Majority of adolescents with prescriptions for pain, stimulant, sleeping and antianxiety medications take them appropriately, study finds

ScienceDaily (Aug. 1, 2011) — Adolescents who misuse controlled medications (e.g., pain, stimulant, sleeping and antianxiety medications) for which they have a legitimate prescription may be more likely to abuse other substances and to sell, give or trade their controlled medications to other individuals, according to a report in the August issue of Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, U.S. children and teens have increasingly received prescriptions for controlled medications. "Despite the importance of controlled medications in treating childhood and adolescent disorders, a consequence of this increase in prescribing may be a concomitant rise in medical misuse, diversion of controlled medications, and nonmedical use of controlled medications among adolescents," write the authors. They define "medical misuse" as "the use of a controlled psychotherapeutic medication by a patient in a manner not intended by the prescribing health care professional, including (but not limited to) not following the prescribed dosage, using intentionally to get high, not taking the medication within a prescribed interval, or co-ingesting with alcohol or other drugs."

Sean Esteban McCabe, Ph.D., from the University of Michigan, Ann Arbor, and colleagues conducted a Web-based survey from December 2009 to April 2010. The 2,597 respondents who completed the survey were students at middle schools and high schools in two southeastern Michigan school districts. The average age was 14.8 years, 65 percent of respondents were white and 51.1 percent of participants were female. The survey included standard measures of substance use (cigarette smoking in the past month, binge drinking in the past two weeks, nonmedical use of prescription medication and marijuana and other illicit drug use in the past year); questions about medical use, misuse and diversion (selling, giving away or trading) of controlled medications; and two drug-screening tests.

Of the 18 percent of respondents who said that during the past year they had used, for medical purposes, one of the controlled medications mentioned, 22 percent also said they had misused these medications, mostly by taking too much. Those defined as frequent users of controlled medications (at least 10 instances) were more likely than less-frequent users to engage in misuse. Prevalence of misuse was greater among frequent users of pain, sleeping and antianxiety medications. Adolescents who misused their controlled medications were also more likely to use alcohol and other drugs, and to divert these medications to others.

"Despite the importance of controlled medications for the treatment of pediatric disorders, our results suggest that a consequence of the greater availability of these medications may be an increase in their nonmedical use," write the authors. "Clinicians must balance the risks and benefits of controlled medication use with the abuse potential when assessing, treating, and monitoring their patients." The researchers also urge clinicians to "consider prescribing controlled medications with less potential for substance abuse and diversion."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

S. E. McCabe, B. T. West, J. A. Cranford, P. Ross-Durow, A. Young, C. J. Teter, C. J. Boyd. Medical Misuse of Controlled Medications Among Adolescents. Archives of Pediatrics and Adolescent Medicine, 2011; 165 (8): 729 DOI: 10.1001/archpediatrics.2011.114

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View the original article here sciencedaily.com

Length of parental military deployment associated with children's mental health diagnoses, study finds

ScienceDaily (July 4, 2011) — Children with a parent who was deployed in the U.S. military efforts Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) for longer periods were more likely than children whose parents did not deploy to receive a diagnosis of a mental health problem, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous research has attributed children's depression and negative affect to parental military deployments. However, there has not been much research into this topic with regards to the United States' present conflicts, OIF and OEF. "As troops face dynamic and evolving threats (e.g., an increasingly sophisticated array of roadside explosive devices)," write the authors, "the need to anticipate the psychological consequences for their children and to offer timely intervention becomes increasingly important."

Alyssa J. Mansfield, Ph.D., M.P.H., then of the University of North Carolina at Chapel Hill, now of the National Center for Posttraumatic Stress Disorder in Honolulu, and colleagues examined electronic medical record data for outpatient care received at military facilities or through military health insurance between 2003 and 2006. The study included children ages 5 years through 17 years who had at least one parent serving on active duty in the U.S. Army. (Children of Reserve and National Guard personnel were excluded.) Researchers used the International Classification of Disease, Ninth Revision, to identify mental health diagnoses.

The study included 307,520 children, of whom 16.7 percent had a mental health diagnosis (most often for stress disorders, depression, behavioral problems, anxiety, and sleep disorders) during the study. More than 62 percent of parents were deployed at least once during the period, for an average of 11 months. The researchers found that mental health diagnoses were more common among children who had a parent who was deployed at least once for military operations in Iraq or Afghanistan. After adjusting the data for age, sex and mental health history, they showed that the likelihood of a mental health diagnosis increased with increases in parental deployment length; other factors included older age groups and male sex. The strongest associations were for acute stress reaction and adjustment disorders, depressive disorders, and behavioral disorders, among the total of 6,579 mental health diagnoses observed in children of deployed parents.

"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," write the authors. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urge further research of this issue among other branches of the military as well as the National Guard and Reserves.

Commentary: A Closer Look at the Effect Military Deployment Has on Children

In a commentary, Stephen J. Cozza, M.D., from the Uniformed Services University School of Medicine in Bethesda, Md., provides perspective on the scope of U.S. military deployment and the population it touches. As of 2009, he notes, 44 percent of active duty military members have children (for a total of 1.2 million children), as well as 43 percent of Reserve and National Guard members. Furthermore, since combat operations began in 2001, roughly 2 million U.S. military personnel have deployed at least once.

The article by Mansfield and colleagues, writes Cozza, provides "an important contribution to our understanding of a child's health and its relationship to parental combat deployment." The study, he adds, appears to confirm earlier research into this topic. But it also raises questions, such as what long-term consequences, if any, deployments have on children's health and development.

Cozza recommends that these findings be used to raise national awareness of the problem, both within the military community and without. Since affected children are likely to at some point receive care outside the military health system, he urges civilian clinicians to pay special attention to these patients. "Brief screening for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high-risk behaviors (such as substance misuse or unsafe sexual practices) is warranted and will help identify treatment needs," Cozza concludes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Alyssa J. Mansfield; Jay S. Kaufman; Charles C. Engel; Bradley N. Gaynes. Deployment and Mental Health Diagnoses Among Children of US Army Personnel. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.123Stephen J. Cozza. Children of Military Service Members: Raising National Awareness of the Family Health Consequences of Combat Deployment. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.117

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View the original article here sciencedaily.com

Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here sciencedaily.com

Short-term use of amphetamines can improve ADHD symptoms in adults, review finds

ScienceDaily (July 28, 2011) — Giving amphetamines to adults with Attention Deficit Hyperactivity Disorder (ADHD) can help them control their symptoms, but the side effects mean that some people do not manage to take them for very long. These conclusions were drawn by a team of five researchers working at Girona and Barcelona Universities in Spain, and published in a new Cochrane Systematic Review.

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset disorder, but half of people with it find that the symptoms of hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours persist into adulthood. "We wanted to see whether amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms," says Xavier Castells, who led the study and works in the Unit of Clinical Pharmacology at University of Girona.

After searching through medical literature, they identified seven studies, which had enrolled a total of 1091 participants in clinical trials. The three amphetamine based medicines they considered (dextroamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS)) all reduced ADHD symptoms, although there was no evidence that higher doses worked better than lower ones.. The researchers did not find any difference between in effectiveness between formulations that release the amphetamines rapidly, and those that have a sustained-release.

While there was evidence that people taking amphetamines drop out of treatment due to adverse events slightly more than those on placebo controls, the researchers were keen to point out that only 9% of people taking amphetamines withdrew from treatment. Looking at the different formulations of amphetamines, those on MAS had lower drop-out rates than those on other versions of the drug. Furthermore, most studies had a duration of between 2 and 7 weeks, therefore precluding the possibility of drawing conclusions regarding amphetamine's efficacy and safety in the long-term.

In many clinical trials, doctors randomly allocate some patients to 'treatment group' and give them the active medication, while others are placed in a 'control group' and receive a placebo -- a treatment that looks and feels like the real thing, but has no active ingredient in it. The idea is that the patient doesn't know which one they are on. This helps researchers determine how much of any apparent treatment effect is actually due to the therapy, and how much is due to other factors unrelated to drug effects such as the person believes regarding the efficacy of the intervention or the natural history of the disease. This experimental system only works, though, if the patients have no idea which group they are in. "One of the problems with trying to make sense of this research is that you cannot do a properly controlled study because the amphetamines have such a distinct set of effects.. Patients instantly know whether they are on the treatment or the placebo, so you have to be more cautious about the way you interpret the data," says Castells.

"Given that other drugs, like atomoxetine or methylphenidate, have also been shown to reduce ADHD symptoms in adults, it would be of great interest to compare the efficacy of amphetamines to these interventions," says Castells.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wiley-Blackwell, via AlphaGalileo.

Journal Reference:

Xavier Castells, Josep Antoni Ramos-Quiroga, Rosa Bosch, Mariana Nogueira, Miguel Casas. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 2011; 6: CD007813 DOI: 10.1002/14651858.CD007813.pub2

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Veterinary medicine students experience higher depression levels than peers, research finds

ScienceDaily (July 28, 2011) — Veterinary medicine students are more likely to struggle with depression than human medicine students, undergraduate students and the general population, according to several recent collaborative studies from Kansas State University researchers.

Mac Hafen, therapist and clinical instructor in K-State's College of Veterinary Medicine, and researchers from K-State, the University of Nebraska and East Carolina University decided to take a closer look at depression and anxiety among veterinary medical students. Although the mental health of human medicine students has been extensively studied, the same extent of study has not been performed with veterinary medicine students. Additionally, most veterinary research related to depression involves pet owners, not veterinarians or students.

"We are hoping to predict what contributes to depression levels so that we can intervene and make things run a little bit more smoothly for students themselves," said Hafen, who has spent five years researching the well-being and mental health of veterinary students.

Once a semester, the researchers anonymously surveyed veterinary medicine students in various stages of academic study. The survey helped uncover a rate of depression occurrence and understand how it related to the amount of stress veterinary students experience during their four years of study.

During the first year of veterinary school, 32 percent of the veterinary medicine students surveyed showed symptoms of depression, compared to 23 percent of human medicine students who showed symptoms above the clinical cutoff, as evidenced by other studies.

The researchers also discovered that veterinary students experience higher depression rates as early as the first semester of their first year of study. Their depression rates appear to increase even more during the second and third year of school. During the fourth year, depression rates drop down to first-year levels.

Hafen said several factors might contribute to the higher rate of depression in veterinary medicine students. Veterinarians deal with stressors that human medicine doctors do not have to experience, such as frequently discussing euthanasia with clients. Although both programs of study are intense, veterinarians must understand a variety of animal species rather than focusing on the human body. Struggles with balancing work, school and life could also lead to higher depression rates.

Hafen said gender differences could also play a role, although such claims are inconclusive so far. Whereas medical schools are nearly split evenly between male and female students, about 75 percent of veterinary medicine students are female. National studies indicate that women are two to three times more likely than men to suffer from mood disorders.

The research team's studies found several other factors connected with higher depression occurrence, including: homesickness; uncertainty about academic expectations; a feeling of not belonging or not fitting in; and perceived physical health. The researchers had students rate their own physical health to indicate how they felt about their overall health. Students who were happier with their physical health had lower depression rates.

But the studies contain more than just negative news; they offer interventions and ways that veterinary schools and their faculty and staff can help students struggling with depression and anxiety. Some of these ways include:

Having clearer expectations of veterinary students, especially during the first year.Sponsoring events and organizations that help improve physical health.Empathizing with students and their concerns about their studies.

The researchers are optimistic that by helping veterinary medicine students care for their own mental health, these students become better prepared to help clients.

"The hope is that we can identify some ways to help alleviate some of the depression and the symptoms of depression and anxiety that might be occurring," Hafen said.

The researchers have already published two articles in the Journal of Veterinary Medicine Education about their work and are in the process of preparing another publication.

Hafen is also working on other research that looks at companion animal loss. He and researchers from the University of Nebraska have interviewed pet owners who have experienced companion animal loss to better understand the grieving process. They continue to gather empirical data for this study and are analyzing their findings.

"I have a sense for the grieving process from my own clinical work," Hafen said. "But we wanted to look at it from more of an empirical standpoint."

Other K-State researchers involved in these projects include: Bonnie Rush, professor and department head of clinical sciences, and Susan Nelson, associate professor of clinical sciences.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Kansas State University.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Social acumen equals spatial skill, psychologist finds

ScienceDaily (July 27, 2011) — People who are socially skilled -- who are adept at metaphorically putting themselves in someone else's shoes -- are also more proficient when it comes to spatial skills, according to a new study led by a Johns Hopkins University psychologist.

The study, published online in the Journal of Experimental Psychology, found that the more socially accomplished a person is, the easier it is for him or her to assume another person's perspective (literally) on the world.

"The results were striking: there was a profound difference in this ability among people with better social skills and those with weaker ones," said study leader Amy Shelton, a professor in the Department of Psychological and Brain Sciences at the Zanvyl Krieger School of Arts and Sciences.

Shelton said that the study results could eventually lead to improved strategies to help people on the autism spectrum -- notable for their lack of social awareness and skills -- compensate for this weakness.

In the study, 48 men and women ages 18 to 22 viewed a model of buildings constructed from LEGOs ®. A series of seven figures (one time it was 13" faceless "dolls," a second time it was toy cameras and a third time it was colored plastic triangles) was arrayed around the building model. Participants then viewed images on laptop computers, each of which corresponded to the would-be visual perspective of one of the figures (dolls, cameras, triangles) and were asked which figure could "see" that view of the buildings displayed on the computer screen.

The study subjects also completed a pencil-and-paper test designed to assess the degree to which adults of normal intelligence showed five different traits associated with autism spectrum disorders: social skills, perseveration, attention to detail, communication, and imagination. Of particular interest in this inquiry were the social and communication scores, as those are aligned with typical social behaviors, Shelton said.

The critical finding was that there was a strong correlation between overall social acumen and the study subjects' accuracy in taking the perspective of the figures only when the figures were dolls, and not when the figures were the toy cameras or triangles.

According to Shelton, this suggests that when people are faced with a task involving taking a different perspective, they "bring something extra to the table when it involves a person, or a potential person, rather than just an object."

"Perhaps the human figures allowed the study subjects to more readily embody the other person and take that 'person's' perspective in this task," she speculated. "The current thinking on this is that this 'embodiment' -- this ability to take another's position -- should be universally helpful, because it's what we do as social beings: we put ourselves in another person's place. Yet our results indicate that this embodiment is only helpful if one is actually socially savvy to begin with."

According to Shelton, these results suggest that a person's ability to take another person's spatial perspective may be related to things such as empathy, or even tolerance for another's belief system.

"Perhaps the most exciting aspect of this research is that it emphasizes a 'whole person' approach," she mused. "We tend to think of ourselves as being either 'good' or 'bad' at certain skills, but these results suggest that different skills really do interact and have an impact on each other. For instance, I might be good at giving directions to another person because I have good spatial skills, but I might be even better at it if I can also empathize or embody the other person's perspective."

This study was funded by a Woodrow Wilson Center Fellowship.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Johns Hopkins University.

Journal Reference:

Amy Lynne Shelton, Amy M. Clements-Stephens, Wai Yim Lam, Diana M. Pak, Alexandra J. Murray. Should social savvy equal good spatial skills? The interaction of social skills with spatial perspective taking.. Journal of Experimental Psychology: General, 2011; DOI: 10.1037/a0024617

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Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Children born after unplanned pregnancy are slower to develop, UK study finds

ScienceDaily (July 27, 2011) — Children born after unplanned pregnancies tend to have a more limited vocabulary and poorer non-verbal and spatial abilities; however this is almost entirely explained by their disadvantaged circumstances, according to a new study published online in the British Medical Journal. The same study reported no adverse effects of infertility treatment on the children.

In the UK, as many as 30-40% of pregnancies that end in childbirth are unplanned, while the number of children born after assisted reproductive technologies is growing every year.

It is already known that children born after a prolonged time to conception or assisted reproduction are at greater risk of poor health outcomes, such as preterm birth, low birth weight, and congenital anomalies, and some researchers have reported lower cognitive (mental) scores in such children.

Unplanned pregnancies also have poorer outcomes, but there has been little research to assess whether child development is associated with pregnancy planning.

So a team of UK researchers set out to investigate how pregnancy planning, time to conception, and infertility treatment influence a child's cognitive development at three and five years old.

They analysed data from approximately 12,000 children from the Millennium Cohort Study, a large UK study of families and infants born in 2000-2. Parents who took part were interviewed when their child was nine months old and then revisited when the child was three and five years old.

Mothers reported whether the pregnancy was planned, their feelings when first pregnant, time to conception, and details of any infertility treatment.

Each child's verbal, non-verbal and spatial abilities were tested at age three and five using the British Ability Scales.

Initial analyses showed that children born after an unplanned pregnancy were four to five months behind planned children in verbal abilities, while children born after assisted reproduction were three to four months ahead.

However, these differences all but disappeared when the researchers took into account the socioeconomic circumstances of each child.

The authors conclude: "These differences are almost entirely explained by socioeconomic factors, providing further evidence of the influence of socioeconomic inequalities on the lives of children in the UK. To help children achieve their full potential, policy makers should continue to target social inequalities."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BMJ-British Medical Journal, via EurekAlert!, a service of AAAS.

Journal Reference:

C. Carson, Y. Kelly, J. J. Kurinczuk, A. Sacker, M. Redshaw, M. A. Quigley. Effect of pregnancy planning and fertility treatment on cognitive outcomes in children at ages 3 and 5: longitudinal cohort study. BMJ, 2011; 343 (jul26 1): d4473 DOI: 10.1136/bmj.d4473

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Short-term use of amphetamines can improve ADHD symptoms in adults, review finds

ScienceDaily (July 28, 2011) — Giving amphetamines to adults with Attention Deficit Hyperactivity Disorder (ADHD) can help them control their symptoms, but the side effects mean that some people do not manage to take them for very long. These conclusions were drawn by a team of five researchers working at Girona and Barcelona Universities in Spain, and published in a new Cochrane Systematic Review.

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset disorder, but half of people with it find that the symptoms of hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours persist into adulthood. "We wanted to see whether amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms," says Xavier Castells, who led the study and works in the Unit of Clinical Pharmacology at University of Girona.

After searching through medical literature, they identified seven studies, which had enrolled a total of 1091 participants in clinical trials. The three amphetamine based medicines they considered (dextroamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS)) all reduced ADHD symptoms, although there was no evidence that higher doses worked better than lower ones.. The researchers did not find any difference between in effectiveness between formulations that release the amphetamines rapidly, and those that have a sustained-release.

While there was evidence that people taking amphetamines drop out of treatment due to adverse events slightly more than those on placebo controls, the researchers were keen to point out that only 9% of people taking amphetamines withdrew from treatment. Looking at the different formulations of amphetamines, those on MAS had lower drop-out rates than those on other versions of the drug. Furthermore, most studies had a duration of between 2 and 7 weeks, therefore precluding the possibility of drawing conclusions regarding amphetamine's efficacy and safety in the long-term.

In many clinical trials, doctors randomly allocate some patients to 'treatment group' and give them the active medication, while others are placed in a 'control group' and receive a placebo -- a treatment that looks and feels like the real thing, but has no active ingredient in it. The idea is that the patient doesn't know which one they are on. This helps researchers determine how much of any apparent treatment effect is actually due to the therapy, and how much is due to other factors unrelated to drug effects such as the person believes regarding the efficacy of the intervention or the natural history of the disease. This experimental system only works, though, if the patients have no idea which group they are in. "One of the problems with trying to make sense of this research is that you cannot do a properly controlled study because the amphetamines have such a distinct set of effects.. Patients instantly know whether they are on the treatment or the placebo, so you have to be more cautious about the way you interpret the data," says Castells.

"Given that other drugs, like atomoxetine or methylphenidate, have also been shown to reduce ADHD symptoms in adults, it would be of great interest to compare the efficacy of amphetamines to these interventions," says Castells.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Wiley-Blackwell, via AlphaGalileo.

Journal Reference:

Xavier Castells, Josep Antoni Ramos-Quiroga, Rosa Bosch, Mariana Nogueira, Miguel Casas. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 2011; 6: CD007813 DOI: 10.1002/14651858.CD007813.pub2

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Yoga boosts stress-busting hormone, reduces pain, study finds

ScienceDaily (July 27, 2011) — A new study by York University researchers finds that practicing yoga reduces the physical and psychological symptoms of chronic pain in women with fibromyalgia.

The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. The condition, which predominantly affects women, is characterized by chronic pain and fatigue; common symptoms include muscle stiffness, sleep disturbances, gastrointestinal discomfort, anxiety and depression.

Previous research has found that women with fibromyalgia have lower-than-average cortisol levels, which contribute to pain, fatigue and stress sensitivity. According to the study, participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

"Ideally, our cortisol levels peak about 30-40 minutes after we get up in the morning and decline throughout the day until we're ready to go to sleep," says the study's lead author, Kathryn Curtis, a PhD student in York's Department of Psychology, Faculty of Health. "The secretion of the hormone, cortisol, is dysregulated in women with fibromyalgia" she says.

Cortisol is a steroid hormone that is produced and released by the adrenal gland and functions as a component of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress.

"Hatha yoga promotes physical relaxation by decreasing activity of the sympathetic nervous system, which lowers heart rate and increases breath volume. We believe this in turn has a positive effect on the HPA axis," says Curtis.

Participants completed questionnaires to determine pain intensity pre- and post-study; they reported significant reductions in pain and associated symptoms, as well as psychological benefits. They felt less helpless, were more accepting of their condition, and were less likely to "catastrophize" over current or future symptoms.

"We saw their levels of mindfulness increase -- they were better able to detach from their psychological experience of pain," Curtis says. Mindfulness is a form of active mental awareness rooted in Buddhist traditions; it is achieved by paying total attention to the present moment with a non-judgmental awareness of inner and outer experiences.

"Yoga promotes this concept -- that we are not our bodies, our experiences, or our pain. This is extremely useful in the management of pain," she says. "Moreover, our findings strongly suggest that psychological changes in turn affect our experience of physical pain."

The study -- Curtis' thesis -- was published July 26 in the Journal of Pain Research. It is co-authored by her supervisor, York professor Joel Katz, Canada Research Chair in Health Psychology, and Anna Osadchuk, a York University undergraduate student.

Curtis was supported by a Canadian Institutes of Health Research (CIHR) Canada Graduate Scholarship and a CIHR Strategic Training Grant Fellowship in Pain: Molecules to Community.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by York University.

Journal Reference:

Kathryn Curtis, Anna Osadchuk, Joel Katz. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. Journal of Pain Research, 2011; : 189 DOI: 10.2147/JPR.S22761

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

View the original article here

Veterinary medicine students experience higher depression levels than peers, research finds

ScienceDaily (July 28, 2011) — Veterinary medicine students are more likely to struggle with depression than human medicine students, undergraduate students and the general population, according to several recent collaborative studies from Kansas State University researchers.

Mac Hafen, therapist and clinical instructor in K-State's College of Veterinary Medicine, and researchers from K-State, the University of Nebraska and East Carolina University decided to take a closer look at depression and anxiety among veterinary medical students. Although the mental health of human medicine students has been extensively studied, the same extent of study has not been performed with veterinary medicine students. Additionally, most veterinary research related to depression involves pet owners, not veterinarians or students.

"We are hoping to predict what contributes to depression levels so that we can intervene and make things run a little bit more smoothly for students themselves," said Hafen, who has spent five years researching the well-being and mental health of veterinary students.

Once a semester, the researchers anonymously surveyed veterinary medicine students in various stages of academic study. The survey helped uncover a rate of depression occurrence and understand how it related to the amount of stress veterinary students experience during their four years of study.

During the first year of veterinary school, 32 percent of the veterinary medicine students surveyed showed symptoms of depression, compared to 23 percent of human medicine students who showed symptoms above the clinical cutoff, as evidenced by other studies.

The researchers also discovered that veterinary students experience higher depression rates as early as the first semester of their first year of study. Their depression rates appear to increase even more during the second and third year of school. During the fourth year, depression rates drop down to first-year levels.

Hafen said several factors might contribute to the higher rate of depression in veterinary medicine students. Veterinarians deal with stressors that human medicine doctors do not have to experience, such as frequently discussing euthanasia with clients. Although both programs of study are intense, veterinarians must understand a variety of animal species rather than focusing on the human body. Struggles with balancing work, school and life could also lead to higher depression rates.

Hafen said gender differences could also play a role, although such claims are inconclusive so far. Whereas medical schools are nearly split evenly between male and female students, about 75 percent of veterinary medicine students are female. National studies indicate that women are two to three times more likely than men to suffer from mood disorders.

The research team's studies found several other factors connected with higher depression occurrence, including: homesickness; uncertainty about academic expectations; a feeling of not belonging or not fitting in; and perceived physical health. The researchers had students rate their own physical health to indicate how they felt about their overall health. Students who were happier with their physical health had lower depression rates.

But the studies contain more than just negative news; they offer interventions and ways that veterinary schools and their faculty and staff can help students struggling with depression and anxiety. Some of these ways include:

Having clearer expectations of veterinary students, especially during the first year.Sponsoring events and organizations that help improve physical health.Empathizing with students and their concerns about their studies.

The researchers are optimistic that by helping veterinary medicine students care for their own mental health, these students become better prepared to help clients.

"The hope is that we can identify some ways to help alleviate some of the depression and the symptoms of depression and anxiety that might be occurring," Hafen said.

The researchers have already published two articles in the Journal of Veterinary Medicine Education about their work and are in the process of preparing another publication.

Hafen is also working on other research that looks at companion animal loss. He and researchers from the University of Nebraska have interviewed pet owners who have experienced companion animal loss to better understand the grieving process. They continue to gather empirical data for this study and are analyzing their findings.

"I have a sense for the grieving process from my own clinical work," Hafen said. "But we wanted to look at it from more of an empirical standpoint."

Other K-State researchers involved in these projects include: Bonnie Rush, professor and department head of clinical sciences, and Susan Nelson, associate professor of clinical sciences.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Kansas State University.

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Yoga boosts stress-busting hormone, reduces pain, study finds

ScienceDaily (July 27, 2011) — A new study by York University researchers finds that practicing yoga reduces the physical and psychological symptoms of chronic pain in women with fibromyalgia.

The study is the first to look at the effects of yoga on cortisol levels in women with fibromyalgia. The condition, which predominantly affects women, is characterized by chronic pain and fatigue; common symptoms include muscle stiffness, sleep disturbances, gastrointestinal discomfort, anxiety and depression.

Previous research has found that women with fibromyalgia have lower-than-average cortisol levels, which contribute to pain, fatigue and stress sensitivity. According to the study, participants' saliva revealed elevated levels of total cortisol following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks.

"Ideally, our cortisol levels peak about 30-40 minutes after we get up in the morning and decline throughout the day until we're ready to go to sleep," says the study's lead author, Kathryn Curtis, a PhD student in York's Department of Psychology, Faculty of Health. "The secretion of the hormone, cortisol, is dysregulated in women with fibromyalgia" she says.

Cortisol is a steroid hormone that is produced and released by the adrenal gland and functions as a component of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress.

"Hatha yoga promotes physical relaxation by decreasing activity of the sympathetic nervous system, which lowers heart rate and increases breath volume. We believe this in turn has a positive effect on the HPA axis," says Curtis.

Participants completed questionnaires to determine pain intensity pre- and post-study; they reported significant reductions in pain and associated symptoms, as well as psychological benefits. They felt less helpless, were more accepting of their condition, and were less likely to "catastrophize" over current or future symptoms.

"We saw their levels of mindfulness increase -- they were better able to detach from their psychological experience of pain," Curtis says. Mindfulness is a form of active mental awareness rooted in Buddhist traditions; it is achieved by paying total attention to the present moment with a non-judgmental awareness of inner and outer experiences.

"Yoga promotes this concept -- that we are not our bodies, our experiences, or our pain. This is extremely useful in the management of pain," she says. "Moreover, our findings strongly suggest that psychological changes in turn affect our experience of physical pain."

The study -- Curtis' thesis -- was published July 26 in the Journal of Pain Research. It is co-authored by her supervisor, York professor Joel Katz, Canada Research Chair in Health Psychology, and Anna Osadchuk, a York University undergraduate student.

Curtis was supported by a Canadian Institutes of Health Research (CIHR) Canada Graduate Scholarship and a CIHR Strategic Training Grant Fellowship in Pain: Molecules to Community.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by York University.

Journal Reference:

Kathryn Curtis, Anna Osadchuk, Joel Katz. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. Journal of Pain Research, 2011; : 189 DOI: 10.2147/JPR.S22761

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Increased risk of Parkinson's disease in methamphetamine users, study finds

ScienceDaily (July 26, 2011) — People who abused methamphetamine or other amphetamine-like stimulants were more likely to develop Parkinson's disease than those who did not, in a new study from the Centre for Addiction and Mental Health (CAMH).

The researchers examined almost 300,000 hospital records from California covering 16 years. Patients admitted to hospital for methamphetamine or amphetamine-use disorders had a 76 per cent higher risk of developing Parkinson's disease compared to those with no disorder.

Globally, methamphetamine and similar stimulants are the second most commonly used class of illicit drugs.

"This study provides evidence of this association for the first time, even though it has been suspected for 30 years," said lead researcher Dr. Russell Callaghan, a scientist with CAMH. Parkinson's disease is caused by a deficiency in the brain's ability to produce a chemical called dopamine. Because animal studies have shown that methamphetamine damages dopamine-producing areas in the brain, scientists have worried that the same might happen in humans.

It has been a challenge to establish this link, because Parkinson's disease develops in middle and old age, and it is necessary to track a large number of people with methamphetamine addiction over a long time span.

The CAMH team took an innovative approach by examining hospital records from California -- a state in which methamphetamine use is prevalent -- from 1990 up to 2005. In total, 40,472 people, at least 30 years of age, had been hospitalized due to a methamphetamine- or amphetamine-use disorder during this period.

These patients were compared to two groups: 207,831 people admitted for appendicitis with no diagnosis of any type of addiction, and 35,335 diagnosed with cocaine use disorders. A diagnosis of Parkinson's disease was identified from hospital records or death certificates. Only the methamphetamine group had an increased risk of developing Parkinson's disease.

While the appendicitis group served as a comparison to the general population, the cocaine group was selected for two reasons. Because cocaine is another type of stimulant that affects dopamine, this group could be used to determine whether the risk was specific to methamphetamine stimulants. Cocaine users also served as a control group to account for the health effects or lifestyle factors associated with dependence on an illicit drug.

"It is important for the public to know that our findings do not apply to patients who take amphetamines for medical purposes, such as attention deficit hyperactivity disorder (ADHD), since these patients use much lower doses of amphetamines than those taken by patients in our study," said Dr. Stephen Kish, a CAMH scientist and co-author.

To put the study findings into numbers, if 10,000 people with methamphetamine dependence were followed over 10 years, 21 would develop Parkinson's, compared with 12 people out of 10,000 from the general population. "It is also possible that our findings may underestimate the risk because in California, methamphetamine users may have had less access to health-care insurance and consequently to medical care," said Dr. Callaghan.

The current project is significant because it is one of the few studies examining the long-term association between methamphetamine use and the development of a major brain disorder. "Given that methamphetamine and other amphetamine stimulants are the second most widely used illicit drugs in the world, the current study will help us anticipate the full long-term medical consequences of such problematic drug use," said Dr. Callaghan.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Centre for Addiction and Mental Health, via EurekAlert!, a service of AAAS.

Journal Reference:

Russell C. Callaghan, James K. Cunningham, Jenna Sykes, Stephen J. Kish. Increased risk of Parkinson's disease in individuals hospitalized with conditions related to the use of methamphetamine or other amphetamine-type drugs. Drug and Alcohol Dependence, 2011; DOI: 10.1016/j.drugalcdep.2011.06.013

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Worrying can impact interpersonal relationships, study finds

ScienceDaily (July 26, 2011) — Most people worry from time to time. A new research study, led by a Case Western Reserve University faculty member in psychology, also shows that worrying can be so intrusive and obsessive that it interferes in the person's life and endangers the health of social relationships.

These people suffer from what's called generalized anxiety disorder (GAD), says Case Western Reserve psychologist Amy Przeworski.

Individuals with GAD frequently put social relationships with family, friends, or coworkers at the top of their lists of worries, but the negative methods they use to cope -- from over nurturing to extreme detachment -- may be destructive.

Przeworski and colleagues at Penn State University observed that people in therapy for GAD manifested their worries in different ways based on how they interact with other people.

In two studies the researchers found four distinct interactive styles prominent among people with GAD -- intrusive, cold, nonassertive and exploitable.

Both studies supported the presence of these four interpersonal styles and their significant role in how people with GAD manifested their worrying.

"All individuals with these styles worried to the same extent and extreme, but manifested those worries in different ways," Przeworski said.

Take the examples of two people with similar worries about someone's health and safety.

One person may exhibit that worry through frequent intrusive expressions of concern for the other person. Think of the parent or spouse who calls every five minutes to get an update on what's happening.

Another person may exhibit the worry by criticizing the behaviors that the person believes to be careless or reckless.

"The worry may be similar, but the impact of the worry on their interpersonal relationships would be extremely different. This suggests that interpersonal problems and worry may be intertwined," Przeworski says.

She suggests that therapies to treat GAD should target both the worry and the related interpersonal problems.

Most treatments for GAD rely on cognitive behavioral therapy, a treatment that is usually successful for about 60 percent of people, a percentage considered successful in therapy. However, one way to improve therapy for worriers may be to integrate techniques that target the interpersonal relationship problems.

The research was part of larger study supported by the National Institute of Mental Health.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Case Western Reserve University.

Journal Reference:

Amy Przeworski, Michelle G. Newman, Aaron L. Pincus, Michele B. Kasoff, Alissa S. Yamasaki, Louis G. Castonguay, Kristoffer S. Berlin. Interpersonal pathoplasticity in individuals with generalized anxiety disorder.. Journal of Abnormal Psychology, 2011; 120 (2): 286 DOI: 10.1037/a0023334

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Misuse of pain medication is pathway to high-risk behaviors, study finds

ScienceDaily (July 24, 2011) — A new study by researchers at Drexel University's School of Public Health suggests that abuse of prescription painkillers may be an important gateway to the use of injected drugs such as heroin, among people with a history of using both types of drugs.

The study, published in the International Journal of Drug Policy, explores factors surrounding young injection drug users' initiation into the misuse of opioid drugs. Common factors identified in this group included a family history of drug misuse and receiving prescriptions for opioid drugs in the past. The results support a need for efforts to prevent misuse of prescription drugs, particularly during adolescence.

"Participants were commonly raised in household where misuse of prescription drugs, illegal drugs, or alcohol, was normalized," explains Dr. Stephen Lankenau, an associate professor in the School of Public Health and principal investigator of the study. "Access to prescription medications -- either from a participant's own source, a family member, or a friend -- was a key feature of initiation into prescription drug misuse."

In numerous cases, the desire to experiment with a prescription opioid drug (the common class of drugs that includes codeine and oxycodone), combined with financial incentives or pressures from friends to sell available quantities, resulted in escalated patterns of opioid misuse, according to the study.

Lankenau and colleagues also describe two key findings as evidence of an emerging dynamic among misuse of opioid drugs and the use of injection drugs. First, four of five IDUs misused an opioid before injecting heroin, in contrast to more conventional patterns of using opioids as a substitute drug after initiating heroin use.

Second, in nearly one out of four young IDUs in this study, a prescription opioid was the first type of drug they injected. Prescription opioids are rarely reported at initiation into injection drug use amongst young IDUs. All but two of these participants later transitioned into injecting heroin.

Opioid misuse is an important public health concern due to the increasing association of opioids with drug dependence and fatal overdose, and much research has focused on the factors affecting how and when people initially misuse opioids. However, descriptive data about initiation into prescription opioid misuse among young injection drug users are scarce.

To fill this gap, in this study researchers interviewed 50 young IDUs aged 16 and 25 years old in New York and Los Angeles, who had misused a prescription drug at least three times in the past three months, to study contextual factors leading to their use of opioid drugs. Participants were recruited in natural settings, such as parks, streets, and college campuses, during 2008 and 2009. A mixed-methods research design was utilized that collected both quantitative and qualitative data.

Additional findings and descriptors of the study population include:

Most were white, heterosexual males in their early 20sMany did not complete high school, were expelled from school, or held back a gradeNearly all were homeless at some point, most were currently homeless, and most regarded themselves as "travelers," (i.e., moving from city to city in search of work, housing, or adventure)Most had received a psychological diagnosis, such as depression, anxiety, or Attention Deficit Hyperactivity Disorder (ADHD), and many had a history of drug treatmentMost generally regarded prescription opioids as readily accessible, valued commodities that could be traded or soldNearly three-quarters had been prescribed an opioid in their lifetime, which occurred on average at 14.6 years old, often for common ailments such as dental procedures or sports injuriesMost witnessed family members misuse one or more substances during childhood and adolescence, ranging from alcoholism to injecting heroin

The authors conclude that prevention efforts, especially during adolescence, are needed, and that parents and guardians need to carefully monitor and safeguard all prescription medications, particularly opioids, within the household. Although households where drug use is normalized or where broader social or psychological problems exist are more difficult to remedy with prevention efforts or policy changes, future research examining prescription opioid misuse among a range of adolescents and young adults to better understand the contextual and environmental factors of drug use may yield additional solutions.

The article was co-authored by Karol Silva (Drexel University); Michelle Teti (University of Missouri); Alex Harocopos (National Development and Research Institutes); and Jennifer Jackson Bloom and Meghan Treese (Children's Hospital Los Angeles).

Lankenau is also principal investigator of two studies evaluating the effectives of overdose prevention programs in Los Angeles and Philadelphia.

Lankenau is an associate professor in the Department of Community Health & Prevention at the Drexel University School of Public Health. He received his PhD and MA degrees in Sociology from the University of Maryland. He earned his BA in Sociology at the University of Vermont.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Drexel University.

Journal Reference:

Stephen E. Lankenau, Michelle Teti, Karol Silva, Jennifer Jackson Bloom, Alex Harocopos, Meghan Treese. Initiation into prescription opioid misuse amongst young injection drug users. International Journal of Drug Policy, 2011; DOI: 10.1016/j.drugpo.2011.05.014

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What mom thinks matters when it comes to mental illness, study finds

ScienceDaily (June 7, 2011) — A new study led by a Northern Illinois University sociologist shows that while family members often provide critical support, they also can sometimes be the source of stigmatizing attitudes that impede the recovery of mentally ill relatives.

"Negative attitudes of family members have the potential to affect the ways that mentally ill persons view themselves, adversely influencing the likelihood of recovery from the illness," said lead researcher Fred Markowitz, an NIU professor of sociology.

Markowitz and his colleagues, Beth Angell from Rutgers, and Jan Greenberg from the University of Wisconsin-Madison, published their findings in the June issue of Social Psychology Quarterly, a peer-reviewed journal of the American Sociological Association.

Over an 18-month period, the researchers studied 129 mothers of adult children with schizophrenia.

"In short, what mom thinks matters," Markowitz said. "It's a chain of effects that unfolds.

"We found that when those with mental illness exhibited greater levels of initial symptoms, lower self-confidence and quality of life, their mothers tended to view them in more stigmatized terms -- for example, seeing them as 'incompetent,' 'unpredictable,' and 'unreliable,'" Markowitz continued. "When mothers held these views, their sons and daughters with mental illness were more likely to come to see themselves in similar terms -- what social psychologists call 'the reflected appraisals process.' Importantly, when the individuals with mental illness took on these stigmatizing views of themselves, their symptoms became somewhat greater and levels of self-confidence and quality of life lower."

A long line of research has shown that the stigma associated with mental illness can be a major impediment to recovery, affecting self-esteem and even job prospects. But research has not historically examined the links between stigma, reflected appraisals, identity formation, and recovery, Markowitz said.

"Our study is part of research that is starting to more fully examine how stigma affects the self-concept and identity of those with mental illness," he said.

Markowitz and his colleagues believe it is important to acknowledge that many of the sentiments conveyed toward ill relatives grow out of positive intentions and reflect attempts to cope with the difficulties of having a relative with serious mental illness. Yet, stigmatizing attitudes are of concern because of their potential adverse effects.

"This study highlights the notion that recovery from mental illness is not simply a matter of controlling symptoms as indicated by a strictly 'psychiatric' perspective," Markowitz said. "It is, to a certain extent, a social-psychological process.

"The ways in which people, including family members and service providers, think about persons with mental illness affect the beliefs and actions of the individuals with mental illness, in turn shaping the trajectory of recovery."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by American Sociological Association, via EurekAlert!, a service of AAAS.

Journal Reference:

Fred E. Markowitz, Beth Angell, and Jan S. Greenberg. Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness. Social Psychology Quarterly, June 2011; [link]

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Length of parental military deployment associated with children's mental health diagnoses, study finds

ScienceDaily (July 4, 2011) — Children with a parent who was deployed in the U.S. military efforts Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) for longer periods were more likely than children whose parents did not deploy to receive a diagnosis of a mental health problem, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

According to background information in the article, previous research has attributed children's depression and negative affect to parental military deployments. However, there has not been much research into this topic with regards to the United States' present conflicts, OIF and OEF. "As troops face dynamic and evolving threats (e.g., an increasingly sophisticated array of roadside explosive devices)," write the authors, "the need to anticipate the psychological consequences for their children and to offer timely intervention becomes increasingly important."

Alyssa J. Mansfield, Ph.D., M.P.H., then of the University of North Carolina at Chapel Hill, now of the National Center for Posttraumatic Stress Disorder in Honolulu, and colleagues examined electronic medical record data for outpatient care received at military facilities or through military health insurance between 2003 and 2006. The study included children ages 5 years through 17 years who had at least one parent serving on active duty in the U.S. Army. (Children of Reserve and National Guard personnel were excluded.) Researchers used the International Classification of Disease, Ninth Revision, to identify mental health diagnoses.

The study included 307,520 children, of whom 16.7 percent had a mental health diagnosis (most often for stress disorders, depression, behavioral problems, anxiety, and sleep disorders) during the study. More than 62 percent of parents were deployed at least once during the period, for an average of 11 months. The researchers found that mental health diagnoses were more common among children who had a parent who was deployed at least once for military operations in Iraq or Afghanistan. After adjusting the data for age, sex and mental health history, they showed that the likelihood of a mental health diagnosis increased with increases in parental deployment length; other factors included older age groups and male sex. The strongest associations were for acute stress reaction and adjustment disorders, depressive disorders, and behavioral disorders, among the total of 6,579 mental health diagnoses observed in children of deployed parents.

"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," write the authors. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urge further research of this issue among other branches of the military as well as the National Guard and Reserves.

Commentary: A Closer Look at the Effect Military Deployment Has on Children

In a commentary, Stephen J. Cozza, M.D., from the Uniformed Services University School of Medicine in Bethesda, Md., provides perspective on the scope of U.S. military deployment and the population it touches. As of 2009, he notes, 44 percent of active duty military members have children (for a total of 1.2 million children), as well as 43 percent of Reserve and National Guard members. Furthermore, since combat operations began in 2001, roughly 2 million U.S. military personnel have deployed at least once.

The article by Mansfield and colleagues, writes Cozza, provides "an important contribution to our understanding of a child's health and its relationship to parental combat deployment." The study, he adds, appears to confirm earlier research into this topic. But it also raises questions, such as what long-term consequences, if any, deployments have on children's health and development.

Cozza recommends that these findings be used to raise national awareness of the problem, both within the military community and without. Since affected children are likely to at some point receive care outside the military health system, he urges civilian clinicians to pay special attention to these patients. "Brief screening for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high-risk behaviors (such as substance misuse or unsafe sexual practices) is warranted and will help identify treatment needs," Cozza concludes.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal References:

Alyssa J. Mansfield; Jay S. Kaufman; Charles C. Engel; Bradley N. Gaynes. Deployment and Mental Health Diagnoses Among Children of US Army Personnel. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.123Stephen J. Cozza. Children of Military Service Members: Raising National Awareness of the Family Health Consequences of Combat Deployment. Archives of Pediatrics and Adolescent Medicine, 2011; DOI: 10.1001/archpediatrics.2011.117

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Mothers with breastfeeding difficulties more likely to suffer postpartum depression, study finds

ScienceDaily (July 19, 2011) — Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill.

"We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

"We found that very commonly the same moms who were struggling with breastfeeding were also depressed," she said. "There was a tremendous clinical overlap."

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

"If they're struggling with breastfeeding, they should seek help and tell their provider. If they don't have joy in their life, if they wake up in the morning and think, 'I just can't do this another day' -- that's a medical emergency. They shouldn't just say, 'I'm going to power through this and snap out of it.' They should call their provider and say, 'I just don't feel right, I'm wondering if I could be depressed, can I come in and talk to you about it?' "

The study is scheduled for publication in the August 2011 print issue of the journal.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of North Carolina School of Medicine.

Journal Reference:

Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d

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Group therapy helps multiple sclerosis patients cope with depression, study finds

ScienceDaily (June 13, 2011) — Offering Multiple Sclerosis sufferers emotional support through group therapy sessions could improve their quality of life and save the NHS almost £500 per patient, a study at The University of Nottingham has discovered.

Researchers are now planning a larger multi-centre study into the issue to establish whether psychological therapy should be incorporated into the MS services currently provided by the NHS.

The study, funded by the MS Society, was led by Professor Nadina Lincoln, of the University's Institute of Work, Health and Organisations. She said: "These are very encouraging findings as many people with MS have problems with depression and anxiety and there are few treatments provided in NHS clinical services to address these. It is important that the psychological effects of MS are fully recognised as they can have a devastating effect on people's lives."

Depression and anxiety are common among sufferers of MS, a disabling neurological condition that affects around 100,000 people in the UK.

Previous studies have suggested that depression in MS can lead to patients failing to take their medication and a reduced quality of life. National Institute for Health and Clinical Excellence (NICE) guidelines also recognise that many people with both MS and depression or anxiety would prefer not to take antidepressants and recommends that psychological therapies should be offered as an alternative.

For the Nottingham study researchers recruited MS patients currently attending clinics run by Nottingham University Hospitals NHS Trust, as well as inviting referrals from specialist MS nurses and placing adverts in publications produced by the MS Society.

The volunteers were asked to complete questionnaires about how MS affects their daily lives and the extent to which they felt in control.

The patients were then randomly divided into two groups of just over 70 people. One group received all the usual care offered to MS and were put on a waiting list to receive group therapy at the end of the study.

The other group were invited to attend a course of six two-hour sessions of group therapy attended by up to eight participants at a time. Each session was led by a research psychologist, supervised by a qualified clinical psychologist with experience of working with people with MS.

Each session focussed on a topic, such as worry, gloom and relationships and was followed by practical exercises in strategies to cope with emotional problems and group discussion. They finished with relaxation exercises and group members were given tasks centred on practising coping strategies between sessions.

To assess the effectiveness of the sessions, questionnaires were sent to the participants at both four and eight months later and the results of those who received treatment were compared to those on the waiting list only.

The researchers found that those MS sufferers who attended the group sessions had fewer problems with anxiety and depression, the impact of the disease on their daily lives was reduced and their quality of life improved.

In terms of potential savings to the NHS, the researchers have also collected information on cost, which will be submitted for a future publication. They found that costs were reduced by £470 per patient for those who attended the therapy sessions compared with usual care. It was shown to almost halve the cost of visits to the GP, falling from £11,340 at the start of the study to just £5,832 at the eight month follow up. The costs of outpatient hospital visits were also slashed from £32,592 at the beginning of the study to £21,534 at the eight-month follow-up.

The next stage of the research will be to assess whether the group therapy approach works equally well in other centres through a larger study with the hope that the treatment could potentially be provided through NHS services for those with MS.

Dr Susan Kohlhass from the MS Society said: "Knowing group-based sessions can reduce anxiety and depression is a strong development towards improving the quality of peoples' lives with MS. We are committed to funding work that will imminently benefit people with the condition and this is a great example. The next stage will be to find if this approach is as effective in other areas of the country."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Nottingham.

Journal Reference:

N. B. Lincoln, F. Yuill, J. Holmes, A. E. Drummond, C. S. Constantinescu, S. Armstrong, C. Phillips. Evaluation of an adjustment group for people with multiple sclerosis and low mood: a randomized controlled trial. Multiple Sclerosis Journal, 2011; DOI: 10.1177/1352458511408753

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New genetic clues for schizophrenia; De novo mutations more frequent, study finds

ScienceDaily (July 11, 2011) — De novo mutations -- genetic errors that are present in patients but not in their parents -- are more frequent in schizophrenic patients than in normal individuals, according to an international group of scientists led by Dr. Guy A. Rouleau of the University of Montreal and CHU Sainte-Justine Hospital. The discovery, published in Nature Genetics, may enable researchers to define how the disease results from these mutations and eventually develop new treatments for it.

"The occurrence of de novo mutations, as observed in this study, may in part explain the high worldwide incidence of schizophrenia," says Dr. Rouleau, who is also Director of the CHU Sainte-Justine Research Center and researcher at the University of Montreal Hospital Research Centre. "Because the mutations are located in many different genes, we can now start to establish genetic networks that would define how these gene mutations predispose to schizophrenia," adds Simon Girard, the student who performed the key experiments that led to this discovery. "Most of the genes identified in this study have not been previously linked to schizophrenia, thereby providing new potential therapeutic targets."

Schizophrenia is a major mental disorder characterized by a wide spectrum of symptoms, including delusions, hallucinations, disturbances in thinking, and deterioration of social behaviours. According to the World Health Organization, as many as 24 million individuals worldwide suffer from schizophrenia and over half of them are not receiving appropriate care to relieve their symptoms.

Dr. Rouleau's team used modern DNA sequencing technologies to identify genetic changes in patients with schizophrenia whose parents showed no signs of the disease. To identify genetic mutations associated with schizophrenia, Dr. Rouleau and his team analysed approximately 20,000 genes from each participant in the study. The research team was especially interested in "de novo" mutations, meaning those that are present in patients but absent in their parents.

"Our results not only open the door to a better understanding of schizophrenia," adds Dr. Rouleau. "They also give us valuable information about the molecular mechanisms involved in human brain development and function."

The identification of de novo mutations in schizophrenia supports the hypothesis proposed by Dr. Rouleau in 2006, that this type of mutation plays a role in several diseases affecting brain development such as autism, schizophrenia and mental retardation.

"Increased exonic de novo mutation rate in probands affected with schizophrenia" was published online on July 10, 2011 in Nature Genetics. The authors are Simon L. Girard, Julie Gauthier, Anne Noreau, Lan Xiong, Sirui Zhou, Loubna Jouan, Alexandre Dionne-Laporte, Dan Spiegelman, Edouard Henrion, Ousmane Diallo, Pascale Thibodeau, Isabelle Bachand, Jessie Y.J. Bao, Amy Hin Yan Tong, Chi-Ho Lin, Bruno Millet, Nematollah Jaafari, Ridha Joober, Patrick A. Dion, Si Lok, Marie-Odile Krebs, and Guy A. Rouleau.

This research was funded in large part by Genome Canada and Génome Québec, with contributions by the Canadian Institutes of Health Research (CIHR) and the Brain and Behavior Research Foundation (formerly NARSAD, the National Alliance for Research on Schizophrenia and Depression) and the University of Montreal. The University of Montreal is officially known as Université de Montréal.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Montreal, via EurekAlert!, a service of AAAS.

Journal Reference:

Simon L Girard, Julie Gauthier, Anne Noreau, Lan Xiong, Sirui Zhou, Loubna Jouan, Alexandre Dionne-Laporte, Dan Spiegelman, Edouard Henrion, Ousmane Diallo, Pascale Thibodeau, Isabelle Bachand, Jessie Y J Bao, Amy Hin Yan Tong, Chi-Ho Lin, Bruno Millet, Nematollah Jaafari, Ridha Joober, Patrick A Dion, Si Lok, Marie-Odile Krebs, Guy A Rouleau. Increased exonic de novo mutation rate in individuals with schizophrenia. Nature Genetics, 2011; DOI: 10.1038/ng.886

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Drinking, cannabis use and psychological distress increase in Ontario, Canada, survey finds

ScienceDaily (June 13, 2011) — The latest survey of Ontario adults from the Centre for Addiction and Mental Health (CAMH) shows increasing rates of daily drinking and cannabis use and high levels of psychological distress. The results of the 2009 CAMH Monitor survey, the longest running survey tracking mental health and addiction indicators among adults in Ontario, were published June 13, 2011.

Alcohol

The proportion of adults reporting daily drinking increased from 5.3% in 2002 to over 9% in 2009. The average number of drinks consumed weekly among drinkers has also increased from 3 drinks to 4.6 drinks, and the proportion of adults exceeding low-risk drinking guidelines remains at elevated levels (22%). However, there were also some encouraging findings: there was a significant decline in binge drinking from 12.6% in 2006 to 7.1% in 2009, and the decline was evident especially among young adults, from 24% to 11.5%.

Although driving within an hour of consuming two or more drinks has shown a steady decline in the past years, from 13.1% in 1996 to 6.9% in 2009, there is evidence that this trend has reversed among young adults. Driving after drinking posted a significant increase among 18 to 29 year olds, from 7.7% in 2005 to 12.8% in 2009.

"The data tell us that while the number of people who drink alcohol has not changed, the way they are drinking has -- people are drinking more often and may be consuming more alcohol when they do drink, although there may be fewer binge occasions," said Dr. Robert Mann, CAMH Senior Scientist and lead investigator on the study. "We know that the more access people have to alcohol, the more people will drink, leading to more instances of drinking and driving. Measures such as Random Breath Testing and lowering legal limits to .05% can reduce drunk driving deaths. The implementation of .05% legislation in British Columbia appears to have resulted in a 50% decrease in drinking and driving deaths in that province."

Cannabis

The prevalence of cannabis use has been steadily increasing from 8.7% in 1996 to 13.3% in 2009, for both men and women and among all age groups. Along with this, there was almost a 2-fold increase in cannabis use among those aged 18-29, from 18.3% to 35.8%.

"These increases are of concern to us," stated Dr. Mann. "We know that cannabis use may increase the risk of psychosis for people who are predisposed to schizophrenia, and may worsen the symptoms of other mental illnesses." Another noticeable change was the large increase in use of cannabis among older adults. Use by those aged 50 years and older increased more than 3-fold from 1.4% to 4.7% between 1996 and 2009 and, among past year cannabis users, the proportion of users aged 50 years and older increased from 1.9% to 13.9% during the same time period.

Tobacco

Some positive findings are that the percentage of adult Ontarians reporting smoking cigarettes declined from 19.7% in 2008 to 18.6% in 2009. Though 14% of Ontarians still report daily smoking, it is a positive sign that cigarette smoking has steadily declined since 1996, from 26.8% to 18.6% in 2009. Dr. Mann notes that the provincial government's commitment to anti- smoking legislation through smoke-free Ontario probably played an important role in the decrease in smoking rates.

Mental Health

One in seven Ontario adults (14.7%), representing 1,400,000 people, reported symptoms of elevated psychological distress, and almost 6% reported that their overall mental health was poor. Those aged 30-39 were the most likely to report poor mental health, and those over age 65 reported the lowest rates of poor mental health. Mental health was strongly correlated with education. Those who had not graduated high school reported higher levels of poor mental health, and those who had graduated from university reported lower rates. "These results suggest that the social determinants of health, such as income, play as important a role in mental health as they do in physical health," said Mann.

The use of anti-anxiety medication has remained stable over the past few years, but trend data shows that over the past 10 years, use of these medications has risen from 4.5% to nearly 7% of Ontario adults. The same pattern can also be seen in the use of antidepressant medication, which has trended upward from 3.6% in 1999 to the current rate of 6.6%. Added Dr. Mann, "Though these are marked increases, they may also be showing that more people experiencing mental health problems are seeking and receiving help, which is a positive step."

Despite several differences, there was no strong dominant pattern in regional differences. Those from Northern Ontario were the most likely to be current smokers and to smoke daily; those from Toronto were the least likely to drink alcohol; those from the South West region of the province reported the highest average number of drinks consumed per week; and driving after drinking was most likely in the South West and in the Central South regions.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Centre for Addiction and Mental Health.

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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