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Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, offers thoughts today on new research on diagnosing bipolar disorder in children. Every Tuesday, he answers viewer questions on mental health on CNNHealth.com.

I get a lot of reader questions on bipolar disorder, particularly bipolar in children. In fact in May we had quite an interesting conversation about whether bipolar disorder can really be diagnosed in young children and the stress and guilt that parents feel in these situations.

A new study touches upon this very issue:  How reliably bipolar disorder can be diagnosed in young people before the development of clear-cut disease symptoms (for example a full-blown mania).

Here is the problem: Looking back into the childhoods of people with bipolar disorder, one typically finds all sorts of early warning signs of future trouble, such as mood swings, depression, attention deficit type symptoms, aggression, etc. On the other hand, if we rounds up children or adolescents with these symptoms and follow them into adulthood, only a minority will go on to develop bipolar disorder. It’s a case of hindsight being 20-20, but of course from a medical point of view we’d like some way of identifying at-risk individuals ahead of time with enough accuracy to justify early interventions.

Researchers from Australia have just published findings directly relevant to this question in The Journal of Affective Disorders. They reported that by applying a set of criteria based on family history, age and present symptoms they were able to identify young people who were 100 times more likely than those without these risk factors to develop a full mania over the next year.

This sounds very promising until one looks a little closer at the article. It turns out that the young people identified as being at risk were already fairly close to meeting criteria for bipolar disorder. And even in this extremely high risk group, only 22 percent went on to develop clear-cut bipolar disorder. This means that even in the highest risk group imaginable, three-quarters did not progress to full disease, at least over close to a year’s follow-up.

So, I would suggest that this really highlights both the importance of accurate diagnoses on the one hand, and the risks of “jumping the gun” on the other and applying labels prematurely. What we can say for sure is that all children and adolescents with behavioral/emotional difficulties should be helped as quickly and as fully as possible, because these types of problems are so horrible in the present that they do not require prognosticating about the future to justify their treatment.

A recent study has revealed that stress caused by child abuse can cause a long lasting mental disturbance, making sufferers vulnerable to chronic pain from such conditions as irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, interstitial cystitis and arthritis.

The findings are revealed in the January issue of Headache: The Journal of Head and Face Pain.

“The linking of these comorbidities may be through abuse-mediated brain changes occurring early in life”, said the study’s lead researcher, Dr. Gretchen E. Tietjen. “Understanding the physiology of abuse’s effects on the brain over the life span may lead to prevention or more effective treatment of migraine and associated conditions”.

However, not all children develop migraines and not everyone who suffers from migraines or any other chronic painful condition was abused.

The study carried by Tietjen’s group, collected data on 1,348 people suffering from migraines who were seen at 11 outpatient headache centers. It reported a 58% people were either afflicted from physical, sexual or emotional abuse, or were suffering physical or emotional neglect during childhood.

Women who had undergone physical abuse during childhood were more likely to have endometriosis and uterine fibroids. However, emotional abuse was connected to both conditions and emotional neglect was associated with uterine fibroids alone, the study found.

The U. S. Department of Health and Human Services cited childhood abuse as a common menace in U. S. It reported that more than 3 million reports of abuse or neglect are investigated each year, of which more than 700,000 children are categorized as victims of neglect or abuse.

via Childhood Abuse Sufferers More Prone to Fatigues and Pain Disorders | TopNews United States.

Two months after the Deepwater Horizon oil rig explosion caused the oil spill now globally acknowledged as the worst environmental disaster in our nation’s history, the residents of the Gulf region immediately impacted are exhibiting dramatically high levels of anxiety, both among adults and children, about the future health and well-being of the region. Many children – and parents – still recovering from Katrina are now reeling from a second major trauma as a result of the oil catastrophe.

At a public town hall meeting today in Plaquemines Parish, Louisiana, Irwin Redlener, MD, the President of the Children’s Health Fund and the Director of the National Center for Disaster Preparedness at the Columbia University Mailman School of Public Health, spoke with families and children about their perceived beliefs and concerns about the impact the oil spill is having and will have on their lives and livelihoods in the region.

“We are seeing a palpable frustration among these families due to the lack of information about health risks in this region by trusted and important authorities,” said David Abramson, PhD, director of research at the National Center for Disaster Preparedness of the Columbia University Mailman School of Public Health.

Dr. Redlener added, “There is a disconnect among elected Federal and State officials and local Parish officials who don’t seem to be able to provide the answers to both long and short-term risks or issues that families need to hear right now.”

The team of public health experts and physicians that accompanied Dr. Redlener learned a number of points on the fact-finding mission, including a statement from a participant that the oil spill is far worse than the impact of Hurricane Katrina.

“Since Katrina, the Children’s Health Fund and the National Center for Disaster Preparedness have been in the Gulf providing comprehensive medical and mental health care and, importantly, surveying the long-term health and mental health issues among children as a result of the disaster,” Dr. Redlener continued. “It was revealing to learn that residents here feel that while Katrina may have destroyed their houses, they could rebuild. This disaster is creating a greater sense of permanence and finality to the community. The irrevocable damage to their communities, and health, feels very real and lasting. And that is terrifying.”

via High Levels of Anxiety Are Found Among Children and Families in The Gulf… — NEW ORLEANS, June 22 /PRNewswire-USNewswire/ –.

Children who live with relatives instead of their parents are at increased risk for physical and mental health problems, new research shows.

About 2.8 million children in the United States live with relatives, called kinship care, and about 800,000 are in foster care. Like those in foster care, the study found, children in kinship care experience a number of health issues.

“Children who live in kinship care with a relative have more special health-care needs, mental health problems such as (attention-deficit/hyperactivity disorder) and depression and dental problems compared with children who live with their parents,” Dr. Sara B. Eleoff, of the University of Rochester School of Medicine and Dentistry, in Rochester, N.Y., said in a news release from the American Academy of Pediatrics.

She and her colleagues analyzed data from more than 91,000 children included in a 2007 national survey, comparing those in kinship care with children who lived with at least one birth parent.

Compared with children who lived with a parent, children in kinship care were more likely to be black, older than 9 years, have public health insurance and live in households with incomes at or near the poverty level. Many kinship caregivers reported having poor overall health or mental health, the researchers noted.

“These children and their families may need additional services and supports,” Eleoff said. “Therefore, health-care providers, educators and public health agencies should ask about children’s living situations and consider the risk of special needs among children in kinship care.”

FORT JACKSON, La. — Even the Super Bowl champions are doing their part to lift people’s spirits during the Gulf oil spill.

“Just like we did after (Hurricane) Katrina, we’re trying to do our part to keep the community’s morale high,” said Sean Payton, coach of the champion New Orleans Saints, as he signed autographs in withering heat. “We’re always here for each other.”

For local officials, the rally was part of a broader plan that goes way beyond football.

They say that anything that can distract Gulf Coast residents from the trauma of the oil spill — whether it’s prayer, a party or just venting their anger — may help prevent the long-term mental health consequences that have plagued previous disasters, such as the 1989 Exxon Valdez oil spill.

“That’s absolutely what this is about,” said Billy Nungesser, the president of coastal Louisiana’s Plaquemines Parish, who also attended Tuesday’s rally.

“I haven’t seen people smile since this whole thing started,” he said. He gestured to the crowd as a jazz band played When the Saints Go Marching In. “Now look at them. They’re smiling today.”

Crisis counselors have deployed throughout the Gulf to provide help to those who need it, said John Young, council chairman in Jefferson Parish. In the fishing community of Grand Isle, he says a state counselor rides around town on a bicycle, striking up conversations with fishermen who might be too shy — or too macho — to seek help on their own.

“She’s the daughter of a fisherman herself, so she knows how to talk to these guys,” Young said.

Louisiana has put five such teams of counselors throughout the state, said Terri Spear, an emergency coordinator at the Department of Health and Human Services. Other Gulf states are relying on existing mental health professionals but held a meeting Tuesday to discuss whether more resources are needed, she said.

A 1993 study for the National Institutes of Health showed significant mental health issues in Alaska one year after the Valdez spill. Among 599 area residents, nearly 10% of them showed signs of post-traumatic stress disorder, the study found.

The study concluded that the mental health consequences of the spill were “as significant as its impact on the physical environment.”

Even today, some Alaska residents continue to deal with psychological effects such as depression stemming from the Valdez spill, according to the website of the Prince William Sound Regional Citizens’ Advisory Council, a community group.

At the Port Sulphur Baptist Church, just north of Fort Jackson, a sign reads, “Pray For Our Fishermen.” Pastor Lynn Rodrigue says part of his job is to look after the spiritual health of his congregation.

“It’s not something people want to talk about, but the situation has definitely got people on edge,” Rodrigue said. “They’re asking things like, ‘What am I going to do to provide for my family?’ So we’re trying to stay ahead of that, talk to people, and address these issues before they explode.”

via Oil spill makes it vital to keep morale up in Gulf region – USATODAY.com.

EXCLUSIVE – By Anthony Bond Wednesday, 9 June, 2010

SCHOOLS in the county have been warned over the way they handle pupils with mental health problems after a court found that Suffolk County Council discriminated against a boy with a ‘school phobia’.

At the end of last year, the Special Educational Needs and Disability Tribunal found that the county council and the governing body of the east Suffolk secondary school unlawfully discriminated against the boy, now 16, on four separate claims.

It followed an unsuccessful prosecution by the county council and the school against the boy’s parents for failing to ensure their son attended school regularly. The boy and the school involved cannot be identified for legal reasons.

Following the tribunal decision, the county council and school appealed against two of the four claims of discrimination which related to the prosecution against the boy’s parents.

But, despite the school winning its appeal, the tribunal judge rejected the council’s.

In his judgement, Upper Tribunal Judge Ward blasted the authority, saying it “proceeded obdurately” with the prosecution against the boy’s parents – despite being provided with medical evidence from the youngster’s GP and a child psychologist showing that he was suffering from mental health problems which affected his attendance at school.

Judge Ward said the council “closed its mind” by continuing with the prosecution.

Last night, the boy’s father, who can’t be identified, told the EADT: “This decision means that after all the heartache we have gone through, it might change the county council and the schools and the way that people like our son are dealt with from now on.

“Hopefully the council will have been shaken up so that it will not keep prosecuting parents of children with these sorts of disabilities.

“We have a son who needed help and all they could do was go through their silly procedures and instead of giving us help they made our lives very difficult.”

Judge Ward also warned that this case should cause the council to “revisit its approach to such prosecutions” and said that schools in similar situations in the future should “carefully consider” how it deals with such cases.

As a result of the appeal decision, the judge has ordered that Suffolk County Council send written apologies to the boy and his parents by June 18 which are to be signed by Eddy Alcock, the chairman of the council.

Despite winning this appeal, which found that the school could not have influenced the council to stop the prosecution, the school did not appeal against the earlier tribunal decision which found that it unlawfully discriminated against the boy by failing to make reasonable adjustments to his education.

As a result of this, the governing body of the school must also ensure that written apologies are sent to the youngster and his parents by June 18.

A spokesman for Suffolk County Council said: “Naturally the council was disappointed not to be successful in the appeal in this case. We have accepted the outcome of the Tribunal and will comply with its decision.”

THE boy involved developed chronic anxiety following time-off due to a viral illness when he first joined the secondary school.

He was diagnosed by a clinical psycholgist as suffering from a school phobia.

His parents always maintained that the school and the county council failed to offer their son the support that he needed because they never understood his mental health problems.

In June last year, the council took the parents to court for failing to ensure their son attended school reguarly.

If found guilty, they could have been sent to prison for three months and fined up to £2,500.

The council continued with the prosecution despite the child psychologist, to whom the boy was referred, saying it was worsening his mental health.

Despite this, and the fact that the couple have other children who successfully attended the same school, the decision was taken to prosecute the parents.

But following a one-day trial at South East Suffolk Magistrates’ Court in Ipswich, the parents were found not guilty.

At the same time, they took the council and school to the Special Educational Needs and Disability Tribunal for unlawfully discriminating against their son’s mental health by failing to make reasonable adjustments to the way in which he attends school.

via Schools warned over how they handle mental health problems – News – East Anglian Daily Times.

Health officials have known for some time the physical ill effects of smoking on a smoker and on those exposed to secondhand smoke. Now new research at the University of London indicates a link between secondhand smoke and an increase in depression in those exposed to secondhand smoke.

The research involved 8,155 men and women and the results were recently published in the Archives of General Psychiatry. Mark Hamer at University of London headed the research team which found as much as a 50% increase in psychological stress in nonsmokers exposed to high amounts of secondhand smoke.

These findings are of particular concerns in group-home and mental-health settings where staff allow patients to smoke in order to relieve mental stress. The data Mark Hamer and his team have uncovered seems to indicate that smoking may actually increase not only mental stress for the smoker but also for those exposed to secondhand smoke.

This research on the ill effects of second smoke on mental health will continue.

via Secondhand Smoke May Harm Mental Health » Tech Jackal.