Most Adolescents Not Receiving Important Health Care Preventive Services

MedicalResearch.com Interview with:

Sally H. Adams, PhD, RN Specialist, Division of Adolescent and Young Adult  Medicine Adolescent and Young Adult Health National Resource Center University of California, San Francisco Benioff Children’s Hospital San Francisco, CA 94118

Dr. Adams

Sally H. Adams, PhD, RN
Specialist, Division of Adolescent and Young Adult  Medicine
Adolescent and Young Adult Health National Resource Center
University of California, San Francisco
Benioff Children’s Hospital
San Francisco, CA 94118

MedicalResearch.com: What is the background for this study?

Response: Major causes of adolescent illness and mortality are preventable. To address this, in the 1990s, professional medical organizations developed healthcare provider guidelines for the delivery of adolescent preventive healthcare. These include the receipt of anticipatory guidance and risk screening services in the effort to promote healthy behaviors and avoid risky behaviors that are intended to be covered within a preventive care visit, but could be addressed in other healthcare visits.

The adolescent developmental period is an important time for adolescents to be engaged with the healthcare system. Transitioning from childhood to adulthood, adolescents are becoming increasingly independent – having more responsibility and freedom for decision making in many areas, including healthy choices in behaviors and activities. While families and community settings (schools, churches) play strong roles in this process, the healthcare system also plays an important role.

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Study Finds ACE Inhibitors and Statins Can Be Safe In Type I Diabetes

MedicalResearch.com Interview with:
M. Loredana Marcovecchio, M.D.
Clinical Scientist and
Professor David Dunger M.D.
Director of Research
Professor of Paediatrics
University of Cambridge

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The efficacy and safety of ACE Inhibitors and statins in adolescents have been shown in the context of hypertension and familial hypercholesterolemia, respectively. However, there is a lack of data on the long-term use of these drugs in those with type 1 diabetes and, in particular, there is no clear indication for their use in patients with increased albumin excretion.

The Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT) was a multi-centre, international study, set up by investigators in the UK, Australia and Canada to explore if drugs already used to lower blood pressure (ACE inhibitors) and cholesterol levels (Statins) in adults with diabetes could reduce the risk of kidney, eye and cardiovascular disease in adolescents with Type 1 diabetes.

Neither ACE inhibitors nor statins significantly reduced the albumin-creatinine ratio during the 2-4 year trial period. However, some of the secondary outcomes suggest that the drugs may have important benefits.

Treatment with the ACE inhibitor resulted in a 43% reduction in the rates of progression to microalbuminuria, which was not statistically significant, but it could have important clinical implications. Preventing even intermittent cases of microalbuminuria is known to reduce the future risk of kidney and cardiovascular complications.

Statin therapy led to reduced levels of lipid levels, which could reduce long-term risk for cardiovascular complications.

These findings could translate into long-term benefits, but follow-up of this unique cohort will be essential. The essential biological samples and data provided by the participants will continue to inform our future understanding and our options for effective therapies for this vulnerable group of young people with type 1 diabetes.

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Healthy Behaviors and Academic Success Go ‘Hand in Hand’

MedicalResearch.com Interview with:

Catherine N. Rasberry, PhD Health Scientist, Division of Adolescent and School Health CDC Atlanta

Dr.Raspberry

Catherine N. Rasberry, PhD
Health Scientist, Division of Adolescent and School Health
CDC Atlanta

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many years, researchers have documented links between health-related behaviors and educational outcomes such as letter grades, test scores, and other measures of academic achievement. However, many of those studies are becoming out-of-date or have used samples that were not nationally representative. The aim of this study was to see if previous findings held in a current, national sample of high school students.

Consistent with previous studies, our findings revealed that regardless of sex, race/ethnicity and grade-level, high school students who received mostly A’s, mostly B’s, or mostly C’s had higher levels of most protective health-related behaviors and lower levels of most health-related risk behaviors. For example, we found that:

  • Students who reported receiving mostly Ds and Fs, were nine times more likely than students who received mostly As to report having ever injected any illegal drugs.
  • Also, students who reported receiving mostly Ds and Fs were more than four times more likely than students who received mostly As to report that they had four or more sexual partners.
  • Conversely, students who reported receiving mostly As were twice as likely as students who received mostly Ds and Fs to report eating breakfast every day in the past week.

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Exploration During Adolescence Critical To Obtaining Wisdom Needed To Navigate Adulthood

MedicalResearch.com Interview with:

Dan Romer PhD Research director, Annenberg Public Policy Center Director of its Adolescent Communication Institute University of Pennsylvania

Dr. Dan Romer

Dan Romer PhD
Research director, Annenberg Public Policy Center
Director of its Adolescent Communication Institute
University of Pennsylvania

MedicalResearch.com: What is the background for this study?

Response: In recent years, findings from research in developmental neuroscience indicate that the myelination of the prefrontal cortex (PFC) extends into the third decade of life, proceeding more slowly than in other brain regions. Because subcortical and sensory brain regions appear to mature earlier, this and other findings have been taken as evidence that adolescents may have less ability to control their behavior than children do. These findings spawned theories of “imbalanced” adolescent brain development that were proposed to explain heightened vulnerability to risky behavior and adverse health outcomes during adolescence.

Although there is little doubt that as adolescents enter adulthood, they are at risk for many health outcomes that can accompany the initiation of such behaviors as driving, having sex, using drugs, and playing sports. But most adolescents make it through this period of development without serious health consequences. Thus, the argument that a brain deficit is responsible for such adverse health outcomes seemed to overgeneralize effects that only occur for a minority of adolescents. Furthermore, when my colleagues and I examined the evidence in support of imbalance theories, we found it unconvincing. Indeed, it seemed that findings from neuroscience were interpreted through the lens of stereotypes about adolescents that conflate exploration with impulsivity. That is, many of the risky behaviors that attract adolescents are novel activities that reflect lack of experience rather than lack of control over behavior.  Continue reading

Despite Sleep Benefits To Teens, Only Half of Parents Support Later School Start Times

MedicalResearch.com Interview with:

Galit Dunietz, Ph.D., MPH Doctor of Philosophy Department of Neurology University of Michigan  Ann Arbor MI

Dr. Dunietz

Galit Dunietz, Ph.D., MPH
Epidemiologist, Sleep Disorders Center
Department of Neurology
University of Michigan
Ann Arbor MI

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Insufficient sleep has a negative impact on health, cognition and mood and is linked to motor vehicle accidents. However, sleep loss in adolescents has become an epidemic and arises in part from biological processes that delay sleep and wake timing at the onset of puberty. This biology does not fit well with early school start times (before 8:30 a.m.). Despite recommendations from the American Academy of Pediatrics and the American Academy of Sleep Medicine to delay school start times, most schools in the U.S. have current start times before 8:30 a.m.

In this nationally representative study of US parents of teens, we examined whether parents supported or opposed later school start times (after 8:30 a.m.). We also examined what may have influenced their opinions.

We found that only about half of surveyed parents of teens with early school start times supported later school start times. Opinions appeared to depend in part on what challenges and benefits were expected to result from the change.

For example, parents who expected an improvement in their teen’s academic performance or sleep quantity tended to support the change, whereas parents that expected negative impact on afterschool activities or transportation opposed delays in school start times.  We also found that parents had misconception about sleep needs of their adolescents, as the majority perceived 7-7.5 hours of sleep as sufficient, or possibly sufficient even at this young age when 8-10 hours are typically recommended.

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Risky Behaviors Linked To Contact Lens–Related Eye Infections Among Adults and Adolescents

MedicalResearch.com Interview with:

Dr. Jennifer R. Cope MD Medical Officer Division of Foodborne, Waterborne, and Environmental Diseases National Center for Emerging and Zoonotic Infectious Diseases CDC

Dr. Cope

Dr. Jennifer R. Cope MD
Medical Officer
Division of Foodborne, Waterborne, and Environmental Diseases
National Center for Emerging and Zoonotic Infectious Diseases
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Wearing contact lenses can increase your chances of getting a severe eye infection. Eye infections can lead to serious problems, including blindness. All contact lens wearers can help prevent serious eye infections by correctly wearing and caring for their contact lenses.

Eighty-one percent of young adults, 85% of adolescents, and 88% of older adults regularly did at least one risky behavior related to their contact lenses. The most frequently reported risk behaviors in adolescents were not visiting an eye doctor as least annually, sleeping or napping in lenses, and swimming in lenses.

Among young adults and older adults, the most frequently reported risk behaviors were replacing lenses at intervals longer than those prescribed, replacing lens storage cases at intervals longer than those recommended, swimming in lenses, and sleeping or napping in lenses.

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“Positive Manifold” : Vocabulary and Reasoning Skills Reinforce Each Other In Adolescents

MedicalResearch.com Interview with:

Dr Rogier Kievit PhD Cambridge Neuroscience

Dr. Kievit

Dr Rogier Kievit PhD
Cambridge Neuroscience

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: One of the most robust findings in psychology is the so-called ‘positive manifold’ – The fact that people who are better at cognitive task A are, on average, also better at task B (and C, D etcetera). Despite over a hundred years of empirical investigations, we don’t really know why this is the case. Here, we aimed to investigate the mechanisms that underlie the positive manifold. To do so, we studied almost 800 adolescents and young adults from Cambridge and London (the NSPN study; Www.nspn.org

We measured both their abstract reasoning skills (e.g. solving a puzzle) and vocabulary knowledge (e.g. example) on two occasions, about 1.5 years apart.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our main finding was that abstract reasoning skills and vocabulary knowledge seem to reinforce each other during development. In other words, the adolescents who started out with higher vocabulary abilities had largest increases in reasoning skills, and those with better reasoning skills gained more vocabulary knowledge. This is exciting as we know mathematically that such a process can (at least partially) help explain the emergence of the positive manifold.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: That cognitive abilities interact with each other during development. It is tempting (also for scientists!) to think about skills like memory, reading and as separate domains. However, in reality they are part of a larger network of cognitive, mental and emotional processes that interact throughout the lifespan. We simple can’t fully understand humans as psychological agents by taking only ‘snapshots’.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The field of psychology has recently realized it needs to increase sample sizes to gain robust knowledge about human behaviour and mental processes. I think the next step is realizing the importance of studying development (i.e. testing people on multiple occasions) as a way to look at longstanding questions in new and exciting ways. Secondly, we find that that mathematical models are a very exciting way to translate theories into directly testable propositions – Although such models are always oversimplifications, they often move scientific debates forward.

MedicalResearch.com: Is there anything else you would like to add?

Response: With the emergence of experience sampling methods (e.g. performing cognitive tests on smartphones), ideally combined with longitudinal brain imaging, I think the next two decades will prove an incredibly exciting time for understanding human cognition.

Disclosures: The Medical Research Council Cognition and Brain Sciences Unit is part of the University of Cambridge, funded through a strategic partnership between the MRC and the University.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Rogier A. Kievit et al, Mutualistic Coupling Between Vocabulary and Reasoning Supports Cognitive Development During Late Adolescence and Early Adulthood, Psychological Science (2017). DOI: 10.1177/0956797617710785

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

Lifestyle-Based Tool Estimates Premature Cardiovascular Events in Young Adults

MedicalResearch.com Interview with:

Holly Gooding, MD, MSc Assistant Professor of Medicine and Pediatrics, Harvard Medical School Division of Adolescent/Young Adult Medicine, Boston Children's Hospital Division of General Internal Medicine, Brigham and Women's Hospital Boston, MA

Dr. Gooding

Holly Gooding, MD, MSc
Assistant Professor of Medicine and Pediatrics
Harvard Medical School
Division of Adolescent/Young Adult Medicine
Boston Children’s Hospital
Division of General Internal Medicine
Brigham and Women’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Dr Stephanie Chiuve and colleagues at the Harvard TH Chan School of Public Health developed the Healthy Heart Score to predict the risk of heart disease in older adults based on lifestyle factors measured in middle age. We have known for some time that the precursor to heart disease – known as atherosclerosis – actually starts in childhood and adolescence. We calculated the Healthy Heart Score for young adults ages 18-30 years old and found it works in this age group as well.

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College Binge Drinkers Also Smoking More Pot In States Where Marijuana Legal

MedicalResearch.com Interview with:

David Kerr PhD Associate professor in the School of Psychological Science College of Liberal Arts Ohio State University 

Dr. Kerr

David Kerr PhD
Associate professor in the School of Psychological Science
College of Liberal Arts
Ohio State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oregon legalized sale and use of marijuana for recreational purposes and the part of the law (regarding use) took effect in July 2015. However, there have been no controlled studies of which we’re aware of the possible effects of the Oregon law that take into account the trends toward increased marijuana use across the country and differences in use rates between states that predated the law.

We used survey data on college students in Oregon and in 6 states without recreational legalization to examine the issue.

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Regular Adolescent Cannabis Users More Likely To Have Later Problems with Drugs, Alcohol and Tobacco

MedicalResearch.com Interview with:
Dr Michelle Taylor PhD
Senior Research Associate in Epidemiology
MRC Integrative Epidemiology Unit (IEU)
School of Social and Community Medicine
University of Bristol
Bristol UK

MedicalResearch.com: What is the background for this study?

Response: Many previous studies have looked at adolescent cannabis use, however most of these look at use at a single time point, for example whether an individual has ever used cannabis at age 16 years, or how regularly a person uses cannabis at age 18. However, as young people do not initiate use at the same time or follow the same pattern of use, using measures at a single time point does not always tell the whole story.
We used a form of statistical modelling using data taken over the course of adolescence to try and characterise underlying patterns of cannabis use across adolescence. We used data from the Avon Longitudinal Study of Parents and Children which had information on cannabis use at six time points between the ages of 13 and 18 years.

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Adolescents Admitted For Self Harm At Risk For Further Self Harming Behavior

MedicalResearch.com Interview with:

Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London  UK

Dr. Herbert

Dr Annie Herbert, PhD
Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare
University College London
London  UK 

MedicalResearch.com: What is the background for this study?

Response: 1 in 25 adolescents (i.e. one in every classroom) will be admitted to hospital as an emergency with injuries related self-harm, drug or alcohol misuse, or violence. Currently, the guidelines for how these adolescents are managed differ greatly depending on the type of injury they come in with (whether through self-harm, drug or alcohol misuse, or violence).

MedicalResearch.com: What are the main findings?

Response: In our study, we found that adolescents admitted with any of these injuries were at an increased risk of suicide and of drug or alcohol related death in the ten years after leaving hospital, compared to other admitted adolescents.While the overall risk is relatively low—for example, 2–3 girls out of 1000 and 7 boys out of 1000 who are admitted as an emergency to hospital with drug or alcohol related injuries die from suicide within 10 years—the rates are 5–6 times higher than among adolescents admitted to hospital following an accident.

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Study Suggests Isolated Systolic Hypertension In Young Adults Should Be Treated To Prevent Damage To Aorta

MedicalResearch.com Interview with:

Wanpen Vongpatanasin, M.D.</strong> Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research Director, Hypertension Section, Cardiology Division, UT Southwestern Medical Center Dallas, TX 75390-8586

Dr. Vongpatanasin

Wanpen Vongpatanasin, M.D.
Professor of Medicine
Norman & Audrey Kaplan Chair in Hypertension
Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research
Director, Hypertension Section,
Cardiology Division,
UT Southwestern Medical Center
Dallas, TX 75390-8586

MedicalResearch.com: What is the background for this study?

Response: It is well know that treatment of isolated systolic hypertension (ISH), a subtype of hypertension with elevated systolic BP 140 or above but normal diastolic BP of < 90 mmHg, improves cardiovascular outcomes in older adults after the sixth decade of life. However, it is controversial if ISH in young adults requires treatment because it was suggested that elevated systolic BP in these individuals are related to high stroke volume, rather than increased aortic stiffness. In earlier case series, ISH in young adults were particularly common in athletes with long arms and legs, suggesting that pulse wave amplification coupled with high stroke volume were responsible for elevated brachial systolic blood pressure but the true central BP was normal. Thus,  isolated systolic hypertension was proposed to be a spurious condition in young adults that can be ignored.

However, previous studies used only indirect technique in assessing aortic structure and function. Furthermore, none of these studies were conducted in the U.S. Population.

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Adolescents Perinatally Infected with HIV Are At Increased Risk of Serious Physical and Mental Health Problems

MedicalResearch.com Interview with:

Anne M Neilan, MD,MPH Assistant In Medicine, Massachusetts General Hospital Research Fellow, Harvard Medical School Department: Medicine Service Division: Infectious Disease Department: Pediatric Service Massachusetts General Hospital Boston, MA 02114

Dr. Neilan

Anne M Neilan, MD,MPH
Assistant in Medicine and Pediatrics
Massachusetts General Hospital
Instructor at Harvard Medical School
Department: Medicine Service
Division: Infectious Disease
Department: Pediatric Service
Massachusetts General Hospital
Boston, MA 02114

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect. This study found that U.S. youth infected with HIV around the time of their birth are at higher risk throughout their adolescence and young adulthood for experiencing serious health problems, poor control of the HIV virus (having high levels of HIV virus in their bodies and fewer CD4 immune cells which protect the body from infection), or death. The study also found that among those with good HIV control, serious health problems are rare.

By combining data from two large, long-term U.S. studies – the Pediatric HIV/AIDS Cohort Study (PHACS, www.phacsstudy.org) and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT, www.impaactnetwork.org) Network – we were able to study the health of more than 1,400 perinatally HIV-infected children, adolescents and young adults ages 7 to 30 years between 2007 and 2015. The study found that youth ages 13 to 30 were most likely to have poor HIV control AIDS-related illnesses, and death compared to younger participants. Among 18 – 30 year-olds, the study found that poor control of the HIV virus – meaning higher levels of HIV virus and lower levels of CD4 immune cells which protect the body from infection –35 percent of the time, increasing the risk that these youth would stop responding to certain HIV medications and could transmit HIV to others. These findings are consistent with other U.S. and European reports. Despite being engaged in health care, the number of deaths among youth born with HIV in the U.S. is 6 to12 times higher than for youth without HIV of the same age, sex and race.

Along with HIV-related health problems, the most commonly reported health conditions concerned mental health and brain and nervous system development. Many women in the study also had sexually transmitted infections, which was found to be associated with lower CD4 immune cell counts. This may suggest a biological mechanism or may reflect that patients who have difficulty with their medications are also engaging in more frequent risky sexual behaviors.

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Should Teenagers Be Able To Get Oral Contraceptives Over The Counter?

MedicalResearch.com Interview with:

Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287

Dr. Upadhya

Krishna K. Upadhya, M.D., M.P.H.
Division of General Pediatrics & Adolescent Medicine
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product.  Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.

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High Achieving Adolescents Less Likely To Smoke, But More Likely to Drink, Use Pot

MedicalResearch.com Interview with:
Dr. James Williams
UCL Medical School
UCL
, London, UK

MedicalResearch.com: What is the background for this study?

Response: Despite a downward trend over the last decade in the usage of particular substances amongst adolescents in the UK, smoking cigarettes, drinking alcohol and smoking cannabis remain prevalent behaviours in this demographic. These risky health behaviours present a large problem in terms of public health due to the immediate and long-term health problems they cause, as well as negative non-health outcomes such as poor educational attainment and reduced employment.

The role of academic ability in determining patterns of substance use is not clear and no study has evaluated academic ability at age 11 in relation to the onset and persistence of all three substances from early to late adolescence and into young adulthood. Our study sought to determine the association between academic ability and the onset and persistence of substance use in adolescence in a representative sample of English school pupils. This would answer for the first time whether ability was associated with ‘experimentation’ in early adolescence or if the association persists into late adolescence.

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Strong Alcohol Policies Linked to Fewer Young Adults Dying In Car Crashes

MedicalResearch.com Interview with:

Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Urban Health & Advocacy Track Director | Boston Combined Residency Program Boston, MA 02118

Dr. Scott Hadland

Scott E. Hadland, MD, MPH, MS
Assistant Professor of Pediatrics
Boston University School of Medicine
Urban Health & Advocacy Track Director | Boston Combined Residency Program
Boston, MA 02118

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Studies to date have shown that states’ alcohol laws can help prevent young people from dying in car crashes. However, studies to date have usually only looked at a single policy at once. We wanted to build on these previous studies by looking at the overall effect of multiple alcohol laws acting at once. We also wanted to look at laws not necessarily only targeting drinking and driving among young people, but also policies aimed primarily at adults over 21.

We studied deaths of young people under 21 who were killed in motor vehicle crashes across the United States between 2000 and 2013. We found that one-quarter of all young people died in a crash involving a driver who alcohol level was over the legal limit. One-half died in a crash in which the driver had any level of alcohol in their bloodstream above zero.

We also found that most young people died on evenings and weekends, which is when people are most likely to have been drinking. Importantly, almost half of all young people died in a crash in which they were the passenger, not the driver. In 80% of cases in which they were the passenger, it was actually an adult >21, not a young person, who was driving the vehicle.

We then looked at states’ alcohol laws, and found that the stronger the set of alcohol policies in a state, the lower the likelihood of young people dying in a crash that was alcohol-related. Policies included laws relating to alcohol taxes, alcohol availability and hours of sales, and graduated driver’s licensing for young people, among many others.

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Collaborative Care is Effective and Cost-Effective For Adolescent Depression

MedicalResearch.com Interview with:

Laura P. Richardson, MD, MPH Interim Chief | Division of Adolescent Medicine Director | UW Leadership Education in Adolescent Health (LEAH) Program Professor | UW Department of Pediatrics Seattle Children's | University of Washington

Dr. Laura Richardson

Laura P. Richardson, MD, MPH
Interim Chief | Division of Adolescent Medicine
Director | UW Leadership Education in Adolescent Health (LEAH) Program
Professor | UW Department of Pediatrics
Seattle Children’s | University of Washington

MedicalResearch.com: What is the background for this study?

Response: Adolescent depression is one of the most common mental health conditions during adolescence. Up to one in five adolescents experience an episode of major depression by age 18. Depressed youth are at greater risk of suicide, dropping out of school and poor long-term health. Treatments, including medications and psychotherapy, have been proven to be effective but most depressed teens don’t receive any treatment.

Two years ago, we showed that the Reaching Out to Adolescents in Distress (ROAD) collaborative care model (a.k.a. Reach Out 4 Teens) designed to increase support and the delivery of evidence-based treatments in primary care was effective in treating depression in teens, significantly improving outcomes. We ran a randomized clinical trial at nine of Group Health’s primary care clinics and reported effectiveness results in JAMA.

The current paper represents the next step in this work, examining the cost-effectiveness of collaborative care for adolescent depression in our intervention sample of 101 adolescents with depression, ages 13-17 years.

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Healthy Eating in Adolescence Sets Pattern For Less Weight Gain As Young Adult

MedicalResearch.com Interview with:

David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075

Dr. David R. Jacobs, Jr.

David R. Jacobs, Jr., PhD
Mayo Professor of Public Health
Division of Epidemiology and Community Health, School of Public Health
University of Minnesota
Minneapolis MN 55454-1075

MedicalResearch.com: What is the background for this study?

Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which
a) predicts a lot of things in several different studies (including total mortality in the Iowa Women’s Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA).

We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet.

We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition).

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Adolescent Girls Not Adequately Screened For Pregnancy Before Chemo or CT Scans

MedicalResearch.com Interview with:

Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine

Dr. Pooja Rao

Pooja Rao, MD, MSCE
Assistant Professor
Division of Pediatric Hematology/Oncology
Milton S. Hershey Medical Center
Penn State College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment.

Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.

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Intentional and Alcohol Poisonings among Adolescents Increasing

MedicalResearch.com Interview with:

Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham

Dr. Edward Tyrrell

Dr Edward Tyrrell
NIHR In-Practice Research Fellow
Division of Primary Care
University Park Nottingham 

MedicalResearch.com: What is the background for this study?

Dr. Tyrrell: Poisonings are among the most common causes of death amongst adolescents across the world, many of them related to self-harm. Poisonings leading to death are just the tip of the iceberg with many more resulting in invasive treatment, time off school and long term health effects. Many adolescent self-harm episodes are linked to mental health problems, which are often predictive of mental health problems in adulthood, making adolescence a key window for preventative intervention. However, up to date rates and time trends for adolescent poisonings are lacking, hindering the development of evidence-informed policy and planning of services.

To quantify this problem at a national level and provide recent time trends of poisonings, we used routinely collected primary care data from 1.3 million 10-17 year olds. We assessed how intentional, unintentional and alcohol-related poisonings for adolescent males and females vary by age, how these have changed between 1992 and 2012 and whether socioeconomic inequalities exist.

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Sex At Earlier Age Increases Risk of Sexually Transmitted Diseases

MedicalResearch.com Interview with:
Seo Yoon Lee, RN

Department of Health Policy and Management
Graduate School of Public Health
Eun-Cheol Park MD, PhD
Institute of Health Services Research
Department of Preventive Medicine
Yonsei University, Seoul, South Korea 

Medical Research: What is the background for this study? What are the main findings?

Response: Sexually Transmitted Infections (STIs) are a major public health issue which causes acute illness, infertility, long-term disability or other serious medical and psychological consequences, around the world. Adolescence is a key developmental period with rapid cognitive growth. In recent decades, substantial change in the sexual behaviors and attitudes of adolescents has occurred and this would lead them greater risk of STIs than other. Our study looked at the relationship between adolescents’ first sexual intercourse age and their STI experience, as well as to identify vulnerable time table of their sexual activity by considering the time gap between their secondary sex characteristic occurrence age and first sexual intercourse age.

The findings from our study show that earlier initiation of sexual intercourse increases the odds of experiencing STIs. Also as the age gap gets shorter, the odds of experiencing STIs increase.

Approximately 7.4% of boys and 7.5% of girls reported had STI. For both boys and girls, the chance of experiencing STIs increased as the age of first sexual intercourse decreased [boys: before elementary school (age 7 or under) OR=10.81, first grade (age 7or 8) OR=4.44, second grade (age 8 or 9) OR=8.90, fourth grade (age 10 or 11) OR=7.20, ninth grade (age 15 or 16) OR=2.31; girls: before elementary school OR=18.09, first grade OR=7.26, second grade OR=7.12, fourth grade OR=8.93, ninth grade OR=2.74]. The association between the absolute age gap (AAG: defined as absolute value of “Age gap” = [Age at first sexual intercourse] – [age of secondary sexual manifest]) and STI experience was examined additionally which the result showed, students who had sexual intercourse after their secondary sexual manifestation, as the AAG increases, the odds of STI experience were decreased (boys OR=0.93, girls OR=0.87).

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Ads Increase Curiosity and Trial of E-Cigarettes Among Young Adults

Dr. Andrea C. Villanti PhD, MPH Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative Washington, DC 20001

Dr. Villanti

MedicalResearch.com Interview with:
Dr. Andrea C. Villanti PhD, MPH
Director, Regulatory Science and Policy Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative
Washington, DC 20001

Medical Research: What is the background for this study? What are the main findings?

Dr. Villanti: Awareness, interest, and use of electronic cigarettes (e-cigarettes) have increased since the products were introduced in the U.S. in 2006. Between 2012 and 2013, 8.3% of young adults reported current e-cigarette use compared to 4.2% of adults overall. One factor likely driving e-cigarette use as well as the use of other tobacco products is advertising, which has been demonstrated to promote the initiation and continued use of cigarettes. Advertising is critical for raising awareness about newly introduced products, and has been shown to influence initiation, experimentation, and progression to regular combustible cigarette smoking in youth.

This study used a randomized control trial to assess the impact of brief exposure to four e-cigarette print advertisements (ads) on perceptions, intention, and subsequent use of e-cigarettes and cigarettes among young adults (age 18-34). It found that exposure to e-cigarette ads may enhance curiosity and limited trial of e-cigarettes in never users. Other findings include:

  • Compared to the control group, ad exposure was associated with greater curiosity to try an e-cigarette among never e-cigarette users (18.3% exposed vs. 11.3% unexposed), and greater likelihood of e-cigarette trial at follow-up among never users of cigarettes and e-cigarettes (3.6% exposed vs. 1.2% unexposed).
  • Exploratory analyses did not find an association between ad exposure and cigarette trial or past 30-day use among never users at follow-up, nor cigarette use among smokers over time.
  • Curiosity to try an e-cigarette mediated the relationship between ad exposure and e-cigarette trial among e-cigarette never users.

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High School Students Smoking More Pot Than Tobacco

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Marijuana plant (Cannabis sativa)

MedicalResearch.com Interview with:
Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD
Office on Smoking and Health
National Center for Chronic Disease Prevention and Health Promotion
CDC

Medical Research: What is the background for this study? What are the main findings?

Response: Since 2010, the proportion of U.S. 12th grade students who used marijuana during the preceding 30 days (21.4%) has surpassed the proportion who used cigarettes (19.2%). Negative outcomes associated with cigarette and marijuana use include addiction to one or both substances and diminished cognitive function, which can lead to lower academic achievement. CDC analyzed data from the 1997–2013 national Youth Risk Behavior Surveys (YRBS) among U.S. non-Hispanic white (white), non-Hispanic black (black), and Hispanic students in grades 9–12 to examine trends in the prevalence of current

1) exclusive cigarette or cigar use,
2) exclusive marijuana use, and
3) any use of the three products.

CDC further examined the prevalence of current marijuana use among current users of cigarettes or cigars. During 1997–2013, exclusive cigarette or cigar use declined overall by 64%, from 20.5% to 7.4% (p<0.01). However, exclusive marijuana use more than doubled overall from 4.2% to 10.2% (p<0.01). Any cigarette, cigar, or marijuana use decreased overall from 46.1% to 29.9% (p<0.01), whereas marijuana use among cigarette or cigar users increased from 51.2% to 62.4%. Considerable increases were identified among black and Hispanic students toward the end of the study period for exclusive marijuana use and marijuana use among cigarette or cigar users. Increased exclusive marijuana use and use of marijuana among cigarette or cigar users could undermine success in reducing tobacco use among youths.

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Youth Suicide Can Be Decreased With Comprehensive Prevention Program

Christine Walrath, PhD Public Health Division, ICF International New York, New York

Dr. Christine Walrath

MedicalResearch.com Interview with:
Christine Walrath, PhD
Public Health Division
ICF International
New York, New York

Medical Research: What is the background for this study? What are the main findings?

Dr. Walrath: The study is part of a legislatively mandated evaluation of programs funded by the Garrett Lee Smith Memorial Act, signed into law in 2004 in recognition of the major public health problem of suicide and suicidal behavior in the US. The legislation set aside funding for campuses, states, tribes and US territories to develop, evaluate, and improve early intervention and suicide prevention programs. This is the most widely implemented group of suicide prevention programs in the United States, and allowed a unique opportunity, as reflected in the findings of this study and the study in the American Journal of Public Health in the spring (Walrath, C., Godoy Garraza, L., Reid, H., Goldston, D. B., & McKeon, R. (2015) to demonstrate that comprehensive community based suicide prevention programs appear to be effective in reducing suicide and suicide attempts.

As mentioned, this is the second article on the impact of GLS suicide prevention program on youth suicide behavior. The previous one, published in APHA earlier this year, focused on suicide deaths, while this one focuses on suicide attempts. They use different sources for the outcome measures: vital records in one case and a large national survey in the other. In both cases, the county is the unit of analysis. They both take advantage of the availability of a large amount of information for relatively small areas to select counties that are essentially comparable. Making sure that the counties being compared are similar except for the GLS implementation is very important when randomized trials to assess impact of the prevention program are not feasible.

The study found a reduction in the rate of suicide attempts among youth 16 to 23 following the implementation of the GLS program in counties exposed to these prevention activities when compared with similar counties that were not exposed to such intervention. The difference is significant and substantial: 4.9 less attempts per thousand youths. There is no evidence of a simultaneous change in the suicide attempt rate among adults, a group that was not targeted by GLS. The findings are consistent with those from the previous study, which found a substantial reduction in suicide mortality among youths 10-24 following GLS implementation: 1.3 fewer deaths per one hundred thousand youths.

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Many Adolescents Report Symptoms Mimicking Concussions

Grant L. Iverson, PhD Director, Sports Concussion Program, MassGeneral Hospital for Children Director, Neuropsychology Outcome Assessment Laboratory, Department of Physical Medicine and Rehabilitation, Harvard Medical School Associate Director, Traumatic Brain Injury, Red Sox Foundation and Massachusetts General Hospital Home Base Program Boston, MassachusettsMedicalResearch.com Interview with:
Grant L. Iverson, PhD
Director, Sports Concussion Program
MassGeneral Hospital for Children
Director, Neuropsychology Outcome Assessment Laboratory, Department of Physical Medicine and Rehabilitation
Harvard Medical School
Associate Director, Traumatic Brain Injury
Red Sox Foundation and Massachusetts General Hospital Home Base Program
Boston, Massachusetts

Medical Research: What is the background for this study? What are the main findings?

Dr. Iverson: Health care providers rely heavily on symptom questionnaires to monitor recovery from concussion and make decisions about returning to sport after concussion.

Common symptoms of concussion include headache, fatigue, sleep problems, and difficulty concentrating.

However, many healthy adolescents, that is, with no prior concussions, report these same symptoms. It is fairly common for healthy adolescents have some symptoms in their daily life. Moreover, a subgroup of healthy high school students report multiple concussion-like symptoms, or a cluster of symptoms that look much like what we see after a concussion.

High school girls are more likely than boys to report multiple concussion-like symptoms.

High school athletes with mental health problems such as depression or anxiety, but no recent prior concussion, report a lot of concussion-like symptoms. Other prior health problems, including multiple past concussions and ADHD, had a similar but less strong association with current symptom reporting.

Girls with prior concussions might be more susceptible to the lingering effects of prior concussions. This requires further research.

Medical Research: What should clinicians and patients take away from your report?

Dr. Iverson: Be cautious about attributing symptoms that last many weeks or months following an injury to concussion, particularly in adolescents with pre-injury health problems.

When evaluating adolescents after a concussion, be sure to ask about any prior mental health problems and ADHD.

Appreciate that many factors separate from concussion can cause symptoms such as headaches, fatigue, and concentration problems in high school students.

Understand that it is difficult to know when an athlete becomes “asymptomatic” after concussion. That is, the longer a person has symptoms, the more difficult it can be to determine the extent to which those symptoms are due to the concussion or to other factors.

Citation:

Grant L. Iverson et al. Factors Associated With Concussion-like Symptom Reporting in High School Athletes. JAMA Pediatrics, 2015 DOI: 10.1001/jamapediatrics.2015.2374

Grant L. Iverson, PhD (2015). Many Adolescents Report Symptoms Mimicking Concussions 

Mental Health, Obesity, Orphan Drugs Linked To High Cost Adolescent Care

Susan Gray MD Division of Adolescent Medicine Boston Children's Hospital Boston, MAMedicalResearch.com Interview with:
Susan Gray MD
Division of Adolescent Medicine
Boston Children’s Hospital
Boston, MA

Medical Research: What is the background for this study? What are the main findings?

Dr. Gray: This is a study of the health care costs of 13,000 privately insured adolescents (13 to 21 years old) cared for in an association of pediatric primary care practices. We found that a tiny fraction (1%) of adolescents accounted almost a quarter of the expenses of the whole cohort. Mental health disorders were the most common diagnosis among these high cost adolescents. The characteristics most strongly associated with high cost were complex chronic medical conditions, behavioral health disorders, and obesity, but many high cost adolescents had no chronic conditions. Pharmacy costs, especially orphan drug costs, were a surprisingly large contributor to high costs for these privately insured adolescents. Primary care costs were very small in high cost patients.

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Teenagers Carry Fewer Guns In States With Stricter Gun Control Laws

Dr. Ziming Xuan ScD, SM, MA Assistant Professor, Community Health Sciences School of Public Health Boston University MedicalResearch.com Interview with:
Dr. Ziming Xuan ScD, SM, MA
Assistant Professor, Community Health Sciences
School of Public Health
Boston University 

Medical Research: What is the background for this study?

Dr. Xuan: With respect to background, among the 15000 some teenagers died annually in the US, the 3 leading causes of death were unintentional injuries, homicide, and suicide. Among these fatal youth injuries, 83% homicides were gun-related, and about half of suicides involved a gun (45%).

So, The purpose of the study was to investigate the association between state gun law environment and youth gun carrying in the United States, and whether this association is mediated by adult gun ownership.

Medical Research: What are the main findings?
Dr. Xuan:

  • Among 38 states in our study, 5.7%of high school students living in the 19 states with stricter gun laws carried a gun in past 30 days while 7.3% of students living in states with the weaker gun laws carried a gun.
  • A 10-point increase in the strictness of the state gun law score was associated with a 9% decrease in the odds of youth gun carrying.
  • Across states, restrictive gun laws may reduce youth gun carrying by limiting adult gun ownership.

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Smaller Gender Gap in Adolescent Marijuana Use

MedicalResearch.com Interview with:Renee M. Johnson, PhD, MPH Assistant Professor Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health Deputy Director, Drug Dependence Epidemiology Training Program (DDET) Baltimore MD
Renee M. Johnson, PhD, MPH
Assistant Professor
Johns Hopkins Bloomberg School of Public Health, Dept. of Mental Health
Deputy Director, Drug Dependence Epidemiology Training Program (DDET)
Baltimore MD

Medical Research: What is the background for this study? What are the main findings?

Dr. Johnson: There has been a lot of policy change with regard to marijuana. Several states have enacted laws regarding medical marijuana and decriminalization, and now four states and the District of Columbia have legalized use for adults. Along with these policy changes, there’s been concern that adolescent marijuana use would skyrocket. This prompted me to think about what’s happened over the past 15 years, and so I decided to examine past 15-year trends in adolescent marijuana use among US high school students.

Our research team analyzed data from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance Study, or YRBS. It is a nationally-representative survey of high school students. A lot of the information we have about adolescents’ risk behavior comes from the YRBS.

What we found is that marijuana use among US high school students has gone down over the time period. In 1999, 47% of high school students reported lifetime use of marijuana. By 2013, 41% reported lifetime use. Use was lowest in 2009, with 37% of high school students reporting lifetime use. The increase in use from 2009 to 2013 was not statistically significant, so we aren’t sure whether it represents random fluctuation or whether it indicates a reversal in trend.

We also found that gender differences have gotten smaller over the time period, reflecting a real change. Boys have historically had higher rates of use, but that’s changing. In 1999, 51% of boys and 43% of girls reported lifetime marijuana use. By 2013, 42% of boys and 39% of girls reported lifetime use.

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Higher Adolescent Marijuana Usage In States That Legalized Pot

Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032MedicalResearch.com Interview with:
Deborah S. Hasin, Ph.D.

Professor of Epidemiology
Columbia University
New York, New York 10032

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Hasin: The background for the study was the need to identify the causes of the marked increase in marijuana use among U.S. adolescents over the last several years, given that early adolescent marijuana use leads to a number of adverse health and psychosocial consequences, including cognitive decline, into adulthood.

We had two main findings from the study:

  1. A comparison of the rates of adolescent marijuana use between states that ever passed a medical marijuana law and those that did not revealed that states with such laws had higher rates of teen marijuana use, regardless of when they passed the law; and
  2. When we compared the rates of teen marijuana use in these states before and after passage of the laws, we did not find a post-passage increase in the rates of teen marijuana use. This suggests that some common factor may be causing both the laws to be passed and the teens to be more likely to smoke marijuana in the states that passed these laws.

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Service To Others May Help Addicted Adolescents Overcome Fear Of Social Humiliation

Maria Pagano, PhD Case Western Reserve University School of Medicine Department of Psychiatry, Division of Child Psychiatry Cleveland, OHMedicalResearch.com Interview with:
Maria Pagano, PhD
Case Western Reserve University School of Medicine
Department of Psychiatry, Division of Child Psychiatry
Cleveland, OH

MedicalResearch: What is the background for this study?

Dr. Pagano: Socially anxious adolescents quickly figure out that alcohol and drugs can provide ease and comfort in social situations that are anxiety provoking.  Reaching for a substance to change how you feel can quickly become a knee-jerk reaction, can develop into an addiction, and robs youths of learning how to tolerate interpersonal differences and uncomfortable feelings, developing emotional maturity, and cultivating self acceptance.

Adolescents who fear being criticized by their peers are likely to not speak up in group therapies during treatment, which can limit their benefit from treatment.  There is a lot of healing that comes sharing your insides with others. Socially anxious patients may not get this healing nor let others really get to know who they are and give input to their lives

Higher peer helping in AA during treatment means getting active in low intensity tasks like putting away chairs, or making coffee at a 12-step meeting.  It is less about needing peer assistance or expecting praise or recognition from giving service.  It is more about adopting the attitude of “how can I be helpful?”

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Adolescents Risk Failing HIV Treatment If No Parent Attends Clinic Visits

Elizabeth Lowenthal, MD MSCE Assistant Professor of Pediatrics Children's Hospital of PhiladelphiaMedicalResearch.com Interview with:
Elizabeth Lowenthal, MD MSCE

Assistant Professor of Pediatrics
Children’s Hospital of Philadelphia

Medical Research: What is the background for this study? What are the main findings?

Dr. Lowenthal: Between 2005 and 2012, HIV related deaths declined by 30% worldwide. However, during the same time period, HIV related deaths increased 50% among adolescents. Over 90% of HIV-infected children and adolescents live in sub-Saharan Africa and HIV is the leading cause of death among adolescents in Africa. Treatment is available that can allow babies born with HIV to live to be healthy adults. However, strict adherence to these medicines is necessary and often becomes a great challenge during adolescence. In our study of 300 adolescents (ages 10-19) in Botswana, my team found that adolescents who come to clinic without a parent or guardian have a 4.5X greater odds of failing their HIV treatment.

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Many At-Risk Adolescents Have Access To Firearms In Home

MedicalResearch.com Interview with:
Joseph A Simonetti, MD MPH

Research Fellow
Harborview Injury Prevention & Research Center
University of Washington Seattle, WA, USA

Medical Research: What is the background for this study? What are the main findings?

Dr. Simonetti: Studies have consistently shown that children living in households where firearms are stored safely have a lower risk of suffering firearm injuries, including lethal firearm injuries, compared to those living in households where firearms are stored unlocked and/or loaded. Safe firearm storage is widely recommended by public health experts, professional medical societies, and gun rights organizations, especially for households where children might be suffering from mental heath and substance abuse issues that put them at increased risk for suicide or unintentional injury. Our goal was to find out if those recommendations were being effectively implemented in the community. To do this, we used survey data that assessed mental health conditions and firearm access among a nationally representative sample of US adolescents.

Medical Research: What are the main findings?

Dr. Simonetti: First, we confirmed previous findings that a large proportion of US adolescents have access to a firearm in the home. Of those who reported living in a home with a firearm, 40% said they could immediately access and shoot the firearm.

Second, the prevalence of most mental health diagnoses was similar between adolescents who did and did not report firearm access. However, a greater proportion of adolescents with firearm access had drug and alcohol disorders compared to adolescents who reported living in a home with a firearm but did not have access to the firearm.

The main finding was that children with mental health risk factors for suicide were just as likely to report in-home firearm access as those without identified risk factors. This finding held true even when comparing firearm access between children with no identified risk factors and those who reported a recent suicide attempt, who arguably have the highest suicide risk in this sample.
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Obese Adolescents May Have Heightened Vulnerability To Food Commercials

Dr. Sonja Yokum Ph.D. Oregon Research Institute Eugene Oregon, 97403MedicalResearch.com Interview with:
Dr. Sonja Yokum Ph.D.
Oregon Research Institute
Eugene Oregon, 97403

Medical Research: What are the main findings of the study?

Dr. Yokum: We found that adolescents showing elevated responses in reward regions to food commercials gained more weight over 1-year follow-up compared to those with less activation in these brain regions. This suggests that there are individual differences in neural vulnerability to food commercials that appear to identify youth at risk for excess weight gain.
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Psychotic Experiences Have Inherited and Environmental Influences

Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HXMedicalResearch.com Interview with:
Dr Angelica Ronald
Genes Environment Lifespan (GEL) laboratory
Centre for Brain and Cognitive Development
Department of Psychological Sciences
Birkbeck, University of London
London WC1E 7HX

Medical Research: What are the main findings of the study?

Dr. Ronald: Psychotic experiences, such as paranoia, hallucinations and disorganised thinking, are commonly reported by adolescents. Until now it has not been understood whether mild variations in psychotic experiences in the community are part of the same construct as more severe psychotic experiences in adolescence. Our findings suggest that they are. In our study, over 10,000 16-year-old adolescents in England and Wales were assessed on measures of psychotic experiences. The study identified a close link between normal, less frequent psychotic experiences and more severe and frequent experiences in the general population. A classic twin design was employed, which enabled us to conduct analyses investigating the role of genetic and environmental influences on psychotic experiences. The same genetic influences appeared to play a role across the spectrum of severity of psychotic experiences.

The study found that psychotic experiences are moderately heritable in adolescence in the general population. This suggests it would be worth directing molecular genetic endeavours towards this area, which has so far received very little attention in terms of causal explanations. We also show that psychotic experiences have considerable environmental influence; in fact, environmental influence appears to play a larger role in causing psychotic experiences in adolescence than for diagnosed psychotic disorders in adults, such as schizophrenia. This result suggests a fruitful avenue will be to tackle what environmental risk factors influence adolescents to have psychotic experiences.
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Adolescent Insomnia Linked to Depression, Anxiety and Chronotype

MedicalResearch.com Interview with:
Pasquale K Alvaro
School of Psychology
University of Adelaide
South Australia, Australia

Medical Research: What are the main findings of the study?

Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype  (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP.

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Emotional Problems in Adolescents: Very Common, Most Brief

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with:
Dr. George Patton
Department of Paediatrics, University of Melbourne
Centre for Adolescent Health, Murdoch Children’s Research Institute,
Royal Children’s Hospital, Parkville, VIC, Australia

MedicalResearch.com: What are the main findings of the study?

Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders.

In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males.

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Adolescent Health: Sex Discussions During Office Visits

Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with:
Stewart C. Alexander, PhD
Department of Medicine
Duke University Medical Center
Durham, North Carolina

MedicalResearch.com: What are the main findings of the study?

Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won’t raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved.
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