64:728-736. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a grant from the Netherlands Organization for Health Research and Development as part of their Addiction Program. 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, June 4, 2007
Media Advisory: To contact Roy H. Perlis, M.D., call Sue McGreevey at 617-724-2764.
GENETIC VARIATIONS MAY PREDISPOSE SOME MEN TO SUICIDAL THOUGHTS DURING SHORT-TERM TREATMENT FOR DEPRESSION
CHICAGO—Genetic variations may help explain why some men with depression develop suicidal thoughts and behaviors after they begin taking antidepressant medications, while most do not, according to a report in the June issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Although most patients with depression respond favorably to antidepressant medications, a very small subgroup may experience worse symptoms after beginning treatment, according to background information in the article. “Regardless of treatment specificity, nearly all antidepressant medication studies find that some patients experience suicidality [suicidal thoughts and behaviors] after treatment initiation,” the authors write. “Identification of this subpopulation before treatment would have tremendous clinical utility.”
Roy H. Perlis, M.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues studied 1,447 individuals with depression who were part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, which was conducted from July 2001 to September 2006, and who did not express suicidal thoughts at the beginning of the study. The participants were men and women ages 18 to 75 years who had been diagnosed with non-psychotic major depressive disorder. They took the antidepressant citalopram hydrobromide for up to 12 weeks, following a protocol that advised follow-up treatment visits at two, four, six, nine and 12 weeks, with an optional visit at 14 weeks if needed. The patients’ DNA was analyzed for common types of mutations nearby or within the CREB1 gene, which codes for a protein previously suggested to be involved in both antidepressant effects and suicide.
Of the 1,447 patients, 123 (8.5 percent) reported suicidal thoughts or behaviors during at least one follow-up visit, including 54 (10 percent) of the 539 men. Two of five single nucleotide polymorphisms (SNPs)—variations that occur when a single building block of DNA is altered—were significantly and strongly associated with the onset of suicidality in men, but not in women.
The researchers performed additional analyses suggesting these variations are not linked to suicidal thoughts and behaviors in men before treatment. “No statistically significant association was noted between any SNP and the presence or absence of baseline suicidality,” the authors write. “Likewise, no evidence of association was noted between any SNP and history of lifetime suicide attempt.”
Studies that link genes to illnesses are most compelling when there is additional evidence of that gene’s function, the authors note. “We recently observed an association between the same CREB1 polymorphisms and a measure of anger expression among males but not females in a sample of 94 patients with major depressive disorder; hostility and anger expression have also been associated with suicide,” they write.
“If replicated, this finding would suggest that pharmacogenetic testing could facilitate the identification of the small subset of individuals at greater risk during short-term antidepressant treatment,” the authors conclude.
(Arch Gen Psychiatry. 2007;64:689-697. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: The STAR*D study is supported by federal funds from the National Institute of Mental Health. Dr. Perlis is supported by a National Institute of Mental Health grant, a NARSAD Young Investigator Award and a grant from the Bowman Family 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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