Varicella Vaccination Cuts Mortality
Mortality due to varicella fell from an average of 0.32 deaths per million between 1990 and 1994 to an average of 0.07 deaths per million between 1999 and 2001 among children aged 1-4 years, as a result of the adoption of universal childhood varicella vaccination in the United States, with the lowest rates for all groups in 2001, said Huong Q. Nguyen and colleagues at the Centers for Disease Control and Prevention (N. Engl. J. Med. 2005;352:450-8).
In addition, deaths due to varicella fell significantly among children aged 10-19 years (67%) and among infants (66%) between the two periods. Among children at high risk due to preexisting conditions, the decline in mortality was 100% in those aged 1-4 years and in those aged 5-9 years; however, children with preexisting conditions might have received aggressive treatment when they developed varicella, the researchers noted.
Overall, mortality was similar across racial and ethnic groups and similar among children born in the United States, compared with foreign-born children, they reported.
Refractory Epilepsy's Costs for Kids
Controlling seizures often lessens behavioral and neuropsychological problems ubiquitous in children with refractory epilepsy, said Marc Boel, M.D., of University Hospitals Gasthuisberg, Leuven, Belgium. Among 573 such children seen in his clinic, 80% showed behavioral problems, and 15% showed significant mental decline related to their epilepsy. About half of the entire group had an IQ below 50 (Eur. J. Pediatr. Neurol. 2005;8:291-7).
Most children had either partial epilepsy (29%) or secondary generalized tonic-clonic epilepsy (25%). About 4% had Lennox-Gastaut syndrome. Other diagnoses included absence, photosensitive epilepsies, tuberous sclerosis, West's syndrome, severe myoclonic epilepsy of infancy, and continuous spike waves during slow-wave sleep.
The most frequent neurobehavioral disorders were pervasive developmental disorder (8%); attention-deficit hyperactivity disorder (7.5%); loss of self-esteem (9%), and self-induction of seizures (7%). Psychosis, anxiety disorders, intermittent explosive disorder, and cursive seizures were seen at lower rates.
Seizure control contributes greatly to reducing these symptoms, Dr. Boel said. In 101 of the 220 children who achieved seizure control, behavioral problems disappeared or were minimized. Seizure control had only a limited effect on patients with mental decline, psychosis, pervasive developmental disorder, or attention disorders.
Hostility Drives Smoking Initiation
An interaction between depressive symptoms and hostility was strongly associated with initiation of smoking in middle school students, reported Jie Wu Weiss, Ph.D., and colleagues at the University of Southern California, Alhambra.
Adolescents who have difficulty controlling their anger often use smoking as a coping mechanism, the researchers noted. An ethnically diverse sample of 1,699 students completed 160-item surveys in both the sixth and seventh grades (J. Adolesc. 2005;28:49-62). Overall, 141 children (8.3%) said they had smoked at least once by sixth grade. Compared with those who had never smoked, those who had smoked scored significantly higher on baseline depressive symptoms, hostility, and socioeconomic status. An additional 141 of the original never-smokers reported smoking at least once by seventh grade, and higher depression and hostility scores at baseline were significantly associated with smoking initiation.
Romantic Stress in Teen Girls
Highly sensitive teenage girls are more likely to develop depression in response to romantic stress, Shannon E. Daley, Ph.D., said at a meeting sponsored by the Society for Research on Adolescence.
In this longitudinal study, 87 girls were studied using questionnaires and telephone interviews; 21% were African American, and 79% were Hispanic. Data were collected 6 months apart, and the measuring tools used were the Structured Clinical Interview for DSM-IV, the Interpersonal Sensitivity Measure, the Chronic Strain Interview, and the Episodic Stress Interview.
Participants, who were 16 years old, were questioned about romantic life events, and their lifetime history of depression was evaluated at the start of the study. Chronic romantic stress was assessed over the 6-month follow-up period, along with any more depressive symptoms, reported Dr. Daley of the University of Southern California.
“Girls who experience a heightened sensitivity to interpersonal processes are especially likely to become depressed when confronted with romantic stress or low-quality romantic relationships,” the researchers concluded.