Medication Use Reduces Recidivism
Bipolar juvenile offenders committed 80% fewer offenses while taking medication than when they were off medication, reported Larry F. Dailey, M.D., of the University of Minnesota, Minneapolis, and his colleagues.
The investigators followed 36 adolescents for 1 year after they left a juvenile correction facility; 31 (6 girls, 25 boys) completed the study (J. Clin. Psychiatry 2005;66:477–84). The patients agreed to continue their medications as prescribed and to attend follow-up appointments. Of the original 36 patients, 31 took lithium for their bipolar disorder. Overall, the patients stayed on their medications for a total of 2,992 days (34% of the study period) and were off their medications for 6,108 days (66% of the study). One offense was committed for every 157 days that patients were on medication, compared with one offense for every 46 days when they were off medication. In addition, 100% of four recidivist behaviors–truancy, suicide attempts, medical trauma due to deviant behavior, and driving-related offenses–occurred while patients were off medication.
Sex Often Precedes Violence
In a study of 6,548 adolescents aged 12–21 years who took part in the National Longitudinal Study of Adolescent Health, 27% reported some form of violence victimization from their romantic partners.
Overall, 37% of those who reported sexual relationships had experienced at least one incident of physical or verbal violence, compared with 19% of those who did not report sexual relationships, said Christine E. Kaestle and Carolyn T. Halpern, Ph.D., of the University of North Carolina, Chapel Hill. In most cases in which adolescents experienced both sex and violence, the violence, whether physical or verbal, came after the relationship became sexual (J. Adolesc. Health 2005;36:386–92). For instance, for 74% of adolescents who reported both having sex and being insulted in public by their partners, the sex occurred before the first incident of public insult.
Adolescents Stratify Stigmas
Substance abuse was associated with greater stigma than mental disorders, based on a survey of 303 high school students in Southern California, said Patrick W. Corrigan, Psy. D., of Evanston (Ill.) Northwestern Healthcare and his associates.
Overall, the students stigmatized alcohol abuse more than mental illness, leukemia, or a brain tumor. Leukemia was the least stigmatized condition, and mental illness due to a brain tumor was less stigmatized than mental illness without an organic cause (Psychiatr. Serv. 2005;56:544–50). Surprisingly, contact with someone who had mental illness seemed to increase stigma rather than diminish it.
Depression and Diabetes
In a study of 231 adolescents aged 11–18 years with type 1 diabetes, those who also demonstrated depressive symptoms were at increased risk for hospitalization from diabetes complications during a 2-year follow-up, said Sunita M. Stewart, Ph.D., and her colleagues at the University of Texas Southwestern Medical Center, Dallas.
Overall, 33% of the patients scored below the cutoff point on the Center for Epidemiological Studies-Depression Scale (Pediatrics 2005;115:1315–9). The cutoff points were 12 for boys and 22 for girls. The mean score was significantly higher among the 26 hospitalized patients, compared with the 205 nonhospitalized patients (18.50 vs. 14.28). The results indicate that adolescents' self-reports are accurate predictors of medical outcomes, and that treatment of mood problems in adolescents with diabetes might reduce the odds of hospitalization.
Teens and Tobacco Addiction
Adolescents appear to become addicted to cigarettes more easily than adults, according to a study of 220 ninth-graders who smoke.
Other studies have suggested this susceptibility to addiction but have not been able to measure tobacco exposure as well, Mark Rubinstein, M.D., said at the annual meeting of the Society for Adolescent Medicine. This study measured cotinine levels in saliva, and correlated it with self-reports of craving and an addiction measure. Cotinine, a metabolite of nicotine, persists longer in saliva than nicotine does in blood.
The study found that even among the 20% of adolescents who reported smoking daily, cotinine levels generally were much lower than typically seen in adult smokers. The cotinine level that defines addiction in adults is 200 ng/mL. But only one of the adolescents had a level equal to or above that.
Still, cotinine levels did correlate with addiction, and 34% of the daily smokers were identified as addicted. Twenty-eight percent of those had undetectable cotinine levels. “This may represent susceptibility at the receptor level, which has been shown in animal models,” said Dr. Rubinstein of the University of California, San Francisco.