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, March 3, 2008)
TAMOXIFEN MAY HELP TREAT MANIA IN PATIENTS WITH BIPOLAR DISORDER
LOW TESTOSTERONE LEVELS ASSOCIATED WITH DEPRESSION IN OLDER MEN
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, March 3, 2008)
DEPRESSIVE SYMPTOMS ASSOCIATED WITH SUBSEQUENT PREGNANCY IN AFRICAN AMERICAN TEEN MOTHERS
DECREASING TELEVISION VIEWING AND COMPUTER USE WITH MONITORING DEVICE MAY HELP REDUCE OVERWEIGHT CHILDREN’S BODY MASS INDEX
NON-MEDICAL USE OF PRESCRIPTION MEDICATIONS ASSOCIATED WITH DRUG ABUSE AMONG COLLEGE STUDENTS
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
JOURNALISTS CAN NOW ACCESS EMBARGOED JAMA/ARCHIVES STUDIES ON-LINE. Go to www.jamamedia.org for more information and to apply for access.
SAVE THE DATE: JAMA will present new research from its theme issue on Genetics and Genomics at a media briefing on Tuesday, March 18, from 10 a.m. – 12:15 p.m., at the National Press Club in Washington, D.C. To register, reply to this email or go to www.jamamedia.org and click on the Events tab, or call 312-464-JAMA. Program information will be included in a future email. Archives of Dermatology, Archives of Neurology, Archives of Ophthalmology and Archives of Surgery also will feature research on genetics and genomics in the March issues.
Please Note: The FOR THE MEDIA website now has a search feature to enable media to find previous JAMA/Archives news releases on specific medical topics. This search feature link is located on the home page at www.jamamedia.org
EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 3, 2008
Media Advisory: To contact Ayşegül Yildiz, M.D., e-mail: agul_yildiz{at}hotmail.com. To contact editorialist Mauricio Tohen, M.D., Dr.P.H., call Christine Van Marter at 317-651-1473.
TAMOXIFEN MAY HELP TREAT MANIA IN PATIENTS WITH BIPOLAR DISORDER
CHICAGO—A small, three-week trial of tamoxifen, a drug typically used to treat breast cancer, indicates that it also may decrease symptoms of mania in patients with bipolar disorder, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Tamoxifen interferes with the effects of the hormone estrogen, which accounts for its effects against breast cancer, according to background information in the article. However, tamoxifen also inhibits the actions of a family of enzymes known as protein kinase C. Abnormal levels of activity by these enzymes have been associated with bipolar disorder and related dysfunctions, such as distractibility, impaired judgments and disorganized thoughts.
Animal studies and human pilot trials have suggested that tamoxifen may be effective in treating mania—an abnormally elevated mood that features impulsive behavior, higher energy and activity levels, and disconnected thoughts—in patients with bipolar disorder. Ayşegül Yildiz, M.D., of the Dokuz Eylül University Medical School, Izmir, Turkey, and colleagues conducted a clinical trial with 66 patients age 18 to 60, all of whom were diagnosed with bipolar disorder and were currently in a manic state or a mixed state that included mania. Participants were randomly assigned to take tamoxifen (40 milligrams to 80 milligrams per day) or identical placebo tablets twice daily for up to three weeks. Participants in both groups also were given up to 5 milligrams per day of the sedative lorazepam as needed to control their symptoms.
A total of 50 patients—29 assigned to take tamoxifen and 21 assigned to take placebo—completed the 21-day trial. Patients in the tamoxifen group had significantly lower scores on tests used to measure the severity of mania at the end of the three-week period, while those in the placebo group had scores that slightly increased. Almost half (48 percent) of patients taking tamoxifen responded to the drug—defined as a reduction of at least half in mania scores—compared with 5 percent of those taking placebo, and 28 percent vs. zero achieved cutoff scores for mania remission.
Patients taking tamoxifen also used less lorazepam during the study—an average of 25.2 milligrams compared with 41.8 milligrams for patients in the placebo group. “Moreover, all subjects used less lorazepam as the trial progressed, and the rate of decrease was 2.5 times greater with tamoxifen,” the authors write. Both tamoxifen and placebo were well tolerated.
“The findings encourage further clarification of the role of protein kinase C in the pathophysiologic mechanism of bipolar 1 disorder and development of novel anti–protein kinase C agents as potential antimanic or mood-stabilizing agents,” the authors conclude.
(Arch Gen Psychiatry. 2008;65[3]:255-263. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a research grant from the Stanley Medical Research Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: TARGETED THERAPIES REPRESENT FUTURE OF BIPOLAR DISORDER TREATMENT
“The role of tamoxifen per se in the treatment of bipolar disorder still remains to be determined, but its anti-estrogen effects are likely to present a safety challenge,” writes Mauricio Tohen, M.D., Dr.P.H., of Eli Lilly Corporate Center, Indianapolis, in an accompanying editorial.
“The evidence-based selection of the therapeutic targets that led to this study hopefully will lead to similar approaches by industry, government and academia in the development of new and better treatments for bipolar disorder,” Dr. Tohen concludes. “Undoubtedly, this will be an important step to conquer this devastating disorder that affects millions of patients around the globe.”
(Arch Gen Psychiatry. 2008;65[3]:252-253. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: Dr. Tohen is a full-time employee and a stockholder of Eli Lilly and Company. 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, March 3, 2008
Media Advisory: To contact Osvaldo P. Almeida, M.D., Ph.D., F.R.A.N.Z.C.P., e-mail: osvaldo.almeida{at}uwa.edu.au.
LOW TESTOSTERONE LEVELS ASSOCIATED WITH DEPRESSION IN OLDER MEN
CHICAGO—Older men with lower free testosterone levels in their blood appear to have higher prevalence of depression, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Depression affects between 2 percent and 5 percent of the population at any given time, according to background information in the article. Women are more likely to be depressed than men until age 65, when sex differences almost disappear. Several studies have suggested that sex hormones might be responsible for this phenomenon.
Osvaldo P. Almeida, M.D., Ph.D., F.R.A.N.Z.C.P., of the University of Western Australia, Perth, and colleagues studied 3,987 men age 71 to 89 years. Between 2001 and 2004, the men completed a questionnaire reporting information about demographics and health history. They underwent testing for depression and cognitive (thinking, learning and memory) difficulties, and information about physical health conditions was obtained from a short survey and an Australian health database. The researchers collected blood samples from the participants and recorded levels of total testosterone and free testosterone, which is not bound to proteins.
A total of 203 of the participants (5.1 percent) met criteria for depression; these men had significantly lower total and free testosterone levels then men who were not depressed. After controlling for other factors—such as education level, body mass index and cognitive scores—men in the lowest quintile (20 percent) of free testosterone concentration had three times the odds of having depression compared to men in the highest quintile.
The mechanism by which low hormone levels might affect depression risk has not been identified, but might involve changes in the levels of neurotransmitters or hormones in the brain, the authors note.
“A randomized controlled trial is required to determine whether reducing prolonged exposure to low free testosterone is associated with a reduction in the prevalence of depression in elderly men,” the authors write. “If so, older men with depression may benefit from systematic screening of free testosterone concentration, and testosterone supplementation may contribute to the successful treatment of hypogonadal [with low hormone levels] older men with depression.”
(Arch Gen Psychiatry. 2008;65[3]:283-289. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by project grants from the National Health and Medical Research Council of Australia. Biochemical analyses were funded by a Sylvia and Charles Viertel Charitable Foundation Clinical Investigator Award. 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, March 3, 2008
Media Advisory: To contact Beth Barnet, M.D., call Sharon Boston at 410-328-8919.
DEPRESSIVE SYMPTOMS ASSOCIATED WITH SUBSEQUENT PREGNANCY IN AFRICAN AMERICAN TEEN MOTHERS
CHICAGO—African American adolescent mothers who have symptoms of depression may be more likely to have a subsequent pregnancy within two years of giving birth, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Studies indicate that teen mothers are twice as likely to experience depression as adult mothers with almost twice as many African American teen mothers affected compared with white teen mothers, according to background information in the article. Rapid subsequent pregnancy (occurring within 24 months of a birth) is common in young mothers. “A recent meta-analysis found that 19 percent of teen mothers experienced a subsequent pregnancy within 12 months and 38 percent experienced a subsequent pregnancy within 24 months. The highest rates are among younger, economically disadvantaged African American adolescents.” Depression and subsequent pregnancy are associated with parenting stress and negative parenting behaviors such as child abuse and neglect.
Beth Barnet, M.D., and colleagues at the University of Maryland School of Medicine, Baltimore, followed 269 predominantly African American teens (ages 12 to 18) with low income who received prenatal care at five community sites. Questionnaires were completed one or two years after childbirth to measure depressive symptoms and occurrence of subsequent pregnancy.
Among those who completed at least one follow-up questionnaire, 46 percent had depressive symptoms at the beginning of the study. A pregnancy within two years of childbirth was experienced by 120 (49 percent) of the 245 teens followed up through two years and 28 (10 percent) had more than one subsequent pregnancy. The average time between subsequent pregnancies was 11.4 months. “Teens having a subsequent pregnancy were more likely to be school dropouts; not use condoms consistently at follow-up; and report a relationship with their baby’s father, who tended to be older,” the authors write. Depressive symptoms were associated with a 44 percent increase in risk of subsequent pregnancy.
“Depression is unhealthy for mothers and their children. Treating maternal depression improves the health and well-being of both,” the authors conclude. “Our findings do not tell us how depression might fit into a casual pathway to repeat adolescent childbearing, but they do suggest that depression may be an important malleable risk factor.”
“Because depression is treatable, future studies should evaluate whether improved recognition and treatment of adolescent depression reduces the risk of rapid subsequent pregnancy.”
(Arch Pediatr Adolesc Med. 2008;162[3]:246-252. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by grants from the Office of Adolescent Pregnancy Programs, U.S. Department of Health and Human Services and from an AAMC/CDC Cooperative Agreement. 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, March 3, 2008
Media Advisory: To contact Leonard H. Epstein, Ph.D., call Lois Baker at 716-645-5000 ext. 1417. To contact editorialist Steven L. Gortmaker, Ph.D., call Todd Datz at 617-432-3952.
DECREASING TELEVISION VIEWING AND COMPUTER USE WITH MONITORING DEVICE MAY HELP REDUCE OVERWEIGHT CHILDREN’S BODY MASS INDEX
CHICAGO—Using a monitoring device to reduce television viewing and computer use time by 50 percent over a two-year period appears to reduce calorie intake, sedentary behavior and body mass index in overweight children age 4 to 7, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Previous studies have shown an association between television viewing and obesity, according to background information in the article. “Television viewing is related to consumption of fast food and foods and beverages that are advertised on television,” the authors write. “Viewing cartoons with embedded food commercials can increase choice of the advertised item in preschoolers, and television commercials may prompt eating. Television viewing or related sedentary behavior may prompt eating by the association of these behaviors with eating, and television viewing and related behavior may impair the development of satiety by interfering with habituation to gustatory and olfactory cues.”
Leonard H. Epstein, Ph.D., of the University at Buffalo, the State University of New York, and colleagues conducted a randomized controlled clinical trial involving 70 children age 4 to 7 years whose body mass index (BMI) was at the 75th percentile or higher for their age and sex. All participants regularly watched television or played computer games for at least 14 hours per week at home. For the study, their families agreed to have a monitoring device installed on each television set and computer monitor. Each family member had an individual code to activate the electronic devices.
During the study, 36 children were randomly assigned to the intervention group; their codes had a set weekly time limit. Study staff reduced these children’s weekly screen time allotment by 10 percent per week until a 50 percent reduction was reached. Additional incentives, including money and stickers on a chart, were provided for watching less than the available amount. The other 34 participating children were assigned to a control group with no restrictions on TV or computer use. Body mass index, television viewing, calorie intake and physical activity were monitored every six months for two years.
By the end of the study, children with no time limits reduced their TV and computer use by an average of 5.2 hours per week, compared with an average reduction of 17.5 hours per week among children whose time was restricted. BMI as adjusted for age and sex and calorie intake also were lower among the group with restrictions on viewing than among the control group. No difference between the two groups was observed in the amount of physical activity.
“Using technology to modify television viewing eliminates parental vigilance needed to enforce family rules and reduces the disciplinary action needed if a child exceeds his or her sedentary behavior limits,” the authors conclude. “Perhaps most important, the device puts the choice of when to watch television in the child’s control, as opposed to a rule such as no television time until homework is completed.”
(Arch Pediatr Adolesc Med. 2008;162[3]:239-245. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases and by the Behavioral Medicine Laboratory, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: INNOVATIVE STRATEGIES HELP REDUCE CHILDHOOD OBESITY
“One of the more useful aspects of the article by Epstein et al is its clear documentation of an innovative and effective strategy that parents and caretakers can use to set screen time limits in children and youth,” writes Steven L. Gortmaker, Ph.D., of the Harvard School of Public Health, Boston, in an accompanying editorial.
Current recommendations suggest that children older than age 2 should watch no more than two hours per day of television, while those younger than age 2 should not watch television at all. “New innovations that assist parents may help make these recommendations a reality,” he concludes.
(Arch Pediatr Adolesc Med. 2008;162[3]:283-284. 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, March 3, 2008
Media Advisory: To contact Sean Esteban McCabe, Ph.D., M.S.W., call Jim Erickson at 734-647-1842.
NON-MEDICAL USE OF PRESCRIPTION MEDICATIONS ASSOCIATED WITH DRUG ABUSE AMONG COLLEGE STUDENTS
CHICAGO—College students who take frequently abused medications without a prescription appear to have a higher risk for drug abuse than those who use such therapies for medical reasons, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
“Several studies have reported recent increases in the prescription rates of abusable medications in the United States, including stimulants, opioids and benzodiazepines,” the author writes as background information in the article. “These increases are likely the result of many factors, including improved awareness regarding the signs and symptoms of several disorders, increased duration of treatment, availability of new medications and increased marketing. The increases in prescription rates have raised public health concerns because of the abuse potential of these medications and high prevalence rates of non-medical use, abuse and dependence, especially among young adults 18 to 24 years of age.”
Sean Esteban McCabe, Ph.D., M.S.W., of the University of Michigan, Ann Arbor, assessed prescription drug use and potential drug abuse in a survey of 3,639 college students (average age 19.9 years). The survey asked whether the students had been prescribed or had used without a prescription four classes of prescription drugs—opioids, stimulants, sleeping aids and sedative or anxiety medications. Questions about whether the students had experienced drug-related problems (for instance, performing illegal activities to obtain drugs, having withdrawal symptoms or developing medical problems as a result of drug use) were used to screen them for drug abuse.
Most of the students (59.9 percent) reported having used at least one of the drugs with a prescription for medical reasons, while approximately one in five reportedly took them without a prescription for non-medical reasons. A total of 1,412 (39.7 percent) reported that they had used the drugs only by prescription; 156 (4.4 percent) were never prescribed any of the medications but had used them anyway; and 563 (15.8 percent) had used some of the medications both with and without a prescription.
Those who had reported that they used drugs without prescription—whether or not they had also used them for medical reasons—were more likely to screen positive for drug abuse than those who had used the drugs only for medical reasons or had never used them at all. There was no difference in the rate of positive screening between those who had reported using the drugs by prescription and those who reported never having taken them.
The findings have important implications for prescribing frequently abused drugs to college students, Dr. McCabe notes. “Clearly, appropriate diagnosis, treatment and therapeutic monitoring of college students who are receiving abusable prescription medications is crucial, not only to improve clinical outcomes but also to help prevent the abuse of these medications within a population that is largely responsible for its own medication management,” he concludes. “Finally, any efforts aimed at reducing non-medical use of prescription drugs will have to take into consideration that these drugs are highly effective and safe medications for most patients who use them as prescribed.”
(Arch Pediatr Adolesc Med. 2008;162[3]:225-231. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study and the development of the manuscript were supported by research grants from the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Md. 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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