Ethnicity and Depression in Teen Girls
Depression scores among white girls and young women decrease over time, but the scores tend to hold steady among their African American counterparts, reported Debra L. Franko, Ph.D., of Northeastern University, Boston, and her associates.
Depression scores among white girls and young women tend to start off higher, and that might play a role in the findings.
Previous comparisons of depression scores in African American and white girls have shown either mixed results or higher scores among white girls at younger ages.
The investigators conducted an age-matched study of 2,221 girls and young women aged 16–22 years, including 1,146 African Americans and 1,075 whites. The girls, participants in the 10-year longitudinal National Growth and Health Study, were asked to complete a packet of questionnaires, including the Center for Epidemiological Studies of Depression scale (CES-D) (J. Adolesc. Health 2005;37:526–9).
Adolescent depression was defined as a score of at least 24 on the CES-D.
Overall, as they got older, the percentage of white girls who met the criteria for depression fell, and the percentage of African American girls who met the criteria remained fairly steady. Specifically, 21% of 483 white 16-year-olds scored 24 or higher, compared with 14% of 332 white 22-year-olds. Among African Americans, 14% of 469 16-year-olds scored 24 or higher, compared with 15% of 452 22-year-olds.
The researchers noted that age-specific risk factors–such as body dissatisfaction subsequent to pubertal development–are more common among white girls and could partly account for the results. Other factors, such as access to and use of mental health care, also could explain some of the differences.
Modafinil for ADHD
Modafinil film-coated tablets significantly improved clinical symptoms of attention-deficit hyperactivity disorder in children and adolescents aged 6–17 years, said Dr. Joseph Biederman of Massachusetts General Hospital in Boston and his colleagues.
Modafinil, an agent generally prescribed to promote wakefulness in patients with narcolepsy, has been shown to activate the cortex alone.
In the randomized, double-blind trial conducted by Dr. Biederman and his colleagues, 164 children received a flexible dose of modafinil in tablet form, and 82 children received a placebo. The children began with one 85-mg tablet for the first 2 days; the dose was titrated to 170 mg on days 3–7, 255 mg on days 8–14, 340 mg on days 15–21, and 425 mg on day 22 (Pediatrics 2005;116:777–84).
After 9 weeks, 48% of patients in the modafinil group were deemed responders, compared with 17% of those in the placebo group. Overall, patients in the modafinil group demonstrated significant improvement in symptoms, including oppositional behavior, cognitive problems/inattention, hyperactivity, and the ADHD index on the Conners' Parent Rating Scale Revised, Short Form, compared with those in the placebo group.
Modafinil (Provigil) also was well tolerated. Only five of the patients in the treatment group (3%) and three in the placebo group (4%) discontinued the study because of adverse events. Given modafinil's safety profile and its low potential of abuse, the drug may offer clinicians a new option for treating ADHD in children and adolescents, the investigators said.
Teens' Perception of Body Weight
Many young teens from disadvantaged backgrounds do not perceive obesity as unacceptable, and despite common perceptions, not all of them are striving for thinness, reported Wendy Wills of the Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, England.
In a qualitative study in eastern Scotland of 36 economically disadvantaged 13− to 14-year-olds, half of the subjects were either overweight (body mass index greater than 25 kg/m
The overweight and obese teens had complex views of their weight and body size. Three-quarters of them talked positively about their weight, body size, or parts of their bodies, or expressed comfort with their bodies. A minority who were comfortable with their bodies also reported dissatisfaction with some parts of their bodies, and about half of these subjects wanted to lose weight or had already tried.
Half of the overweight and obese teens had tried to lose weight (as had three in the normal-weight group). These teens experienced an “emotional high” when they lost weight, and a deterioration in well-being when they failed. Only a minority of the subjects cited the health benefits of weight loss, even after expressing a desire to lose weight. Most of the subjects said that family and friends did not need to lose weight and should not feel pressured to do so.