Addiction epidemiology in adolescents receiving inpatient psychiatric treatment.

This study sought to characterize adolescent psychiatric inpatient populations from two sites and to determine correlates of substance use disorders (SUD). Screening procedures for SUD differ substantially between these sites. A retrospective review of adolescent inpatients (n=636) revealed that the populations were similar in gender, race and age. Rates of SUD at the site with a formalized SUD screening regimen were higher (39%) than those at the other site (16.5%). Similar correlates of SUD were observed across sites, including older age, legal involvement, sexual activity, childhood disruptive disorder, and tobacco use. These results suggest that SUD is a major issue in adolescent psychiatric patients. More rigorous screening for SUD and its correlates may facilitate earlier detection of substance use in this vulnerable population.

Body mass index (BMI) in newly admitted child and adolescent psychiatric inpatients.

INTRODUCTION: Obesity is a major problem among children and adolescents suffering from chronic mental illness. State-of-the-art measures such as body mass index (BMI) and growth-related weight charts are now readily available to clinicians and investigators interested in psychotropic drug-associated weight gain in the pediatric population. However, no reports that utilize such measures in large series of children and adolescents with psychiatric disorders are available. METHODS: The authors employed the Nutstat module of the Centers for Disease Control and Prevention (CDC) Epi Info software to assess BMI in a psychiatry inpatient child and adolescent population in Central Virginia. The authors also developed a scoring system to relate psychotropic administration to BMI. RESULTS: Children and adolescents with chronic mental illness had greater BMI measurements than the general pediatric population. Our scoring system found a relationship between antipsychotic drug administration and increased BMI that almost reached a level of significance (p=0.062). CONCLUSIONS: The present methodology using absolute weight to assess psychotropic drug-associated increase in body weight for children and adolescents is unsatisfactory. The authors offer a new and convenient methodology to correct this problem.

Child and adolescent suicides in Virginia: 1987 to 2003.

OBJECTIVES: The aim of this study was to better understand suicides in children and adolescents using records from the Office of the Medical Examiner of Virginia from 1987 to 2003. MAIN FINDINGS, KEY DATA, AND STATISTICS: Suicide accounted for 16.8% of unnatural deaths. Suicide rates were highest for Caucasians. Guns were the most common method of death for suicides, followed by hanging and poisoning. Poisoning other than carbon monoxide accounted for 7.8% of suicides, with tricyclic antidepressants (TCAs) the most identifiable poison. Female youths were 10 times more likely to die from TCAs than male youths, after adjusting for race and age. CONCLUSIONS: Guns and hanging were the principal methods of suicide. Among the antidepressants, TCAs have been the most common poisons used in suicide. Increasing age was a powerful determinant of suicide. Some patients may have stockpiled their TCAs for a while before their TCA overdose. Other suicide victims may have used TCA supplies from family members. Hence, some of the suicide victims may not have taken TCAs on a regular basis before committing suicide. Further exploration of TCA-induced suicidal thoughts is needed. Conclusions cannot be made at the time about the precise role that TCAs played in TCA-induced suicide reported in our study.

Body image and attitude toward obesity in an historically black university.

INTRODUCTION: The obesity epidemic is a major problem in the United States, particularly among black women. Body image and attitudes toward obesity are important areas to understand and address in any comprehensive approach to this epidemic. METHODS: From an initial evaluation of 200 college students (25 male and 25 female freshmen, sophomores, juniors and seniors each) attending an historically black university, we selected those students who identified themselves as black for data analysis (n = 191). All students underwent height and weight measurement from which body mass index (BMI) was calculated. Each student answered two questions related to nine silhouettes for each sex that progressively moved from extreme thinness to extreme obesity. Also, each student answered 20 questions describing attitudes about obesity. RESULTS: Black college students placed between the 62nd and 72nd percentiles of national BMI data for adolescents. Black female students were more likely than their black male counterparts to be obese. BMI did not vary by sex or grade level. Students of both sexes generally preferred "trim" silhouettes with the caveat that students with BMIs <25 kg/m2 preferred smaller silhouettes than did students with BMIs > or =25 kg/m2. BMI and sex did not favor any particular set of attitudes toward obesity. CONCLUSION: Black male and female college students from an historically black university were largely in the "normal" range of BMI percentiles for sex and age. Our black female students were more likely to be obese than our black male students. Our findings suggest that young black women are tolerant of a variety of body sizes. Based on findings from our Attitudes Toward Obese Persons scale, body size sense of self and sex do not influence attitudes toward obese persons. Further studies are needed.

Perceived mental health treatment need and substance use correlates among young adults.

OBJECTIVES: The relationship between perceived need for mental health treatment, reasons for not receiving care, substance use, and race and gender among young adults was examined to identify barriers to mental health care. METHODS: Data from the 2010 National Survey on Drug Use and Health for 14,718 adults ages 18 to 23 were used. Logistic regression analysis compared substance use among young adults with perceived mental health treatment need grouped by race and gender. RESULTS: A total of 7.6% of young adults wanted mental health treatment but did not receive care. Persons with perceived treatment need were more likely than recipients of treatment to smoke cigarettes, use marijuana, meet criteria for marijuana abuse or dependence, and engage in binge drinking, after analyses controlled for income and health insurance. White males with perceived need were 3.2 times more likely to smoke and to meet criteria for marijuana abuse or dependence and were 2.6 times more likely to engage in binge drinking. Hispanic males were 2.9 times more likely to smoke and meet criteria for marijuana abuse or dependence. White females were 1.7 times more likely than other subgroups to perceive need for mental health care. CONCLUSIONS: Young adults with perceived mental health treatment need are at high risk of substance abuse and dependence. Results support targeting knowledge and attitudes surrounding mental health services by race-ethnicity and gender to improve willingness to receive care.