Stimulant medication and psychotic symptoms in offspring of parents with mental illness

BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to drug-induced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders. METHODS: We assessed psychotic symptoms, psychotic-like experiences, and basic symptoms in 141 children and youth (mean ± SD age: 11.8 ± 4.0 years; range: 6–21 years), who had 1 or both parents with major depressive disorder, bipolar disorder, or schizophrenia, and of whom 24 (17.0%) had taken stimulant medication. RESULTS: Psychotic symptoms were present in 62.5% of youth who had taken stimulants compared with 27.4% of participants who had never taken stimulants. The association between stimulant use and psychotic experiences remained significant after adjustment for potential confounders (odds ratio: 4.41; 95% confidence interval: 1.82–10.69; P = .001) and was driven by hallucinations occurring during the use of stimulant medication. A temporal relationship between use of stimulants and psychotic symptoms was supported by an association between current stimulant use and current psychotic symptoms and co-occurrence in cases that were assessed on and off stimulants. CONCLUSIONS: Psychotic symptoms should be monitored during the use of stimulants in children and adolescents. Family history of mood and psychotic disorders may need to be taken into account when considering the prescription of stimulants.

In German gaols : a narrative of two years' captivity in German East Africa

by Ernest F. Spanton, priest of the Universities Mission to Central Africa, pricipal of St. Andrew's College, Zanzibar. With a prefatory note by Harry Hamilton Johnston

Systematic review of interventions designed to reduce screen time in children and adolescents

This descriptive systematic review describes intervention trials for children and youth that targeted screen time (ST) as a way to prevent or control obesity and measured ST, and at least one of the following: physical activity, dietary intake, and adiposity. Both “hands-on” (e.g., video games) and “hands free” (e.g., television viewing) ST were included. Published, completed intervention trials (k=12), not-yet-published, completed trials (k=6), and in-progress trials (k=11) were identified through searches of electronic databases, including trial registries and bibliographies of eligible study reports. Study characteristics of the 29 identified trials were coded and presented in evidence tables. Considerable attention was paid to the type of ST addressed, measures used, and the type of interventions. Based on the number of in-progress and not-yet-published trials, the number of completed, published reports will double in the next three years. Most of the studies were funded by federal sources. General populations, not restricted by race, gender, or weight status, were targets of most interventions with children ages 9-12 yeas as the modal age group. Most trials used randomized control trials in which the majority of control or comparison group received an intervention. The mean number of participants was 242.8 (SD=314.7) and interventions were delivered over an average of 10.5 months and consisted of approximately 16 sessions, with a total time of about eight hours. The majority of completed trials evaluate each of the four constructs, however, most studies have more than one measure to assess each construct (e.g., BMI and tricep skinfold thickness to evaluate adiposity) and rarely did studies use the same measures. This is likely why the majority of studies produced at least one significant intervention effect on each outcome that was assessed. The four major outcomes should be evaluated in all interventions attempting to reduce screen time in order to determine the mechanisms involved that may contribute to obesity. More importantly researchers should work together to determine the best measures to evaluate the four main constructs to allow studies to be compared. Another area for consensus is the definition of ST. ^

Reconstruction of sea-surface conditions at middle to high latitudes of the Northern Hemisphere

A new calibration database of census counts of organic-walled dinoflagellate cyst (dinocyst) assemblages has been developed from the analyses of surface sediment samples collected at middle to high latitudes of the Northern Hemisphere after standardisation of taxonomy and laboratory procedures. The database comprises 940 reference data points from the North Atlantic, Arctic and North Pacific oceans and their adjacent seas, including the Mediterranean Sea, as well as epicontinental environments such as the Estuary and Gulf of St. Lawrence, the Bering Sea and the Hudson Bay. The relative abundance of taxa was analysed to describe the distribution of assemblages. The best analogue technique was used for the reconstruction of Last Glacial Maximum (LGM) sea-surface temperature and salinity during summer and winter, in addition to sea-ice cover extent, at sites from the North Atlantic (n=63), Mediterranean Sea (n=1) and eastern North Pacific (n=1). Three of the North Atlantic cores, from the continental margin of eastern Canada, revealed a barren LGM interval, probably because of quasi-permanent sea ice. Six other cores from the Greenland and Norwegian seas were excluded from the compilation because of too sparse assemblages and poor analogue situation. At the remaining sites (n= 54), relatively close modern analogues were found for most LGM samples, which allowed reconstructions. The new LGM results are consistent with previous reconstructions based on dinocyst data, which show much cooler conditions than at present along the continental margins of Canada and Europe, but sharp gradients of increasing temperature offshore. The results also suggest low salinity and larger than present contrasts in seasonal temperatures with colder winters and more extensive sea-ice cover, whereas relatively warm conditions may have prevailed offshore in summer. From these data, we hypothesise low thermal inertia in a shallow and low-density surface water layer.