WEDNESDAY, Sept. 24 (HealthDay News) -- American children are three times more likely to be prescribed psychotropic medications for conditions such as ADHD and bipolar disease than European children are, a new study finds.

Differences in regulatory practices and cultural beliefs about the benefit of medication for emotional and behavioral problems may explain this dramatic difference, the U.S. researchers added.

"There is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe," said lead researcher Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland. "Since most of the use is 'off-label' -- without adequate evidence of benefits and risks, close monitoring should be considered when these medications are used."

The report was published in the Sept. 24 online edition of Child and Adolescent Psychiatry and Mental Health.

For the study, Zito's group looked at the use of antidepressants such as Prozac and stimulants such as Ritalin in the United States, the Netherlands and Germany.

Researchers found that the annual prevalence of psychotropic medications among children in the United States was significantly greater than in either the Netherlands or Germany. In the United States, 6.7 percent of children were taking these drugs, compared with 2.9 percent in the Netherlands and 2 percent in Germany.

In addition, use of antidepressants and stimulants was three or more times higher in the United States than in the Netherlands or Germany, and use of antipsychotic drugs was 1.5 to 2.2 times greater in the United States than in either of the other countries.

The difference in the use of these drugs may be partly due to differences in diagnosis systems. For example, in the United States, there are more diagnoses of bipolar disease among children and adolescents than there are in Europe, the researchers noted.

In addition, there are more child psychiatrists in the United States per capita than in Europe, and many children in the United States are taking two or more psychotropic drugs in a single year.

"Direct-to-consumer drug advertising, which is common in the U.S., is also likely to account for some of the differences. The increased use of medication in the U.S. also reflects the individualist and activist therapeutic mentality of U.S. medical culture," the researchers concluded.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, thinks finding out what accounts for these differences may be important in determining the best treatment for children with emotional and mental problems.

"It has been said many times that the U.S. has a sick-care system, rather than a health-care system, with a particular emphasis on use of drugs and procedures for diagnosed conditions," Katz said. "This study reaffirms that pattern, with more use of medication for various mental health conditions among children in the U.S than other countries."

What this study cannot show is whether the use of medication is appropriate, given variations in culture, or whether other countries under-prescribe psychotropic drugs or whether the U.S. over-prescribes them, Katz added.

"To make that determination, a comparison of outcomes associated with these differing practice patterns is required," Katz said. "The value in comparing and contrasting resides ultimately in gaining insights about best practices. We now know that practices vary, but don't know which pattern, if any, is demonstrably superior to the others."

More information

For more about children and mental health, visit the U.S. National Library of Medicine.

TUESDAY, Sept. 23 (HealthDay News) -- Nasally administered insulin won't protect children at high risk of developing type 1 diabetes from getting the illness, Finnish researchers say.

The study included 264 children with an increased genetic risk for type 1 diabetes who tested positive for two or more diabetes-associated autoantibodies in consecutive blood samples taken 3 month to 6 months apart.

The team gave nasally-administered insulin to 137 children for a median of 1.8 years, while 127 children received a placebo.

In the insulin group, 56 children eventually developed diabetes, compared to 53 children in the placebo group.

"Administration of nasal insulin did not delay or prevent type 1 diabetes in children with genetically conferred risk of disease, even when started soon after antibodies to the condition were detected," wrote Drs. Kirsti Nanto-Salonen and Olli Simell, of the University of Turku, and colleagues.

The study was published online and was expected to be in an upcoming print edition of The Lancet.

"As Nanto-Salonen and colleagues and others have shown, autoantibody seroconversion in the first 13 years of life may be a common prerequisite for development of type I diabetes, which would suggest that an early window of susceptibility exists, after which seroconversion and type I diabetes are much less likely," Dr. David B Dunger and Dr. John Todd, University of Cambridge, U.K., wrote in an accompanying editorial.

More information

The American Academy of Family Physicians has more about type 1 diabetes  .

THURSDAY, Sept. 18 (HealthDay News) -- Parenting style starts to influence a child's ability to deal with stress as early as 6 months of age, a new report says.

The findings, published in the September/October issue of Child Development, show that parenting and genes influence how a child deals with stress, and that parental actions could put infants at risk of developing poor responses to such situations.

Researchers from three North Carolina universities and Pennsylvania State University measured heart rates of 142 infants during a stressful situation (separation from their mothers) to check vagal tone, a cardiac response that slows the heart when calm but allows it to pump faster in challenging situations. They also checked the babies' DNA to determine which dopamine receptor gene the infants carried; some forms of this gene are linked to later problems such as aggression, substance abuse, and other risky behaviors.

At 3 and 6 months old, those infants with the dopamine gene associated with later risky behaviors also did not have effective vagal tones to take the brake off the heart during stressful situations; infants with the non-risk version of the gene did. At these early ages, the researchers found, whether mothers were sensitive to their child's stress did not seem to affect their vagal tone.

By age 12 months, infants with the risk gene who also had mothers who were highly sensitive now showed the expected cardiac response when stressed. Those same infants with insensitive mothers continued to show an ineffective cardiac response to the stress.

These findings suggest that while genes affect development of physiological responses to stress, environmental experience (such as mothers' sensitive care-giving behavior) can have a strong enough influence to change the effect of those genes very early in life.

"Our findings provide further support for the notion that the development of complex behavioral and physiological responses is not the result of nature or nurture, but rather a combination of the two," study lead author Cathi Propper, a research scientist at the University of North Carolina at Chapel Hill, said in a news release issued by the journal's publisher. "They also illustrate the importance of parenting not just for the development of children's behavior, but for the underlying physiological mechanisms that support this behavior.

"Although these processes will continue to change over time, parenting can have important positive effects even when children have inherited a genetic vulnerability to problematic behaviors."

More information

The U.S. National Institute of Mental Health has more about child and adolescent mental health.

MONDAY, Aug. 4 (HealthDay News) -- Getting too little sleep or not spending enough time in rapid eye movement (REM) sleep is associated with being overweight among children and teens, a new U.S. study.

For three consecutive nights, researchers assessed the sleep patterns of 335 youngsters, aged 7 to 17. They looked at total sleep time, time spent in REM, and time it took to fall asleep. Body-mass index was checked at the start of the study, and 45 participants (13.4 percent) were overweight, while 49 (14.6 percent) were at risk for becoming overweight.

Compared to normal-weight children, those who were overweight slept about 22 minutes less per night and had lower sleep efficiency (percentage of time in bed that a person is asleep), shorter REM sleep, less eye activity during REM sleep, and a longer wait before the first REM period.

After they adjusted for other factors, the researchers concluded that one hour less of total sleep was associated with a twofold increased risk of being overweight. One hour less of REM sleep was associated with a threefold increased risk.

Although the precise mechanisms are currently under investigation, the association between short sleep duration and overweight may be attributed to the interaction of behavioral and biological changes as a result of sleep deprivation, wrote Dr. Xianchen Liu, of the Western Psychiatric Institute and Clinic in Pittsburgh, and colleagues.

They explained that sleep loss causes changes in hormone levels that may affect hunger, and less sleep also means a person has more waking hours in which to eat. Sleep loss also contributes to fatigue the following day, which may lead to less physical activity and fewer calories burned.

Given the fact that the prevalence of overweight among children and adolescents continues to increase and chronic sleep insufficiency becomes more prevalent in modern society, family- and school-based sleep interventions that aim to enhance sleep hygiene and increase sleep duration may have important public health implications for the prevention and intervention of obesity and type 2 diabetes in children, the authors concluded.

"Furthermore, our results demonstrate an important relationship between REM sleep and high BMI and obesity, suggesting that the short sleep-obesity association may be attributed to reduced REM sleep time and decreased activity during REM sleep," they wrote.

The study was published in the August issue of the Archives of General Psychiatry.

More information

The Nemours Foundation has more about overweight and obesity in children  .