4 Troubled Teens Blog

The number of preschoolers diagnosed with bipolar disorder doubled in the past ten years, according to new research in the Journal of the American Academy of Child and Adolescent Psychiatry. The number of children under 18 years old diagnosed with the disorder has increased by forty times over in the same period.

• About 1.5 percent of children ages two to five years old are now taking some kind of psychotropic drug, according to the new study by Dr. Mark Olfson, professor of clinical psychiatry at Columbia University.
  
• These drugs may include antipsychotics, mood stabilizers, stimulants or antidepressants.
• Bipolar disorder, which involves severe mood changes, was once thought only to appear in late adolescence.
  

It is hard to diagnose psychiatric disorders in very young children because bipolar disorder, Attention Deficit Hyperactivity Disorder, sexual abuse and family dysfunction can produce similar symptoms.

Dr. Olfson said that physicians should prescribe drugs to preschoolers only after they have tried other interventions, "but that's not happening if you look at the billing records" from insurance and drug companies.

About 9 percent of the children who went through Hurricane Katrina are still experiencing serious emotional disturbances as a result of their trauma, according to a new study from several universities, including Virginia Tech.

• The disturbances include symptoms of inappropriate behaviors, depression, hyperactivity, eating disorders, fears, phobias, and learning disabilities.
• The children who experienced the deaths of loved ones were the most affected.
• The authors of the study recommended continued psychological treatment for children in former hurricane disaster areas in Louisiana, Mississippi, and Alabama. Hurricane Katrina occurred in August 2005.
  

"The effects of trauma, especially on impressionable young minds, can be long-lasting and far-reaching," said Dr. Beverly Smallwood, a psychologist. "If significant time has passed and the child or adolescent is still having problems that are disruptive to the life of the young person or the family, professional help is definitely advisable."

This study appeared in the Journal of Child and Adolescent Psychiatry.

Doctors can help suicidal teenagers, but they have to use sensitive language to be effective, according to two new studies.

The first study from the University of Massachusetts Children's Medical Center looked at 66 children ages 13 to 18 years old and their parents. Most participants in the study underestimated the problem of teen suicide but all agreed that doctors could be the best source of help and advice. The study appears in the journal Pediatrics.

In the second study, Dr. Steven Vannoy of the University of California in Davis combed through the transcripts of 298 doctors' visits, and found that physicians asked their patients about suicide 91 times.

If a doctor was "clear, supportive, and sensitive," the patient was more likely to confide in him or her. "Some aspects of the physicians' discourse may inhibit patient disclosure," according to Dr. Vannoy's report in the Annals of Family Medicine. "A small portion of inquiries were not prefaced by context statement. Failing to create a context before the inquiry may catch patients off guard and inhibit subsequent disclosure."

In 2001, suicide was the 11th leading cause of death among teenagers. Today, its #3. The U.S. Centers for Disease Control (CDC) estimates that suicide results in thousands of lives lost every year (4,500 people between the ages of 10 and 24).

According to a Jan. 12 Medical News Today article, researchers have discovered that much work remains in the effort to educate both parents and teens about warning signs that might indicate a young person is considering suicide:

In focus groups in Chicago and Kansas City, both teenagers and their parents correctly identified many of the known risk factors for suicide, including mental illness, alcohol and substance abuse, relational or social loss, and hopelessness.

However, study authors said it was concerning that some of the parents reported regular drug and alcohol use as being a normal part of adolescent development, rather than problem behavior.

Parents and teens suggested guns should be removed if an adolescent is known to be suicidal, but parents acknowledged they may not be able to identify a suicidal teen. Parents and teens didn't think suicide was a problem in their communities.

All groups were interested in learning how to identify and intervene with a suicidal adolescent.

Study authors conclude pediatricians should regularly screen all adolescents in their offices and encourage families to be open to discussing depression and suicide.

Teenagers who resort to violence may be seeking respect and appreciation among their peer groups, according to a new study from Spain.

• Dr. David Ruiz and his colleagues studied 1320 teenagers in Valencia, Spain.
  
• One of their main findings was that if teens experience lowered social status and social rejection, they suffer loneliness, low self-esteem, and lowered satisfaction with their lives.
  
• This results in many teenagers using relational violence to gain acceptance.
  
• Relational violence is defined as behavior designed to provoke harm within another person's circle of friends or damage their perception of belonging to a group.

"Having high self-esteem is a key aspect because this is important in inhibiting teenagers from indulging in behavior that involves relational violence between peers at school," the author wrote in the study, which was published in the journal Psicothema.

Hurricane Katrina, the storm that ravaged the Gulf Coast in 2005, has left more than physical destruction in its wake. A new study has found serious emotional disturbances among children who were caught in the storm.

"The study, published in a recent issue of the Journal of the American Academy of Child and Adolescent Psychiatry, showed the estimated prevalence of serious emotional disturbances (SED) among residents was 14.9 percent. Of those, 9.3 percent of youths were believed to have SED that was directly attributable to Hurricane Katrina." [Source: Virginia Tech News]

Youth who lost loved ones had the strongest emotional disturbances, followed by those who were exposed to physical adversity. Russell Jones, professor of psychology in the College of Science at Virginia Tech, said the study points to a substantial need for mental health treatment resources in hurricane-affected areas.

A new study in the Journal of the American Medical Association reports that teenagers who take antipsychotic medications are at risk of becoming overweight or obese, and for developing metabolic syndrome.

Metabolic syndrome includes symptoms such as overweight, too much abdominal fat, and abnormal cholesterol and high blood pressure. Some of the teenagers who took these medications developed symptoms of cardiovascular disease.

• Dr. Christoph Correll of Zucker Hillside Hospital in New York and his colleagues studied 272 patients ages 4 to 19 years old who were taking drugs such as Abilify, Zyprexa, Seroquel, and Risperdal.
• Between 10 and 36 percent of the studied teens became overweight or obese.
  
• Dr. Correll recommended that "the cardiometabolic risk of these drugs in children should be balanced through careful assessment of the indication for their use, consideration of lower risk alternative, and proactive adverse effect monitoring and management."

"Cardiometabolic adverse effects, such as age-inappropriate weight gain, obesity, hypertension, and lipid and glucose abnormalities are particularly problematic during development," said Dr. Correll, "because they predict adult obesity, the metabolic syndrome, cardiovascular morbidity, and malignancy."

Teenagers who go to bed after midnight are 24 percent more likely to become depressed, according to a new study from Columbia University Medical Center in New York.

• The researchers also found that teenagers who sleep five hours or less are 70 percent more likely to be depressed and 50 percent more likely to attempt suicide.
• Dr. James Gangwisch used data on 15,659 adolescents enrolled in the National Longitudinal Study of Adolescent Health.
  
• The average teenager sleeps seven hours 53 minutes per night, about one hour less than the nine recommended by physicians.
  

Insomnia can be a symptom of depression, Dr. Gangwisch noted. Inadequate sleep is also linked to a higher rate of accidents, lower productivity, and increased daytime fatigue.

A new set of state and federal laws might improve the speed at which police departments file missing persons reports on runaway children.

The laws might help correct a problem in that police departments are failing to file missing person reports on 10 to 40 percent of runaway children within the first 24 hours of receiving notice that a child is missing.

• The reasons for delay can be complex.
  
• Youth shelters, for example, often want more time than just one day to gain the trust of a runaway child.
  
• Some children come from abusive homes, and it may not be in their best interest to go back to their parents.

U.S. Rep. Carolyn Maloney said the reporting failures, which average 16 percent nationwide, are "absolutely outrageous."

"It's absolutely inappropriate that many runaway children are missing not only from their homes but also from the very databases meant to help law enforcement find them," she said.

Rep. John Conyers of the House Judiciary Committee is sponsoring the new bill in Congress.

If teenagers are admitted to a hospital psychiatric ward because of a suicide attempt or suicidal ideation, they are much less likely to be readmitted if his doctor prescribes antidepressant drugs.

• Dr. Cynthia Fonanella of Ohio State University studied 318 teenagers admitted to three Maryland hospitals because of suicide problems.
  
• One in four were prescribed three or more medications, and these teenagers were 2.6 times more likely to be readmitted to the hospital within 30 days.
  
• However, this group also had the most severe problems. The group prescribed antidepressants improved their chances of not being readmitted by 85 percent.

The use of antidepressant drugs in adolescence has been under fire ever since the Federal Food and Drug Administration put warning labels on these drugs. The labels said that using antidepressants could actually increase the possibility of a teenager committing suicide.

There has been an increase in teenage suicides since the warning labels went into place.

The study appeared in the journal Annals of Pharmacotherapy.

Traumatic experiences can affect children's memories, according to new research from Stanford University.

• Dr. Victor Carrion and his colleagues tested 16 children ages 10 to 17 years old, who had Post-Traumatic Stress Syndrome (PTSS), and 11 children without the syndrome.
• Researchers monitored brain responses using magnetic resonance imaging as the children tried to remember lists of words.
  
• The children in the PTSS group suffered poor memory, and the hippocampi in their brains did not activate as often as those in the control group.

Dr. Carrion said he is hopeful that this research may help children who survive natural disasters and other traumas. The study appeared in the Journal of Pediatric Psychology.