Tag Archives: medicine

Harvard study: More children showing signs of adult illnesses like hypertension

16 Jul

Moi wrote in Study: Parental education reduces childhood obesity, but more physical activity may be needed:
The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. There is an epidemic of childhood obesity and obesity is often prevalent among poor children. The American Heart Association has some great information about Physical Activity and Children http://www.heart.org/HEARTORG/GettingHealthy/Physical-Activity-and-Children_UCM_304053_Article.jsp#.TummU1bfW-c
Because many children are obese, they are at increased risk of adult diseases.

Alexandra Sifferlin reports in the Time article, Sick Before Their Time: More Kids Diagnosed With Adult Diseases:

Diabetes, obesity and elevated blood pressure typically emerge in middle-age, but more young children are showing signs of chronic conditions that may take a toll on their health.
The latest report on the trend, from researchers at Harvard Medical School found that children and adolescents are increasingly suffering from elevated blood pressure. Published in the American Heart Association journal Hypertension, the study showed a 27% increase in the proportion of children aged 8 years to 17 years with elevated blood pressure over a thirteen-year period.
The scientists compared over 3,200 children involved in the National Health and Nutrition Examination Survey (NHANES) III in 1988-1994 to over 8,300 who participated in NHANES in 1999-2008. The national survey records health, eating and lifestyle behaviors of the volunteers. More kids in the recent survey were overweight, with larger waistlines than those in the previous cohort. And the children with body mass index (BMI) readings in the top 25% of their age group were two times more likely to have elevated blood pressure than the kids in the bottom 25%.
The kids did not have diagnosed hypertension, which requires a threshold of 140 -90, but elevated blood pressure — anything above 120-80 — at such young ages could prime them for hypertension later. “High blood pressure is dangerous in part because many people don’t know they have it,” said lead study author Bernard Rosner, a professor of medicine at Harvard Medical School in a statement.
The results are only the latest to reveal the first signs of chronic conditions that normally don’t occur until middle-age, in children and teens.

Sick Before Their Time: More Kids Diagnosed With Adult Diseases

Citation:

Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure
The NHANES Experience 1988–2008
1.Bernard Rosner,
2.Nancy R. Cook,
3.Stephen Daniels,
4.Bonita Falkner
+ Author Affiliations
1.From the Childhood Blood Pressure Trends and Risk Factors for High Blood Pressure, Boston, MA; Professor and Chairman, Department of Pediatrics, University of Colorado School of Medicine, Aurora CO (S.D.); and Professor of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA (B.F.).
1.Correspondence to Bernard Rosner, Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, 181 Longwood Ave, Boston, MA 02115. E-mail stbar@channing.harvard.edu
Abstract
The obesity epidemic in children makes it plausible that prevalence rates of elevated blood pressure (BP) are increasing over time. Yet, previous literature is inconsistent because of small sample sizes. Also, it is unclear whether adjusting for risk factors can explain longitudinal trends in prevalence of elevated BP. Thus, we analyzed a population-based sample of 3248 children in National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and 8388 children in continuous NHANES (1999–2008), aged 8 to 17 years. Our main outcome measure was elevated BP (systolic BP or diastolic BP ≥90th percentile or systolic BP/diastolic BP ≥120/80 mm Hg). We found that the prevalence of elevated BP increased from NHANES III to NHANES 1999–2008 (Boys: 15.8% to 19.2%, P=0.057; Girls: 8.2% to 12.6%, P=0.007). Body mass index (Q4 versus Q1; odds ratio=2.00; P<0.001), waist circumference (Q4 versus Q1; odds ratio=2.14; P<0.001), and sodium (Na) intake (≥3450 mg versus <2300 mg/2000 calories; odds ratio=1.36; P=0.024) were independently associated with prevalence of elevated BP. Also, mean systolic BP, but not diastolic BP, was associated with increased Na intake in children (quintile 5 [Q5] versus quintile 1 [Q1] of Na intake; β=1.25±0.58; P=0.034). In conclusion, we demonstrate an association between high Na intake and elevated BP in children. After adjustment for age, sex, race/ethnicity, body mass index, waist circumference, and sodium intake, odds ratio for elevated BP in NHANES 1999–2008 versus NHANES III=1.27, P=0.069.
Key Words:
blood pressure
body mass index
National Health and Nutrition Examination Survey
nutrition surveys
pediatrics
sodium
waist circumference
Received December 10, 2012.
Revision received January 8, 2013.
Accepted May 13, 2013.
© 2013 American Heart Association, Inc.

The issue of childhood obesity is complicated and there are probably many factors. If a child’s family does not model healthy eating habits, it probably will be difficult to change the food preferences of the child. Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

University of Illinois Chicago study: Laws reducing availability of snacks are decreasing childhood obesity

University of Illinois Chicago study: Laws reducing availability of snacks are decreasing childhood obesity

New emphasis on obesity: Possible unintended consequences, eating disorders https://drwilda.wordpress.com/2012/01/29/new-emphasis-on-obesity-possible-unintended-consequences-eating-disorders/

Childhood obesity: Recess is being cut in low-income schools
https://drwilda.wordpress.com/2011/12/15/childhood-obesity-recess-is-being-cut-in-low-income-schools/

Where information leads to Hope. ©   Dr. Wilda.com
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Blogs by Dr. Wilda:
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U.S.D.A. has new rules for snacks in school vending machines

7 Jul

Moi has been following the school vending machine issue for awhile. In Government is trying to control the vending machine choices of children, moi wrote:
The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. Ron Nixon reports in the New York Times article, New Guidelines Planned on School Vending Machines about the attempt to legislate healthier eating habits. http://www.nytimes.com/2012/02/21/us/politics/new-rules-planned-on-school-vending-machines.html?_r=1&hpw
There have been studies about the effect of vending machine snacking and childhood obesity.
Katy Waldman wrote the Slate article, Do Vending Machines Affect Student Obesity?

Despite all the recent handwringing (even pearl clutching) over junk food in schools, a study out this month in the quarterly Sociology of Education found no link between student obesity rates and the school-wide sale of candy, chips, or sugary soda. The finding undermines efforts by policy makers to trim kids’ waistlines by banning snacks from the classroom. And it must taste odd to the many doctors and scientists who see vending machines as accessories in the childhood obesity epidemic.  
The study followed 19,450 fifth graders of both sexes for four years. At the beginning, 59 percent of the students went to schools that sold “competitive foods”—that is, non-cafeteria fare not reimbursable through federal meal programs. CFs tend to have higher sugar or fat content and lower nutritional value (think the indulgences at the top of the food pyramid, like Coke and Oreos). By the time the students reached eighth grade, 86 percent of them attended schools that sold competitive foods. The researchers, led by Pennsylvania State University’s Jennifer Van Hook, then compared body mass indexes from the 19,450 students, including those who’d spent all four years in junk food-free environments, those who’d left such schools for vending machine-friendly ones, those who’d transferred from vending machine-friendly schools to junk food-free schools, and those who enjoyed access to vending machines for all four years. Regardless of which data sets they contrasted, the researchers were unable to find any sort of connection between obesity and the availability of “unhealthy” snacks in school. In other words, children who could theoretically grab a Snickers bar after class every day for four years were, on average, no heavier than those who couldn’t.
While Van Hook speculated to the New York Times that the findings reflect our tendency to “establish food preferences… early in life,” she also noted in her paper that middle schoolers’ regimented schedules could prevent them from doing much unsupervised eating. (I guess that means that the students didn’t have time to utilize the junk food options they had, which is an issue for another day). In any case, the takeaway is clear. You can’t solve childhood obesity by outlawing vending machines. The obesity epidemic (if it is one) depends on a complex interplay of genetic, environmental, and behavioral factors. Maybe a full-court press of school regulations plus zoning laws that encourage supermarkets to come to poor neighborhoods plus government subsidies for fruits and veggies plus crackdowns on fast food advertising plus fifty other adjustments would begin to make a dent in the problem. (Maybe a saner cultural attitude towards food, weight, and looks in general would also help). http://www.slate.com/blogs/xx_factor/2012/01/24/junk_food_in_school_do_vending_machines_make_kids_fat_.html

https://drwilda.wordpress.com/2012/02/20/government-is-trying-to-control-the-vending-machine-choices-of-children/
See, Rising Childhood Obesity and Vending Machines http://www.medicaladvices.net/Child_Health/rising-childhood-obesity-and-vending-machines-a14.html
Nirvi Shah writes in the Education Week article, Rules for School Vending Machines, Snacks Unveiled:

Long-awaited rules that regulate the fat, salt, sugar, and calories in snacks and vending machine foods sold in schools were finally released by the U.S. Department of Agriculture today.
The rules take effect during the 2014-15 school year. Nutrition advocates have been pressing the USDA to issue the rules this month. Any later, and they wouldn’t have taken effect until the 2015-16 school year.
The new rules are the first update to school snack regulations since the 1970s. The existing rules only limited “foods of minimal nutritional value,” which didn’t keep candy bars, snack cakes, and sugary, vitamin-fortified sports drinks, from being regulated, said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest.
Despite some high hopes for the rules, which come on the heels of strict rules for school lunches, they won’t completely wipe out sodas, chips, or sweets from schools. But they will make a dent.
“Millions of students currently have widespread access to snacks and beverages that are high in sugar, fat, and salt, but limited access to nutritious options such as fruits and vegetables in school stores, snack bars, and vending machines,” said Jessica Donze Black, director of the Kids’ Safe and Healthful Foods Project. “With many students consuming up to half of their daily calories at school, these new standards represent the kind of positive change we need to help reduce obesity rates among children and teens.”
Many of the rules are adapted from those that were originally proposed by the agency, which received about 250,000 comments.
What happens if schools don’t comply? Agriculture Secretary Tom Vilsack said he hopes schools do, though there aren’t explicit penalties if they don’t, unlike rules for the school lunch and breakfast programs. http://blogs.edweek.org/edweek/rulesforengagement/2013/06/rules_for_school_vending_machines_snacks_unveiled.html?intc=es

Here is the press release for the “Smart Snacks in Schools” rule:

News Release
 
Release No. 0134.13
Contact:
USDA Office of Communications (202) 720-4623

Printable version
Email this page

 
Agriculture Secretary Vilsack Highlights New “Smart Snacks in School” Standards; Will Ensure School Vending Machines, Snack Bars Include Healthy Choices

 
WASHINGTON, June 27, 2013 – Agriculture Secretary Tom Vilsack today announced that under USDA’s new ” Smart Snacks in School” nutrition standards, America’s students will be offered healthier food options during the school day.
“Nothing is more important than the health and well-being of our children,” said Secretary Vilsack. “Parents and schools work hard to give our youngsters the opportunity to grow up healthy and strong, and providing healthy options throughout school cafeterias, vending machines, and snack bars will support their great efforts.”
The Healthy, Hunger-Free Kids Act of 2010 requires USDA to establish nutrition standards for all foods sold in schools — beyond the federally-supported meals programs. The “Smart Snacks in School” nutrition standards, to be published this week in the Federal Register, reflect USDA’s thoughtful consideration and response to the nearly 250,000 comments received on the proposal earlier this year.
“Smart Snacks in School” carefully balances science-based nutrition guidelines with practical and flexible solutions to promote healthier eating on campus, drawing on recommendations from the Institute of Medicine and existing voluntary standards already implemented by thousands of schools around the country, as well as healthy food and beverage offerings already available in the marketplace.
Highlights of the “Smart Snacks in School” nutrition standards include:
More of the foods we should encourage. Like the new school meals, the standards require healthier foods, more whole grains, low fat dairy, fruits, vegetables and leaner protein.
Less of the foods we should avoid. Food items are lower in fat, sugar, and sodium and provide more of the nutrients kids need.
Targeted standards. Allowing variation by age group for factors such as portion size and caffeine content.
Flexibility for important traditions. Preserving the ability for parents to send their kids to school with homemade lunches or treats for activities such as birthday parties, holidays, and other celebrations; and allowing schools to continue traditions like fundraisers and bake sales.
Ample time for implementation. Schools and food and beverage companies will have an entire school year to make the necessary changes, and USDA will offer training and technical assistance every step of the way.
Reasonable limitations on when and where the standards apply. Ensuring that standards only affect foods that are sold on school campus during the school day. Foods sold at afterschool sporting events or other activities will not be subject to these requirements.
Flexibility for state and local communities. Allowing significant local and regional autonomy by only establishing minimum requirements for schools. States and schools that have stronger standards than what is being proposed will be able to maintain their own policies.
USDA is focused on improving childhood nutrition and empowering families to make healthier food choices by providing science-based information and advice, while expanding the availability of healthy food.
America’s students now have healthier and more nutritious school meals due to improved nutrition standards implemented as a result of the historic Healthy, Hunger-Free Kids Act of 2010.
USDA’s MyPlate symbol and the resources at ChooseMyPlate.gov provide quick, easy reference tools for parents, teachers, healthcare professionals and communities.
USDA launched a new $5 million Farm to School grant program in 2012 to increase the amount of healthy, local food in schools.
USDA awarded $5.2 million in grants to provide training and technical assistance for child nutrition foodservice professionals and support stronger school nutrition education programs.
Collectively these policies and actions will help combat child hunger and obesity and improve the health and nutrition of the nation’s children; a top priority for the Obama Administration. The interim final rule announced today is an important component of First Lady Michelle Obama’s Let’s Move! initiative to combat the challenge of childhood obesity.
#
Additional materials available:
High-resolution version info-graphic
Questions & Answers
TV Feature
Interim Final Rule
For more information on Smart Snacks in School, please visit http://www.usda.gov/healthierschoolday
USDA is an equal opportunity provider, employer and lender. To file a complaint of discrimination, write: USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 795-3272 (voice), or (202) 720-6382 (TDD).

The issue of childhood obesity is complicated and there are probably many factors. If a child’s family does not model healthy eating habits, it probably will be difficult to change the food preferences of the child. Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:
University of Illinois Chicago study: Laws reducing availability of snacks are decreasing childhood obesity https://drwilda.com/2012/08/13/university-of-illinois-chicago-study-laws-reducing-availability-of-snacks-are-decreasing-childhood-obesity/
New emphasis on obesity: Possible unintended consequences, eating disorders https://drwilda.wordpress.com/2012/01/29/new-emphasis-on-obesity-possible-unintended-consequences-eating-disorders/
Childhood obesity: Recess is being cut in low-income schools https://drwilda.wordpress.com/2011/12/15/childhood-obesity-recess-is-being-cut-in-low-income-schools/
Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/
Dr. Wilda Reviews © http://drwildareviews.wordpress.com/
Dr. Wilda © https://drwilda.com/

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Is there something really wrong with a society with depressed preschoolers????

1 Jul

Here’s today’s COMMENT FROM AN OLD FART: Moi read this article from Science Daily, Brain Differences Seen in Depressed Preschoolers:

A key brain structure that regulates emotions works differently in preschoolers with depression compared with their healthy peers, according to new research at Washington University School of Medicine in St. Louis.

The differences, measured using functional magnetic resonance imaging (fMRI), provide the earliest evidence yet of changes in brain function in young children with depression. The researchers say the findings could lead to ways to identify and treat depressed children earlier in the course of the illness, potentially preventing problems later in life. http://www.sciencedaily.com/releases/2013/07/130701172022.htm

Really. We have depressed preschoolers? Should one have experienced more about life before developing a negative opinion of it?

The National Institute of Mental Health in the Depression in Children and Adolescents (Fact Sheet) estimates about “About 11 percent of adolescents have a depressive disorder by age 18.”

About 11 percent of adolescents have a depressive disorder by age 18 according to the National Comorbidity Survey-Adolescent Supplement (NCS-A). Girls are more likely than boys to experience depression. The risk for depression increases as a child gets older. According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age 15 to 44.

Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a child who shows changes in behavior is just going through a temporary “phase” or is suffering from depression.

PDF

http://www.nimh.nih.gov/health/publications/depression-in-children-and-adolescents/index.shtml

Statistics for the numbers of preschoolers who exhibit depression are hard to come by, but researchers are beginning to study the issue.

Pamela Paul reports in the New York Times article, Can Preschoolers Be Depressed?

But generally speaking, preschool depression, unlike autism, O.D.D. and A.D.H.D., which have clear symptoms, is not a disorder that is readily apparent to the casual observer or even to the concerned parent. Depressed preschoolers are usually not morbidly, vegetatively depressed. Though they are frequently viewed as not doing particularly well socially or emotionally, teachers rarely grasp the depth of the problem. Sometimes the kids zone out in circle time, and it’s mistaken for A.D.H.D., “because they’re just staring,” explains Melissa Nishawala, the child psychiatrist at N.Y.U. “But inside, they’re worrying or thinking negative thoughts.” More often, they are simply overlooked. “These are often the good kids who tend to be timid and withdrawn,” says Sylvana Côté, a researcher at the University of Montreal who studies childhood mood and behavioral disorders. “It’s because they’re not the oppositional, aggressive children who disrupt everyone in class that their problems go undernoticed.”

Many researchers, particularly those with medical training, are eager to identify some kind of a “biologic marker” to make diagnosis scientifically conclusive. Recent studies have looked at the activity of cortisol, a hormone the body produces in response to stress. In preschoolers who have had a diagnosis of depression, as in depressed adults, cortisol levels escalate under stressful circumstances and then fail to recover with the same buoyancy as in typical children.

But in adults, cortisol reactivity can be an indication of anxiety. Other research has found that in young children, anxiety and depression are likewise intertwined. At Duke, Egger found that children who were depressed as preschoolers were more than four times as likely to have an anxiety disorder at school age. “Are these two distinct but strongly related syndromes?” asks Daniel Pine of the N.I.M.H. “Are they just slightly different-appearing clinical manifestations of the same underlying problem? Do the relationships vary at different ages? There are no definitive answers.”

Further complicating the picture is the extent to which depressed children have other ailments. In Egger’s epidemiological sample, three-fourths of depressed children had some additional disorder. In Luby’s study, about 40 percent also had A.D.H.D. or O.D.D., disruptive problems that tend to drown out signs of depression. Though it looks as if only the children with depression experience anhedonia, other symptoms like irritability and sadness are shared across several disorders. http://www.nytimes.com/2010/08/29/magazine/29preschool-t.html?pagewanted=all&_r=0

There is no one single cause of depression.

The American Academy of Child and Adolescent Psychiatry says this about the causes of depression:

Depression has no single cause. Both genetics and the environment play a role, and some children may be more likely to become depressed. Depression in children can be triggered by a medical illness, a stressful situation, or the loss of an important person. Children with behavior problems or anxiety also are more likely to get depressed. Sometimes, it can be hard to identify any triggering event. http://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Depression_Resource_Center/FAQ.aspx

Moi would theorize that these preschoolers are picking up stressors form unhealthy family situations and an unhealthy society.

Everyone would probably have some thoughts about what makes a good society or a healthy society. Here are some thoughts from Professor Patrick W. Jordan about THE GOOD SOCIETY FRAMEWORK:

• Relationships – the quality of people’s social, family and interpersonal relationships; the extent to which society is coherent and harmonious.

• Economy – people’s degree of economic prosperity and spending power;the extent to which jobs are rewarding and offer potential for growth and development.

• Environment and Infrastructure – the pleasantness and sustainability of the natural environment; the degree to which the built environment is pleasant and functions well and extent to which the infrastructure is effective and efficient.

• Health – whether people have access to good healthcare and healthy food; whether work, home and public environments are generally safe.

• Peace and Security – whether crime is low and people feel safe in their homes and public areas; whether or not society is affected by war or terrorism.

• Culture and Leisure – whether there is a rich and rewarding culture, both ‘high’ and ‘popular’; whether there are opportunities to participate in rewarding leisure activities.

• Spirituality, Religion and Philosophy – whether there is access to religious and spiritual teachings and the opportunity to practice one’s religion of choice; whether there is access to philosophical teachings and ideas about how to live.

• Education – whether there is education that enables people to function effectively in society; whether the education is intellectually enriching.

• Governance – whether there is democracy, fairness and freedom of expression; whether justice is transparent and consistent, and whether society is governed with compassion and equality.                                                                            http://www.une.edu.au/faculties/professions/Resources/goodsocietyframework.pdf

Given Professor Jordan’s framework for a healthy society, one might ask how the U.S. is doing? Like the canaries in the mineshaft who die when overcome by poisonous gases, maybe the depressed preschoolers are telling us.

Where information leads to Hope. ©   Dr. Wilda.com

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American Academy of Neurology study: Doctors cautioned against using drugs to treat children

19 Mar

Moi wrote in More children now on antipsychotics drugs:

Duff Wilson chronicles one family’s harrowing ordeal as they sought first, an accurate diagnosis and then appropriate treatment for their child. In the New York Times article, Child’s Ordeal Shows the Risk of Psychosis Drugs For The Young Wilson reports about the Warren family. Judy Lightfoot has a very informative article at Crosscut, We’re Doing Experiments On Poor Children whose are prescribed antipsychotic drugs more often. Pamela Paul has a fascinating article in the New York Times about preschoolers and depression. In the article, Can Preschoolers Be Depressed? Paul does a great job of describing what depression looks like in small children and reporting about nascent research efforts by various universities.                                                                                   https://drwilda.com/2012/08/10/more-children-now-on-antipsychotics-drugs/

“The American Academy of Neurology (AAN), the world’s largest professional association of neurologists, is releasing a position paper on how the practice of prescribing drugs to boost cognitive function, or memory and thinking abilities, in healthy children and teens is misguided.”

Genevra Pittman of Reuters writes in the article, Be cautious of mind-altering drugs for kids: doctors:

Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.

Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.

According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.

Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.

“What we’re saying is that because of the volume of drugs and the incredible increase… the possibility of overdiagnosis and overtreatment is clearly there,” said Graf, from Yale University in New Haven, Connecticut.

In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents’ advice.

Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.

http://www.reuters.com/article/2013/03/13/us-medications-kids-idUSBRE92C17H20130313

Here is the press release from the American Academy of Neurology:

FOR IMMEDIATE RELEASE, MARCH 13, 2013

AAN: Doctors Caution Against Prescribing Attention-Boosting Drugs for Healthy Kids

Share:

MINNEAPOLIS – The American Academy of Neurology (AAN), the world’s largest professional association of neurologists, is releasing a position paper on how the practice of prescribing drugs to boost cognitive function, or memory and thinking abilities, in healthy children and teens is misguided. The statement is published in the March 13, 2013, online issue of Neurology, the medical journal of the American Academy of Neurology.

This growing trend, in which teens use “study drugs” before tests and parents request ADHD drugs for kids who don’t meet the criteria for the disorder, has made headlines recently in the United States. The Academy has spent the past several years analyzing all of the available research and ethical issues to develop this official position paper.

“Doctors caring for children and teens have a professional obligation to always protect the best interests of the child, to protect vulnerable populations, and prevent the misuse of medication,” said author William Graf, MD, of Yale University in New Haven, Conn., and a member of the American Academy of Neurology. “The practice of prescribing these drugs, called neuroenhancements, for healthy students is not justifiable.”

The statement provides evidence that points to dozens of ethical, legal, social and developmental reasons why prescribing mind-enhancing drugs, such as those for ADHD, for healthy people is viewed differently in children and adolescents than it would be in functional, independent adults with full decision-making capacities. The Academy has a separate position statement that addresses the use of neuroenhancements in adults.

The article notes many reasons against prescribing neuroenhancement including: the child’s best interest; the long-term health and safety of neuroenhancements, which has not been studied in children; kids and teens may lack complete decision-making capacities while their cognitive skills, emotional abilities and mature judgments are still developing; maintaining doctor-patient trust; and the risks of over-medication and dependency.

“The physician should talk to the child about the request, as it may reflect other medical, social or psychological motivations such as anxiety, depression or insomnia. There are alternatives to neuroenhancements available, including maintaining good sleep, nutrition, study habits and exercise regimens,” said Graf.

The statement had no industry sponsors.

View the full statement at: http://neurology.org/lookup/doi/10.1212/WNL.0b013e318289703b. View the AAN’s full statement on neuroenhancements and adults at: http://www.neurology.org/content/early/2009/09/23/WNL.0b013e3181beecfe.full.pdf

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy. For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

Parents must be advocates for their children. If the first medical opinion does not seem right, get a second or even a third opinion.

Related:

Schools have to deal with depressed and troubled children https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’ https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Where information leads to Hope. ©                 Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©                        http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©                                               http://drwildareviews.wordpress.com/

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Journal of American Medical Association study: Folic acid may reduce autism risk

12 Feb

Moi has written several blog posts about autism. In University of Connecticut study: Some children with autism may be ‘cured’ with intense early therapy:

In order for children with autism to reach their full potential there must be early diagnosis and treatment.

Autism Speaks reports about a University of Connecticut study in the post, Study Confirms “Optimal Outcomes”:

Some children diagnosed with autism in early childhood reach “optimal outcomes” with levels of function similar to their typical peers. The findings appear today in the Journal of Child Psychology and Psychiatry.

“Although the diagnosis of autism is not usually lost over time, the findings suggest that there is a very wide range of possible outcomes,” says Thomas Insel, M.D., director of the National Institutes of Mental Health (NIMH). “For an individual child, the outcome may be knowable only with time and after some years of intervention.”

This week’s report is the first in a series of autism studies on optimal outcomes, sponsored by the NIMH. They follow up on earlier reports that a small group of children appear to “lose” their autism diagnosis over time. Some experts have questioned the accuracy of these children’s initial diagnoses. Others argued that simply being able to function in a mainstream classroom doesn’t mean that these children don’t quietly struggle with autism-related disabilities. http://www.autismspeaks.org/science/science-news/study-confirms-%E2%80%9Coptimal-outcomes%E2%80%9D

https://drwilda.com/2013/01/19/university-of-connecticut-study-some-children-with-autism-may-be-cured-with-intense-early-therapy/

The Journal of the American Medical Association (JAMA) is reporting in a new study that folic acid use during pregnancy may reduce autism risk.

Steven Reinberg, Health Day Reporter for WebMD reports in Folic Acid in Pregnancy May Lower Autism Risk:

A new study suggests that women who start taking folic acid supplements either before or early in their pregnancy may reduce their child’s risk of developing autism.

“The study does not prove that folic acid supplements can prevent childhood autism. But it does provide an indication that folic acid might be preventive,” said study lead author Dr. Pal Suren, from the division of epidemiology at the Norwegian Institute of Public Health in Oslo.

“The findings also provide a rationale for further investigations of possible causes, as well as investigations of whether folic acid is associated with a reduced risk of other brain disorders in children,” he said.

Taking folic acid supplements during pregnancy is already known to prevent birth defects such as spina bifida, which affects the spine, and anencephaly, which causes part of the brain to be missing.

Alycia Halladay, senior director of environmental and clinical sciences at Autism Speaks, said that “parents always wonder what they can do to reduce the risk [of autism], and this [folic acid] is a very inexpensive item that mothers can do both before pregnancy and very early in their pregnancy.”

As to why folic acid may be beneficial, Halladay speculated that the nutrient might blunt a genetic risk for autism or boost other processes during pregnancy that are protective.

Another expert, Dr. Roberto Tuchman, director of the Autism and Neurodevelopment Program at Miami Children’s Hospital’s Dan Marino Center, said, “This study suggests that in some kids autism spectrum disorders may be preventable. As a clinician who works with autism spectrum disorders it is exciting that we can look at potentially preventable factors in autism. This is really encouraging.”

Still, Tuchman cautioned that the study findings are very preliminary, and it isn’t possible to tell which autism spectrum disorders, if any, folic acid may prevent. http://www.webmd.com/brain/autism/news/20130212/folic-acid-in-pregnancy-may-lower-autism-risk

Citation:

February 13, 2013, Vol 309, No. 6 >

Original Contribution | February 13, 2013

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children FREE

Pål Surén, MD, MPH; Christine Roth, MSc; Michaeline Bresnahan, PhD; Margaretha Haugen, PhD; Mady Hornig, MD; Deborah Hirtz, MD; Kari Kveim Lie, MD; W. Ian Lipkin, MD; Per Magnus, MD, PhD; Ted Reichborn-Kjennerud, MD, PhD; Synnve Schjølberg, MSc; George Davey Smith, MD, DSc; Anne-Siri Øyen, PhD; Ezra Susser, MD, DrPH; Camilla Stoltenberg, MD, PhD

JAMA. 2013;309(6):570-577. doi:10.1001/jama.2012.155925.

Text Size: A A A

Article

Figures

Tables

References

Importance  Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders.

Objective  To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder–not otherwise specified [PDD-NOS]) in children.

Design, Setting, and Patients  The study sample of 85 176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression analysis. Analyses were adjusted for maternal education level, year of birth, and parity.

Main Outcome Measure  Specialist-confirmed diagnosis of ASDs.

Results  At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61 042) had autistic disorder, compared with 0.21% (50/24 134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41-0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use.

Conclusions and Relevance  Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in the MoBa cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation. http://jama.jamanetwork.com/article.aspx?articleid=1570279

One of the implications of this study is the necessity that women receive adequate prenatal care and women really should have pre-pregnancy counseling and care.

United Health Foundation reports Prenatal Care (1990 – 2011): Percentage of pregnant women receiving adequate prenatal care, as defined by Kessner Index:

Prenatal care is a critical component of health care for pregnant women and a key step towards having a healthy pregnancy and baby. Early prenatal care is especially important because many important developments take place during the first trimester, screenings can identify babies or mothers at risk for complications and health care providers can educate and prepare mothers for pregnancy.  Women who receive prenatal care have consistently shown better outcomes than those who did not receive prenatal care[1]. Mothers who do not receive any prenatal care are three times more likely to deliver a low birth weight baby than mothers who received prenatal care, and infant mortality is five times higher[2].  Early prenatal care also allows health care providers to identify and address health conditions and behaviors that may reduce the likelihood of a healthy birth, such as smoking and drug and alcohol abuse.                                           http://www.americashealthrankings.org/All/PrenatalCare/2012

Given this recent study it is imperative that ALL women receive prenatal care particularly poor and those women at risk of difficult pregnancies.

Related:

Autism and children of color                                                https://drwilda.com/tag/children-of-color-with-autism/

Archives of Pediatrics and Adolescent Medicine study: Kids with autism more likely to be bullied                                   https://drwilda.com/2012/09/06/archives-of-pediatrics-and-adolescent-medicine-study-kids-with-autism-more-likely-to-be-bullied/

Father’s age may be linked to Autism and Schizophrenia https://drwilda.com/2012/08/26/fathers-age-may-be-linked-to-autism-and-schizophrenia/

Chelation treatment for autism might be harmful  https://drwilda.com/2012/12/02/chelation-treatment-for-autism-might-be-harmful/

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GAO report: Children’s mental health services are lacking

12 Jan

Moi wrote about troubled children in Schools have to deal with depressed and troubled children:

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.

As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids….

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?      

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical,  cognitive, emotional/affective, and motivational well-being, no matter  their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.

Prevalence and Risk Factors

While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk  of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:

* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression    

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression. 

How to Recognize Depression In Your Child?     

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.

Signs and symptoms of depression in children include:       

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced  ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or  interests

* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide        

Not all children have all of these symptoms. In fact, most will  display different symptoms at different times and in different settings.  Although some children may continue to function reasonably well in  structured environments, most kids with significant depression will  suffer a noticeable change in social activities, loss of interest in  school and poor academic performance, or a change in appearance.  Children may also begin using drugs or alcohol,
especially if they are  over the age of 12.

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Joy Resmovits reported in the article, Mental Health Care For Kids Severely Lacking, Says GAO which was posted at Huffington Post:

“Most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year,” the GAO wrote.

The report comes after Sen. Tom Harkin (D-Iowa), Rep. Rosa DeLauro (Conn.), and Rep. Lucille Roybal-Allard (Calif.) requested that the GAO look into how psychotropic drugs affect the long-term development of kids who grow up in foster care. While the report is very specific in its scope, it’s sure to be a relevant piece of evidence as the Obama administration formulates policy to deal with the ramifications of the Newtown, Conn. elementary school shooting. The shooting has sparked a nationwide debate on gun control, but it has also directed America’s attention to the state of its mental health care system.

Here are some findings:

  • On average, 6.2 percent of noninstitutionalized children in Medicaid and 4.8 percent of privately insured kids received psychotropic medications.

  • 30 percent of foster children who might have required mental health care didn’t receive them over the last year.

  • Most kids outside the foster care system whose behavior displayed red flags didn’t receive mental care services.

  • Many kids who got psychotropic medication didn’t get counseling or therapy to complete the care.

  • While the National Institutes of Health spent1.2 billion on children’s mental health care research between 2008 and 2011, most of the funding focused on research studying therapy, rather than the effects of such medication. http://www.huffingtonpost.com/joy-resmovits/mental-health-care-for-ki_b_2449205.html?utm_hp_ref=education

Here is the GAO press release:

What GAO Found

An annual average of 6.2 percent of noninstitutionalized children in Medicaid nationwide and 4.8 percent of privately insured children took one or more psychotropic medications, according to GAO’s analysis of 2007-2009 data from the Department of Health and Human Services’ (HHS) Medical Expenditure Panel Survey (MEPS). MEPS data also showed that children in Medicaid took antipsychotic medications (a type of psychotropic medication that can help some children but has a risk of serious side effects) at a relatively low rate–1.3 percent of children–but that the rate for children in Medicaid was over twice the rate for privately insured children, which was 0.5 percent. In addition, MEPS data showed that most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year. The Centers for Medicare & Medicaid Services (CMS) and many states have initiatives under way to help ensure that children receive appropriate mental health treatments. However, CMS’s ability to monitor children’s receipt of mental health services is limited because CMS does not collect information from states on whether children in Medicaid have received services for which they were referred. GAO recommended in 2011 that CMS identify options for collecting such data from state Medicaid programs. Findings in this report underscore the continued importance of CMS’s monitoring of children’s receipt of mental health services.

HHS’s Administration for Children and Families (ACF) reported that 18 percent of foster children were taking psychotropic medications at the time they were surveyed, although utilization varied widely by the child’s living arrangement. ACF also reported that 30 percent of foster children who may have needed mental health services did not receive them in the previous 12 months. HHS agencies are taking steps to promote appropriate mental health treatments for foster children, such as by sending information to states on psychotropic medication oversight practices.

HHS’s National Institutes of Health spent an estimated $1.2 billion on over 1,200 children’s mental health research projects during fiscal years 2008 through 2011. Most of the funding–$956 million–was awarded by the National Institute of Mental Health, with more research projects studying psychosocial therapies than psychotropic medications. Other HHS agencies spent about $16 million combined on children’s mental health research during this period.

HHS reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate.

Why GAO Did This Study

Experts have concerns that children with mental health conditions do not always receive appropriate treatment, including concerns about appropriate use of psychotropic medications (which affect mood, thought, or behavior) and about access to psychosocial therapies (sessions with a mental health provider). These concerns may be compounded for low-income children in Medicaid and children in foster care (most of whom are covered by Medicaid)–populations who may be at higher risk of mental health conditions. Within HHS, CMS oversees Medicaid, and ACF supports state child welfare agencies that coordinate health care for foster children.

GAO was asked to provide information on children’s mental health. This report examines (1) the use of psychotropic medications and other mental health services for children in Medicaid nationwide, and related CMS initiatives; (2) HHS information on the use of psychotropic medications and other mental health services for children in foster care nationwide, and related HHS initiatives; and (3) the amount HHS has invested in research on children’s mental health.

GAO analyzed data from HHS’s MEPS –a national household survey on use of medical services–from 2007 through 2009 for children covered by Medicaid and private insurance. GAO reviewed two recent ACF foster care reports with data from a national survey conducted during 2008 through 2011. GAO analyzed data from HHS agencies that conduct or fund research and interviewed HHS officials and children’s mental health providers, researchers, and advocates.

For more information, contact Katherine Iritani at (202) 512-7114 or iritanik@gao.gov.

Concerns Remain about Appropriate Services for Children in Medicaid and Foster Care GAO-13-15, Dec 10, 2012

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Resources:

Counselors, School Support Staff Toil Amid Scant Resources http://www.edweek.org/ew/articles/2013/01/10/16staffing.h32.html?tkn=VPLFw6EYbOz23lTzoeSKlVNGV4SNwasebCry&cmp=clp-edweek&intc=EW-QC13-EWH

About.Com’s Depression In Young Children

  1. Psych Central’s Depression In Young Children
  2. Psychiatric News’ Study Helps Pinpoint Children With Depression
  3. Family Doctor’s What Is Depression?
  4. WebMD’s Depression In Children
  5. Healthline’s Is Your Child Depressed?
  6. Medicine.Net’s Depression In Children
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Study: Current therapies may not be effective in preventing teen suicide, but targeted treatment helps

8 Jan

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Why Do Teens Attempt Suicide?

The American Academy of Adolescent Psychiatry has some excellent suicide resources

Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.

Teenagers experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while growing up. For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems and stress.

Sometimes, people see suicide as an answer to their problems. All of us must stress that suicide is always the WRONG answer to what in all likelihood is a transitory situation.

What are the Warning Signs of Suicide?

According to Teen’s Health there are some suicide warning signs

Warning Signs

There are often signs that someone may be thinking about or planning a suicide attempt. Here are some of them:

talking about suicide or death in general

talking about “going away”

referring to things they “won’t be needing,” and giving away possessions

talking about feeling hopeless or feeling guilty

pulling away from friends or family and losing the desire to go out

having no desire to take part in favorite things or activities

having trouble concentrating or thinking clearly

experiencing changes in eating or sleeping habits

engaging in self-destructive behavior (drinking alcohol, taking drugs, or cutting, for example)

These are signs that indicate a person may be depressed.

According to JaredStory.com the primary cause of suicide is depression.

# 1 CAUSE OF SUICIDE: UNTREATED DEPRESSION

It can be very hard to diagnose depression. There are many different kinds of depression and not all people will have the same symptoms, or have them to the same degree. Here are some symptoms to watch for and if they last more than a few weeks, a doctor or psychiatrist should be consulted.

Persistent sad or “empty” mood

Feeling hopeless, helpless, worthless

pessimistic and or guilty

Substance abuse

Fatigued or loss of interest in ordinary activities

Disturbances in eating and sleeping patterns

Irritability, increased crying, anxiety and panic attacks, (Post Traumatic Stress Disorder)

Difficulty concentrating, remembering or making decisions

Thoughts of suicide; suicide plans or attempts

Persistent physical symptoms or pains that do not respond to treatment

The site also lists events that might trigger depression in a person.

A death of a family member or close friend – which could include a fellow student from school

An assault, car accident or painful physical event – which could include physical bullying

Mental, or emotional event – which could include non-physical bullying

Marriage breakup, or love lost suddenly – which could include “breaking up” with a girlfriend or boyfriend

Constant physical, mental, or emotional pain that goes on for a length of time – which includes constant bullying that is not intervened, resolved or stopped entirely

Major Financial setback – which includes a teenager who may have lost a job

Something “embarrassing” happens – as an example; getting kicked off a football team or a public insult by a teacher or popular student; bullying

Failing an important exam a school – not a normal trigger unless the exam was life changing and the individual is under a lot of stress

A best friend moves out of town – especially true for teenagers who are being bullied and have very few friends as it is

If you notice these signs, the key is to get help for yourself or a friend. The type of treatment will depend upon the underlying symptoms.

Benedict Carey reports in the New York Times article, Study Questions Effectiveness of Therapy for Suicidal Teenagers:

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference. ..

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies. http://www.nytimes.com/2013/01/09/health/gaps-seen-in-therapy-for-suicidal-teenagers.html?hp&_r=0

See, A Tragedy and a Mystery http://harvardmagazine.com/2011/01/tragedy-and-mystery

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center has some excellent advice about suicide prevention

Resources

Teen’s Health’s Suicide

American Academy of Adolescent Psychiatry

Suicide Prevention Resource Center

Teen Depression

Jared Story.Com

CNN Report about suicide

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

Youth Suicide Prevention

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The Dr.Wilda.com chronicles

4 Dec

Here’s today’s COMMENT FROM AN OLD FART: Moi is like most people. A little this, a little that. She is no angel, but certainly not eeevil. She has this dream, Dr. Wilda.com which is a brand based upon the premise “Where information leads to hope.”

EVERYTHING IS AGAINST MOI’S SUCCESS. Building my brand is like a blind climber scaling the highest mountain. They can only succeed with some ONE guiding them. Everything that the world can throw against a person in terms of challenges is what moi faces. That includes moi’s nearly terminal stupidity. In the view of the world, someone like moi could NEVER succeed. In God’s world, ALL THINGS ARE POSSIBLE, even for someone like, moi. In fact, God just loves people that the world thinks are not worthy. You see God has a great sense of humor. God likes to chuckle when people like moi succeed because the world is forced to acknowledge that their success was purely a “God Thing.”

Moi wants Dr. Wilda.com to be a place of hope, nurturing, safety, and acceptance.

More later.

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Study: too many kids are pumping up with steroids

20 Nov

Moi wrote in In Children, body image, bullying, and eating disorders, moi said:

The media presents an unrealistic image of perfection for women and girls. What they don’t disclose is for many of the “super” models their only job and requirement is the maintenance of their appearance. Their income depends on looks and what they are not able to enhance with plastic surgery and personal trainers, then that cellulite can be photoshopped or airbrushed away. That is the reality. Kid’s Health has some good information about Body Image https://drwilda.wordpress.com/2012/01/09/children-body-image-bullying-and-eating-disorders/

In an attempt to have a buff body many teens are using steroids.

Brian Toporek writes in the Education Week article, Study: Muscle-Enhancing Behaviors Increasingly Common Among Teens:

Both teenage boys and girls are engaging in muscle-enhancing behaviors far more than previously known, according to a study published online today in the journal Pediatrics.

As large, lean, muscular male body images have risen in popularity in Western culture, so too has teenage boys’ dissatisfaction with their own bodies, the study suggests. Some boys thus decide to engage in muscle-enhancing behaviors to shape their bodies like the ones being presented to them in the media.

For this study, three researchers from the University of Minnesota and Columbia University examined data from 2,793 youths (with a mean age of 14.4) at 20 urban middle and high schools taken during the 2009-10 school year. The researchers set out to determine the prevalence of five specific muscle-enhancing behaviors: changing eating habits to increase muscle size, increasing exercise, the use of protein powder, the use of steroids, and the use of other muscle-enhancing substances.

Nearly 70 percent of the boys in the study (897 of 1,307 total) reported having changed their eating habits in order to increase their muscle size or tone within the past 12 months, and more than 90 percent of boys increased their amount of exercise to achieve the same goal.

More than 40 percent of boys reported that they often exercised more to boost their muscle mass or tone, while 39.1 percent sometimes did, and 11.3 rarely did. Only 8.8 percent of boys never did, according to the study.

While changing eating habits and exercising more could each be considered healthy habits, many boys engaged in unhealthy behaviors, too. More than one-third of the boys in the study reported using protein powders or shakes, 5.9 percent reported using steroids, and 10.5 percent reported using some other muscle-enhancing substance.

On the female side, more than 60 percent of girls reported changing their eating habits to increase muscle size or tone, and more than 80 percent of girls exercised more for the same reason. More than 20 percent of girls reported using protein powders or shakes, 4.6 percent reported using steroids, and 5.5 percent reported using other muscle-enhancing substances…

The researchers suggest that pediatricians should ask their adolescent patients about muscle-enhancing behaviors, and say sports physicals could present a perfect opportunity to do so. http://blogs.edweek.org/edweek/schooled_in_sports/2012/11/muscle-enhancing_behaviors_increasingly_common_among_teens_study_finds.html?intc=es

Generva Pittman of Reuters writes about steroids in the article, One in 20 youth has used steroids to bulk up: study:

Anabolic steroids are synthetic versions of testosterone, the male sex hormone. Steroids are prescribed legally to treat conditions involving hormone deficiency or muscle loss, but when they’re used for non-medical purposes, it’s typically at much higher doses, according to the National Institute on Drug Abuse.

In those cases, steroids can cause mood swings – sometimes known as roid rage – and for adolescents, stunted growth and accelerated puberty.

Anabolic steroids have become pervasive in professional sports, including baseball, football and boxing. (Another example of performance-enhancing drug use is “blood doping” with erythropoietin or EPO, which is behind the Lance Armstrong cycling controversy that caused him to be stripped of his Tour de France titles last month.)

Experts have worried that the drive to get ahead of competitors at any cost could trickle down to college and high school athletes, as well.

Goldberg, co-developer of the ATLAS and ATHENA programs to prevent steroid and other substance use on high school teams, said it’s important to give teens healthier alternatives to build muscle. http://news.yahoo.com/one-20-youth-used-steroids-bulk-study-052014145.html

Citation:

Muscle-enhancing Behaviors Among Adolescent Girls and Boys

  1. Marla E. Eisenberg, ScD, MPHa,b,
  2. Melanie Wall, PhDc, and
  3. Dianne Neumark-Sztainer, PhD, MPH, RDb

+ Author Affiliations

  1. aDivision of Adolescent Health and Medicine, Department of Pediatrics, and
  2. bDivision of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and
  3. cDepartments of Biostatistics and Psychiatry, Columbia University, New York, New York
    Abstract

OBJECTIVE: Media images of men and women have become increasingly muscular, and muscle-enhancing techniques are available to youth. Identifying populations at risk for unhealthy muscle-enhancingbehaviors is of considerable public health importance. The current study uses a large and diverse population-based sample of adolescents to examine the prevalence of muscle-enhancing behaviors and differences across demographic characteristics, weight status, and sports team involvement.

METHODS: Survey data from 2793 diverse adolescents (mean age = 14.4) were collected at 20 urban middle and high schools. Use of 5 muscle-enhancing behaviors was assessed (changing eating, exercising, protein powders, steroids and other muscle-enhancing substances), and a summary score reflecting use of 3 or more behaviors was created. Logistic regression was used to test for differences in each behavior across age group, race/ethnicity, socioeconomic status, BMI category, and sports team participation.

RESULTS: Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys. In models mutually adjusted for all covariates, grade level, Asian race, BMI category, and sports team participation were significantly associated with the use of muscle-enhancing behaviors. For example, overweight (odds ratio = 1.45) and obese (odds ratio = 1.90) girls had significantly greater odds of using protein powders or shakes than girls of average BMI.

CONCLUSIONS: The use of muscle-enhancing behaviors is substantially higher than has been previously reported and is cause for concern. Pediatricians and other health care providers should ask their adolescent patients about muscle-enhancing behaviors. http://pediatrics.aappublications.org/content/early/2012/11/14/peds.2012-0095.abstract

Parents have more influence on their children’s values and beliefs than most are willing to exercise. You need to support your children’s dreams, not yours.

Because people have free will, even the best parents will have children who make mistakes. Some so identified “progressives” will attribute this lapse not to individual free will, but the fact that the message of morality is a failure. It is not. People learn lessons at different speeds, some sooner, some later. Remember the lesson of the Prodigal Son

Resources:

8 Reasons to Make Time for Family Dinner http://www.health.com/health/gallery/0,,20339151,00.html

The Family Dinner Deconstructed                                      http://www.npr.org/templates/story/story.php?storyId=18753715

The Magic of the Family Meal                                          http://www.time.com/time/magazine/article/0,9171,1200760,00.html

Related

Making time for family dinner                                             https://drwilda.com/2012/09/10/making-time-for-family-dinner/

Study: Girls as young as six think of themselves as sex objects https://drwilda.com/2012/07/18/study-girls-as-young-as-six-think-of-themselves-as-sex-objects/

Social media spreads eating disorder ‘Thinspiration’ https://drwilda.com/2012/06/19/social-media-spreads-eating-disorder-thinspiration/

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