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, September 1, 2008)
CHILDREN OF OLDER FATHERS MORE LIKELY TO HAVE BIPOLAR DISORDER
PET SCANS HELP IDENTIFY MECHANISM UNDERLYING SEASONAL MOOD CHANGES
STUDY EXAMINES RELATIONSHIP BETWEEN LOW BIRTH WEIGHT AND PSYCHIATRIC PROBLEMS IN CHILDREN
FAMILY THERAPY HELPS RELIEVE DEPRESSION SYMPTOMS IN BIPOLAR TEENS
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, September 1, 2008)
CHILDREN’S CALORIE EXPENDITURE, HEART RATE INCREASE DURING ACTIVE VIDEO GAMES
DEPRESSION COMMON AMONG RWANDAN YOUTH WHO HEAD HOUSEHOLDS
NEW MOTHERS GET MIXED MESSAGES: HOSPITALS PROVIDE FORMULA SAMPLE PACKS WHILE MEDICAL ORGANIZATIONS ENCOURAGE BREASTFEEDING
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 1, 2008
Media Advisory: To contact Emma M. Frans, M.Med.Sc., e-mail: Emma.Frans{at}ki.se.
CHILDREN OF OLDER FATHERS MORE LIKELY TO HAVE BIPOLAR DISORDER
CHICAGO—Older age among fathers may be associated with an increased risk for bipolar disorder in their offspring, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Bipolar disorder is a common, severe mood disorder involving episodes of mania and depression, according to background information in the article. Other than a family history of psychotic disorders, few risk factors for the condition have been identified. Older paternal age has previously been associated with a higher risk of complex neurodevelopmental disorders, including schizophrenia and autism.
Emma M. Frans, M.Med.Sc., of the Karolinska Institutet, Stockholm, Sweden, and colleagues identified 13,428 patients in Swedish registers with a diagnosis of bipolar disorder. For each one, they randomly selected from the registers five controls who were the same sex and born the same year but did not have bipolar disorder.
When comparing the two groups, the older an individual’s father, the more likely he or she was to have bipolar disorder. After adjusting for the age of the mother, participants with fathers older than 29 years had an increased risk. “After controlling for parity [number of children], maternal age, socioeconomic status and family history of psychotic disorders, the offspring of men 55 years and older were 1.37 times more likely to be diagnosed as having bipolar disorder than the offspring of men aged 20 to 24 years,” the authors write.
The offspring of older mothers also had an increased risk, but it was less pronounced than the paternal effect, the authors note. For early-onset bipolar disorder (diagnosed before age 20), the effect of the father’s age was much stronger and there was no association with the mother’s age.
“Personality of older fathers has been suggested to explain the association between mental disorders and advancing paternal age,” the authors write. “However, the mental disorders associated with increasing paternal age are under considerable genetic influence.” Therefore, there may be a genetic link between advancing age of the father and bipolar and other disorders in offspring.
“As men age, successive germ cell replications occur, and de novo [new, not passed from parent to offspring] mutations accumulate monotonously as a result of DNA copy errors,” the authors continue. “Women are born with their full supply of eggs that have gone through only 23 replications, a number that does not change as they age. Therefore, DNA copy errors should not increase in number with maternal age. Consistent with this notion, we found smaller effects of increased maternal age on the risk of bipolar disorder in the offspring.”
(Arch Gen Psychiatry. 2008;65[9]:1034-1040. 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, September 1, 2008
Media Advisory: To contact corresponding author Jeffrey H. Meyer, M.D., Ph.D., call Kirk Lemessurier at 416-535-8501, ext. 6631.
PET SCANS HELP IDENTIFY MECHANISM UNDERLYING SEASONAL MOOD CHANGES
CHICAGO—Brain scans taken at different times of year suggest that the actions of the serotonin transporter—involved in regulating the mood-altering neurotransmitter serotonin—vary by season, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals. These fluctuations may potentially explain seasonal affective disorder and related mood changes.
“It is a common experience in temperate zones that individuals feel happier and more energetic on bright and sunny days and many experience a decline in mood and energy during the dark winter season,” the authors write as background information in the article. This is thought to be related to variations in brain levels of serotonin, which is involved in the regulation of functions such as mating, feeding, energy balance and sleep. The serotonin transporter, a protein that binds to serotonin and clears it from the spaces between brain cells, “is a key element in regulating intensity and spread of the serotonin signal.”
Nicole Praschak-Rieder, M.D., and Matthaeus Willeit, M.D., of the Centre for Addiction and Mental Health and the University of Toronto, Ontario, Canada, and colleagues studied 88 healthy individuals (average age 33) between 1999 and 2003. Participants underwent one positron emission tomography (PET) scan to assess serotonin transporter binding potential value, an index of serotonin transporter density. The higher the binding potential value, the less serotonin circulates in the brain. For the analysis, individual scans were grouped according to the season of the scan—fall and winter or spring and summer.
“Serotonin transporter binding potential values were significantly higher in all investigated brain regions in individuals investigated in the fall and winter compared with those investigated in the spring and summer,” the authors write. When they matched binding potential values to meteorological data, the researchers found that higher values occurred during times when there were fewer hours of sunlight per day.
“An implication of greater serotonin transporter binding in winter is that this may facilitate extracellular serotonin loss during winter, leading to lower mood,” the authors write. “Higher regional serotonin transporter binding potential values in fall and winter may explain hyposerotonergic [related to low serotonin levels] symptoms, such as lack of energy, fatigue, overeating and increased duration of sleep during the dark season.”
“These findings have important implications for understanding seasonal mood change in healthy individuals, vulnerability to seasonal affective disorder and the relationship of light exposure to mood,” they conclude. “This offers a possible explanation for the regular reoccurrence of depressive episodes in fall and winter in some vulnerable individuals.”
(Arch Gen Psychiatry. 2008;65[9]:1072-1078. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Alliance for Research on Schizophrenia and Depression, the Austrian Science Foundation, the Canadian Institute for Health Research, the Ontario Mental Health Foundation, the Canada Foundation for Innovation and the Ontario Innovation Trust. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 1, 2008
Media Advisory: To contact corresponding author Naomi Breslau, Ph.D., call Andy Henion at 517-355-3294.
STUDY EXAMINES RELATIONSHIP BETWEEN LOW BIRTH WEIGHT AND PSYCHIATRIC PROBLEMS IN CHILDREN
CHICAGO—Low-birth-weight children appear to be at higher risk for psychiatric disturbances from childhood through high school than normal-birth-weight children, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In addition, low-birth-weight children from urban communities may be more likely to have attention problems than suburban low-birth-weight children.
“Advances in neonatal medicine have raised the survivorship of low-birth-weight infants (2,500 grams [about 5.5 pounds] or less), especially very low-birth-weight infants (1,500 grams [about 3.3 pounds] or less) and extremely low-birth-weight infants (1,000 grams [2.2 pounds] or less),” according to background information in the article. Previous studies have reported that low-birth-weight children appear to have an increased risk of internalizing, externalizing and attention problems.
Kipling M. Bohnert, B.A., and Naomi Breslau, Ph.D., of Michigan State University, East Lansing, examined the long-term association between low-birth-weight and psychiatric problems among 413 children from a socially disadvantaged community in Detroit and 410 children from a middle-class Detroit suburb. Children’s psychiatric disturbances were rated by mothers and teachers at ages 6, 11 and 17. Psychiatric disturbances were separated into three categories: externalizing, including delinquent and aggressive behavior; internalizing, including withdrawn behavior and anxiety/depression; and attention, including characteristic symptoms of ADHD such as not being able to pay attention for long or difficulty following directions.
Low-birth-weight children were more likely to exhibit externalizing and internalizing problems than normal-birth-weight children in their community. “An increased risk of attention problems was associated with low birth weight only in the urban community and was greater among very low-birth-weight children (weighing 1,500 grams or less) than heavier low-birth-weight children (weighing 1,501 grams to 2,500 grams),” the authors write. “In the suburban community, there was no increased risk for attention problems associated with low birth weight. Psychiatric outcomes of low birth weight did not vary across ages of assessments.”
“Attention problems at the start of schooling predict lower academic achievement later, controlling for key factors that contribute to academic test scores, which in turn predicts termination of schooling and curtailed educational attainment,” the authors conclude. “Attention problems influence academic performance by reducing the time that students devote to class learning and homework assignments and hinder organization and work habits.
“Early interventions to improve attention skills in urban low-birth-weight children might yield better outcomes later.”
(Arch Gen Psychiatry. 2008;65[9]:1080-1086. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by grants from the National Institute of Mental Health and 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, September 1, 2008
Media Advisory: To contact David J. Miklowitz, Ph.D., call Greg Swenson at 303-492-3113.
FAMILY THERAPY HELPS RELIEVE DEPRESSION SYMPTOMS IN BIPOLAR TEENS
CHICAGO—Family-focused therapy, when combined with medication, appears effective in stabilizing symptoms of depression among teens with bipolar disorder, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Between one-half and two-thirds of patients with bipolar disorder develop the condition before age 18, according to background information in the article. “Early onset of illness is associated with an unremitting course of illness, frequent switches of polarity, mixed episodes, psychosis, a high risk of suicide and poor functioning or quality of life,” the authors write. “The past decade has witnessed a remarkable increase in diagnoses of bipolar disorder in children and adolescents and, correspondingly, drug trials for patients with early-onset disorder. There has been comparatively little controlled examination of psychotherapy for pediatric patients.”
David J. Miklowitz, Ph.D., of the University of Colorado, Boulder, and colleagues conducted an outpatient randomized controlled trial among 58 adolescents (average age 14.5) with bipolar disorder who had experienced a mood episode in the prior three months. Between 2002 and 2005, 30 teens were randomly assigned to receive pharmacotherapy plus family-focused treatment for adolescents. Over nine months, they participated in 21 50-minute sessions. Therapy included the patient, parents and siblings and consisted of education about their disease, communication training and problem-solving skills training.
The other 28 teens were assigned to pharmacotherapy plus enhanced care, which involved three 50-minute family sessions that focused on preventing relapse. Independent evaluators, who did not know patient group assignments, assessed the teens every three to six months for two years.
A total of 60 percent of the family-focused therapy group and 64.3 percent of the enhanced care group completed the two-year follow-up; of those, 53 (91.4 percent) experienced a full recovery from their original mood episode. There were no differences between the two groups in rates of recovery or in the amount of time that elapsed before a subsequent mood episode. However, patients in the family-focused therapy group recovered from depressive symptoms more quickly, spent fewer weeks in depressive episodes over the two-year period and had an overall more favorable trajectory of depressive symptoms than those in the enhanced care group.
“To enhance full symptomatic and functional recovery among adolescents, family-focused treatment for adolescents may need to be supplemented with collaborative care interventions found effective in mania stabilization,” the authors conclude. The program’s emphasis on “reducing conflict in family relationships, enhancing social supports and teaching interpersonal skills may underlie its stronger effects on bipolar depression.”
(Arch Gen Psychiatry. 2008;65[9]:1053-1061. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by National Institute of Mental Health grants, a Distinguished Investigator Award from the National Alliance for Research on Schizophrenia and Depression and a Faculty Fellowship from the University of Colorado Council on Research and Creative Work (Dr. Miklowitz). 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, September 1, 2008
Media Advisory: To contact corresponding author Alison M. McManus, Ph.D., e-mail: alimac{at}hku.hk. To contact editorialist Russell R. Pate, Ph.D., call Karen Petit at 803-777-5400.
CHILDREN’S CALORIE EXPENDITURE, HEART RATE INCREASE DURING ACTIVE VIDEO GAMES
CHICAGO—Children burn more than four times as many calories per minute playing an active video game than playing a seated game, and their heart rate is also significantly higher with the active game, according to a report in the September issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Video and computer gaming is rapidly becoming the preferred leisure-time activity for school-aged children, according to background information in the article. In the last decade, computer and video game sales have increased by $5.2 billion and more than 83 percent of U.S. children age 8 to 18 have video game players in their bedrooms. At the same time, obesity rates continue to increase worldwide; sedentary activities such as seated game-playing may contribute.
The gaming industry has begun producing active “extertainment” gaming systems, the authors note. “A recent active gaming concept that allows players to experience various activities (e.g., bowling, fishing, tennis, golf) in a virtual world is the XaviX gaming system (SSD Company Ltd., Shiga, Japan),” the authors write. “In addition to the exercise gaming modalities, the XaviX system includes a gaming mat (XaviX J-Mat) that allows participants to travel the streets of Hong Kong at a walk or a run, avoiding obstacles and stamping out ninjas.”
Robin R. Mellecker, B.Sc., and Alison M. McManus, Ph.D., of the Institute of Human Performance, University of Hong Kong, Pokfulam, measured heart rate and energy (calorie) expenditure in 18 children age 6 to 12 (average age 9.6) during a 25-minute gaming protocol. Participants rested for five minutes, then played a seated computer bowling game, an active bowling game and the action/running game for five minutes each, with five minutes of rest between active games.
Compared with resting, children burned 39 percent more calories per minute playing a seated game, 98 percent more playing active bowling and 451 percent more during the action/running game. When compared with seated gaming, they burned 0.6 more calories playing active bowling and 3.9 more calories per minute playing on the action mat. “This translates into a more than four-fold increase in energy expenditure for the XaviX J-Mat game,” the authors write. “Preventing weight gain requires an energy adjustment of approximately 150 kilocalories [calories] per day. The four-fold increase in energy expenditure when playing on the XaviX J-Mat would fill the proposed energy gap, if this game were played for 35 minutes a day.”
In addition, participants’ heart rate was significantly higher during either active game than during rest (20 more beats per minute for active bowling and 79 more beats per minute for the action/running game), and also was higher during the action mat gaming than during seated gaming.
“Our data demonstrate that the two active gaming formats result in meaningful increases in energy expenditure compared with the seated screen environment,” the authors conclude. “The next step is to test whether active gaming interventions can provide sustainable increases in childhood physical activity.”
(Arch Pediatr Adoles Med. 2008;162[9]:886-891. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was funded by the University of Hong Kong Research Council Strategic Research Theme Public Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: ACTIVE GAMING MAY BE PART OF THE SOLUTION TO OBESITY CRISIS
The study “findings show that kids who play the new generation of video games requiring physical activity expend energy at levels that could help to prevent overweight,” writes Russell R. Pate, Ph.D., of the University of South Carolina School of Public Health, Columbia, in an accompanying editorial.
“This observation is important because electronic entertainment is not going away. So, if we want to promote physical activity in the context of contemporary society, we will have to fight fire with fire. Physically active video gaming may be part of the antidote to the poisonous growth of sedentary entertainment.”
“Some previous research has shown that reducing sedentary entertainment can beneficially affect body composition in youth, so there is support for the efficacy of this approach,” Dr. Pate concludes. “What is lacking is a clear sense of how we can take this strategy to the population level. Substituting physically active video gaming for sedentary gaming is an attractive option. The economics of this strategy could work at the societal level. If that proves to be true, the video gaming industry and the kids themselves will solve the problem. We ought to find out if they will.”
(Arch Pediatr Adoles Med. 2008;162[9]:895-896. 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, September 1, 2008
Media Advisory: To contact Neil W. Boris, M.D., call Keith Brannon at 504-862-8789.
DEPRESSION COMMON AMONG RWANDAN YOUTH WHO HEAD HOUSEHOLDS
CHICAGO—More than half of orphaned youth age 12 to 24 who head households in rural Rwanda meet criteria for depression, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
The combined effects of the 1994 genocide and the HIV epidemic give Rwanda one of the highest numbers of orphans in the world—an estimated 290,000 in 2005, according to background information in the article. “Most African orphans have been absorbed into informal fostering systems,” the authors write. “Such systems, however, are increasingly overwhelmed, and many orphans either head households or live on the street.”
Neil W. Boris, M.D., of the Tulane University School of Medicine, New Orleans, and colleagues assessed depressive symptoms in 539 youth in Rwanda who served as heads of households. Trained interviewers met with the youth (age 24 or younger, average age 20) and administered scales measuring symptoms of grief, depression, adult support and marginalization from the community. Questions about demographics, health, vulnerability and risky behaviors also were included.
The researchers found that:
- 77 percent of the youth were subsistence farmers
- 7 percent had attended school for six years or more
- 71.4 percent reported that both of their parents were dead and 26.2 percent reported that one parent was dead; of all of these, almost one-fourth indicated that at least one parent was killed in the genocide
- Almost half (44 percent) reported eating only one meal per day in the past week
- 80 percent rated their health as fair or poor
- The average score on a scale measuring depression was 24.4—higher than the most conservative published cutoff score for adolescents (24); 53 percent of the participants screened positive for depression
- 76 percent agreed with the statement that the community rejects orphans, and only 26 percent strongly agreed that they had at least one friend
- 64 percent said they had lost confidence in people, and 40 percent agreed that life was meaningless or reported losing faith in God since the deaths of their parents
“Hunger, grief, few assets, poor health status and indices of social marginalization were associated with more depressive symptoms in this sample,” the authors write. “Ten years after the Rwandan genocide and in the midst of the HIV/AIDS epidemic, the effects of poverty and social disruption on the most vulnerable youth in Rwanda are evident.”
“The effect of caregiver depression on younger children living in youth-headed households is not yet known,” they conclude. “Further study of orphans and vulnerable children in countries such as Rwanda, in particular, studies that inform large-scale interventions, are necessary if the next generation of youth is to thrive.”
(Arch Arch Pediatr Adolesc Med. 2008;162[9]:836-843. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Population Council Horizons Program, which was funded by the U.S. Agency for International Development. 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, September 1, 2008
Media Advisory: To contact Anne Merewood, M.P.H., I.B.C.L.C., call Allison Rubin at 617-638-8491.
NEW MOTHERS GET MIXED MESSAGES: HOSPITALS PROVIDE FORMULA SAMPLE PACKS WHILE MEDICAL ORGANIZATIONS ENCOURAGE BREASTFEEDING
CHICAGO—A majority of U.S. hospitals on the East coast distribute formula sample packs to new mothers, contrary to recommendations from most major medical organizations concerned about the potential for distributing these packs to reduce breastfeeding rates, according to a report in the September issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. However, the practice is changing significantly.
“Packaged as smart diaper bags, the commercial sample packs contain formula, coupons, advertisements and baby products,” the authors write as background information in the article. “Typically, they are given free to the hospital by the relevant infant formula manufacturer and are distributed to patients by clinicians when mother and newborn are discharged from the hospital.” Institutions that have voiced opposition to this practice include the Centers for Disease Control and Prevention, American Academy of Pediatrics, American College of Obstetricians and Gynecologists and World Health Organization.
Anne Merewood, M.P.H., I.B.C.L.C., of the Boston University School of Medicine, and colleagues contacted 1,295 hospitals in 21 Eastern states and the District of Columbia by telephone between October 2006 and March 2007. Of those, 1,215 (93.8 percent) distributed formula sample packs to at least some new mothers. Patterns were evident by state and by region. In New Hampshire, 70.4 percent of hospitals distributed the packs, while 100 percent of those in New Jersey, Maryland, Mississippi, West Virginia and the District of Columbia did so.
Among 80 hospitals that were free of sample packs, 20 had eliminated the practice before 2000 and 60 since 2000. “The proportion of bag-free hospitals has risen significantly between 1979 and 2006,” the authors write. “Elimination of sample packs was ongoing, with clusters of activity in certain regions such as New York City and Massachusetts.” The reductions in these areas were likely associated with focused public health efforts to eliminate the packs, the authors note.
“Exclusive breastfeeding rates among young infants are discouragingly low,” with only 11 percent of U.S. infants exclusively breast-fed at 6 months, they conclude. “Formula sample packs have been shown to undermine breastfeeding, and their elimination from U.S. hospitals may help to increase exclusive breastfeeding rates nationally. The prevalence of sample pack distribution is disturbing and incongruous given extensive opposition, but encouraging trends suggest that the practice may be curtailed in the future.”
(Arch Arch Pediatr Adolesc Med. 2008;162[9]:823-827. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by a contract from the Department of Health and Human Services to the Breastfeeding Center, Boston Medical Center. 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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