PTSD and Asthma
Adolescents with asthma who have experienced a life-threatening event–as well as their parents–are significantly more likely to experience posttraumatic stress symptoms than are adolescents with less severe asthma or healthy controls, reported Emily Millikan Kean, Ph.D., of the Children's Hospital, Denver, and her associates.
Events related to severe asthma attacks–such as ambulance rides and invasive procedures, as well as lingering feelings about the possibility of death even after the events resolve–may make children and adolescents with asthma, and their parents, vulnerable to posttraumatic stress disorder (PTSD), the researchers noted.
Their study of three groups of adolescents aged 12–18 years included 49 adolescents who had experienced a life-threatening episode, 71 who had asthma but had not experienced a severe episode, and 80 healthy controls (J. Am. Acad. Child Adolesc. Psychiatry 2006;45:78–86).
Overall, 20% of the adolescents with life-threatening events met the criteria for PTSD, compared with 11% of those with mild asthma and 8% of controls.
The adolescents completed three measures: the UCLA PTSD Reaction Index for DSM-IV, the Multidimensional Anxiety Scale for Children, and the Reynolds Depression Inventory-2. Parents also completed several measures, including the Brief Symptom Inventory.
Predictably, the parents of children who had experienced life-threatening events were significantly more likely to meet criteria for PTSD (29%), compared with the parents of adolescents with nonsevere asthma (14%) and the parents of controls (2%).
Substance Abuse and Suicide
Substance abuse within 48 hours of suicide was far more common among white adolescents than African American adolescents in an investigation of 75 cases, wrote Dr. Steven J. Garlow of Emory University, Atlanta, and his colleagues.
The researchers reviewed the medical examiner's records for 49 African American and 26 white adolescents aged 19 years and younger in Fulton County, Ga., from January 1989 to December 2003 (J. Psychiatr. Res. 2005[Epub doi:10.1016/j.jpsychires.08.008]).
About 82% of the African American teens tested negative for cocaine and alcohol, compared with 58% of the white teens. Only 9% of African American teens had used cocaine prior to death, compared with 28% of the white teens, and 9% of African American teens had used alcohol prior to death, compared with 21% of white teens.
When the data were analyzed along gender lines, white males had the highest detectable levels of alcohol use (22%), which was more than double the incidence among African American males (10%). Only one of the white females and none of the African American females showed signs of alcohol use prior to death.
Whites had higher rates of alcohol and cocaine use, but African American adolescents had slightly higher rates of completed suicides than did white adolescents (5.5 vs. 4.2 per 100,000 teens per year). In addition, African American teens had a significantly higher rate of firearm use in suicides, compared with white teens.
OCD Often Cormorbid With ADHD
More than 25% of children and adolescents with obsessive-compulsive disorder had comorbid attention-deficit hyperactivity disorder in a consecutive study of 94 patients, reported Dr. Gabriele Masi and her associates at the Scientific Institute of Child Neurology and Psychiatry in Calambrone, Pisa (Italy).
Overall, 88% of the 24 comorbid patients were male, and the average age of onset of obsessive-compulsive disorder (OCD) was slightly higher among patients with comorbid attention-deficit hyperactivity disorder (ADHD). Several disruptive behavior disorders–oppositional defiant disorder, bipolar disorder, and tic disorder–were significantly more common among comorbid patients.
The 3-year study included 65 males and 29 females aged 8–18 years. All of the patients were undergoing treatment for OCD with serotonin reuptake inhibitors, such as fluoxetine and sertraline (Zoloft), but none was being treated for ADHD with psychostimulants (Compr. Psychiatry 2006;47:42–7). In patients with comorbid ADHD, functional baseline impairment was higher, and improvement in symptoms after 6 months of follow-up was lower. Patients with co-occurring OCD-ADHD were more frequently male (88% vs. 62%). No significant differences were seen between patients with and without comorbid ADHD with regard to OCD behaviors involving ordering, aggression, contamination, and hoarding. The study results suggest a need for ADHD screening in all children and adolescents with OCD, the investigators wrote.