IVF Tied to Small Risk of Mental Deficits in Children

Large Swedish study did not find higher risk for autism

By Amy Norton

HealthDay Reporter

TUESDAY, July 2 (HealthDay News) -- Despite some concerns, children born by in vitro fertilization do not seem to have an increased risk of autism, a large new study finds. They may, however, have a slightly higher-than-normal chance of being intellectually impaired.

The study, reported in the July 3 issue of the Journal of the American Medical Association, looked at more than 2.5 million infants born in Sweden between 1982 and 2007. It found that the nearly 31,000 children conceived via in vitro fertilization (IVF) did not have an increased risk of the developmental disorder autism.

They were, however, 18 percent more likely to have an intellectual disability (which used to be called mental retardation), defined as an IQ lower than 70 and limited abilities in schoolwork .

Experts stressed that the risk is quite low: The rate of intellectual disability among IVF kids was about 46 per 100,000 each year, versus about 40 per 100,000 among kids conceived naturally.

"The vast majority of children born after the different types of IVF treatment will be perfectly healthy," said lead researcher Sven Sandin, of the Karolinska Institute, in Stockholm, and King's College London, in England.

What's more, the risk seemed largely related to the fact that babies born via IVF are often multiples (such as twins or triplets), and, therefore, frequently born preterm or at a low weight. That in itself carries a higher-than-normal risk of intellectual disability.

Experts said the findings suggest that whenever possible, IVF should involve implanting only one embryo in the woman's uterus, rather than the traditional route of implanting at least two.

"From the results of this study, we think that the use of single-embryo transfer should be extended," Sandin said.

An infertility specialist not involved in the study agreed. "I think we should be encouraging more single-embryo transfers," said Dr. Marcelle Cedars, director of reproductive endocrinology at the University of California, San Francisco.

That is happening more often these days, said Cedars, who wrote an editorial published with the study. At her center, she said, more than half of IVF patients have a single embryo implanted -- although that is higher than the national norm.

There is still a chance, however, that certain IVF procedures carry a risk.

Sandin's team found that a specific IVF technique used for male infertility -- called intracytoplasmic sperm injection, or ICSI -- was related to an increased risk of intellectual disability, even among single babies.

Again, the actual rates of intellectual impairment were quite low, Sandin said. But the results suggest there could be something about the intracytoplasmic sperm injection, or fathers' infertility, that contributes to the risk.

"People have for some time been concerned about the ICSI procedure," Cedars said.

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Many Seniors Suffer Mental Decline in Silence: CDC

By Steven Reinberg
HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- About 13 percent of Americans 60 and older say they have increasing problems with thinking and memory and that they suffer growing confusion, a new report released Thursday shows.

One-third of these people add that the confusion or memory loss caused problems at work or with social activities and household chores, according to the U.S. Centers for Disease Control and Prevention.

The findings underscore the need to be alert for early signs of dementia or Alzheimer's disease, experts said.

"This is the first data of this kind," said report co-author Angela Deokar, a CDC public health advisor. In 2011, older adults from 21 states answered survey items on whether they'd suffered increased confusion or memory loss in the past year.

According to Deokar, signs to look out for include the following:

Asking the same questions over and over again,Getting lost in familiar places,Not being able to follow directions,Becoming more confused about time, people and places.

These problems go beyond normal forgetfulness, Deokar said.

Since this is the first such report, it is not possible to see if there is an increasing trend or if these data are similar throughout the nation, she said. The survey is ongoing, however, so in a couple of years more information should be available.

The report was published in the May 10 issue of the CDC's Morbidity and Mortality Weekly Report.

People experiencing cognitive decline -- the gradual loss of the ability to think, reason and remember -- can face considerable challenges. Even so, only 35 percent of them have discussed the problem with their doctor, the researchers found.

Such conversations are important, because they make planning for the future easier as a person's mental health continues to decline, according to the report.

A dementia expert noted that these kinds of symptoms should be taken seriously.

People experiencing them "should have thorough medical exams to exclude treatable metabolic or cardiac diseases," said Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center, in New York City.

Report co-author Deokar noted that people with these symptoms can reach out to the aging services network, including agencies on aging and the Alzheimer's Association.

When causes of mental decline are identified early there is the opportunity to treat reversible causes, the report authors said. If the cause isn't reversible, as with Alzheimer's disease, there is more time to develop advance directives, to enroll in clinical trials and to plan for care needs.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Angela Deokar, M.P.H., public health advisor, U.S. Centers for Disease Control and Prevention; Sam Gandy, M.D., associate director, Mount Sinai Alzheimer's Disease Research Center, New York City; May 10, 2013, Morbidity and Mortality Weekly Report

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More Kids Diagnosed With Mental Health Disabilities, Study Finds

Conditions such as autism, ADHD appear to drive 16 percent increase in a decade

By Serena Gordon

HealthDay Reporter

SUNDAY, May 5 (HealthDay News) -- Significantly more U.S. children have a neurodevelopmental or mental health disability than did a decade ago, according to new research.

Disabilities that impair a child's day-to-day living have risen 16 percent, with the greatest increase seen in richer families, according to the study. Conditions such as autism or attention-deficit/hyperactivity disorder appear to lie behind the increase, experts said.

But the surveys of parents in 2001-'02 and 2009-'10 also revealed some good news: The rate of disability due to physical conditions went down, according to the study, which is scheduled for presentation Sunday at the Pediatric Academic Societies' annual meeting in Washington D.C. Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

"This may mean there are differences in people getting early access to care," said study lead author Dr. Amy Houtrow, vice chairwoman of pediatric rehabilitation medicine at Children's Hospital of Pittsburgh. For example, medications for children with juvenile idiopathic arthritis, a potentially debilitating inflammatory arthritis, have improved significantly in recent years, she said.

"For some conditions, it may be that medical care has improved so much that children may have a diagnosis but not a disability," she said, adding that this particular example is from what she has seen in her practice, not from the study data.

For the study, Houtrow and colleagues reviewed data from two National Health Interview Surveys conducted by the U.S. Centers for Disease Control and Prevention (CDC). They included more than 102,000 parents of children from infancy through 17 years of age.

Parents were asked if their children had any limitations in play or activity, received special education services, needed help with personal care, had difficulty walking without supports, had trouble with memory or had any other limitation.

"It's not enough to just have something like ADHD," she said. "You have to be limited somehow by that diagnosis."

The researchers found that nearly 6 million children were considered disabled at the end of the study. Children living in poverty had the highest rates of disability, although poor children didn't experience the largest increases in the incidence of disability during the study period.

Families with incomes 300 percent above the federal poverty level -- around $66,000 for a family of four -- had a 28 percent increase in children with disabilities. Families whose income levels exceeded the poverty level by 400 percent -- about $88,000 -- saw a 24 percent increase in the number of children with disabilities.

Houtrow said it wasn't clear exactly why this was the case, and the researchers suspect increases in neurodevelopmental disorders may be behind the rise.

In children under 6 years old, the trend was most evident, with almost double the rate of neurodevelopmental disorders -- 36 cases per 1,000 children up from 19 a decade earlier.

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Medicaid Expansion Enhances Financial and Mental Well-Being, Study Says

Yet no clear evidence the program improves diabetes, high-blood pressure, other ills, at least in early years of enrollment

By Karen Pallarito

HealthDay Reporter

WEDNESDAY, May 1 (HealthDay News) -- As states prepare to expand Medicaid in 2014, a new study provides insight into how that health insurance coverage might affect low-income adults and what it means for access to care and the cost of care.

The study found that having Medicaid -- the U.S. public health insurance program for lower-income Americans -- reduced financial strain related to out-of-pocket health care costs and improved mental health during the first two years of enrollment.

Medicaid also increased prescription drug use and office visits, according to the study, which is based on data from Oregon's 2008 Medicaid expansion.

People with Medicaid spent $1,172 a year more -- about 35 percent more -- on medical care than a comparable group of adults not enrolled in the program.

Yet there's no clear evidence that having Medicaid improved control of diabetes, high-blood pressure and high cholesterol, at least in the early years of enrollment.

"One thing it doesn't tell us is what happens three, four, five and six years later, and that's important because so many of the benefits of health care accumulate over time," said Dr. David Meltzer, associate professor of medicine, economics and public policy studies at the University of Chicago, who was not involved in the study.

Expanding Medicaid to millions of uninsured adults is one of the goals of the 2010 health reform law known as the Affordable Care Act.

Oregon's experience offers a rare opportunity to examine the effects of Medicaid coverage by comparing people who made it into a health care lottery program with those who did not. Unable to cover everyone who wanted to enroll in Medicaid, Oregon held lottery drawings, pulling names from a waiting list of nearly 90,000 uninsured people to fill 10,000 openings.

For the study, published online May 2 in the New England Journal of Medicine, researchers at the Harvard School of Public Health and Massachusetts Institute of Technology conducted more than 12,000 in-person interviews and health exams of lottery participants in the Portland, Ore., area about two years after the lottery.

"It's not just another study on Medicaid; it's the first randomized, controlled study of Medicaid," said lead author Katherine Baicker, professor of health economics in the department of health policy and management at the Harvard School of Public Health.

When comparing outcomes of the people selected to apply for Medicaid with those who were not selected, the researchers found that:

Use of health services increased among Medicaid enrollees. "People go to the doctor more, they use more prescription drugs, they go to the hospital more, they get more preventive care," Baicker said.Medicaid enrollment improved access to care, sharply increasing some preventive health screenings, including mammography for women and PSA testing for men.Medicaid nearly eliminated "catastrophic" expenditures -- out-of-pocket medical expenses exceeding 30 percent of income. "It's important to remember that Medicaid is not just about access to health care," Baicker added. "Like any insurance product, it's also supposed to protect you from financial ruin if you have a high medical expense."The rate of depression dropped by 30 percent among people with Medicaid versus people without insurance who screened positive for depression. The authors don't offer an explanation for this, but the study noted that having Medicaid led to an increase in the probability of receiving a diagnosis of depression. "The suggestion is that there were people walking around with undiagnosed depression who were then treated," Baicker said.Medicaid's impact on physical health -- specifically high blood pressure, high cholesterol and high blood-sugar levels (indicating diabetes) -- was less clear-cut. The research team chose those health outcomes because they are widespread and serious, yet treatable.

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Faith May Complement Treatment for Mental Illness

Patients with stronger belief in God did better in small study

By Robert Preidt

HealthDay Reporter

THURSDAY, April 25 (HealthDay News) -- A belief in God may boost the effectiveness of short-term treatment for mental illness, according to a small new study.

The study included 159 psychiatric patients whose levels of depression, well-being and self-harm were assessed at the start and end of the study. The patients also were asked about their belief in God.

Patients with higher levels of belief in God were twice as likely to respond to treatment as those with no or little belief in God. Even among the more than 30 percent of patients who said they had no specific religious affiliation, those who had a moderate or high belief in God had a better response to treatment than those with little or no belief.

The study appears in the latest issue of the Journal of Affective Disorders.

"Our work suggests that people with a moderate to high level of belief in a higher power do significantly better in short-term psychiatric treatment than those without, regardless of their religious affiliation," study author David Rosmarin, a clinician at McLean Hospital in Belmont, Mass., and an instructor in the psychiatry department at Harvard Medical School, said in a hospital news release. "Belief was associated with not only improved psychological well-being, but decreases in depression and intention to self-harm."

A strong belief in God may boost patients' conviction that treatment will help them and their expectations of success, the researchers suggested.

Although the study found an association between belief in God and increased response to psychiatric treatment, it did not prove a cause-and-effect relationship.

"Given the prevalence of religious belief in the United States -- more than 90 percent of the population -- these findings are important in that they highlight the clinical implications of spiritual life," Rosmarin said. "I hope that this work will lead to larger studies and increased funding in order to help as many people as possible."

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Mental Exercise May Help Keep Seniors Sharp

Even solving puzzles might stave off decline and memory loss, study hints

By Robert Preidt

HealthDay Reporter

MONDAY, April 15 (HealthDay News) -- Mental exercise can help prevent thinking and memory decline in seniors, but evidence for the benefits of supplements and exercise is weak, according to a new study.

The findings were published in the CMAJ (Canadian Medical Association Journal).

The researchers reviewed 32 studies, including three that examined the effects of mental exercise involving computerized training programs or intensive one-on-one personal training in memory, reasoning or processing speed.

One of the studies found significant improvements in participants' memory over five years of follow-up. Another found an improvement in auditory memory and attention, according to a journal news release.

Supplements such as gingko, vitamins, dehydroepiandrosterone (DHEA) and other substances, however, appeared to provide no benefit. The same was true for physical exercise. Estrogen was associated with an increase in mental decline and dementia.

"This review provides some evidence to help clinicians and their patients address what strategies might prevent cognitive decline," wrote Dr. Raza Naqvi, of the division of geriatric medicine at the University of Toronto, and co-authors. "Future studies should address the impact of cognitive training on the prevention of cognitive decline, and we encourage researchers to consider easily accessible tools such as crossword puzzles and Sudoku that have not been rigorously studied."

Mild cognitive impairment affects 10 percent to 25 percent of people over age 70, according to the news release.

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Mental Illness a Frequent Cell Mate for Those Behind Bars

Title: Mental Illness a Frequent Cell Mate for Those Behind Bars
Category: Health News
Created: 4/5/2013 10:35:00 AM
Last Editorial Review: 4/5/2013 12:00:00 AM

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Family Meals Nourish Teens' Mental Health: Study

Title: Family Meals Nourish Teens' Mental Health: Study
Category: Health News
Created: 3/25/2013 2:35:00 PM
Last Editorial Review: 3/26/2013 12:00:00 AM

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1 in 5 U.S. Kids Has a Mental Health Disorder: CDC

ADHD is most common current diagnosis in children aged 3 to 17

By Brenda Goodman

HealthDay Reporter

THURSDAY, May 16 (HealthDay News) -- As many as one in five American children under the age of 17 has a diagnosable mental disorder in a given year, according to a new federal report.

Released Thursday, the report represents the government's first comprehensive look at mental disorders in children. It focuses on diagnoses in six areas: attention-deficit/hyperactivity disorder (ADHD), behavioral or conduct disorders, mood and anxiety disorders, autism spectrum disorders, substance abuse, and Tourette syndrome.

The most common mental disorder among children aged 3 through 17 is ADHD. Nearly 7 percent -- about one in 15 children -- in that age group have a current diagnosis, according to the report from the U.S. Centers for Disease Control and Prevention.

For other disorders, 3.5 percent of children currently have behavioral or conduct problems, 3 percent suffer from anxiety, about 2 percent have depression and about 1 percent have autism. About two children out of 1,000 aged 6 to 17 have Tourette Syndrome.

Among teens, about 5 percent had abused or were dependent on illegal drugs within the past year. More than 4 percent were abusers of alcohol, and nearly 3 percent reported being regular cigarette smokers.

The report, which supplements the May 17 issue of the CDC's Morbidity and Mortality Weekly Report, also noted gender differences in mental disorders.

"Boys are more likely than girls to have most of the disorders overall," said Ruth Perou, the team leader for child development studies at the CDC.

Boys specifically are more prone to ADHD, behavioral or conduct problems, autism spectrum disorders, anxiety and Tourette syndrome, and are more likely to be smokers than girls, Perou said. They're also more likely to die by suicide.

"On the other hand, girls are more likely to have depression or an alcohol-use disorder," she said.

Although this is the first time the CDC has tried to compile prevalence estimates for some of the most common mental disorders in a single report, the agency has long tracked rates of many of these illnesses through population surveys.

"We are seeing increases across the board in a lot of mental disorders," Perou said. Some of the biggest jumps have been in ADHD and autism. "We don't know if it's due to greater awareness, or if these conditions actually are going up," she said.

Perou said that is a question they will try to answer as they continue to track children's mental disorders going forward.

"The good news is that mental disorders are diagnosable and treatable," she said. "If we act early, we can really make a huge difference in children's live and in families' lives overall."

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Hearing Loss Linked to Mental Decline in Elderly

Jan. 22, 2013 -- Hearing loss and mental decline are two common conditions of aging, and now a new study finds that they may be related.

Older people with hearing deficits were more likely than those with normal hearing to develop problems with memory and thinking over the course of the study.

On average, the study participants with hearing issues had significant mental impairments three years earlier than those without them.

About two-thirds of adults over the age of 70 have some degree of hearing loss. 

And the number of people with dementia is projected to double over the next two decades as the population ages.

The researchers now hope to study whether hearing aids can slow mental decline in the elderly.

Otologist and epidemiologist Frank R. Lin, MD, PhD, led the study. He says only about 15% of people who need hearing aids get them. Lin is an assistant professor at the Johns Hopkins University School of Medicine in Baltimore.

“Our findings emphasize just how important it is for physicians to discuss hearing with their patients and to be proactive in addressing any hearing declines over time,” he says.

The investigation included close to 2,000 men and women in their 70s and 80s who took part in an aging and health study that began in the late 1990s.

Hearing was tested in year five of the study, and the men and women underwent a series of tests over the next six years to assess declines in memory and thinking.

The men and women with hearing loss showed evidence of these declines 30% to 40% faster than the people with normal hearing. And those people with more hearing loss had steeper declines in mental function.

The study was published online in the journal JAMA Internal Medicine.

While it did not address how age-related hearing loss may worsen problems with memory or thinking, Lin says there are several theories.

One theory is that the social isolation common among people with untreated hearing loss leads to mental decline. Previous research has identified loneliness as a risk factor for such decline, he says.

Another theory is the idea that the working memory is limited with respect to the amount of information it can hold and the operations it can perform.

“The job of the inner ear is to take in sounds and encode them with accurate fidelity before the signal goes to the brain for decoding, but with hearing loss the brain has a very hard time doing that,” Lin says. “If the brain constantly has to expend more resources to decode sound, this may come at a cognitive cost.”

Neurologist and Alzheimer’s researcher Marc L. Gordon, MD, calls the research compelling, but he says more studies are needed to confirm that hearing loss has a direct impact on mental decline and to understand the reasons for the link.

He adds that the study emphasizes the importance of addressing not just hearing loss but also vision loss in the elderly.

“This reinforces the notion that evaluating and treating these sensory impairments may be even more important for an aging person’s overall well-being than we have known,” he says.

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