Sleep-Disordered Breathing, Behavior
Children with mild to moderate sleep-disordered breathing demonstrated significantly more problem behaviors, compared with controls in a cross-sectional study of 829 8- to 11-year-olds, said Carol L. Rosen, M.D., of Case Western Reserve University, Cleveland, and her associates.
The children were assessed with unattended in-home overnight cardiorespiratory recordings of airflow, respiratory effort, oximetry, and heart rate. Overall, children with sleep-disordered breathing were at least twice as likely to score in the borderline or clinically abnormal range on the Child Behavior Checklist (CBCL) externalizing and internalizing scales (Pediatrics 2004;114:1640-8).
The children with sleep-disordered breathing were significantly more likely to demonstrate hyperactivity, emotional lability, aggression, and opposition, compared with controls. Black ethnicity was a significant predictor for the CBCL total problem scale, while preterm birth was a significant predictor for the CBCL total and social problem scales and a hyperactivity scale. The significantly higher odds of behavior problems in black children as a subgroup may be the result of a greater vulnerability to sleep disruption in this group.
CBT Relieves Depression in IBD Patients
Adolescents with inflammatory bowel disease and either major or minor depression showed a significant reduction in depressive symptoms after 12 sessions of a manual-based cognitive-behavioral therapy program, reported Eva Szigethy, M.D., of Children's Hospital Boston and her associates.
In a pilot study, 11 adolescents aged 12-17 years participated. Seven patients had Crohn's disease and four had ulcerative colitis, with an average of 40 months' duration. Scores on the Children's Depression Inventory dropped from 16.18 before treatment to 4.82 after treatment. At baseline, all the teens reported depressed mood and anhedonia; 10 reported sleep disturbance and fatigue (J. Am. Acad. Child Adolesc. Psychiatry 2004;43:1469-77).
Although illness severity remained the same, the adolescents' own perception of their physical functioning improved by the end of the study period.
Recreational Ritalin on the Rise
Approximately 4% of a national sample of 8th, 10th, and 12th graders reported illicit use of methylphenidate (Ritalin) within the past year, said Sean Esteban McCabe, Ph.D., and his associates at the University of Michigan, Ann Arbor.
Based on data from the 2001 Monitoring the Future Survey, students in grades 10 (4.6%) and 12 (5%) were significantly more likely to report illicit use than eighth graders (2.7%). Illegal methylphenidate use was significantly more common among students with grade point averages of C or D (6.4%), compared with those with a B average (3.9%) or A average (2.6%). In addition, white students (4.8%) were significantly more likely to report illegal use than black students (0.8%), which mirrored racial differences in prescription patterns (J. Adolesc. Health 2004;35:501-4).
Iron Deficiency's Role in ADHD
Children with attention-deficit hyperactivity disorder had significantly lower levels of iron, compared with controls in a study of 53 children aged 4-14 years, said Eric Konofal, M.D., of Hôpitaux de Paris, and his colleagues.
The mean serum iron level was 23 ng/mL in the children with ADHD, compared with 44 ng/mL in the controls. In addition, 42 (84%) of the ADHD children had iron levels considered abnormally low–below 30 ng/mL–compared with 5 (18%) of the 27 controls (Arch. Pediatr. Adolesc. Med. 2004;158:1113-5). Low levels of iron may hamper the development of the central nervous system and consequently contribute to the likelihood of behavioral disorders, so children with ADHD might benefit from iron supplements.
Nature and Neighborhoods
Adolescent girls who mature early and live in economically disadvantaged neighborhoods committed three times as many violent acts as early maturers in less disadvantaged neighborhoods, said Dawn Obeidallah, Ph.D., of Harvard Medical School, Boston, and her colleagues.
The investigators used census data to characterize neighborhoods in the Chicago area and interviewed 501 adolescent girls and their families twice during a 3-year period (J. Am. Acad. Child. Adolesc. Psychiatry 2004;43:1460-8).
Overall, 121 girls had engaged in violent behavior at the time of the second interview: 18% of the early maturers, 48% of on-time maturers, and 33% of late maturers. Approximately 50% of the girls were Hispanic, 36% were black, and 14% were white, and 20% of early maturing black girls, 14% of early maturing Hispanic girls, and 7% of early maturing white girls had engaged in violence at the time of the second interview.