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, January 7, 2008)
EXTREME STRESS REACTIONS TO TERRORIST ATTACKS ASSOCIATED WITH SUBSEQUENT HEART PROBLEMS
REMOVING THIMEROSAL FROM VACCINES DID NOT REDUCE AUTISM CASES IN CALIFORNIA
FDA WARNINGS AFFECTED PRESCRIPTIONS OF ANTIDEPRESSANTS TO YOUTH
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, January 7, 2008)
DISORDERED EATING LESS COMMON AMONG TEEN GIRLS WHO REGULARLY EAT FAMILY MEALS
SOCIAL STANDING MAY BE LINKED TO BODY MASS INDEX IN TEEN GIRLS
PHYSICALLY ACTIVE TEENS LESS LIKELY TO BECOME OVERWEIGHT AS YOUNG ADULTS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, January 7, 2008
Media Advisory: To contact E. Alison Holman, F.N.P., Ph.D., call Laura Rico at 949-824-9055.
EXTREME STRESS REACTIONS TO TERRORIST ATTACKS ASSOCIATED WITH SUBSEQUENT HEART PROBLEMS
CHICAGO—Individuals who experienced severe stress-related symptoms in response to the terrorist attacks on 9/11 appear more likely to have been diagnosed with heart problems over the following three years, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
“Extremely stressful events may precipitate biological processes that increase one’s risk of developing cardiovascular ailments,” the authors write as background information in the article. “While acute stress may trigger immediate potentially lethal cardiovascular responses, acute, subacute and chronic stress can gradually increase cardiovascular risk through neurohormonal arousal. This physiologic reactivity may be easily rekindled by trauma reminders, leaving individuals vulnerable to the detrimental effects of arousal over time.”
E. Alison Holman, F.N.P., Ph.D., of the University of California, Irvine, and colleagues studied a national sample of 2,729 adults. Of these, 95 percent (2,592) had completed an online health assessment before the terrorist attacks. About nine to 14 days following the attacks, they responded to a Web-based survey regarding their acute stress responses, such as anxiety, dissociative symptoms (feeling detached from oneself or the world) or a re-experiencing of the event. Participants were then surveyed yearly about their health for three years.
Before the attacks, 21.5 percent of the participants had been diagnosed with a heart ailment; three years after the attacks, the rate had increased to 30.5 percent. “Acute stress responses to the 9/11 attacks were associated with a 53 percent increased incidence of cardiovascular ailments over the three subsequent years, even after adjusting for pre-9/11 cardiovascular and mental health status, degree of exposure to the attacks, cardiovascular risk factors (i.e. smoking, body mass index and number of endocrine ailments), total number of physical health ailments, somatization [the conversion of psychological symptoms into physical symptoms] and demographics,” the authors write.
Participants who reported high levels of acute stress immediately after the attacks were about twice as likely to report being diagnosed with hypertension and about three times as likely to report a diagnosis of heart problems over the following two years. “Among individuals reporting ongoing worry about terrorism post-9/11, high 9/11–related acute stress symptoms predicted increased risk of physician-diagnosed heart problems two to three years following the attacks,” the authors write.
“These findings highlight the possibility that acute stress reactions may indicate subsequent vulnerability to potentially serious health problems,” they conclude.
(Arch Gen Psychiatry. 2008;65[1]:73-80. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a grant from The Josiah Macy, Jr. Foundation and grants from the U.S. National Science 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, January 7, 2008
Media Advisory: To contact Robert Schechter, M.D., M.Sc., call Suanne Buggy or Lea Brooks at 916-440-7259. To contact editorialist Eric Fombonne, M.D., e-mail eric.fombonne{at}mcgill.ca.
REMOVING THIMEROSAL FROM VACCINES DID NOT REDUCE AUTISM CASES IN CALIFORNIA
CHICAGO—Autism cases continued to increase in California after the mercury-containing preservative thimerosal was eliminated from most childhood vaccines, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals. This suggests that exposure to thimerosal is not a primary cause of autism.
Diagnosed cases of autism and related conditions, known collectively as autism spectrum disorders, have increased in recent years, according to background information in the article. “Young children receive immunizations in the period preceding the typical manifestations or diagnosis of autism spectrum disorders,” the authors write. “Increased exposure to thimerosal, a preservative that contains 49.6 percent ethylmercury by weight, has been postulated to have contributed to the upswing in reported cases of autism spectrum disorders.” Thimerosal was eliminated from most vaccines by 2001. A 2004 report by the Institute of Medicine cited the lack of data supporting thimerosal as a cause of autism, but recommended that trends in autism diagnoses be observed as exposure to thimerosal decreased.
Robert Schechter, M.D., M.Sc., and Judith K. Grether, Ph.D., of the California Department of Public Health, Richmond, studied the prevalence of children with autism in California from 1995 through March 2007. They used data provided by the California Department of Developmental Services, which administers a statewide system of centers that serve individuals with autism and other developmental problems.
“The estimated prevalence of autism for children at each year of age from 3 to 12 years increased throughout the study period,” the authors write. Per 1,000 children born in 1993, 0.3 had autism at age 3, compared with 1.3 per 1,000 births in 2003. The highest estimated prevalence—4.5 cases per 1,000 births—was reached in 2006 for children born in 2000. “Although insufficient time has passed to calculate the prevalence of autism for children 6 years and older born after 2000, the prevalence at ages 3 to 5 years has increased monotonically for each birth year since 1999, during which period exposure to thimerosal has been reduced,” they continue.
In addition to analyzing the prevalence of autism by birth year, the researchers also examined the rate among children age 3 to 5 based on quarterly reports issued by the Department of Developmental Services. Prevalence increased each quarter from January 1995 (0.6 per 1,000 live births) through March 2007 (4.1 per 1,000 live births), including after 2004, when the researchers estimate that exposure to thimerosal during infancy and early childhood declined. Over the same time period, the rate of all developmental disabilities increased but at a slower rate, from 5.4 to 9.5 per 1,000 live births.
“The hypothesis that a modifiable risk factor, such as thimerosal exposure, is a major cause of autism offers the hope for prevention through reduced exposure,” the authors conclude. “Although our analysis of Department of Developmental Services data shows an increase in autism in California despite the removal of thimerosal from most vaccines, we support the continued quest for the timely discovery of modifiable risk factors for autism and related conditions. Continuing evaluation of the trends in the prevalence of autism for children born in recent years is warranted to confirm our findings.”
(Arch Gen Psychiatry. 2008;65[1]:19-24. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported through the California Department of Public Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: FEARS ABOUT VACCINES PERSIST DESPITE EVIDENCE
“In the last decade, two hypotheses on autism-immunization links were raised that have had a profound impact in the field of autism research and practice and on public health at large,” writes Eric Fombonne, M.D., of the Montreal Children’s Hospital, in an accompanying editorial. “One incriminated the measles component of the triple measles-mumps-rubella (MMR) vaccine, the other the amount of thimerosal (about 50 percent of which is ethylmercury) contained in most other childhood vaccines.”
Since the 2004 Institute of Medicine report favored the rejection of both hypotheses, “more studies have accumulated that have reinforced this conclusion, one independently reached by scientific and professional committees around the world,” he writes.
“Parents of autistic children should be reassured that autism in their child did not occur through immunizations,” Dr. Fombonne concludes. “Their autistic children, and their siblings, should be normally vaccinated, and as there is no evidence of mercury poisoning in autism, they should avoid ineffective and dangerous ‘treatments’ such as chelation therapy for their children.”
(Arch Gen Psychiatry. 2008;65[1]:15-16. 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, January 7, 2008
Media Advisory: To contact Mark Olfson, M.D., M.P.H., call Elizabeth Streich at 212-305-6535.
FDA WARNINGS AFFECTED PRESCRIPTIONS OF ANTIDEPRESSANTS TO YOUTH
CHICAGO—U.S. Food and Drug Administration warnings regarding the risk of suicidal thoughts and behaviors in children and adolescents taking antidepressants appear to have had modest and targeted effects on the intended populations, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
“The possibility that antidepressant medications, especially selective serotonin reuptake inhibitors (SSRIs), increase the risk of suicidal behavior was first raised in several case reports of children and adults during the early 1990s,” the authors write as background information in the article. “In June 2003, the Food and Drug Administration (FDA) recommended that paroxetine hydrochloride not be used to treat young people because of potential increased risk of suicidal behavior, and in October 2004, the FDA issued a black box warning concerning all antidepressants for youth.” This warning received extensive media attention and is the strongest action the FDA can take other than withdrawing approval for a drug.
Mark Olfson, M.D., M.P.H., of the Columbia University Medical Center, New York, and colleagues analyzed trends in antidepressant use based on data from Medco, a company that manages prescription drug benefits. The researchers assessed antidepressant prescriptions for youth (age 6 to 17), adults (age 18 to 64) and older adults (age 65 and older) over three time periods: prewarning (May 1, 2002, to June 19, 2003), paroxetine warning (June 20, 2003, to Oct. 15, 2004) and black box warning (Oct. 16, 2004, to Dec. 31, 2005).
“After the FDA first recommended not treating youth with paroxetine, there was a significant absolute decline in paroxetine use by youth but not significant declines in use of other antidepressants by young people,” the authors write. “Similar, though less pronounced, declines occurred in paroxetine treatment of older patients. Following the black box warning, there was a statistically nonsignificant decline in antidepressant treatment of youth, including a significant deceleration in the rate of treatment with SSRIs other than paroxetine.”
The warnings appeared to effectively increase the perception of the risks involved with antidepressant treatment, especially in young people, the authors note. “From 1985 to 1999, there was a four-fold national increase in per capita antidepressant prescriptions,” they write. “The FDA warnings appear to have slowed this longer-term growth of antidepressant treatment of children and adults. Despite fears that these advisories might result in a precipitous decline in antidepressant prescribing, it is reassuring that the pattern of changes in treatment, which were modest in size and greatest for treatment of youth, were broadly consistent with the FDA warnings and the scientific literature.”
(Arch Gen Psychiatry. 2008;65[1]:94-101. 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.
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, January 7, 2008
Media Advisory: To contact Dianne Neumark-Sztainer, Ph.D., M.P.H., R.D., call Laura Stroup at 612-624-5680.
DISORDERED EATING LESS COMMON AMONG TEEN GIRLS WHO REGULARLY EAT FAMILY MEALS
CHICAGO—Adolescent girls who frequently eat meals with their families appear less likely to use diet pills, laxatives or other extreme measures to control their weight five years later, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
As youth progress from adolescence into adulthood, disordered eating behaviors—including binge eating and self-induced vomiting—become more common, according to background information in the article. “Disordered eating behaviors are associated with a number of harmful behavioral, physical and psychological consequences, including poorer dietary quality, weight gain and obesity onset, depressive symptoms and the onset of eating disorders,” the authors write. “Thus, it is important to identify strategies for the prevention of disordered eating behaviors.”
Dianne Neumark-Sztainer, Ph.D., M.P.H., R.D., and colleagues at the University of Minnesota, Minneapolis, and colleagues studied 2,516 adolescents at 31 Minnesota schools. Participants completed two surveys—an in-class survey in 1999 and a mailed survey in 2004—regarding how often they ate with their families as well as their body mass index, feelings of family connectedness and eating behaviors.
Among teen girls, those who ate five or more meals with their families each week in 1999 were significantly less likely to report using extreme measures (such as self-induced vomiting and diuretics) to control their weight in 2004, regardless of their sociodemographic characteristics, body mass index or family connectedness. However, among adolescent boys, regular family meals did not predict lower levels of disordered eating behaviors five years later.
The reasons for the sex difference are unclear, the authors note. “Perhaps boys who engage in regular family meals are different in some way that increases their risk for disordered eating behaviors,” they write. “There is also the possibility that adolescent boys and girls have different experiences at family meals. For example, girls may have more involvement in food preparation and other food-related tasks, which may play a protective role in the development of disordered eating behaviors. Finally, family meals may offer more benefits to adolescent girls, who may be more sensitive to and likely to be influenced by interpersonal and familial relationships than are adolescent boys.”
Given the findings of this and other studies and the prevalence of disordered eating among teen girls, it is important to find ways to help families eat meals together, the authors note. “Health care professionals have an important role to play in reinforcing the benefits of family meals, helping families set realistic goals for increasing family meal frequency given schedules of adolescents and their parents, exploring ways to enhance the atmosphere at family meals with adolescents and discussing strategies for creating healthful and easy-to-prepare family meals,” they conclude. “Schools and community organizations should also be encouraged to make it easier for families to have shared mealtimes on a regular basis.”
(Arch Pediatr Adolesc Med. 2008;162[1]:17-22. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the Maternal and Child Health Bureau, Health Resources and Service Administration, U.S. Department of Health and Human Services, and from the General Mills Bell Institute of Health and Nutrition. 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, January 7, 2008
Media Advisory: To contact Adina R. Lemeshow, S.M., call 212-788-5290. To contact corresponding editorialist Clea McNeely, M.A., Dr.P.H., call Tim Parsons at 410-955-7619.
SOCIAL STANDING MAY BE LINKED TO BODY MASS INDEX IN TEEN GIRLS
CHICAGO—Teen girls who perceive themselves as being lower on the social ladder appear more likely to gain weight over the subsequent two years, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Between 1999 and 2004, the percentage of American teen girls classified as overweight increased from 14 percent to 16 percent, according to background information in the article. “Children who are overweight experience many health complications but perceive the most immediate consequence of overweight to be social discrimination,” the authors write. “To lessen this health and economic burden, it is important to identify factors that contribute to excess weight gain and the development of obesity.”
Adina R. Lemeshow, S.M., of the Harvard School of Public Health, Boston, and the New York City Department of Health and Mental Hygiene, Bureau of Tobacco Control, and colleagues assessed questionnaires completed by 4,446 girls age 12 to 18 years in 1999. In addition to reporting their height and weight, television viewing habits, diet and other factors, the girls answered the following question: “‘At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?’” Girls who placed themselves at five or above on the 10-rung ladder were compared with those who ranked themselves at or below four.
The average body mass index (BMI) among participants was 20.8 in 1999 and 22.1 in 2001. In that two-year period, 520 of the girls (11.7 percent) had at least a two-unit increase in BMI. “After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother’s BMI and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69 percent increased odds of having a two-unit increase in BMI during the next two years compared with other girls,” the authors write.
“It is important that researchers consider physical, behavioral, environmental and socioemotional factors that might contribute to the rising prevalence of overweight in adolescents,” they conclude. “Previous research suggests that emotional factors such as depression and low self-esteem and self-perception contribute to the burden of overweight in adolescents. Our study contributes to this body of literature in that, to our knowledge, it is the first to prospectively evaluate the relationship between subjective social status in the school community and change in BMI, and our findings suggest that low school subjective social status may be an important contributor to increases in BMI in girls over time.”
(Arch Pediatr Adolesc Med. 2008;162[1]:23-28. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: UNDERSTANDING SOCIAL INFLUENCES COULD HELP PREVENT OBESITY
“Despite the need for urgent action in the obesity epidemic, the health community’s mixed history of success with peer interventions should serve as a story of caution for designing interventions based on incomplete understandings of how adolescents’ health behaviors are shaped by their peers,” write Clea McNeely, M.A., Dr.P.H., and Robert Crosnoe, Ph.D., of the Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, in an accompanying editorial.
“Future adolescent health research, therefore, should seek to identify the specific ways that peers transmit health-related information and norms to each other in their everyday lives, either through face-to-face contact or through social networking activities on the Internet (e.g., MySpace),” they continue. “The study by Lemeshow and colleagues contributes to this knowledge base, which in the future can be used to consistently harness the power of peers to promote health.”
(Arch Pediatr Adolesc Med. 2008;162[1]:91-92. 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, January 7, 2008
Media Advisory: To contact corresponding author Robert Wm. Blum, M.D., M.P.H., Ph.D., call Tim Parsons at 410-955-7619.
PHYSICALLY ACTIVE TEENS LESS LIKELY TO BECOME OVERWEIGHT AS YOUNG ADULTS
CHICAGO—Participating in school-based physical education and certain extracurricular physical activities during adolescence may be associated with a lower risk of being overweight as a young adult, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
About 16 percent of U.S. teens are overweight or obese, according to background information in the article. Eighty-five percent of obese adolescents become obese adults. “In the pediatric population, adolescent overweight is the best predictor of adulthood overweight; however, to date, no single intervention in adolescence has proved to be effective in reducing the transition to adult overweight,” the authors write.
David Menschik, M.D., M.P.H., then at The Johns Hopkins University, Baltimore, and now at the Food and Drug Administration, Rockville, Md., and colleagues studied 3,345 teens in grades eight through 12 who participated in the National Longitudinal Study of Adolescent Health. In 1996, participants took an in-home survey, reporting on how often they participated in physical activities both at school and outside of school. They then reported their height and weight five years later, in 2001 or 2002.
“Increasing participation in certain extracurricular physical activities and physical education decreased the likelihood of young adulthood overweight,” the authors write. “Regarding extracurricular physical activities, the likelihood of being an overweight adult was reduced most (i.e. 48 percent) by performing certain wheel-related activities (i.e. rollerblading, roller skating, skateboarding or bicycling) more than four times per week.”
For every weekday that teens participated in physical education at school, their risk of being overweight as young adults was reduced by 5 percent. Those who had physical education five days per week had 28 percent lower odds of being overweight as young adults.
In general, the effects of physical activity were stronger for teens who began as normal weight than those who were overweight, suggesting that exercise is more effective for maintaining a normal weight than encouraging weight loss. “Accordingly, a greater emphasis on prevention, rather than intervention, may be well warranted in approaching the obesity epidemic,” the authors write.
“In the current climate of decreasing adolescent physical activity in and out of school, it is important for policy makers to have firm evidence that justifies increasing time and bolstering resources for quality exercise programs and sports,” they conclude. “In view of an obesity epidemic costing the United States an estimated $117 billion annually, policy makers now have evidence that a relatively low-cost strategy may offer a long-lasting solution.”
(Arch Pediatr Adolesc Med. 2008;162[1]:29-33. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported in part by the William H. Gates Sr. Endowment, Johns Hopkins Bloomberg School of Public 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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