Tag Archives: Mental Health

Aarhus University study: Using antidepressants during pregnancy may affect your child’s mental health

9 Sep

Laura G Owens wrote in the Huffington Post article, What I Wished I’d Had: Maternal Mental Health Screening:

When I was pregnant nineteen years ago I wish my doctor had warned me I might be at risk for postpartum depression.
Her words wouldn’t have freaked me out, they would have helped me cope when the darkness did indeed hit.
I wish during my 6 week check-up (when I was at my private worst) my Ob-Gyn had handed me a mental health screening and even if I lied on every question, she still explained how the “baby blues” are different than depression.
In January for the first time the United States Preventive Services Task Force recommended screening pregnant and postpartum women for maternal mental illness.
Hopefully now more health care practitioners will talk to women so those who suffer know they’re not bad people or rotten mothers or God knows, alone.
The fact is worldwide 10% of pregnant women and 13% of postpartum women have a mental disorder and the numbers are even higher in developing countries.
While maternal mental illness is often lumped into the catchall “postpartum depression” it’s more complicated than a single kitchen sink diagnosis.
Symptoms can show up during pregnancy or long after birth and they don’t always look like depression, sometimes they look like:
• Anxiety
• Panic disorder
• Post-traumatic stress disorder
• Obsessive compulsive disorder
• Psychosis
Alone, or in combination.
Mental illness has always been stigmatized but especially inside the idealized institution of motherhood where pretending superhuman resilience to change, sleep deprivation, anger, frustration, fear, anxiety and sadness awards women the coveted “best” mother prize…. http://www.huffingtonpost.com/laura-g-owens/maternal-mental-health-screening_b_9485446.html

The timing of a pregnancy should include diagnosis of potential maternal mental health issues and what treatment may be necessary.

Science Daily reported in Using antidepressants during pregnancy may affect your child’s mental health:

The use of antidepressants has been on the rise for many years. Between 2 and 8% of pregnant women are on antidepressants. Now researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.
The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.
They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.
“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu, who is the lead author of the article, which has just been published in BMJ-British Medical Journal.
More specifically, the researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy. The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.
The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy. Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5%) than in group 1 (8%). In groups 2 and 3 respectively, 11.5% and 13.6% were diagnosed with a psychiatric disorder at age 16 years.
Psychiatric disorders are hereditary
In their analyses, the researchers took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb…. https://www.sciencedaily.com/releases/2017/09/170907112400.htm

Citation:

Using antidepressants during pregnancy may affect your child’s mental health
Date: September 7, 2017
Source: Aarhus University
Summary:
The use of antidepressants during pregnancy increases the risk of your child being diagnosed with a psychiatric disorder later in life, a study of almost one million Danish children shows. However, heritability also plays a part, according to the researchers.
Journal Reference:
1. Xiaoqin Liu, Esben Agerbo, Katja G Ingstrup, Katherine Musliner, Samantha Meltzer-Brody, Veerle Bergink, Trine Munk-Olsen. Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study. BMJ, 2017; j3668 DOI: 10.1136/bmj.j3668

Here is the press release from Aarhus University:

Using antidepressants during pregnancy may affect your child’s mental health
A study from Aarhus BSS of almost one million Danish children shows that the use of antidepressants during pregnancy increases the risk of your child being diagnosed with a psychiatric disorder later in life. However, heritability also plays a part, according to the researchers.
2017.09.07 | Ingrid Marie Fossum
The use of antidepressants has been on the rise for many years. Between 2 and 8% of pregnant women are on antidepressants. Now researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.
The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.
They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.
“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu, who is the lead author of the article, which has just been published in BMJ-British Medical Journal.
More specifically, the researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy. The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.
The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy. Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5%) than in group 1 (8%). In groups 2 and 3 respectively, 11.5% and 13.6% were diagnosed with a psychiatric disorder at age 16 years.
Psychiatric disorders are hereditary
In their analyses, the researchers took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb.
“We chose to conduct the study on the assumption that psychiatric disorders are highly heritable. For this reason, we wanted to show that is too narrow if you only look at autism, which is what many previous studies have done. If heritability plays a part, other psychiatric disorders such as depression, anxiety, ADHD-like symptoms would also appear in the data,” says Trine Munk-Olsen, who is also one of the researchers behind the study.
Indeed, the study also shows that the increase covers not only autism but also other psychiatric disorders such as depression, anxiety, and ADHD. Thus it becomes clear that the mother’s underlying psychiatric disorder matters in relation to the child’s mental health later in life. At the same time, it cannot be ruled out that the use of antidepressants further increases the risk of psychiatric diseases in the child.
“Our research shows that medication seems to increase the risk, but that heritability also plays a part,” says Trine Munk-Olsen, who also points out that it might be the mothers who suffer from the most severe forms of depression who need to take medication during their pregnancy.
Not just black and white
The researchers hope that the study can increase the focus on the fact that the research results are not just black and white. This could help doctors advise women on the use of antidepressants both before and after their pregnancy. Some women might be able to discontinue treatment with the medication while pregnant. However, the researchers also acknowledge that some women need medication and stress that the consequences of an untreated depression are severe and can lead to serious consequences to both mother and child.
The most important message is that we ensure and safeguard the mental well-being of the pregnant women, and for some women, this involves the use of antidepressants.
“These women should not feel guilty about taking antidepressants. Even though there is an increased risk of the child developing a psychiatric disorder later in life, our research shows that we cannot blame medication alone. Heritability also plays a part,” says Trine Munk-Olsen.
Facts:
• The article “Antidepressant use during pregnancy and psychiatric disorders in the offspring: A Danish nationwide register-based cohort study” has been published in the medical journal BMJ-British Medical Journal.
• The research has been conducted by researchers at the National Centre for Register-based Research at Aarhus BSS in collaboration with an American and a Dutch psychiatrist.
• The research has been partly funded by The Lundbeck Foundation Initiative for Integrative Psychiatric Research”- iPSYCH, as well as the National Institute of Mental Health (NIMH) (R01MH104468)
• The study includes all children born in Denmark between 1998 and 2012. The study followed the children until 2014, where some of the children were 16,5 years old.
Further info:
Trine Munk-Olsen
Senior Researcher
National Centre for Register-based Research
Aarhus BSS, Aarhus University
tmo@econ.au.dk
+45 87165749 / + 45 51505161
¬Xiaoqin Liu
Postdoc
National Centre for Register-based Research
Aarhus BSS, Aarhus University
lxq@econ.au.dk
+45 87165358

Children will have the most success in school, if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of societies’ problems would be lessened if the goal was a healthy child in a healthy family.

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Tulane University study: Don’t want to raise a psychopath? Be sensitive to a child’s distress

9 Dec

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

Jyoti Madhusoodanan and Nature magazine reported in the Scientific American article, Stress Alters Children’s Genomes:

Growing up in a stressful social environment leaves lasting marks on young chromosomes, a study of African American boys has revealed. Telomeres, repetitive DNA sequences that protect the ends of chromosomes from fraying over time, are shorter in children from poor and unstable homes than in children from more nurturing families…
http://www.scientificamerican.com/article/stress-alters-childrens-genomes/?WT.mc_id=SA_Facebook

Not only are the child’s gene’s altered, but there are behavioral indications of the stress being felt by the child.

Science Daily reported in Don’t want to raise a psychopath? Be sensitive to a child’s distress:

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving — especially when children are in distress — helps prevent boys from becoming callous, unemotional adolescents, according to a new Tulane University study of children raised in foster care.

The research, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry, is the first to show that an intervention can prevent the precursors to psychopathy. The destructive condition affects approximately 1 percent of the population and is characterized by callous interpersonal interactions and lack of guilt or empathy.

Researchers measured levels of callous-unemotional behavior in 12-year-olds from the Bucharest Early Intervention Project, a cohort of children abandoned in Romanian orphanages in the early 2000s and followed longitudinally ever since. Half of these children were placed in high-quality foster care as toddlers, while others grew up in institutional care. Researchers compared their results with children who had never been orphans. The study is led by Dr. Charles H. Zeanah from Tulane, Nathan A. Fox from the University of Maryland, and Charles A. Nelson from Harvard Medical School.

Overall, children reared in orphanages had significantly higher levels of callous-unemotional traits compared to children who had never been institutionalized. Boys placed in foster care had lower levels of callous-unemotional traits than those who did not receive the intervention. What explained the difference? Researchers observed children with their caregivers as toddlers and found that the more sensitive caregivers were to a young child’s distress, the less callous and more empathic the boys were in adolescence.

Lead author Kathryn Humphreys, a who conducted the study as a postdoctoral fellow in infant mental health at Tulane, says the findings can help child welfare advocates target and support specific caregiver behaviors when reaching out to families.

“If we can intervene early to help kids in their development, it not only helps them but also the broader society,” she says. “The best way to do that is making sure children are placed in homes with responsive caregivers and helping caregivers learn to be more responsive to their child’s needs.” Don’t want to raise a psychopath? Be sensitive to a child’s distress: New study is the first to show that an intervention can prevent the precursors to psychopathy

Citation

Don’t want to raise a psychopath? Be sensitive to a child’s distress  New study is the first to show that an intervention can prevent the precursors to psychopathy

Date:        December 3, 2015

Source:   Tulane University

Summary:

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving — especially when children are in distress — helps prevent boys from becoming callous, unemotional adolescents, according to a new study of children raised in foster care.

Journal Reference:

  1. Kathryn L. Humphreys, Lucy McGoron, Margaret A. Sheridan, Katie A. McLaughlin, Nathan A. Fox, Charles A. Nelson, Charles H. Zeanah. High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 2015; 54 (12): 977 DOI: 10.1016/j.jaac.2015.09.010

Here is the press release from Tulane University:

Don’t want to raise a psychopath? Be sensitive to a child’s distress

December 3, 2015

Keith Brannon
Phone: 504-862-8789
kbrannon@tulane.edu

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving – especially when children are in distress – helps prevent boys from becoming callous, unemotional adolescents, according to a new Tulane University study of children raised in foster care.

The research, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry, is the first to show that an intervention can prevent the precursors to psychopathy.

Researchers measured levels of callous-unemotional behavior in 12-year-olds from the Bucharest Early Intervention Project, a cohort of children abandoned in Romanian orphanages in the early 2000s and followed longitudinally ever since. Half of these children were placed in high-quality foster care as toddlers, while others grew up in institutional care. Researchers compared their results with children who had never been orphans. The study is led by Dr. Charles H. Zeanah from Tulane, Nathan A. Fox from the University of Maryland, and Charles A. Nelson from Harvard Medical School.

Overall, children reared in orphanages had significantly higher levels of callous-unemotional traits compared to children who had never been institutionalized. Boys placed in foster care had lower levels of callous-unemotional traits than those who did not receive the intervention. What explained the difference? Researchers observed children with their caregivers as toddlers and found that the more sensitive caregivers were to a young child’s distress, the less callous and more empathic the boys were in adolescence.

Lead author Kathryn Humphreys, a who conducted the study as a postdoctoral fellow in infant mental health at Tulane, says the findings can help child welfare advocates target and support specific caregiver behaviors when reaching out to families.

“If we can intervene early to help kids in their development, it not only helps them but also the broader society,” she says. “The best way to do that is making sure children are placed in homes with responsive caregivers and helping caregivers learn to be more responsive to their child’s needs.”                                                                                                    Tulane University – Don’t want to raise a psychopath? Be sensitive to a child’s distress                           http://tulane.edu/news/releases/how-to-prevent-raising-a-psychopath.cfm

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.

Related:

GAO report: Children’s mental health services are lacking

https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children

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

University of Cambridge study: Saliva test may detect depression in kids

https://drwilda.com/2014/02/23/university-of-cambridge-study-saliva-test-may-detect-depression-in-kids/

Study: Some of the effects of adverse stress do not go away

https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

American Psychological Association: Kids too stressed out to be healthy

https://drwilda.com/2014/02/12/american-psychological-association-kids-too-stressed-out-to-be-healthy/

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/

 

Harvard study: High doses of antidepressants appear to increase risk of self-harm in children and young adults

29 Apr

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.

Medical Press reported in the article, High doses of antidepressants appear to increase risk of self-harm in children young adult:

Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk….
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude. http://medicalxpress.com/news/2014-04-high-doses-antidepressants-self-harm-children.html

Citation:

Online First >
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Original Investigation|April 28, 2014
Antidepressant Dose, Age, and the Risk of Deliberate Self-harm
ONLINE FIRST
Matthew Miller, MD, ScD1; Sonja A. Swanson, ScM2; Deborah Azrael, PhD1; Virginia Pate, PhD, PhD3; Til Stürmer, MD, ScD3
[+] Author Affiliations
JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053
Text Size: A A A
Article
Figures
Tables
References
Comments
ABSTRACT
ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Importance A comprehensive meta-analysis of randomized trial data suggests that suicidal behavior is twice as likely when children and young adults are randomized to antidepressants compared with when they are randomized to placebo. Drug-related risk was not elevated for adults older than 24 years. To our knowledge, no study to date has examined whether the risk of suicidal behavior is related to antidepressant dose, and if so, whether risk depends on a patient’s age.
Objective To assess the risk of deliberate self-harm by antidepressant dose, by age group.
Design, Setting, and Participants This was a propensity score–matched cohort study using population-based health care utilization data from 162 625 US residents with depression ages 10 to 64 years who initiated antidepressant therapy with selective serotonin reuptake inhibitors at modal or at higher than modal doses from January 1, 1998, through December 31, 2010.
Main Outcomes and Measures International Classification of Diseases, Ninth Revision (ICD-9) external cause of injury codes E950.x-E958.x (deliberate self-harm).
Results The rate of deliberate self-harm among children and adults 24 years of age or younger who initiated high-dose therapy was approximately twice as high as among matched patients initiating modal-dose therapy (hazard ratio [HR], 2.2 [95% CI, 1.6-3.0]), corresponding to approximately 1 additional event for every 150 such patients treated with high-dose (instead of modal-dose) therapy. For adults 25 to 64 years of age, the absolute risk of suicidal behavior was far lower and the effective risk difference null (HR, 1.2 [95% CI, 0.8-1.9]).
Conclusions and Relevance Children and young adults initiating therapy with antidepressants at high-therapeutic (rather than modal-therapeutic) doses seem to be at heightened risk of deliberate self-harm. Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that antidepressant dose is generally unrelated to therapeutic efficacy, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to closely monitor patients starting antidepressants, especially youth, for several months.

Here is the press release from Harvard:

PUBLIC RELEASE DATE:
28-Apr-2014

Contact: Marge Dwyer
mhdwyer@hsph.harvard.edu
617-432-8416
The JAMA Network Journals
High doses of antidepressants appear to increase risk of self-harm in children young adult
Bottom Line:
Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
Author:
Matthew Miller, M.D., Sc.D., of the Harvard School of Public Health, Boston, and colleagues.
Background:
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
How the Study Was Conducted:
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
Results: The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk.
Discussion: “Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that dose is generally unrelated to the therapeutic efficacy of antidepressants, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to monitor all patients starting antidepressants, especially youth, for several months and regardless of history of DSH.”
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made a conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Initial Dose of Antidepressants, Suicidal Behavior in Youth
In a related commentary, David A. Brent, M.D., of the University of Pittsburgh, and Robert Gibbons, Ph.D., of the University of Chicago, write: “In summary Miller et al are to be commended on a thoughtful and careful analysis of the effects of initiating antidepressants at higher than modal doses.”
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude.
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2013.14016. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
###
Media Advisory:
To contact author Matthew Miller, M.D., Sc.D., call Marge Dwyer at 617-432-8416 or email mhdwyer@hsph.harvard.edu. To contact commentary author David A. Brent, M.D., call Gloria Kreps at 412-586-9764 or email krepsga@upmc.edu.

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 http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention

Resources:

Teen’s Health’s Suicide http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx
Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression http://helpguide.org/mental/depression_teen.htm

Jared Story.Com http://www.jaredstory.com/teen_epidemic.html
CNN Report about suicide http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html
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
About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

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.

Related:
University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations https://drwilda.com/tag/depression/

GAO report: Children’s mental health services are lacking https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

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

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/

Harvard Study: Television impairs kid’s sleep patterns

21 Apr

Moi wrote in Study: Blue light may affect the sleep habits of students:
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. One of the mantras of this blog is there should not be a one size fits all approach to education and that there should be a variety of options to achieve the goal of a good basic education for all children.
The University of Illinois Extension has some good advice for helping children with study habits. In Study Habits and Homework he University of Illinois recommends:

Parents can certainly play a major role in providing the encouragement, environment, and materials necessary for successful studying to take place.
Some general things adults can do, include:
Establish a routine for meals, bedtime and study/homework
Provide books, supplies, and a special place for studying
Encourage the child to “ready” himself for studying (refocus attention and relax)
Offer to study with the child periodically (call out spelling words or do flash cards) http://urbanext.illinois.edu/succeed/habits.cfm

Some folks claim they need as few as four hours of sleep. For most folks, that is not healthy and it definitely isn’t healthy for children.

Sarah D. Sparks reported in the Education Week article, ‘Blue Light’ May Impair Students’ Sleep, Studies Say:

Schools may soon face an unintended consequence of more flexible technology and more energy-efficient buildings: sleepier students.
That’s because evidence is mounting that use of artificial light from energy-efficient lamps and computer and mobile-electronics screens later and later in the day can lead to significant sleep problems for adults and, particularly, children….
http://www.edweek.org/ew/articles/2013/12/11/14sleep_ep.h33.html?tkn=XYNFw7hK%2F8TdYrgvqxBY6H%2FjAT%2FMKwiy%2FAaU&cmp=clp-edweek

Technology may be interrupting children’s sleep patterns.
https://drwilda.com/tag/blue-light-may-impair-students-sleep-studies-say/

Tara Haelle reported in the Yahoo news post, More TV, Less Sleep for Kids:

A recent study found that children tended to get slightly less sleep with the more TV they watched. The most dramatic drop in daily sleep time, however, was linked to having a TV in the bedroom for minority children.
The authors suggested that reducing TV time and/or removing televisions from children’s bedrooms might help their sleep time.
The study, led by Elizabeth Cespedes, of the Obesity Prevention Program at Harvard Medical School, looked at the possible impact of television of children’s sleep.
The researchers collected daily average TV viewing information and sleep time from the parents of 1,864 children, starting at 6 months old and then once a year through age 7.
The researchers also gathered information on which children had a TV in their bedroom when they were aged 4 through 7.
Then the researchers analyzed the interaction of television viewing and sleep along with the children’s age, sex, race/ethnicity, income and mothers’ education level.
The group of children were diverse, including 35 percent who were racial/ethnic minorities and 37 percent who had family incomes of at least $70,000.
The children went from getting an average 12.2 hours of sleep each day at age 6 months old to an average of 9.8 hours a day at age 7.
During the same time span, the amount of TV the children watched increased from 0.9 hours a day to 1.6 hours a day.
About 17 percent of the children had a TV in their bedrooms when they were 4 years old, which increased to 23 percent by the time the children were 7 years old.
In comparing TV viewing time with sleep, the researchers found that each additional hour per day of watching TV was linked to seven fewer minutes of sleep each day.
Having a TV in children’s room also appeared to influence how much sleep the children got, but only for racial/ethnic minority children.
Among racial and ethnic minorities, children got an average 31 fewer minutes of sleep each day if they had a TV in their bedrooms than if they didn’t have a TV.
Among white, non-Hispanic children, however, a TV in the bedroom was only linked to eight fewer minutes of sleep each day, but this finding could have been the result of chance.
“Our study supports a negative influence of TV viewing and bedroom TV on children’s sleep,” the researchers wrote.
“TV viewing and the presence of a bedroom TV track over time,” they added. “Thus, modest decreases in sleep duration could form lasting habits leading to substantial sleep deficits as children age.”
The researchers suggested that making changes related to children’s TV viewing could have a positive impact on their sleep time.
http://health.yahoo.net/articles/parenting/more-tv-less-sleep-kids

Citation:

• Article
Television Viewing, Bedroom Television, and Sleep Duration From Infancy to Mid-Childhood
Authors
1. Elizabeth M. Cespedes, SMa,b,
2. Matthew W. Gillman, MD, SMa,b,
3. Ken Kleinman, ScDa,
4. Sheryl L. Rifas-Shiman, MPHa,
5. Susan Redline, MD, MPHc, and
6. Elsie M. Taveras, MD, MPHb,d
1. aObesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
2. bDepartment of Nutrition, Harvard School of Public Health, Boston, Massachusetts;
3. cBrigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and
4. dDivision of General Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
Abstract
BACKGROUND: Television and insufficient sleep are associated with poor mental and physical health. This study assessed associations of TV viewing and bedroom TV with sleep duration from infancy to midchildhood.
METHOD: We studied 1864 children in Project Viva. Parents reported children’s average daily TV viewing and sleep (at 6 months and annually from 1–7 years) and the presence of a bedroom TV (annually 4–7 years). We used mixed effects models to assess associations of TV exposures with contemporaneous sleep, adjusting for child age, gender, race/ethnicity, maternal education, and income.
RESULTS: Six hundred forty-three children (35%) were racial/ethnic minorities; 37% of households had incomes ≤ $70 000. From 6 months to 7 years, mean (SD) sleep duration decreased from 12.2 (2.0) hours to 9.8 (0.9) hours per day; TV viewing increased from 0.9 (1.2) hours to 1.6 (1.0) hours per day. At 4 years, 17% had a bedroom TV, rising to 23% at 7 years. Each 1 hour per day increase in lifetime TV viewing was associated with 7 minutes per day (95% confidence interval [CI]: 4 to 10) shorter sleep. The association of bedroom TV varied by race/ethnicity; bedroom TV was associated with 31 minutes per day shorter sleep (95% CI: 16 to 45) among racial/ethnic minority children, but not among white, non-Hispanic children (8 fewer minutes per day [95% CI: −19 to 2]).
CONCLUSIONS: More TV viewing, and, among racial/ethnic minority children, the presence of a bedroom TV, were associated with shorter sleep from infancy to midchildhood.
Key Words:
• television
• sleep duration
• sleep hygiene
• childhood
• Accepted February 11, 2014.
• Copyright © 2014 by the American Academy of Pediatrics
1. Published online April 14, 2014

(doi: 10.1542/peds.2013-3998)
1. » AbstractFree
2. Full Text (PDF)Free

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Resources:

National Sleep Foundation’s Teens and Sleep http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America
http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success
http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:
Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

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Canadian study: Teens who have suffered a concussion at higher risk for bullying and suicide

16 Apr

Kids Health has some great information about concussions at their site:

What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function.
Most people with concussions recover just fine with appropriate treatment. But it’s important to take proper steps if you suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear.
People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Guys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_
https://drwilda.com/2012/03/06/dont-ignore-concussions/
See, Update: Don’t ignore concussions https://drwilda.com/2012/05/20/update-dont-ignore-concussions/

Bryan Toporek reported in the Education Week article, Once-Concussed Teenagers Found to Be at Higher Risk for Bullying, Suicide:

Teenagers who have suffered a traumatic brain injury such as a concussion are twice as likely to be bullied and roughly three times as likely to attempt suicide compared to those who haven’t, according to a new study published online today in the open-access journal PLOS ONE.
The study drew upon data from the 2011 Ontario Student Drug Use and Health Survey, which contains responses from nearly 9,300 students between grades 7 and 12 in 181 publicly funded schools across Ontario. Questions about traumatic brain injuries were added to the OSDUHS for the first time in 2011 and were answered by a subsample of 4,816 students.
The teenagers were asked whether they had ever suffered a head injury that resulted in them being unconscious for at least five minutes or required at least one night’s stay in a hospital. Just under 20 percent of the students involved in the study had suffered at least one head injury that met either of those qualifications….
http://blogs.edweek.org/edweek/schooled_in_sports/2014/04/once-concussed_teenagers_found_to_be_at_higher_risk_for_bullying_suicide.html

Citation:

Research Article
Suicidality, Bullying and Other Conduct and Mental Health Correlates of Traumatic Brain Injury in Adolescents
Gabriela Ilie mail,
Robert E. Mann,
Angela Boak,
Edward M. Adlaf,
Hayley Hamilton,
Mark Asbridge,
Jürgen Rehm,
Michael D. Cusimano
Published: April 15, 2014
•DOI: 10.1371/journal.pone.0094936

Objective
Our knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario.
Method and Findings
Data were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours.
Conclusions
Significant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce injuries and comorbid problems in this age group…. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0094936
Here is the press release from St. Michael’s Hospital:
Teenagers who have had a concussion also have higher rates of suicide attempts, being bullied and high-risk behavior, study finds
Toronto, April 15, 2014
Teenagers who have suffered a traumatic brain injury such as a concussion are at “significantly greater odds” of attempting suicide, being bullied and engaging in a variety of high risk behaviours, a new study has found.
They are also more likely to become bullies themselves, to have sought counselling through a crisis help-line or to have been prescribed medication for anxiety, depression or both, said Dr. Gabriela Ilie, lead author of the study and a post-doctoral fellow at St. Michael’s Hospital.
They have higher odds of damaging property, breaking and entering, taking a car without permission, selling marijuana or hashish, running away from home, setting a fire, getting into a fight at school or carrying or being threatened by a weapon, she said in a paper published today in the journal PLOS ONE.
Dr. Ilie said the study provides the first population-based evidence demonstrating the extent of the association between TBI and poor mental health outcomes among adolescents.
“These results show that preventable brain injuries and mental health and behavioural problems among teens continue to remain a blind spot in our culture,” Dr. Ilie said. “These kids are falling through the cracks.”
The data used in the study was from the 2011 Ontario Student Drug Use and Health Survey developed by the Centre for Addiction and Mental Health. The survey, one of the longest ongoing school surveys in the world, contains responses from almost 9,000 students from Grades 7-12 in publicly funded schools across Ontario. The OSDUHS began as a drug use survey, but is now a broader study of adolescent health and well-being. Questions about traumatic brain injury were added to the survey for the first time in 2011.
“We know from a previous study based on OSDUHS data that as many as 20 per cent of adolescents in Ontario said they have experienced a traumatic brain injury in their lifetime,” said Dr. Robert Mann, senior scientist at CAMH and director of the OSDUHS. “The relationship between TBI and mental health issues is concerning and calls for greater focus on prevention and further research on this issue.”
Dr. Ilie said the teenage years are already a turbulent time for some, as they try to figure out who they are and what they want to be. Since a TBI can exacerbate mental health and behavioural issues, she said primary physicians, schools, parents and coaches need to be vigilant in monitoring adolescents with TBI.
In addition, she said many TBI experienced by youth occur during sports and recreational pursuits, and are largely preventable through use of helmets and the elimination of body checking in hockey.
The study found that adolescents who had suffered a TBI sometime in their life had twice the odds of being bullied at school or via the Internet and almost three times the odds of attempting suicide or being threatened at school with a weapon compared to those without a TBI.
This research was funded by a Canadian Institute of Health Research Team Grant in Traumatic Brain Injury and Violence and by the Ontario Neurotrauma Foundation. Additional funding was obtained from a grant from AUTO21, a member of the Networks of Centres of Excellence program that is administered and funded by the Natural Sciences and Engineering Research Council, the Social Sciences and Humanities Research Council, in partnership with Industry Canada, and ongoing funding support from the Ontario Ministry of Health and Long-Term Care.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
Media contacts
For more information, or to arrange an interview with Dr. Sievenpiper, contact:
Leslie Shepherd
Manager, Media Strategy
416-864-6094
shepherdl@smh.ca
About CAMH
The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, as well as one of the world’s leading research centres in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit http://www.camh.ca.
For more information on OSDUHS or to interview Dr. Mann, please contact:
Kate Richards
Media Relations
Centre for Addiction and Mental Health (CAMH)
Office: 416 535 8501 x36015
Mobile: 416 427 7743
kate.richards@camh.ca
http://www.camh.ca

The Sports Concussion Institute has some great information about concussions http://www.concussiontreatment.com/concussionfacts.html

People must take concussions very seriously.

Resources:

Concussions
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Concussion http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

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

Dr. Wilda says this about that ©

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University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations

23 Mar

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.
Schools are developing strategies to deal with troubled kids…. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

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 http://www.healthyplace.com/depression/children/recognizing-symptoms-of-depression-in-teens-and-children/

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. http://www.onhealth.com/depression_in_children/article.htm

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/

Science Daily reported in the article, Study identifies most common, costly reasons for mental health hospitalizations for kids:

Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 14 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases — Kids’ Inpatient Database and Pediatric Health Information System — the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals…. http://www.sciencedaily.com/releases/2014/03/140317084531.htm

Citation:

Study identifies most common, costly reasons for mental health hospitalization

Date: March 17, 2014

Source: University of California, San Francisco

Summary:
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis. The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
Journal Reference:
1.Naomi S. Bardach, Tumaini R. Coker, Bonnie T. Zima, J. Michael Murphy, Penelope Knapp, Laura P. Richardson, Glenace Edwall, and Rita Mangione-Smith. Common and Costly Hospitalizations for Pediatric Mental Health Disorders. Pediatrics, March 2014 DOI: 10.1542/peds.2013-3165

Here is the press release from the University of San Francisco:

Study Identifies Most Common, Costly Reasons for Mental Health Hospitalizations for Kids
By Juliana Bunim on March 13, 2014
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 4 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases – Kids’ Inpatient Database and Pediatric Health Information System – the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals.
At both kinds of hospitals, the most common mental health diagnoses were similar (depression, bipolar disorder, and psychosis), which the researchers say supports the creation of diagnosis-specific quality measures for all hospitals that admit children.
Depression accounted for 44.1 percent of all pediatric primary mental health admissions, with charges of $1.33 billion dollars, based on the billing databases used in the study. Bipolar was the second most common diagnosis accounting for 18.1 percent and $702 million, followed by psychosis at 12.1 percent and $540 million.
“These are costly hospitalizations, and being hospitalized is a heavy burden for families and patients. Prevention and wellness is a huge part of the Affordable Care Act, along with controlling costs by delivering great care,” said Bardach. “This study helps us understand that mental health is a key priority. The long term goal is not only to improve hospital care for these kids, but also to understand how to effectively optimize mental health resources in the outpatient world.”
Co-authors include Tumaini Coker, MD, MBA and Bonnie Zima, MD, MPH, both of UCLA; J. Michael Murphy, EdD, Massachusetts General Hospital Boston; Penelope Knapp, MD, UC Davis; Laura Richardson, MD, MPH and Rita Mangione-Smith, MD, MPH, both of the University of Washington School of Medicine, Seattle; and Glenace Edwall, PsyD, PhD, MPP, Minnesota State Health Access Data Assistance Center.
The study was supported by the Agency for Healthcare Research and Quality and the National Institute for Children’s Health and Human Development.
UCSF Benioff Children’s Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital.

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.

Related:

GAO report: Children’s mental health services are lacking
https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

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

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

Dr. Wilda says this about that ©

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

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Dr. Wilda ©
https://drwilda.com/

University of Strathclyde study: Obese children get lower grades

13 Mar

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 http://kidshealth.org/teen/your_mind/body_image/body_image.html

Huffington Post reported in the article, Children Diet To Keep Off Pounds And Ward Off Bullying, Survey Says:

A recent survey of 1,500 of children between ages 7 and 18 revealed that young teens diet and worry about their weight.
About 44 percent of children between the ages of 11 and 13 say they’ve been bullied because of their weight, and more than 40 percent of kids younger than 10 admitted they were concerned about packing on the pounds, with nearly one-fourth reporting having been on a diet in the last year, according to the Press Association….
Last year, 13-year-old Nicolette Taylor resorted to plastic surgery to escape harassment and name-calling, particularly on social networking sites such as Facebook.
“All my friends could see [my nose], all my new friends, and I didn’t want them saying things,” Taylor told Nightline about her decision to get a nose job. “Gossip goes around, and it really hurts.”
Other teens have felt suicide was their only way to escape daily scrutiny about their appearance or sexuality.
Although adolescents get picked on for a variety of reasons, weight is the top reason children are bullied at school, Yahoo! Shine reports.
And according to Rebecca Puhl, Director of Research at the Rudd Center for Food Policy at Yale University, a new ad campaign in Georgia is only “perpetua[ting] negative stereotypes.”
The ads, which aim to curb childhood obesity rates, feature photos of overweight children accompanied by text, such as “WARNING: It’s hard to be a little girl if you’re not.” http://www.huffingtonpost.com/2012/01/05/children-diet-bullying_n_1186422.html?ref=email_share

It is situations like this which cause unhealthy eating habits and disorders like anorexia and bulimia.

Linda Poon of NPR reported in the story, Obesity Linked To Lower Grades Among Teen Girls:

Since the 1990s, the U.K has seen childhood obesity rates grow at an alarming rate, says John Reilly, specialist in the prevention of childhood obesity at the University of Strathclyde, and the study’s lead author. Today, nearly a quarter of children in U.K. are obese by the time they reach 12. Increasingly, researchers in both the U.S. and the U.K. have been interested in how obesity might affect students’ academic achievement, but Reilly says few studies have examined the same students over several years, or been able tease out obesity’s effects from the influence of social factors, such as socioeconomic status.
The current study analyzed data from nearly 6,000 adolescent students in the U.K., comparing their body mass index from ages 11 to 16 with how well they performed in standardized tests during those years. About 71 percent of the students surveyed were of a “healthy weight” at the start, the researchers said, and about 15 percent were obese. The academic exams, which tested the students’ English, math and science abilities, were given three times — at ages 11, 13 and 16. After adjusting for factors like socioeconomic status, IQ and menstruation cycles, the researchers found that, on average, girls who were obese at age 11 performed worse at age 11, 13 and 16 than girls deemed to have a healthy weight. Being obese at 11, the scientists found, was enough “to lower average attainment to a grade D instead of a grade C,” by age 16…. Though the study followed British teens, Reilly says the findings are likely also applicable to students in the United States, where the proportion of children between the ages 12 and 19 who are obese grew from 5 percent in 1980 to nearly 21 percent by 2012.
“The similarities between the environment, the culture, [and] school systems between the U.S. and the U.K. are more similar than may be obvious,” Reilly says….
http://www.npr.org/blogs/health/2014/03/11/289070502/obesity-linked-to-lower-grades-among-teen-girls?
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See also, Obesity associated with lower academic attainment in teenage girls, says new study http://www.sciencedaily.com/releases/2014/03/140311100604.htm

Citation:

Journal Reference:
1.J N Booth, P D Tomporowski, J M E Boyle, A R Ness, C Joinson, S D Leary, J J Reilly. Obesity impairs academic attainment in adolescence: findings from ALSPAC, a UK cohort. International Journal of Obesity, 2014; DOI: 10.1038/ijo.2014.40

Here is the news release from the Universities of Strathclyde, Dundee, Georgia and Bristol

News Releases
main content
Obesity associated with lower academic attainment in teenage girls, says new study
Obesity in adolescent girls is associated with lower academic attainment levels throughout their teenage years, a new study has shown.
The research conducted by the Universities of Strathclyde, Dundee, Georgia and Bristol is the most comprehensive study yet carried out into the association between obesity and academic attainment in adolescence. The results are published in the International Journal of Obesity.
The results showed that girls who were obese, as measured by BMI (body mass index) at age 11 had lower academic attainment at 11, 13 and 16 years when compared to those of a healthy weight. The study took into account possible mediating factors but found that these did not affect the overall results.
Attainment in the core subjects of English, Maths and Science for obese girls was lower by an amount equivalent to a D instead of a C, which was the average in the sample.
Associations between obesity and academic attainment were less clear in boys.
University of Strathclyde Professor of Physical Activity and Public Health Science, John Reilly – the Principal Investigator of the study – said: “Further work is needed to understand why obesity is negatively related to academic attainment, but it is clear that teenagers, parents, and policymakers in education and public health should be aware of the lifelong educational and economic impact of obesity.”
Dr Josie Booth, of the School of Psychology at the University of Dundee, said: “There is a clear pattern which shows that girls who are in the obese range are performing more poorly than their counterparts in the healthy weight range throughout their teenage years.”
The study examined data from almost 6000 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), including academic attainment assessed by national tests at 11, 13 and 16 years and weight status. 71.4% were healthy weight (1935 male, 2325 female), 13.3% overweight (372 male, 420 female) and 15.3% obese (448 male, 466 female).
The researchers took into account potentially distorting factors such as socio-economic deprivation, mental health, IQ and age of menarche (onset of the menstrual cycle) but found these did not change the relationship between obesity and academic attainment.
This study was funded through a BUPA Foundation grant to the University of Strathclyde. ALSPAC receives core support from the Medical Research Council, the Wellcome Trust and the University of Bristol.
11 March 2014
Web MD has some excellent information about Anorexia
Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. More importantly, it is also a psychological disorder. Anorexia is a condition that goes beyond concern about obesity or out-of-control dieting. A person with anorexia often initially begins dieting to lose weight. Over time, the weight loss becomes a sign of mastery and control. The drive to become thinner is actually secondary to concerns about control and/or fears relating to one’s body. The individual continues the ongoing cycle of restrictive eating, often accompanied by other behaviors such as excessive exercising or the overuse of diet pills to induce loss of appetite, and/or diuretics, laxatives, or enemas in order to reduce body weight, often to a point close to starvation in order to feel a sense of control over his or her body. This cycle becomes an obsession and, in this way, is similar to an addiction.
Who is at risk for anorexia nervosa?
Approximately 95% of those affected by anorexia are female, most often teenage girls, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups. According to the U.S. National Institute of Mental Health (NIMH), other statistics about this disorder include the fact that an estimated 0.5%-3.7% of women will suffer from this disorder at some point in their lives. About 0.3% of men are thought to develop anorexia in their lifetimes
Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes, models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa. Health-care professionals are usually encouraged to present the facts about the dangers of anorexia through education of their patients and of the general public as a means of preventing this and other eating disorders.
What causes anorexia nervosa?
At this time, no definite cause of anorexia nervosa has been determined. However, research within the medical and psychological fields continues to explore possible causes.
Studies suggest that a genetic (inherited) component may play a more significant role in determining a person’s susceptibility to anorexia than was previously thought. Researchers are currently attempting to identify the particular gene or genes that might affect a person’s tendency to develop this disorder, and preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person’s susceptibility to anorexia nervosa.
Other evidence had pinpointed a dysfunction in the part of the brain, the hypothalamus (which regulates certain metabolic processes), as contributing to the development of anorexia. Other studies have suggested that imbalances in neurotransmitter (brain chemicals involved in signaling and regulatory processes) levels in the brain may occur in people suffering from anorexia. http://www.onhealth.com/anorexia_nervosa/article.htm

Beautiful people come in all colors, shapes, and sizes. The key is to be healthy and to live a healthy lifestyle

Related:

Helping Girls With Body Image http://www.webmd.com/beauty/style/helping-girls-with-body-image

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