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, March 2, 2009)
Swimming Lessons Associated With Reduced Risk of Drowning in Toddlers
Impulsivity in Kindergarten May Predict Gambling Behavior in Sixth Grade
Owning Alcohol-Branded Merchandise Common, Associated With Drinking Behaviors Among Teens
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, March 2, 2009)
Alcohol Abuse May Lead to Depression Risk, Rather Than Vice Versa
Untreated Psychiatric and Substance Abuse Disorders Common Among Single Mothers Receiving Welfare Assistance
Young Adults With Posttraumatic Stress Disorder May Be More Likely to Attempt Suicide
Having Parents With Bipolar Disorder Associated With Increased Risk of Psychiatric Disorders
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 2, 2009
Media Advisory: To contact Ruth A. Brenner, M.D., M.P.H., call Robert Bock or Marianne Glass Miller at 301-496-5133 or e-mail bockr{at}mail.nih.gov. To contact editorial author Frederick P. Rivara, M.D., M.P.H., call Mary Guiden at 206-616-3192 or e-mail mguiden{at}u.washington.edu.
Swimming Lessons Associated With Reduced Risk of Drowning in Toddlers
CHICAGO—ages 1 to 4 appear to have a lower risk of drowning if they have taken formal swimming lessons, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Between 2000 and 2005, 6,900 children younger than 20 died of non-boating–related drowning, according to background information in the article. Interventions to prevent these events depend on the circumstances and the age of the victim—for instance, pool fencing helps protect toddlers who gain unauthorized access to a pool, but does not prevent drowning among children near a lake or canal. The American Academy of Pediatrics currently recommends that all children be taught to swim after age 5 years as a preventive strategy, but does not recommend for or against swimming lessons in younger children because of a lack of data.
Ruth A. Brenner, M.D., M.P.H., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md., and colleagues studied the association between drowning and swimming lessons in children and adolescents age 1 to 19 in six states. Interviews were conducted with 88 children families of children who drowned between 2003 and 2005 and also with the families of 213 control children who were the same age and sex and lived in the same county as those who had drowned.
Among children ages 1 to 4 years, two of the 61 who had drowned (3 percent) had ever taken formal swimming lessons, compared with 35 of the 134 controls (26 percent), representing a statistically significant reduction in the odds of drowning among children who had taken swimming lessons. Parents reported that children who drowned were less skilled swimmers—for example, only 5 percent of them were able to float on their back for 10 seconds, vs. 18 percent of controls.
Of the 27 children age 5 to 19 who drowned, seven (27 percent) had ever taken formal swimming lessons, compared with 42 of the 79 controls (53 percent). However, the association between swimming lessons and drowning was not statistically significant. As with younger children, those who drowned were reported to be poorer swimmers, with 42 percent being unable to swim continuously for at least one minute (vs. 16 percent of controls).
"Previous concerns have been raised about the potential for swimming lessons to increase the risk of drowning, either through increased exposure to water or through decreased parental vigilance as parents become more confident in their child's swimming ability," the authors write. However, these results and those of similar studies provide reassurance that swimming lessons may have a protective effect.
"In combination with other prevention strategies, such as pool fencing, appropriate adult supervision and training in cardiopulmonary resuscitation, swimming instruction can now be viewed as a potential component of a multifaceted approach to prevention for younger children," the authors conclude. Still, parents should be cautioned that swimming skills alone cannot completely protect children and that even the most proficient swimmers can drown, they note.
(Arch Pediatr Adoles Med. 2009;163[3]:203-210. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by the National Institute of Child Health and Human Development. Complete or partial salary support for Dr. Brenner and co-authors Dr. Taneja, Dr. Haynie, Dr. Trumble and Dr. Klebanoff was provided from National Institute of Child Health and Human Development intramural funds. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: The Time to Prevent Drowning Is Now
Drowning kills nearly 200,000 children each year, defies the most advanced medical care and affects those in high-income developed countries as well as in the developing world, writes Frederick P. Rivara, M.D., M.P.H., of the University of Washington, Seattle, and editor of Archives of Pediatrics & Adolescent Medicine, in an accompanying editorial.
"It is against this setting that the article by Brenner and colleagues in this issue of the Archives must be viewed and why it is so important," Dr. Rivara continues. "This widely anticipated case-control study found that formal swimming lessons were strongly associated with a lower risk of drowning for preschool children aged 1 to 4 years. This is the age group at greatest risk of drowning and for which the idea of swimming lessons has been most controversial."
"Other interventions to prevent drowning are also important, such as pool fencing, use of personal floatation devices and supervised swim areas," Dr. Rivara concludes. "Swimming lessons should not replace these other strategies nor should they substitute for adult supervision and vigilance. However, formal swimming lessons offer an opportunity to make a real difference in communities around the globe to prevent the sound of happy children splashing in water from turning into the wail of an ambulance siren or the sound of a parent crying in grief."
(Arch Pediatr Adoles Med. 2009;163[3]:277-278. 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 2, 2009
Media Advisory: To contact Linda S. Pagani, Ph.D., call Nicole Saint-Pierre at 514-345-4931, ext. 2555 or e-mail nicole_saint-pierre{at}ssss.gouv.qc.ca.
Impulsivity in Kindergarten May Predict Gambling Behavior in Sixth Grade
CHICAGO—Children whose teachers rated them as more impulsive in kindergarten appear more likely to begin gambling behaviors by the sixth grade, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Although gambling has become an increasingly common activity among U.S. adults and teens, public health risks remain, the authors write as background information in the article. "Problematic gambling in adults is associated with substance use, depression and suicide, psychopathology, poor general health and a multitude of family, legal and criminal problems," the authors wrote. "Most disconcerting is that young people seem more vulnerable than adults to gambling-related morbidity [illness] and suicidality. Data suggest that in most cases, youthful recreational gambling predates pathological gambling in adulthood."
Linda S. Pagani, Ph.D., of Sainte-Justine University Hospital Research Center and the Université de Montréal, Canada, and colleagues studied 163 children who were in kindergarten in 1999 (average age 5.5). At the beginning of the school year, teachers were asked to complete a questionnaire rating their students' inattentiveness, distractibility and hyperactivity on a scale from one to nine (with higher values indicating a higher degree of impulsiveness). After six years, when the children were an average of 11.5 years old, they were interviewed by phone and asked whether and how often they played cards or bingo, bought lottery tickets, played video games or video poker for money or placed bets at sports venues or with friends.
After considering other behaviors that may be associated with youth gambling, including parental gambling, a one-unit increase on the kindergarten impulsivity scale corresponded to a 25-percent increase in a child's involvement in gambling in sixth grade.
"Our results suggest that behavioral features such as inattentiveness, distractibility and hyperactivity at school entry represent a vulnerability factor for precocious risk-oriented behavior like gambling in sixth grade," the authors write. "It is very plausible that these childhood characteristics snowball into cumulative risks for youngsters who do not eventually outgrow the distractibility and inattentiveness from early childhood and become involved in gambling as a typical pastime for many youth. Most importantly, our observations suggest a developmentally continuous effect of impulsivity that places individuals on a life course trajectory toward gambling involvement in adolescence and emerging adulthood."
Brain mechanisms underlying both impulsivity and problem gambling may include reward pathways and areas associated with decision making and self-regulation, the authors note. Training in self-control and executive functions before first grade may show positive results, they conclude.
(Arch Pediatr Adoles Med. 2009;163[3]:238-243. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was funded by Canada's Social Science and Humanities Research Council Standard Research Grants Program. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, March 2, 2009
Media Advisory: To contact Auden C. McClure, M.D., M.P.H., call Jason Aldous at 603-653-1913 or e-mail Jason.Aldous{at}hitchcock.org. To contact editorial author David H. Jernigan, Ph.D., call Tim Parsons at 410-955-7619 or e-mail tmparson{at}jhsph.edu.
Owning Alcohol-Branded Merchandise Common, Associated With Drinking Behaviors Among Teens
CHICAGO—Between 11 percent and 20 percent of U.S. teens are estimated to own T-shirts or other merchandise featuring an alcohol brand, and those who do appear more likely to transition through the stages of drinking from susceptibility to beginning drinking to binge drinking, according to a report in the March issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Alcohol-branded merchandise includes T-shirts, hats or other items that feature a particular brand of beverage, according to background information in the article. Increasing evidence suggests that this specialized type of marketing effectively reaches teenagers and is associated with alcohol use.
Auden C. McClure, M.D., M.P.H., of Dartmouth Hitchcock Medical Center, Hanover, N.H., and colleagues conducted a telephone survey of a representative sample of 6,522 U.S. adolescents age 10 to 14 years in 2003. The teens reported information about their drinking behaviors and drinking susceptibility, measured by items assessing responses to peer offers, intentions to drink and positive expectancies about drinking. At three follow-up surveys conducted every eight months, participants answered questions about changes in drinking habits and ownership of alcohol-branded merchandise.
The percentage of teens owning alcohol-branded merchandise ranged from 11 percent at the eight-month survey to 20 percent at the 24-month survey. The most commonly owned products were clothing (64 percent) and headwear (24 percent), with the remaining items a wide array that included jewelry, key chains, shot glasses, posters and pens. Most (75 percent) of the brands were beer, including 45 percent that featured the Budweiser label.
Among teens who had never drank alcohol, owning alcohol-branded merchandise and susceptibility to drinking were reciprocally related, with each predicting the other during an eight-month period. In addition, owning alcohol-branded merchandise and having a susceptible attitude toward drinking predicted both the initiation of alcohol use and binge drinking, even after controlling for other risk factors.
"Alcohol-branded merchandise is widely distributed among U.S. adolescents, who obtain the items one-quarter of the time through direct purchase at retail outlets," the authors write. "The results also demonstrate a prospective relationship between alcohol-branded merchandise ownership and initiation of both alcohol use and binge drinking. This is the first study to link alcohol-branded merchandise ownership to more problematic youth alcohol outcomes that predict morbidity [illness] and mortality [death]. Notably, the relationship is independent of a number of known social, personality and environmental risk factors for alcohol use."
Together with the literature to date, the study "provides strong evidence that alcohol-branded merchandise distribution among adolescents plays a role in their drinking behavior and provides a basis for policies to restrict the scope of such alcohol-marketing practices," they conclude.
(Arch Pediatr Adoles Med. 2009;163[3]:211-217. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study is funded by a grant from the National Institute on Alcohol Abuse and Alcoholism. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Action Needed to Regulate Alcohol-Branded Merchandise
"The evidence is strong that youth exposure to alcohol marketing increases the likelihood of early initiation, which in turn puts young people at greater risk of alcohol-related harm," writes David H. Jernigan, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, in an accompanying editorial.
"Voluntary approaches have been ineffective in reducing the risk. Political will is needed both to improve data collection and reporting and to move toward restrictions that will give young people a chance to grow up alcohol-free. McClure et al provide important new evidence that points to an urgent need for action."
(Arch Pediatr Adoles Med. 2009;163[3]:278-279. 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 2, 2009
Media Advisory: To contact David M. Fergusson, Ph.D., e-mail dm.fergusson{at}otago.ac.nz.
Alcohol Abuse May Lead to Depression Risk, Rather Than Vice Versa
CHICAGO—A statistical modeling study suggests that problems with alcohol abuse may lead to an increased risk of depression, as opposed to the reverse model in which individuals with depression self-medicate with alcohol, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
A number of epidemiological studies have shown that alcohol abuse or dependence is associated with major depression, according to background information in the article. However, it has previously been unclear whether one disorder causes the other, or whether a common underlying genetic or environmental risk factor increases risk for both.
Using data gathered from a 25-year study of health and development in New Zealand, David M. Fergusson, Ph.D., and colleagues at the Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand, examined the associations between alcohol abuse and depression. A sample of 1,055 participants born in 1977 were assessed for both conditions at ages 17 to 18, 20 to 21 and 24 to 25 years and also asked questions about lifestyle and demographic factors.
At ages 17 to 18, 19.4 percent of the participants met criteria for alcohol problems and 18.2 percent for major depression; at ages 20 to 21, 22.4 percent had alcohol disorders and 18.2 percent major depression; and at age 24 to 25, 13.6 percent met alcohol disorder criteria and 13.8 percent had major depression. At all ages, alcohol abuse or dependence was associated with an increased risk of major depression—those who fulfilled criteria for alcohol abuse or dependence were 1.9 times more likely to also fulfill criteria for major depression.
Three models were tested to fit the data—one in which major depression and alcohol abuse disorders had a reciprocal association within time, a second in which alcohol disorders caused major depression and a third in which major depression caused alcohol disorders. "This analysis suggested that the best-fitting model was one in which there was a unidirectional association from alcohol abuse or dependence to major depression but no reverse effect from major depression to alcohol abuse or dependence," the authors write.
"The underlying mechanisms that give rise to such an association are unclear; however, it has been proposed that this link may arise from genetic processes in which the use of alcohol acts to trigger genetic markers that increase the risk of major depression," they continue. "In addition, further research suggests that alcohol's depressant characteristics may lead to periods of depressed affect among those with alcohol abuse or dependence."
The causal links also may include an increased risk of depression due to stressful life circumstances brought by alcohol problems, including social, financial and legal issues. "However, further research is required to elucidate the nature of the possible links between alcohol use and major depression," the authors conclude.
(Arch Gen Psychiatry. 2009;66[3]:260-266. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by grants from the Health Research Council of New Zealand, the National Child Health Research Foundation, the Canterbury Medical Research Foundation and the New Zealand Lottery Grants Board. 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 2, 2009
Media Advisory: To contact Judith A. Cook, Ph.D., call Sherri McGinnis González at 312-996- 8277 or e-mail smcginn{at}uic.edu.
Untreated Psychiatric and Substance Abuse Disorders Common Among Single Mothers Receiving Welfare Assistance
CHICAGO—Urban single mothers nearing the end of their welfare eligibility appear more likely to have substance use and psychiatric disorders than women in the general population, and often do not receive treatment, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
In 1996, U.S. welfare reform legislation created the Temporary Assistance for Needy Families (TANF) program, according to background information in the article. Unlike previous programs, TANF imposed a five-year limit on financial support for families with children younger than age 18. The new regulations also involved stricter requirements for employment and work-related activities. "These changes were intended to enhance self-sufficiency and reduce long-term reliance on public income support," the authors write.
Concerns about the new legislation have emerged from findings regarding the mental health vulnerabilities of low-income families headed by women. Judith A. Cook, Ph.D., of the University of Illinois at Chicago, and colleagues surveyed 333 urban single mothers in the final 24 months of their eligibility for TANF, part of a random sample of 1,000 women selected by the Illinois Department of Human Services. Participants were all "work eligible," meaning they had not been exempted from employment requirements by factors such as pregnancy, substance use treatment or disability. Between 2003 and 2004, in-person interviews were conducted to detect psychiatric and substance use disorders and assess whether women with these conditions received treatment.
A total of 61 percent of the women had a psychiatric or substance use disorder during their lifetime and 46.8 percent had at least one disorder in the 12 months preceding the interview. Psychiatric disorders—the most common being anxiety and mood disorders—affected 53.2 percent of the women over their lifetime and 44.1 within the previous 12-months. A total of 29.1 percent had lifetime substance use disorders and 9 percent had substance use disorders within the previous 12 months.
These rates are significantly higher than those of U.S. women in the general population, the authors note. For example, depression in the previous 12 months was more than twice as common in the study sample as in a recent national study of women in the general population (17.4 percent vs. 8.6 percent), prevalence of anxiety disorders was 60 percent higher (39 percent vs. 23.4 percent), drug abuse estimates were five times higher (5.4 percent vs. 0.7 percent) and alcohol abuse and dependence estimates were almost three times higher (5.1 percent vs. 1.8 percent). In addition, 21.3 percent of the participants on TANF had both substance use and other mental health disorders over their lifetime, including 6.3 percent in the previous 12 months.
"These results confirm what has long been suspected on the basis of earlier research, namely, mothers of young children remaining on TANF near the end of their lifetime eligibility face significant behavioral health challenges within the context of poverty, single parenthood and low human capital in the way of formal education and job skills," the authors write.
"Despite the high prevalence of psychiatric and substance use disorders in this population, many remain untreated," they continue. Only 21.7 percent of those with psychiatric disorders in the previous 12 months received treatment, whereas 41.4 percent of those with 12-month substance abuse disorders received treatment. "The consequences of terminating welfare assistance are worthy of further investigation, given the potential for adverse effects on both mothers and their young children."
(Arch Gen Psychiatry. 2009;66[3]:249-258. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was jointly funded by a cooperative agreement from the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education, and the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration. 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 2, 2009
Media Advisory: To contact Holly C. Wilcox, Ph.D., call Ekaterina Pesheva at 410-516-4996 or e-mail epeshev1{at}jhmi.edu.
Young Adults With Posttraumatic Stress Disorder May Be More Likely to Attempt Suicide
CHICAGO—Posttraumatic stress disorder (PTSD)—but not exposure to traumatic events without the development of PTSD—may be associated with subsequent attempted suicide in young adults, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Approximately 421,200 to 842,400 Americans age 15 to 24 attempt suicide every year, according to background information in the article. "History of a suicide attempt has been identified as one of the best predictors of a future attempt as well as completed suicide," the authors write. Suicide was the third leading cause of death among U.S. young people in 2005.
Holly C. Wilcox, Ph.D., of Johns Hopkins University School of Medicine, Baltimore, and colleagues studied 1,698 young adults of a group of 2,311 who had been tracked since entering the first grade in Baltimore public schools. Fifteen years later, 90-minute interviews were conducted with the participants (average age 21) to assess the occurrence of traumatic experiences, suicide attempts and the development of PTSD.
Of the participants interviewed, 1,273 (81 percent) had been exposed to a traumatic event and 100 (6 percent, or 8 percent of those exposed to trauma) developed PTSD. Suicide had been attempted by 10 percent of those with PTSD, compared with 2 percent of those who were exposed to trauma but did not develop PTSD and 5 percent of those who had never been exposed to traumatic events.
"The mechanisms involved in the association between PTSD and suicide attempts are not known," the authors write. "There could be a common pre-existing predisposition to PTSD and suicide attempts that was present before the trauma occurred. Studies of early trauma and suicidal behaviors have implicated depression and impulsivity as possible mediators or possible pre-existing susceptibility traits."
Previous research has found that up to 20 percent of suicide attempts in young people are attributable to sexual abuse during childhood, the authors note. "Although we did not focus explicitly on child sexual abuse, our results point to the need to base risk estimates of attempted suicide on data that take into account the psychiatric response to the trauma. By distinguishing between trauma-exposed persons without and with PTSD, we found that it is PTSD that is associated with an increased risk of a suicide attempt. Whether or not this finding applies to sexual abuse in childhood or adulthood should be investigated in future studies."
(Arch Gen Psychiatry. 2009;66[3]:305-311. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institute of Mental Health and 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, March 2, 2009
Media Advisory: To contact Boris Birmaher, M.D., call Megan Grote Quatrini at 412-647-3555 or e-mail groteme{at}upmc.edu.
Having Parents With Bipolar Disorder Associated With Increased Risk of Psychiatric Disorders
CHICAGO—Children and teens of parents with bipolar disorder appear to have an increased risk of early-onset bipolar disorder, mood disorders and anxiety disorders, according to a report in the March issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
As many as 60 percent of patients with bipolar disorder experience symptoms before age 21, according to background information in the article. Identifying the condition early may improve long-term outcomes, potentially preventing high psychosocial and medical costs. Having family members with bipolar disorder is the best predictor of whether an individual will go on to develop the condition, the authors note. "Therefore, carefully evaluating and prospectively following the psychopathology of offspring of parents with bipolar disorder and comparing them with offspring of parents with and without non-bipolar disorder psychopathology, are critical for identifying the early clinical presentation of bipolar disorder," they write.
Boris Birmaher, M.D., of Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, and colleagues compared 388 offspring (ages 6 to 18) of 233 parents with bipolar disorder to 251 offspring of 143 demographically matched control parents. Parents were assessed for psychiatric disorders, family psychiatric history, family environment and other variables, and were also interviewed about their children. Children were assessed directly for bipolar disorder and other psychiatric disorders by researchers who did not know their parents' diagnoses.
Compared with the offspring of control parents, children of parents with bipolar disorder had an increased risk of having a bipolar spectrum disorder (41 or 10.6 percent vs. two or 0.8 percent) and having any mood or anxiety disorder. Children in families where both parents had bipolar disorders also were more likely than those in families containing one parent with bipolar disorder to develop the condition (four of 14 or 28.6 percent vs. 37 of 374 or 9.9 percent); however, their risk for other psychiatric disorders was the same as offspring of one parent with bipolar disorder.
"Consistent with the literature, most parents with bipolar disorder recollected that their illness started before age 20 years and about 20 percent had illness that started before age 13 years," the authors write. "In contrast, most of their children developed their first bipolar disorder episode before age 12 years, suggesting the possibility that parents were more perceptive of their children's symptoms early in life or perhaps that bipolar disorder has more penetrance and manifests earlier in new generations."
The findings have important clinical implications, they note. "Clinicians who treat adults with bipolar disorder should question those who are parents about their children's psychopathology to offer prompt identification and early interventions for any psychiatric problems that may be affecting the children's functioning, particularly early-onset bipolar disorder," they continue. Further studies are needed to help determine the clinical, biological and genetic risk factors that may be modified to prevent the development of psychiatric disorders in the offspring of those with bipolar disorder.
(Arch Gen Psychiatry. 2009;66[3]:287-296. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This work was supported by a grant from the National Institute of Mental Health. Dr. Birmaher has participated in forums sponsored by some pharmaceutical companies (Solvay, Abcomm Inc. and Jazz Pharmaceuticals Inc.). Co-author Dr. Kupfer has served on the advisory boards of Pfizer Inc., Eli Lilly and Co., Forest Pharmaceuticals Inc., F. Hoffman–La Roche Ltd. and Solvay/Wyeth Pharmaceuticals and has been a consultant to Servier Amérique. 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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