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, May 5, 2008)
U.S. TEENS ADOPTED AS INFANTS APPEAR TO HAVE INCREASED ODDS OF MENTAL HEALTH PROBLEMS
YOUTHS IN TOWNS WITH SMOKE-FREE RESTAURANT LAWS APPEAR LESS LIKELY TO BECOME SMOKERS
SUDDEN DEATH OF A PARENT MAY POSE MENTAL HEALTH RISKS FOR CHILDREN, SURVIVING CAREGIVERS
STUDY ASSESSES TV VIEWING AND VERBAL INTERACTIONS AMONG LOW-INCOME PARENTS AND INFANTS
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 5, 2008)
BREASTFEEDING MAY IMPROVE CHILDREN’S INTELLIGENCE SCORES
LOW BLOOD LEVELS OF VITAMIN D MAY BE ASSOCIATED WITH DEPRESSION IN OLDER ADULTS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 5, 2008
Media Advisory: To contact Margaret A. Keyes, Ph.D., call Mark Cassutt at 612-624-8038.
U.S. TEENS ADOPTED AS INFANTS APPEAR TO HAVE MODERATELY INCREASED ODDS OF MENTAL HEALTH PROBLEMS
CHICAGO—Although most adopted American teens are psychologically healthy, adoptees appear to be at greater risk for emotional and behavioral problems than non-adoptees, according to a report in the May issue of Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals. They are also more likely to have contact with a mental health professional.
Approximately 120,000 American children are adopted each year and there are about 1.5 million adoptees under age 18 in total, according to background information in the article. As domestic adoptions have decreased, the number of international adoptions has increased. “Worldwide, approximately 40,000 children per year are moved between more than 100 countries through adoption. Despite the popularity of adoption, there is a persistent concern that adopted children may be at heightened risk for mental health or adjustment problems.”
Margaret A. Keyes, Ph.D., of the University of Minnesota, Minneapolis, and colleagues assessed 540 non-adopted adolescents, 514 internationally adopted adolescents and 178 domestically adopted adolescents (ages 11 to 21) to determine if adopted adolescents were at a higher risk for behavioral and emotional problems. Assessments were based on child and parent reports of attention-deficit/hyperactivity, oppositional defiant, conduct, major depressive and separation anxiety disorders, teacher reports of psychological health and contact with mental health professionals.
Adoptees scored moderately higher on continuous measures of behavioral and emotional problems. “Nevertheless, being adopted approximately doubled the odds of having contact with a mental health professional and of having a disruptive behavior disorder [attention-deficit/hyperactivity, oppositional defiant, or conduct disorder]. Relative to international adoptees, domestic adoptees had higher odds of having [a disruptive] disorder,” the authors write. “Focusing on internalizing problems, teachers reported that international adoptees were significantly more anxious than non-adopted adolescents and their parents reported significantly more symptoms of internalizing disorders, specifically major depressive disorders and separation anxiety disorders.”
“Although most adopted adolescents are psychologically healthy, they may be at elevated risk for some externalizing disorders, especially among those domestically placed,” the authors conclude. “This excess of clinically meaningful behavioral problems in adopted adolescents has significance for researchers who examine the effect adoption has on individual functioning, for adoption agencies and their workers who counsel and advise members of the adoption triad and for physicians who are dealing with an overrepresentation of adoptees in their clinical practices.”
(Arch Pediatr Adolesc Med. 2008;162[5]:419-425. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism and 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 5, 2008
Media Advisory: To contact Michael Siegel, M.D., M.P.H., call Lisa Brown at 617-414-1401.
YOUTHS IN TOWNS WITH SMOKE-FREE RESTAURANT LAWS APPEAR LESS LIKELY TO BECOME SMOKERS
CHICAGO—Young people who live in towns where regulations ban smoking in restaurants may be less likely to become established smokers, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine.
Many studies have examined the risk factors that lead young people to try their first cigarette, according to background information in the article. However, fewer researchers have differentiated these factors from those that cause children and teens to progress to established smoking, or having smoked 100 or more cigarettes. “Yet understanding this difference is critical,” the authors write. “It would allow us to determine the age and stage at which youths are most sensitive to various types of interventions, thus enabling the more specific tailoring and more effective delivery of smoking prevention interventions.”
Michael Siegel, M.D., M.P.H., of Boston University School of Public Health, and colleagues studied 3,834 Massachusetts youths who were age 12 to 17 at the first interview, conducted between 2001 and 2002. Of those, 2,791 were interviewed again two years later and 2,217 were interviewed four years later.
Overall, 9.3 percent of the participants became established smokers over the study period, including 9.6 percent of those living in towns with weak restaurant smoking regulations (where smoking is restricted to designated areas or not restricted at all), 9.8 percent of those in towns with medium regulations (smoking is restricted to enclosed or ventilated areas, or no smoking is allowed but variations are permitted) and 7.9 percent of those in towns with strong regulations (complete smoking bans). The strength of local smoking regulations was not associated with the transition from non-smoking to experimentation, but was associated with the transition from experimentation to established smoking.
The researchers note that smoking bans may influence youth by reducing their exposure to smokers in public places and also altering the perceived social acceptability of smoking. “Both of these effects would be expected to influence the transition from experimentation to established smoking but not experimentation in the first place,” they write.
The results “suggest that local smoke-free restaurant laws may decrease youth smoking initiation,” the authors continue. “If it represents a true effect, the observed 40 percent reduction in the odds of progression to established smoking in towns with local restaurant smoking bans would suggest that smoke-free policies may be the most effective intervention available to reduce youth smoking.”
(Arch Pediatr Adolesc Med. 2008;162[5]:477-483. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Cancer Institute, the State and Community Tobacco Control Interventions Research Grant Program and the Flight Attendant Medical Research Institute. 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 5, 2008
Media Advisory: To contact corresponding author David A. Brent, M.D., call Megan Grote Quatrini at 412-647-3555. To contact editorial co-author Irwin Sandler, Ph.D., call Skip Derra at 480-965-4823.
SUDDEN DEATH OF A PARENT MAY POSE MENTAL HEALTH RISKS FOR CHILDREN, SURVIVING CAREGIVERS
CHICAGO—Children who had a parent who died suddenly have three times the risk of depression than those with two living parents, along with an increased risk for post-traumatic stress disorder (PTSD) according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine.
About 4 percent of children in Western countries experience the death of a parent, according to background information in the article. Parents who have psychiatric disorders, including mood disorders and substance abuse, are more likely to die from suicide, accidents and heart disease. The same psychiatric factors that increase parents’ risk of sudden death also predispose their children to similar mental health problems.
Nadine M. Melhem, Ph.D., of the University of Pittsburgh School of Medicine, and colleagues identified 140 families in which one parent died of suicide, accident or sudden natural death. They were compared with 99 control families in which two parents were living and no first-degree relatives had died within the past two years. The offspring, ages 7 to 25, underwent interviews and assessments for psychiatric disorders, as well as a review of their parents’ psychiatric history.
Children whose parents had died, along with their surviving caregivers, were at higher risk for depression and post-traumatic stress disorder (PTSD) than those in control families. This association remained after controlling for psychiatric disorders in the deceased parent. Children and caregivers in families where a parent had died of suicide were no more likely than those in families where a parent died of other causes to develop PTSD or other psychiatric disorders. Children’s symptoms of depression, anxiety, PTSD, suicidal behavior and complicated grief (severe, lasting unhappiness) were associated with similar symptoms in surviving caregivers.
“Our findings have important clinical and public health implications,” the authors conclude. “The best way to attenuate the effect of parental bereavement among offspring is to prevent early death in their parents by improving the detection and treatment of bipolar illness, substance and alcohol abuse and personality disorders, and by addressing the lifestyle correlates of these illnesses that lead to premature death.”
When parents die, surviving caregivers should be monitored for depression and PTSD, since their psychiatric health affects that of children. “Given the increased risk of depression and PTSD, bereaved offspring should be monitored and, if needed, referred and treated for their psychiatric disorder,” the authors write. “Further studies are needed to examine the course and long-term effect of bereavement on offspring and their surviving caregivers, to test the mechanisms by which parental bereavement exerts these effects and to identify the subset of bereaved families who may require treatment, which can then frame targets for intervention and prevention efforts.”
(Arch Pediatr Adolesc Med. 2008;162[5]:403-410. 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 Mental Health (Dr. Brent) and a Young Investigator Award and a Travel Award from the American Foundation for Suicide Prevention (Dr. Melhem). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: PEDIATRICIANS SHOULD BE AWARE OF PARENTS’ PROBLEMS, AVAILABLE SERVICES
The study authors’ “findings that sudden parental death is associated with an increased risk for child mental health problems as well as increased mental health problems for the surviving parent have significant implications for pediatric practice,” write Irwin Sandler, Ph.D, and Thomas F. Boat, M.D., of Arizona State University, Tempe, in an accompanying editorial.
“First, a pediatrician should be aware that parental death, as well as other family adversities, is a risk factor for childhood mental disorders,” they write. “The second implication for pediatric practice is that once the pediatrician becomes aware of increased risk of children due to parental death or other family adversities, the pediatrician may have a responsibility to help link children and/or their parents with appropriate services. To do this effectively, pediatricians should become familiar with the kinds of services offered in their community and the evidence for their effectiveness.”
(Arch Pediatr Adolesc Med. 2008;162[5]:487-488. 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, May 5, 2008
Media Advisory: To contact Alan L. Mendelsohn, M.D., call Pamela McDonnell at 212-404-3555.
STUDY ASSESSES TV VIEWING AND VERBAL INTERACTIONS AMONG LOW-INCOME PARENTS AND INFANTS
CHICAGO—Mothers in low-income families seldom speak to their infants while the children are watching television or videos, which most do on a daily basis, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine.
“There has been a dramatic increase in television programming directed toward young infants,” the authors write as background information in the article. “This has occurred despite recommendations from the American Academy of Pediatrics that children younger than 2 years should not watch any television. Much of this programming is marketed toward parents as ‘educational,’ despite limited data to support this assertion.”
Alan L. Mendelsohn, M.D., of the New York University School of Medicine, and colleagues assessed 154 mothers and children of low socioeconomic status between 2005 and 2006, when the infants were an average of 6.6 months old. Mothers reported how much television their infants watched, along with the type of programming, whether they were watching with the child and whether they talked to the child during the viewing.
Over one 24-hour period, 149 of the 154 mothers (96.8 percent) reported that their infants watched television or videos, for a total of 426 exposures. These included 139 exposures (32.6 percent) to educational programs oriented to young children, 46 (10.8 percent) to non-educational programs oriented to young children, 205 (48.1 percent) to programs aimed at school-aged children, teenagers or adults and 36 (8.5 percent) to unknown programs. Mothers reported verbally interacting with their infants during 101 (23.7 percent) of 426 separate exposures to programs.
“Consistent with our first hypothesis, interactions were most commonly reported in association with educational content, especially among programs that had been co-viewed,” the authors write. “However, approximately half of the exposures consisted of programs not intended for young children; these were not associated with frequent interactions even when they were co-viewed.”
“Our findings are important because parent-infant interactions are associated with long-term developmental-behavioral outcomes,” they conclude. “Verbal responsiveness is frequently seen in association with reading and playing with toys. Given the large amount of media exposure and low frequency of reported interactions, additional study is needed to determine whether media exposure can facilitate interactions of sufficient quantity and quality to be associated with benefits for young children.”
(Arch Pediatr Adolesc Med. 2008;162[5]:411-417. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a grant to the National Institutes of Health/National Institute of Child Health and Human Development–funded study “Promoting Early School Readiness in Primary Health Care.” 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 5, 2008
Media Advisory: To contact Michael S. Kramer, M.D., call Cynthia Lee at 514-398-6754.
BREASTFEEDING MAY IMPROVE CHILDREN’S INTELLIGENCE SCORES
CHICAGO—Long-term, exclusive breastfeeding appears to improve children’s cognitive development, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Previous studies have reported that children and adults who were breastfed as infants have higher scores on IQ tests and other measures of cognitive (thinking, learning and memory) development than those who were fed formula, according to background information in the article. However, the evidence has been based on observational studies, in which children whose mothers chose to breastfeed were compared with those whose mothers chose not to breastfeed. The results of these studies may be complicated by subtle differences in the way breastfeeding mothers interact with their infants, the authors note.
Michael S. Kramer, M.D., of McGill University and the Montreal Children’s Hospital, Montreal, Quebec, and colleagues conducted a randomized trial of a breastfeeding promotion program involving patients at 31 maternity hospitals and affiliated clinics in Belarus. Between June 1996 and December 1997, clinics were randomly assigned either to adopt a program supporting and promoting breastfeeding or to continue their current practices and policies. A total of 7,108 infants and mothers who visited facilities promoting breastfeeding and 6,781 infants and mothers who visited control facilities received follow-up interviews and examinations between 2002 and 2005, when the children were an average of 6.5 years old.
Mothers who visited a facility promoting breastfeeding were more likely to feed their infants only breast milk at age 3 months (43.3 percent vs. 6.4 percent in the control group) and at all ages through 1 year. At age 6.5, the children in the breastfeeding group scored an average of 7.5 points higher on tests measuring verbal intelligence, 2.9 points higher on tests measuring non-verbal intelligence and 5.9 points higher on tests measuring overall intelligence. Teachers also rated these children significantly higher academically than control children in both reading and writing.
“Even though the treatment difference appears causal, it remains unclear whether the observed cognitive benefits of breastfeeding are due to some constituent of breast milk or are related to the physical and social interactions inherent in breastfeeding,” the authors write. Essential long-chain fatty acids and a compound known as insulinlike growth factor I, both found in breastmilk, could be responsible for the cognitive differences. On the other hand, the physical or emotional component of breastfeeding may lead to permanent changes affecting brain development. Breastfeeding also may increase verbal interaction between mother and child, which could improve children’s cognitive development.
“Although breastfeeding initiation rates have increased substantially during the last 30 years, much less progress has been achieved in increasing the exclusivity and duration of breastfeeding,” the authors conclude. “The consistency of our findings based on a randomized trial with those reported in previous observational studies should prove helpful in encouraging further public health efforts to promote, protect and support breastfeeding.”
(Arch Gen Psychiatry. 2008;65[5]:578-584. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This research was funded by a grant from the Canadian Institutes of Health Research. Dr. Kramer is the recipient of a Senior Investigator Award from the Canadian Institutes of Health Research. Co-author Dr. Platt is a Monat-McPherson Career Investigator of McGill Unviersity and a career investigator of the Fonds de la recherche en santé du Québec. Co-author Dr. Fombonne holds a Canada Research Chair in Child Psychiatry. 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 5, 2008
Media Advisory: To contact Witte J. G. Hoogendijk, M.D., Ph.D., e-mail: witteh{at}ggzba.nl.
LOW BLOOD LEVELS OF VITAMIN D MAY BE ASSOCIATED WITH DEPRESSION IN OLDER ADULTS
CHICAGO—Older adults with low blood levels of vitamin D and high blood levels of a hormone secreted by the parathyroid glands may have a higher risk of depression, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
About 13 percent of older individuals have symptoms of depression, and other researchers have speculated that vitamin D may be linked to depression and other psychiatric illnesses, according to background information in the article. “Underlying causes of vitamin D deficiency such as less sun exposure as a result of decreased outdoor activity, different housing or clothing habits and decreased vitamin intake may be secondary to depression, but depression may also be the consequence of poor vitamin D status,” the authors write. “Moreover, poor vitamin D status causes an increase in serum parathyroid hormone levels.” Overactive parathyroid glands are frequently accompanied by symptoms of depression that disappear after treatment of the condition.
Witte J. G. Hoogendijk, M.D., Ph.D., and colleagues at VU University Medical Center, Vrije Universiteit Amsterdam, the Netherlands, measured blood levels of vitamin D and parathyroid hormone and assessed symptoms of depression among 1,282 community residents age 65 to 95. Of those individuals, 26 had a diagnosis of major depressive disorder, 169 had minor depression and 1,087 were not depressed. The average blood vitamin D level was 21 nanograms per milliliter and the average parathyroid hormone level was 3.6 picograms per milliliter.
Blood vitamin D levels were 14 percent lower in individuals with major and minor depression (average, 19 nanograms per milliliter) compared with non-depressed participants (average, 22 nanograms per milliliter). In addition, parathyroid hormone thyroid levels were an average of 5 percent higher in those with minor depression (average, 3.72 picograms per milliliter) and 33 percent higher in those with major depressive disorder (average, 4.69 picograms per milliliter) than in those who were not depressed (average, 3.53 picograms per milliliter).
The findings may be important to patients because both low blood vitamin D levels and high parathyroid hormone levels can be treated with higher dietary intake of vitamin D or calcium and increased sunlight exposure. “Moreover, the clinical relevance of the present study is underscored by our finding that 38.8 percent of men and 56.9 percent of women in our community-based cohort had an insufficient vitamin D status,” they conclude. Additional studies are needed to determine whether changes in levels of vitamin D and parathyroid hormone precede depression or follow it.
(Arch Gen Psychiatry. 2008;65[5]:508-512. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by a clinical fellow grant from the Netherlands Organisation for Scientific Research. 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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