Premature babies predisposed to depression

A recent study claims that premature babies have a high risk of depression later in life.

People born extremely premature have a significantly higher risk of developing psychiatric problems later in life, a new Canadian study says.

Researchers at McMaster University in Hamilton, Ont., studied 174 people born in Ontario between 1977 and 1982 — 84 of whom weighed less than 1 kg (2.2 lbs.) at birth, and 90 of whom fell into the range of normal birth weight.

The low-birth-weight babies were 2.5 times more likely to develop a mental health problem such as depression, an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD), the study found.

The likelihood is even higher — nearly 4.5 times — for those whose mothers received a high dose of steroids before giving birth.

At the same time, the research found a positive outcome: the low-birth-weight babies were nearly three times less likely to develop an alcohol or substance abuse disorder.

The study was published in the journal Pediatrics.

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Kids with ADHD may be more likely to drink and smoke

A study shows that kids who have ADHD may be more likely to drink and smoke as teenagers.

Teens are more likely to start smoking or drinking with each additional symptom they have of attention-deficit hyperactivity disorder (ADHD) or conduct disorder, new research suggests.

"Our findings underscore the need to counsel families about the risk of substance use as [these] children approach adolescence," said study author Dr. William Brinkman, research director at Cincinnati Pediatric Research Group, which is part of Cincinnati Children's Hospital. "This need is heightened among children with ADHD and/or conduct disorder diagnoses or symptoms."

Brinkman's team analyzed data on more than 2,500 teens, aged 12 to 15, in a national survey conducted with their parents between 2000 and 2004.

First, the researchers identified the teens with an ADHD and/or conduct disorder diagnosis, as well as those with the symptoms of either disorder, regardless of whether there was a diagnosis. Conduct disorder is characterized by aggressive, destructive or deceitful behavior. Children with ADHD tend to be hyperactive, impulsive and/or inattentive.

Then Brinkman's team compared use of tobacco and alcohol among the teens, to look for a link between symptoms of ADHD or conduct disorder and substance use.

Brinkman said that 45 percent of the children in the study had at least one ADHD symptom, and nearly 15 percent had at least one conduct disorder symptom.

For each additional ADHD symptom related to inattention -- but not hyperactivity or impulsivity -- the risk that a teen would use tobacco or alcohol increased by 8 percent to 10 percent. Similarly, each additional conduct disorder symptom was linked to a 31 percent increase in the likelihood of using tobacco, according to the study.

A very small percentage of teens in the study -- about 1.5 percent -- were diagnosed with both ADHD and conduct disorder. These teens were more than three times more likely to use tobacco or alcohol, even after accounting for differences in age, race/ethnicity, sex, household income and having a household member who smoked.

The findings were published recently in the journal Drug and Alcohol Dependence.

Brinkman said more research may provide clues as to why the link exists between these disorders and substance use.

"Because nicotine can improve attention and arousal, some have speculated that the association between inattention symptoms and higher rates of tobacco use suggests a form of self-medication for ADHD," Brinkman said. "Certainly higher rates of risk taking and novelty seeking has been documented among children with a diagnosis of ADHD, as well as those with ADHD symptoms [but too few for a diagnosis]."

Social pressures may be involved as well, suggested Dr. Glen Elliott, chief psychiatrist and medical director of Children's Health Council in Palo Alto, Calif.

"It is important to emphasize that not all teens with ADHD follow this path, just a higher percentage than those without ADHD," Elliott said. "We believe it is a combination of impulsive decision-making and perhaps the social strain that ADHD can place on the individual, who may feel unable to connect with peers in socially acceptable ways and therefore more vulnerable to trying other methods such as doing things peers dare them to do or that they view as 'cool' or 'adult.' "

Elliott said the study provides new insights into the interplay between ADHD and conduct disorder. But it sheds little light on whether treating ADHD, either earlier in childhood or during adolescence, might change the risk of starting to smoke or drink, he said.

"We believe medication can make a difference, but the evidence is not nearly as compelling as we wish it were -- partly because teens often go through a phase of refusing to take medications just when it might do them the most good," Elliott said. "Just as with parents of any teenager, there is no guaranteed way to prevent a son or daughter from experimenting if they are determined to do so."

The best tools parents have, Elliott said, are setting consistent and clear expectations for their children, closely monitoring them, praising them for good choices and administering appropriate, meaningful consequences for poor choices -- while also showing children early on what behavior is acceptable.

"Adolescence is hard," Elliott said. "And having ADHD can make it harder. So parents need to be vigilant, caring, consistent and involved."

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Teenagers proscribed anti-anxiety or sleep medications more likely to abuse them

When teenagers are proscribed anti-anxiety or sleep medication, they are more likely to abuse those drugs later in life.

The medical community may be inadvertently creating a new generation of illegal, recreational drug users by prescribing anti-anxiety or sleep medications to teenagers, say University of Michigan researchers.

Teens prescribed anxiety or sleep medications are up to 12 times more likely to abuse those drugs than those who had never had a prescription, either by using someone else's prescription pills or to get high or experiment, according to a study from the U-M School of Nursing.

Nearly 9 percent of the 2,745 adolescent study participants had received a prescription for anxiety or sleep medications during their lifetime, and more than 3 percent received at least one prescription during the three-year study period.

"I recognize the importance of these medications in treating anxiety and sleep problems," said the study's first author Carol Boyd, the Deborah J. Oakley Professor of Nursing. "However, the number of adolescents prescribed these medications and the number misusing them is disturbing for several reasons."

Anxiety and sleep medications can be addictive or even fatal when mixed with narcotics or alcohol, said Boyd, who is also a professor of women's studies and research professor at the Institute for Research on Women and Gender and at the U-M Addiction Research Center in the Department of Psychiatry.

"What happened to [actor] Heath Ledger could happen to any teen who is misusing these medications, particularly if the teen uses alcohol in combination with these drugs," Boyd said.

Examples of anti-anxiety medications include Klonopin, Xanax and Ativan; sleep medications include Ambien, Restoril and Lunesta. These are controlled substances partly because of the potential for abuse, and it's a felony to share them, Boyd said.

The U-M study included students from five Detroit-area schools grouped into three categories: those never prescribed anxiety or sleep medications; those prescribed those medications within the three-year study period; and those previously prescribed those medications but not during the study period.

Key findings include:

Adolescents prescribed anxiety medications during their lifetime, but not during the study, were 12 times more likely to use someone else's anxiety medication than participants who had never been prescribed such drugs.

Those prescribed anxiety or sleep medications during the study period were 10 times more likely to abuse them within two years, to get high or to experiment, than teens without prescriptions.

White students were twice as likely as black students to use others' medications, and females older than 15 and teens who had prescriptions for longer periods of time were more likely to abuse the medications.

It's the first longitudinal study to determine whether teens' recent medical use of anxiety or sleep medications is associated with later taking somebody else's prescription medication illegally, either for self-treatment or recreational use.

Boyd said the group intended to write a paper about teens abusing their own prescriptions, but changed course when the results became clear.

"I looked at these numbers and said, 'There's a story here.' It just catches you off guard that so many adolescents are being prescribed these medications," Boyd said. "Why is it that our youth are anxious and sleepless? Is it because they are under stress, consuming too much caffeine or seeking an altered state? "

The study recommends better education for parents and adolescents prescribed these medications, monitoring refills and making it standard practice to give teens a substance use assessment before prescribing these drugs.

Boyd's co-authors include Elizabeth Austic, Quyen Epstein-Ngo, Philip Veliz and Sean Esteban McCabe of the U-M Institute for Research on Women and Gender. Epstein-Ngo also has appointments at the U-M Injury Research Center and Institute for Clinical and Health Research.

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Link between ADHD and family troubles

A study found a link between children with ADHD and suffering from family troubles.

New research indicates that children with attention-deficit hyperactivity disorder may be more likely to be part of families that are affected by poverty, divorce, neighborhood violence and substance abuse.

"Our findings suggest that children with ADHD experience significantly higher rates of trauma than those without ADHD," study author Dr. Nicole Brown said in a news release from the American Academy of Pediatrics. "Providers may focus on ADHD as the primary diagnosis and overlook the possible presence of a trauma history, which may impact treatment."

The researchers analyzed the answers of parents of 65,680 children aged 6-17 who responded to a 2011 survey. About 12 percent of the kids had been diagnosed with ADHD, and their parents reported higher rates of various problems than the parents of kids without ADHD did.

"Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," said Brown, an assistant professor of pediatrics at The Children's Hospital at Montefiore, Albert Einstein College of Medicine, New York City.

The findings are to be presented Tuesday at the annual meeting of the Pediatric Academic Societies in Vancouver, Canada. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.

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