Girls with social and/or attention deficits: a descriptive study of 100 clinic attenders.

OBJECTIVE: Examine clinical correlates and distinguishing features of autism spectrum disorders (ASD), ADHD, and tic disorders in girls referred for social impairment, attention/academic deficits, and/or tics. METHOD: One hundred 3- to 18-year-old girls referred for social impairment and attention symptoms were assessed in detail. Sixty of these girls, 7 to 16 years of age (IQ >or= 80) were compared with age-matched girls (IQ >or= 80) from the community. RESULTS: Main diagnoses of ASD, ADHD, tic disorders, and "other psychiatric disorder" were made in 46, 46, 3, and 5, respectively, of the referred girls. The ASD and ADHD groups (mean age at diagnosis 8.8 and 13.0 years, respectively) had the same types and high rates of psychiatric comorbidity. Girls with ASD had more problems with global functioning and adaptive levels of daily living skills than girls with ADHD. Differences between these girls referred for investigation and the community sample of girls were very considerable across a range of factors. CONCLUSIONS: Girls referred for social and/or attention deficits usually meet diagnostic criteria for either ASD or ADHD. They have severe psychiatric comorbidities and low global levels of functioning.

Missed opportunities-adolescents with a chronic condition (insulin-dependent diabetes mellitus) describe their cigarette-smoking trajectories and consider health risks.

AIM: To enhance our knowledge on why adolescents with a chronic condition (insulin-dependent diabetes mellitus, IDDM) choose to smoke despite possible awareness of health risks. METHODS: Twelve patients aged 15-20 with IDDM who smoked cigarettes volunteered to participate in qualitative interviews. The results were analyzed with content analysis according to Miles and Huberman 1994. RESULTS: One set confirmed what is earlier known on cigarette smoking among adolescents, such as plain exploring, needs to conform with group norms, identity needs and denial of risks. Other themes gave new insights. One was the emotional attitudes-or lack of emotions-expressed by important others, which exerted strong influences on the smoking trajectories. These emotions affected both initiation and motivation for quitting cigarette smoking and seemed crucial as means of meaningful communications concerning smoking. One theme was a flow path of cigarette smoking, which demonstrated opportunities for secondary prevention. Finally, developmental reasons for smoking and motivation for quitting could be described. CONCLUSIONS: There are several windows of opportunities to lower the risk of adolescents with IDDM and other chronic conditions from becoming and remaining smokers, as reported by young people themselves.

Promoting adolescent health.

The aim is to discuss why paediatricians should be involved in adolescent health care and provide youth-friendly-health-services. Global epidemiological data on morbidity and mortality demonstrate that much of ill health in the short and long run are connected to adolescent behaviour and in theory available for prevention. Young people seemingly lose their heads and do not consider dangers. Recent research on brain development provides us with an understanding how this may have a biological base. Also psychology has long taught us how adolescents use experimental behaviours as means to satisfy developmental needs and explore identity. Prevention and health promotion are areas of research where much more needs to be done. There is also a lack of venues for publishing even excellent studies in this field.

Comparing youth health in Sweden and Bosnia.

The Adolescence Medical Group in Sweden has performed a questionnaire every second year since 1990. The questionnaire is performed during school hours in seventh and ninth grade and also in the second grade in the upper secondary school (gymnasium). The questionnaire is completed anonymously. The schools are not chosen by statistical methods, but more depending on youth-health-iterested school doctors and nurses who have interest in these studies. The result of these studies has been used locally in each community, but also been reported for example i Acta Pediatrica. After the war in Bosnia there has been different projects to help to build up the countries health system, for example in psychiatry. The question was laso raised how the youth health was in Bosnia. Representatives from the Adolescence section in Sweden were invited to Bosnia to introduce the questionnaire and also to help in analysing the results. We were also in Bosnia to present results to local authorities and those who performed the study locally.

Childhood stunting in relation to adolescent living environment and resilience: a follow up study in Lahore, Pakistan.

BACKGROUND: Stunting, as a manifestation of deprivation in early childhood, is a common problem among young Pakistani children. Poverty and lack of resources may predispose a child to maladjustment in the grown-up society. Resilience has been studied in young children to ascertain how the children cope with the challenges in life. The aim of the investigation was to study differences in growth, socio-economic situation and resilience between adolescent boys who had been stunted or normal in height at the age of five years. METHODS: Using both quantitative and qualitative study designs, the study areas were an urban slum area and a village outside Lahore, Pakistan. All boys (n = 36) had been followed from birth to 5 years of age in an earlier epidemiological study conducted at the Dept of Social and Preventive Paediatrics, King Edward Medical College, Lahore and were identified for follow up at 12-15 years of age. RESULTS: Those who were stunted at 5 years were also shorter as adolescents than those who were normal in height at 5 years of age. Resilience, i.e., the combination of the adolescent's emotional abilities, his access to emotional and family support and view of himself was interestingly not heavily influenced by earlier malnutrition. CONCLUSIONS: Despite the hardships faced by the young adolescent boys, living in poor socio-economic situations, are capable of displaying resilience despite being stunted.