FRIDAY, May 17 (HealthDay News) -- As the American Psychiatric Association unveils the latest edition of what is considered the "bible" of modern psychiatry this weekend, the uproar over its many changes continues.

"This is unprecedented, the amount of commentary and debate and criticism," said Dr. Jeffrey Lieberman, president-elect of the American Psychiatric Association (APA). "It's been an interesting phenomenon, but the evidence is what it is. You have to evaluate it and then make your own determination of how compelling it is, and what would be best clinical practice."

The APA believes that changes made in this fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will allow for more precise diagnoses of mental illnesses in patients, because this edition better characterizes and categorizes disorders.

But it has drawn fire from critics who are concerned that the revised version will lead to the diagnosis of mental illness in people who are simply being challenged by life.

More than 1,500 experts from 39 countries representing a wide variety of medical fields contributed to the new DSM-5, which was more than a decade in the making. Drafts of the manual were made available online as part of three open-comment periods that drew more than 13,000 responses.

One of the most notable naysayers has been Dr. Allen Frances, chairman of the task force that created the DSM-4, the previous version of the guide that has been in use since 1994.

In a commentary released the day of the DSM-5's release, Frances wrote that this latest revision introduces "several high-prevalence diagnoses at the fuzzy boundary with normality," and predicted that the changes "will probably lead to substantial false-positive rates and unnecessary treatment."

"In DSM-5, normal grief becomes a major depressive disorder, temper tantrums become disruptive mood dysregulation disorder, worrying about medical illness becomes somatic symptom disorder, gluttony becomes binge eating disorder and almost everyone will soon qualify for attention-deficit disorder," Frances said in an interview.

The main points of contention regarding the DSM-5 include:

• The combination of a number of autism-related disorders into a single category called autism spectrum disorder. Although some clinicians believe that placing autism on a continuum from mild to severe will allow for more accurate diagnoses, others are concerned that high-functioning people with autism will find themselves unable to receive services or treatment. This is particularly true of people with Asperger's Syndrome, a diagnosis that has been eliminated from the DSM-5, critics of the new version contend.

  "We're concerned that people who have Asperger's -- who have high-functioning autism -- are going to be dismissed as just being different when the majority of adults with Asperger's will need people to assist them in parts of their lives," said Karen Rodman, president and founder of Families of Adults Affected With Asperger's Syndrome.

  "We are very concerned that medicine is going to drop the ball again, and the children who need services won't get them," Rodman said. "Fortunately, clinicians and physicians and the public around the world are still going to refer to Asperger's as Asperger's. It's like saying people don't have a right arm anymore.

  "Many people with Asperger's are [also] concerned there will be a stigma -- that everyone will be considered autistic -- and when people think of that they think of a child sitting in a corner and spinning," Rodman added.

• Changes made to the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD). Critics are concerned that changes made to better diagnose ADHD will instead lead to over-diagnosis. In the previous version of the DSM, a person needed to show the onset of symptoms before age 7 to be diagnosed with ADHD. The new version now says 12 is the latest age at which ADHD symptoms can manifest themselves. The DSM-5 also reduces the number of criteria needed to arrive at a diagnoses of adult ADHD from six to five.
• A new diagnostic category for children who are hostile or acting out. The DSM-5 includes a new category called disruptive mood dysregulation disorder, which would apply to children who have extreme irritability but fall short of the standards for bipolar disorder or depression. The category was created to deal with the upswing in bipolar diagnoses among children, but there is concern that some clinicians will label a simple childhood temper tantrum as a treatable mental illness.
• Breaking out obsessive-compulsive disorders into their own category. Obsessions such as hoarding, hair-pulling and skin-picking had been considered anxiety disorders, but in the DSM-5 they will have their own category. Critics are concerned that this change has more to do with reality television's recent focus on hoarders than with the need for a new category of mental illness.

Lieberman called the DSM-5 "a reflection of the state of our scientific knowledge," and strongly disagreed with the notion that over-diagnosis and overmedication will be the end result of the manual's new standards.

"This doesn't reflect any expansion of the people who would be diagnosed. It just classifies them in a more concise and accurate way," he said. "The goal of the DSM is not to expand the number [of people] who receive diagnoses who don't warrant them. The reality is that there is tremendous under-treatment of people with real needs, and this new revision will help."

Reflecting on the strong reaction to the changes, Lieberman said it may go hand-in-hand with the public's uneasiness with mental illness.

"I think there's a strong stigma factor associated with mental illness," he said. "There are people who are either fearful of it or want to minimize its existence. That stigma has been historic, but it has been diminishing with greater education and research and better treatment."

For his part, Frances ascribes nothing but good intentions to those who worked on the new DSM, but is concerned that their efforts will lead to bad outcomes.

"The people who are suggesting these changes are experts in their field who are pure of heart, but they have made terrible decisions because they don't understand that new diagnoses that may work well for them can be an absolute disaster in everyday care, especially when drug companies get their hands on them," he said.

Frances has written a new book, Saving Normal, in which he argues that mental illness is over-diagnosed in America. He urged both parents and clinicians to be skeptical when it comes to the DSM-5 and any diagnoses that spring from it.

"My advice to physicians is to use the DSM-5 cautiously, if at all," Frances concluded in his commentary. "It is not an official manual; no one is compelled to use it unless they work in an institutional setting that requires it."

More information

Fore more on the DSM-5, go to the American Psychiatric Association.

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FRIDAY, May 17 (HealthDay News) -- Alcoholics who smoke have more problems with memory, problem solving and quick thinking than those who are nonsmokers, researchers have found.

This "early aging" of the brain gets worse over time, according to the study published online May 17 and in the October print issue of Alcoholism: Clinical & Experimental Research.

The study measured mental or "cognitive" functioning.

"The independent and interactive effects of smoking and other drug use on cognitive functioning among individuals with [alcohol dependence] are largely unknown," Alecia Dager, an associate research scientist in the department of psychiatry at Yale University, said in a journal news release. "This is problematic because many heavy drinkers also smoke. Furthermore, in treatment programs for alcoholism, the issue of smoking may be largely ignored," she noted.

For the study, adult participants were divided into four groups. The first included 39 healthy people who never smoked. The other groups included people seeking treatment for alcoholism after not drinking for one month. Of these, 30 people had never smoked, 21 were former smokers and 68 were current smokers.

According to study corresponding author Timothy Durazzo, the investigators "focused on the effects of chronic cigarette smoking and increasing age on cognition because previous research suggested that each has independent, adverse effects on multiple aspects of cognition and brain biology in people with and without alcohol use disorders."

The researchers analyzed participants' mental ability in a number of areas.

Durazzo, who is an assistant professor in the department of radiology and biomedical imaging at the University of California, San Francisco, said in the news release that "at one month of abstinence, actively smoking [alcohol-dependent participants] had greater-than-normal age effects on measures of learning, memory, processing speed, reasoning and problem-solving, and fine motor skills."

In contrast, among participants with alcohol problems, "never-smokers and former-smokers showed equivalent changes on all measures with increasing age as the never-smoking controls," he explained.

"These results indicate the combination of alcohol dependence and active chronic smoking was related to an abnormal decline in multiple cognitive functions with increasing age," Durazzo said, and that "the combined effects of these drugs are especially harmful and become even more apparent in older age."

He pointed out that other factors, including nutrition and exercise, may also influence brain function during early abstinence. He added that underlying medical issues including high blood pressure and diabetes as well as psychiatric conditions such as depression and post-traumatic stress disorder could also play a role.

Based on their findings, the authors suggested that as people get older, chronic smoking and heavy drinking are associated with increased oxidative damage to the brain.

"Oxidative damage results from increased levels of free radicals and other compounds that directly injure neurons and other cells that make up the brain. Cigarette smoking and excessive alcohol consumption expose the brain to a tremendous amount of free radicals," Durazzo explained.

While the study tied alcohol dependence combined with smoking to early brain aging, it didn't establish a cause-and-effect relationship.

The researchers advised that people seeking treatment for alcohol abuse should also be routinely offered help to quit smoking.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more about effects of alcohol on the brain.

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FRIDAY, May 17 (HealthDay News) -- It comes as little surprise that college students sometimes binge drink, but new research shows that college women are more likely to drink unhealthy amounts of alcohol on a weekly basis than are college men.

Much of this difference is probably because the amount of alcohol that's considered safe on a weekly basis is much lower for women than it is for men: seven drinks for women versus 14 for men. But, there's good reason for that difference. Women don't metabolize alcohol in the same way as men, and lesser amounts of alcohol can increase the risk of breast cancer and liver disease in women.

Throughout the study, 15 percent of women exceeded weekly drinking limits compared to 12 percent of men. In addition, men's weekly drinking appeared to go down throughout the year, but not so for women.

"College women adopt a drinking style that will cause toxicity soon. Overall, women drink less than men do, but they don't seem to know how much less they should be drinking in a week," explained Bettina Hoeppner, lead study author and an assistant professor of psychology at Harvard Medical School.

Hoeppner said the biggest concern is that women may be setting themselves up for long-term health problems, particularly if they're not aware of the safe weekly alcohol limits. She noted that women might think they're fine if they don't binge drink, but it's easy to hit the weekly limit by just having a glass of wine with dinner every night.

The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines low-risk drinking as no more than three drinks a day or seven drinks a week for women. For men, those limits are four drinks a day and 14 drinks a week.

The daily limits were set to avoid the physical and thinking problems that can occur from drinking too much in one day. The weekly limits took into account how much alcohol someone would need to consume to raise their risk of chronic health conditions, such as liver disease, sleep disorders, heart disease and some cancers.

Hoeppner's study included 992 college students: 575 females and 417 males. The students provided biweekly reports of their daily drinking habits through a Web-based questionnaire.

Two-thirds of both the men and women exceeded the NIAAA weekly or daily guidelines at least once during the year, according to the study. Slightly more than 51 percent of the women and about 45 percent of the men exceeded weekly drinking limits at least once during the year.

Men were slightly more likely to exceed daily limits than women: 28 percent of men versus 25 percent of women, but the researchers said this difference wasn't statistically significant.

The study findings appear online May 17 and in the upcoming October print issue of Alcoholism: Clinical & Experimental Research.

Dr. Marc Galanter, director of the division of alcoholism and drug abuse at the NYU Langone Medical Center, said he suspects that college women may be trying to drink as much as their male counterparts. "I think these young women are independent souls and are motivated to drink in a manner that's similar to the way that men are drinking," he said. "In terms of what's considered normative, there isn't much difference between men and women now."

But, he cautioned, "Comparable levels of drinking for women have a greater impact in terms of intoxication."

Study author Hoeppner said she didn't think that women were necessarily trying to drink as much as men, just that they might not be as aware of what's considered a safe weekly limit.

"Women need to be reminded that there are weekly limits, and women can exceed those limits quickly. It's important to track the number of drinks you have per week, not just on occasion. And, alcohol prevention information should address the rationale behind weekly limits," Hoeppner suggested.

More information

Learn more about drinking in college from the U.S. National Institute on Alcohol Abuse and Alcoholism.

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FRIDAY, May 17 (HealthDay News) -- Teen bullies are more likely to be criminals when they're adults, a new study finds.

UT Dallas researchers analyzed several decades of data collected from more than 400 men in Britain. All of them had similar working-class backgrounds and most came from two-parent families. They were followed until they were in their mid-50s.

Nearly half of the men who said they were bullies during their teen years engaged in some form of criminal activity -- such as theft, burglary and assault -- when they were adults, according to the study in a recent issue of the Journal of Youth and Adolescence.

"We also found that these men were more likely to be repeat offenders and at a much higher rate," study co-author Alex Piquero, a professor of criminology, said in a UT Dallas news release.

Risk factors for being a teen bully also predicted criminal activity as an adult. These factors included poor school performance, impulsivity, poor parental supervision, family disruption and poor living conditions.

The findings suggest that early action to help children at risk of becoming bullies may lower rates of criminal behavior among adults, the researchers said.

"From a policy perspective, if we can address some of these risk factors early and identify children who are at risk of bullying, we can ameliorate adverse outcomes that may occur much later in life," Piquero said.

More information

The Nemours Foundation explains how parents can teach children not to bully.

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FRIDAY, May 17 (HealthDay News) -- Although being openly gay appears to affect a male actor's masculinity ratings, it does not affect views on his performance, according to a new study.

Researchers from Clemson University in South Carolina found that an actor who is "out" can be convincing when playing a heterosexual role, despite stereotypes about homosexuals.

"Early research showed that people tend to perceive a direct connection between sexual orientation and established gender roles, especially in the entertainment industry," said the study's leader, Paul Merritt, a psychology professor, in a Clemson news release. "However, these new findings indicate that knowledge of an actor's sexual orientation doesn't necessarily cause their performance to be perceived in light of stereotypes about gays and lesbians."

The study, published recently in Psychology of Popular Media Culture, was conducted in the wake of news columns that maintained that knowing someone is gay will bias perceptions of his or her performance in a heterosexual role.

The researchers questioned roughly 400 college students about a male actor's fictional Facebook page, featuring photos and information about his sexual orientation.

The students then watched a video of the actor and rated his performance. The students also stated how likely they would be to cast the actor in their own production. The study revealed that being openly gay didn't affect perceptions or ratings of the actor's performance, but it did influence their opinion of his masculinity.

More information

The American Psychological Association has more about sexual orientation and homosexuality.

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THURSDAY, May 16 (HealthDay News) -- The adult children of parents who were addicted to alcohol or drugs are at increased risk for depression, a new study finds.

Researchers looked at data from nearly 6,300 Canadian adults and found that 312 of them had suffered major depression in the past year. Also, 877 of the adults said that when they were younger than age 18 and still living at home, at least one parent drank or used drugs "so often that it caused problems for the family."

After adjusting for age, sex and race, the University of Toronto researchers found that adults with childhood experiences of parental addiction had a more than two-fold increased risk of depression.

Even after compensating for other factors, "ranging from childhood maltreatment and parental unemployment to adult health behaviors including smoking and alcohol consumption, we found that parental addictions were associated with 69 percent higher odds of depression in adulthood," study lead author Esme Fuller-Thomson, a professor of social work, said in a university news release.

The study, published online recently in the journal Psychiatry Research, did not pinpoint any factors that might explain the association between a parent's addiction and depression in adult children.

"It is possible that the prolonged and inescapable strain of parental addictions may permanently alter the way these children's bodies react to stress throughout their life," study co-author Robyn Katz, a graduate student at the university, said in the news release. "One important avenue for future research is to investigate potential dysfunctions in cortisol production -- the hormone that prepares us for 'fight or flight' -- which may influence the later development of depression."

According to Fuller-Thompson, "these findings underscore the intergenerational consequences of drug and alcohol addiction and reinforce the need to develop interventions that support healthy childhood development."

"As an important first step, children who experience toxic stress at home can be greatly helped by the stable involvement of caring adults, including grandparents, teachers, coaches, neighbors and social workers," she suggested. "We do know that these caring relationships promote healthy development and buffer stress."

The study found an association between parental addiction and depression in children, but it did not prove cause-and-effect.

More information

The U.S. National Institute of Mental Health has more about depression.

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THURSDAY, May 16 (HealthDay News) -- Students targeted because they're believed to be gay -- as many as one in seven young teens -- are much more likely than others to be suicidal and depressed, a new survey finds.

More than 10 percent of eighth-grade boys and girls reported that they're victimized because of perceived sexual orientation, according to a large survey of students in Washington state.

"It has a profound impact on their quality of life and the way they think of themselves," said Donald Patrick, a professor of health services at the University of Washington in Seattle. "Those in eighth grade are in a particularly vulnerable position."

These children "feel alone in life, that they don't feel as good as other people and their self-esteem is highly affected," Patrick said.

The survey results, published online May 16 in the American Journal of Public Health, don't offer insight into whether bullying contributes to depression and suicidal thoughts in its victims. It's possible that kids with existing mental illnesses may be more likely to be bullied and perceived as gay.

Nor does the research establish a clear cause-and-effect relationship between bullying and suicidal thoughts. But Patrick said "it's clear that there's an association, and I wouldn't be so worried about the causation." Prior research has also suggested that gay, lesbian, bisexual and transgender children are more likely to be suicidal and hurt themselves.

A string of teen suicides in 2010 -- including the death of Rutgers University freshman Tyler Clementi -- put the issue in the public eye. Syndicated columnist Dan Savage launched a campaign called "It Gets Better" to give hope to gay teens that their lives will improve. Participants have included numerous celebrities and politicians, including President Barack Obama.

Based on the new findings, bully-prevention programs must address kids picked on because of their sexual orientation, the study authors said.

The study is based on a 2010 survey of nearly 28,000 students in grades eight, 10 and 12. Among boys, 14 percent of eighth-graders, 11 percent of 10th-graders and 9 percent of 12th-graders reported being bullied within the previous month because they were thought to be gay. The numbers were 11 percent, 10 percent and 6 percent, respectively, for girls.

The survey defined bullying based on sexual orientation as being "bullied, harassed or intimidated at school" because they were thought to be gay or bisexual. It defined other types of bullying as when one or more students "say or do nasty or unpleasant things" to another person or tease someone "repeatedly in a way he or she finds offensive." In most cases, more students reported being bullied for other reasons.

Compared to kids bullied for other reasons or not bullied at all, those targeted because they were perceived to be gay were much more likely to have considered suicide in the past year, to have been depressed in the past year and to say they don't feel good about themselves.

For example, 26 percent of male 12th-graders targeted for being perceived as gay said they had been suicidal within the past year, compared to 8 percent of those not bullied. The rate also was more than three times greater for female seniors.

Brian Mustanski, an associate professor in the department of medical social sciences at the Northwestern University Feinberg School of Medicine, in Chicago, said the survey has some strengths but fails to ask whether those bullied are actually gay and not just perceived to be.

"Because of this, it is a major underestimate of the rate of bullying among gay youth," he said.

Mustanski agreed with Patrick that teachers and school leaders need to promote comfortable and safe environments. "While family and peer support have important positive effects for gay youth and reduce feelings of suicide and depression, you cannot 'support away' these toxic effects of bullying," he said.

"Schools and communities need to put in place policies and practices that make schools and neighborhoods safe for all kids," he said.

More information

The Trevor Project offers a confidential suicide hotline for gay teens and those questioning their sexuality.

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THURSDAY, May 16 (HealthDay News) -- Women in their 40s and 50s who suffer from depression are almost twice as likely to have a stroke as women who aren't depressed, according to a large, long-running Australian study.

This is not the first study to link depression with an increased risk for stroke, in both men and women. Exactly how depression is associated with stroke is unclear, as is whether treating it reduces the risk, experts say.

"Although the absolute risk of stroke is low in mid-aged women, depression does appear to have a large adverse effect on stroke risk in this age group," said lead researcher Caroline Jackson, an epidemiologist in the School of Population Health at the University of Queensland.

"Our findings, however, suggest that depression may be a stronger risk factor for stroke in mid-aged women than was previously thought," she said.

Despite the growing body of evidence on depression and risk of stroke, depression is generally not included in guidelines for primary stroke prevention, which appears to be an important omission that should be addressed, Jackson noted.

The report was published May 16 in the journal Stroke.

One expert said this latest finding adds to the growing pile of evidence on the link.

"This large study among Australian women adds further evidence supporting the association between depression and stroke risk," said Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine.

Other studies have also demonstrated the effects of depression on stroke risk, he added. "Although we are not clear about the mechanisms, depression is frequent and needs to be more readily recognized and appropriately treated," Sacco said.

To see how much depression influenced the risk of stroke, Jackson and her colleague Gita Mishra, a professor of life course epidemiology at the University of Queensland, collected data on more than 10,000 women aged 47 to 52 who took part in the Australian Longitudinal Study on Women's Health.

Women in the survey answered questions about both physical and mental health every three years from 1998 to 2010.

Among these women, about 24 percent said they suffered from depression. Over the study period 177 women had a stroke for the first time.

Analysis by Jackson and Mishra found depressed women were 2.4 times more likely to have a stroke than women who weren't depressed.

After eliminating some of the other factors that increase the risk of stroke, depressed women still were 1.9 times more likely to have a stroke, compared to women who were not depressed, they found.

Risk factors included: age; socioeconomic status; lifestyle habits such as smoking, alcohol and physical activity; and high blood pressure, heart disease, being overweight and diabetes.

Jackson noted that in absolute terms the risk for women in this age group having a stroke is still small.

In the study, about 1.5 percent of all women had a stroke, and it increased to slightly more than 2 percent among women with depression, she noted.

While the study tied depression to increased stroke risk, it did not establish a cause-and-effect relationship.

According to Jackson, this is the first large study that looked at the association between depression and stroke in younger middle-aged women.

In the United States, another long-running study on women's health -- the Nurses' Health Study -- found a 30 percent higher risk of stroke among depressed women. The average age of women in that study, however, was 14 years older, Jackson said.

The compelling evidence of an association between depression and stroke, "reinforce the need for adequate targeted prevention, detection and control of poor mental health among mid-aged women," Jackson said.

And since the reasons for association aren't known, "we need to carry out further research to identify the mechanism by which depression affects stroke risk, since this may have implications for development of future treatment of depression and stroke prevention strategies," she said.

More information

To learn more about stroke, visit the National Stroke Association.

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THURSDAY, May 16 (HealthDay News) -- Drop by for a visit or share the drive -- but please, no smoking.

That's the message the vast majority of Americans send to the smokers within their social circle, a new study finds.

Four out of five adults now have smoke-free rules in their homes, while about three out of four have enacted the same ban in their cars, according to the national survey from the U.S. Centers for Disease Control and Prevention.

Getting tough on smoking is always a good idea, experts say.

"We have made tremendous progress in the last 15 years protecting people in public spaces from secondhand smoke," Dr. Tim McAfee, director of the CDC's Office on Smoking and Health, said in an agency news release. "The good news is that people are applying the same protection in their homes and vehicles."

Whether or not you've banned smoking inside the home seems to depend on your smoking status, the CDC study found. While 89 percent of non-smokers say they have a smoke-free policy at home, only 48 percent of smokers have a similar rule. When it comes to cars or other vehicles, 85 percent of non-smokers do not allow smoking, compared to just 27 percent of smokers, the research showed.

Many people may be taking their cue from local legislation, the CDC said. The agency noted that most of the people who've established their own smoke-free rules live in states with longstanding tobacco-control programs and comprehensive smoking bans.

Nevertheless, there's more work to be done, McAfee said. "Millions of non-smokers, many of whom are children, remain exposed to secondhand smoke in these environments," he said.

According to the CDC, nearly 11 million non-smokers remain exposed to secondhand smoke at home and almost 17 million non-smokers are exposed in cars.

The non-smokers most affected by secondhand smoke are men, younger adults, blacks and those with less education. States with the fewest smoking bans or tobacco-control programs had the most adult smokers, the study found.

The danger to nonsmokers' health from stray cigarette smoke is real. Adults exposed to secondhand smoke can develop heart disease and lung cancer, the CDC said. For children, secondhand smoke increases the risk for more severe and frequent asthma attacks, acute respiratory infections, ear infections and sudden infant death syndrome (SIDS), the agency said.

Exposure to secondhand smoke claims the lives of an estimated 50,000 people in the United States each year. Because of that, the U.S. Surgeon General advises 100 percent smoke-free policies that protect non-smokers from secondhand smoke.

"While almost half of all U.S. residents are protected by 100 percent smoke-free policies in worksites, restaurants and bars, overall there are still an estimated 88 million non-smoking Americans over the age of 3 who are exposed to secondhand smoke," study lead author Brian King, an epidemiologist in the CDC's Office on Smoking and Health, said in the news release. "It's important to educate people on the dangers of secondhand smoke exposure and how smoke-free homes and vehicles can reduce that exposure."

The study appears in the May issue of the CDC journal Preventing Chronic Disease.

More information

The American Cancer Society provides more information on secondhand smoke.

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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."

More information

To find out more about children's mental health, head to the U.S. National Institute for Mental Health.

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WEDNESDAY, May 15 (HealthDay News) -- Among young heart attack victims, women often have more medical issues, more chest pain and worse quality of life before the event than men, a new study reveals.

The researchers, from the Yale School of Medicine, said young women also tend to have worse mental health with more physical limitations prior to their heart attacks.

The findings could help explain why young women often have worse outcomes than their male peers after a heart attack, said the researchers, who concluded that doctors should regularly assess young women's heart attack risk.

"Compared with young men, women under 55 are less likely to have heart attacks," study author Rachel Dreyer, a research fellow in cardiovascular medicine at Yale, said in an American Heart Association news release. "But when they do occur, women are more likely to have medical problems, poorer physical and mental functioning, more chest pain and a poorer quality of life in the month leading up to their heart attack."

The study involved nearly 3,000 women and men, aged 18 to 55, who participated in an international study of heart attack patients. The researchers questioned the participants to assess their chest pain and quality of life before their heart attack.

The study also revealed that the women were more likely than the men to have other conditions linked to heart disease, such as diabetes: 40 percent of women compared to just 27 percent of the men. Moreover, 55 percent of the women were obese, compared to 48 percent of the men.

Of the women, 6 percent had a history of stroke and 6 percent had heart failure. In contrast, 3 percent of men had a history of stroke, and 2 percent had heart failure. Meanwhile, 13 percent of women had renal failure and 49 percent suffered from depression. The researchers said only 9 percent of men had renal failure and just 24 percent were depressed.

"These data suggest that young women were suffering more from their heart disease than young men prior to their heart attack," Dreyer said.

"We need to develop better methods for recognizing and treating young women with chest pain to optimize their quality of life and potentially even prevent a heart attack," Dreyer said in the news release.

"General health and disease-specific health-status assessments are valuable tools for health care providers to measure the burden of disease on patients," she said. "These should be standardized into clinical practice, much like assessments for other traditional heart disease risk factors."

The study findings were scheduled to be presented Wednesday at the American Heart Association annual meeting in Baltimore. The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. Centers for Disease Control and Prevention has more about women and heart disease.

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TUESDAY, May 14 (HealthDay News) -- About one in every 20 U.S. teens has used "smokeless" tobacco products such as chew or snuff, and that rate hasn't budged since 2000, a new report finds.

Researchers led by Israel Agaku of the Harvard School of Public Health compared data from the 2000 and 2011 U.S. National Youth Tobacco Survey. The 2000 survey included nearly 36,000 students at 324 middle and high schools, while the 2011 survey included nearly 19,000 students at 178 middle and high schools.

The students were asked if they had used smokeless tobacco products such as snuff, chewing or dipping tobacco for one or more days within the past 30 days.

Overall, the percentage of students who reported using smokeless tobacco was 5.3 percent in 2000 and 5.2 percent in 2011, the team found. During that time, there was a drop in smokeless tobacco use among youngsters aged 9-14, but an increase among teens aged 15-17, according to the study, which appears in the May 15 issue of the Journal of the American Medical Association.

Relatively low prices for this form of tobacco, compared to cigarettes, might be stalling efforts to curb uptake among youth, the researchers suggested.

"The use of modified traditional smokeless tobacco products, such as moist snuff, coupled with lower taxes on smokeless tobacco products [vs. cigarettes] may have contributed to the stable prevalence of smokeless tobacco" even as rates of cigarette smoking has declined among teens, they wrote.

According to the American Chemical Society, roughly 9 million Americans used smokeless tobacco products in 2012. This has raised alarm about the potentially elevated risk users may face for mouth, esophageal and pancreatic cancers, all of which have been linked to use of such products.

More information

The U.S. National Cancer Institute has more about smokeless tobacco.

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THURSDAY, May 9 (HealthDay News) -- Having fun with family and friends can help relieve breast cancer patients' pain and improve their quality of life, a new study indicates.

The study included more than 3,100 women in California who were diagnosed with breast cancer between 2006 and 2011. Within about two months of their diagnosis, they completed questionnaires on their social networks, the kinds of support they received, their emotional and physical quality of life, and their physical symptoms from breast cancer.

Women with the largest social networks were most likely to report the best overall quality of life during breast cancer treatment. Higher levels of social support were also linked with better emotional quality of life, according to the Kaiser Permanente researchers.

Having family and friends to do fun things with (positive social interaction) was the most important predictor of good physical quality of life. Patients with little or no positive social interaction were three times more likely to report a low quality of life and more physical symptoms, the investigators found.

The study also found that the benefits of tangible support from others -- such as doing household chores, bringing food or providing transportation to the doctor -- were strongest among women with late-stage breast cancer. Those with low levels of tangible support were nearly three times more likely to have a lower-than-average quality of life.

The study was published May 9 in the journal Breast Cancer Research and Treatment.

"This study provides research-based evidence that social support helps with physical symptoms," study author Candyce Kroenke, a staff scientist with the Kaiser Permanente division of research, said in a Kaiser news release. "Social support mechanisms matter in terms of physical outcomes."

Each year in the United States, about 230,000 women are diagnosed with invasive breast cancer and, in 2012, there were about 2.9 million breast cancer survivors. The fact that more women are being cured of breast cancer increases the importance of quality of life after diagnosis, Kroenke said.

More information

The American Cancer Society has more about how cancer patients can find support.

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THURSDAY, May 9 (HealthDay News) -- Teenage boys who play violent video games for hours on end may become desensitized to the brutality, a small new study finds.

The research focused on 30 boys, aged 13 to 15, who were divided into two groups. One group typically played violent video games for three or more hours a day (high exposure) while the other group played such games for no more than an hour a day (low exposure).

The researchers monitored the boys' reactions after playing a violent game ("Manhunt") and a nonviolent cartoon game ("Animaniacs"). They played each game for two hours on different evenings.

Differences between the boys' reactions emerged later in the night after gaming. During sleep, the boys in the low-exposure group who played the violent game had faster heart rates and poorer quality of sleep than those in the high-exposure group. The boys in the low-exposure group also reported increased feelings of sadness after playing the violent game.

Both groups of boys had higher stress and anxiety levels after playing the violent game, according to the study, which was published in the May issue of Psychosomatic Medicine: Journal of Biobehavioral Medicine.

"The violent game seems to have elicited more stress at bedtime in both groups, and it also seems as if the violent game in general caused some kind of exhaustion," wrote Malena Ivarsson, of the Stress Research Institute at Stockholm University in Sweden, and colleagues. "However, the exhaustion didn't seem to be of the kind that normally promotes good sleep, but rather as a stressful factor that can impair sleep quality."

The differences between the two groups' physical and mental responses suggest that frequent exposure to violent video games may have a desensitizing effect, the researchers said. The study, however, didn't prove a cause-and-effect relationship, and it's possible that boys with certain traits may be attracted to violent games, the researchers said.

More information

The American Academy of Child & Adolescent Psychiatry has more about children and video games.

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THURSDAY, May 9 (HealthDay News) -- The red in redheads' hair is thought to put them at increased risk of the dangerous skin cancer melanoma, even if they don't spend a lot of time in the sun, according to a new study.

Study co-author Dr. David Fisher and his research team first uncovered the apparent link between red hair pigment and melanoma last fall. That study used genetically altered mice that had been given a mutant gene that increased their risk of contracting the skin cancer.

Now the researchers are taking the next step: asking why the body's creation of the red hair pigment -- called pheomelanin -- might prompt that risk.

Their new paper, published May 9 in the journal BioEssays, speculates that pheomelanin could increase skin cancer risk by leaving skin cells more vulnerable to DNA damage.

By determining the way pheomelanin increases cancer risk, the researchers hope to figure out a way to prevent future cases of melanoma.

"We are focusing on what the possibilities are, what the directions for new research are and how that could impact treatment," said Fisher, chief of dermatology at Massachusetts General Hospital in Boston.

The researchers had previously found that at least half of red-furred mice developed melanoma, even though none of them had been exposed to any ultraviolet (UV) radiation. By comparison, only about 10 percent of mice without red fur contracted melanoma.

"In the mouse studies, it was possible to completely remove UV and there was still a major incidence of melanoma that was attributable to the red pigment," Fisher said.

Scientists note, however, that animal studies often fail to produce similar results in humans.

Fisher speculated on two ways the red pigment might cause skin cells to be more vulnerable to melanoma.

It could be that the creation of pheomelanin in the body might also generate unstable oxygen-containing molecules that can damage cells. These molecules are known as reactive oxygen species, or ROS.

On the other hand, synthesis of pheomelanin might rob skin cells of crucial stores of antioxidants that would otherwise be used to prevent ROS damage.

"We think a new prevention opportunity exists if we can block the form of reactive oxygen damage that the red pigment is producing," Fisher said.

Despite his research, Fisher does not downplay the role that UV rays have in skin cancer risk for everyone -- particularly redheads.

"I want to emphasize that we strongly believe UV is a contributor to melanoma, and UV may actually amplify this red pigment phenomenon," he said. "It still is absolutely crucial for people to avoid sun exposure."

But the knowledge that sun exposure is only one factor in their increased risk of melanoma should prompt redheads to take additional precautions, said Dr. Jeanine Downie, a spokeswoman for the Skin Cancer Foundation.

"Redheads should get more frequent body checks," said Downie, a dermatologist based in Montclair, N.J. "If they have no family history of skin cancer, they should still be checked at least twice a year, rather than the annual check we recommend for everyone else. If they have a family history of skin cancer, they should be checked every three months."

This is crucial since melanoma could form even on a part of the body that is never touched by sunlight.

"The location on one's skin of where a melanoma may occur is not necessarily confined to the sun-exposed parts of the skin," Fisher said. "It could occur elsewhere on the body."

Redheads also should practice vigilant sun avoidance, Downie said. They should use a sunscreen with at least SPF 30, and they should reapply it every hour.

They also should consider wearing broad-brimmed hats when outdoors, sticking to the shady side of the sidewalk and even vacationing in mountain areas rather than at the beach.

"Unfortunately with redheads, they have to practice some lifestyle alterations," Downie said. "They should practice even more strict sun avoidance than we originally thought they should."

More information

Visit the U.S. Centers for Disease Control and Prevention for tips on skin cancer prevention.

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WEDNESDAY, May 8 (HealthDay News) -- Women who come down with the flu during pregnancy may be at increased risk of having a child who develops bipolar disorder, a new study suggests.

The chance of a child eventually developing the mental health disorder was nearly four times higher when comparing mothers-to-be who had the flu to those who didn't, the researchers reported.

"We don't fully understand this," said study co-author Dr. Alan Brown. "The best guess is it's an inflammatory response. It could also be a result of fever," he noted.

"Mothers should stay away from people who have the flu," said Brown, a professor of clinical psychiatry and clinical epidemiology at the Columbia University College of Physicians and Surgeons in New York City.

However, he added, regarding the new findings, "women should not be greatly concerned, because a fourfold increase is pretty high from an epidemiological standpoint, but still the vast majority of the offspring did not get bipolar disorder."

Brown explained that "the risk of bipolar disorder in the population is about 1 percent, so if it's increased fourfold that would make it a 4 percent risk." Moreover, the researchers only looked at one risk factor for bipolar disorder, not all risk factors, which could skew these results, he noted.

The report was published in the May 8 online edition of JAMA Psychiatry.

Bipolar disorder, also called manic-depressive illness, causes unusual shifts in mood, energy, activity levels and the ability to carry out routine tasks. Bipolar disorder can be treated, and people with this illness can lead full and productive lives, according to the U.S. National Institute of Mental Health.

The condition often develops in the late teens or early adult years. Some people have their first symptoms during childhood, while others may develop symptoms as adults, the agency noted.

For the study, researchers at Columbia University and Kaiser Permanente identified cases of bipolar disorder by database linkages of a Northern California health plan and a county health care system, along with data from a mailed survey.

Participants were mothers who gave birth between 1959 and 1966 and their offspring. Researchers found 92 cases of bipolar disorder and compared them with 722 people matched in terms of occurrence of maternal influenza during pregnancy.

While the new study found an association of pregnant women getting the flu and a higher risk of bipolar disorder in their offspring, it didn't establish a cause-and-effect relationship.

"There is no understanding of the causal factors of this," said Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City. He was not involved with the study.

"Pregnancy itself puts extra stress on women in general," he pointed out. "Pregnancy also affects the immune system and increases the risk of getting the flu."

Flu during pregnancy increases the risk of miscarriage, premature birth and low birth weight infants, Manevitz said.

Pregnant women should get a flu shot, both Manevitz and Brown suggested.

Other studies have shown a similar association between flu during pregnancy and the child's risk for autism and schizophrenia -- now there is this association with bipolar disorder, Manevitz said. "This doesn't give us any causal connection," he emphasized.

More information

To learn more about bipolar disorder, visit the U.S. National Institute of Mental Health.

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TUESDAY, May 7 (HealthDay News) -- By slowing down the programmed response rate on implantable cardioverter defibrillators (ICDs), doctors can reduce the number of shocks these devices deliver without causing a significant increase in the risk of fainting or death, new research suggests.

"The aim of [our] study was to evaluate a different programming strategy to reduce unnecessary therapies delivered by the ICD," explained study author Dr. Maurizio Gasparini, chief of the pacing and electrophysiology unit at the Humanitas Clinical and Research Center in Rozzano, Italy.

"The study found that the strategy utilizing a long detection period to recognize arrhythmias [irregular heartbeats] is associated not only to an overall reduction of therapies, but also to less inappropriate shocks experienced by the patients as well as fewer hospitalizations in the 12 months following ICD implant," Gasparini said.

ICDs are small devices implanted in the upper chest. Electrodes from the device are attached to the heart. If an ICD senses a dangerous heartbeat or no heartbeat, it can help correct that through electrical pacing -- like a pacemaker -- or it can deliver a shock to the heart to restore a normal heartbeat, according to the U.S. National Heart, Lung, and Blood Institute.

Results of the study are published in the May 8 issue of the Journal of the American Medical Association. The study was funded by Medtronic Inc., which makes ICDs.

While ICDs can literally be lifesavers, they can also cause problems for some patients.

"Defibrillator shocks, whether for appropriate or inappropriate indications, are associated with adverse effects. These adverse effects include the acute discomfort of the shock, as well as late and longer-lasting psychological trauma including depression and post-traumatic stress disorder," wrote Dr. Merritt Raitt, author of an accompanying journal editorial. Raitt is with the Oregon Health and Science University and the Portland Veterans Administration Medical Center, in Oregon.

The current study included about 1,900 people who were receiving their first ICD implant. Their average age was 65, and 84 percent of the study volunteers were male.

The volunteers were randomly placed into one of two groups: standard programming or programming with a long detection interval.

"Every time the heart beats, an electrical activity is recorded by the device. An interval is the time between two consecutives beats. Basically it is the time between two heartbeats. So, a long detection interval simply means a longer period of time to permit recognition of arrhythmias," Gasparini explained.

During an average of 12 months of follow-up, 530 episodes of an arrhythmia were recorded. The long detection group had a 37 percent lower rate of delivered therapies (pacing or shocks) than the standard therapy group, according to the study.

There were no significant differences in mortality or in fainting (syncope) episodes between the groups.

"This study shows that we can decrease inappropriate and unnecessary therapies, and clearly you make people feel better because they're not getting inappropriate or unnecessary therapy, said Dr. Ranjit Suri, director of the electrophysiology service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City.

However, Suri said it's not yet clear what the ideal interval time is. The current study doesn't show a benefit in terms of reduced risk of death. Another study, published last December in the New England Journal of Medicine, did find a mortality benefit. But, the interval was longer in that study.

Still, Suri said, doctors could start programming ICDs with longer intervals, and making such a change to the device isn't difficult or time-consuming.

In his editorial, Raitt wrote: "Regardless of whether these programming interventions lead to reduced mortality, the unequivocal reduction in ICD shocks and the reduction in hospitalization without an increase in adverse events such as syncope suggests that this programming approach should be considered for adoption in the care of patients with ICDs and clinical characteristics similar to those enrolled in these studies."

Study author Gasparini noted that the research provides physicians with an easy programming guideline that's "applicable to the great majority of patients who may benefit from the reduction of unnecessary painful shocks and hospitalizations."

More information

Learn more about implantable cardioverter defibrillator from the U.S. National Heart, Lung, and Blood Institute.

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TUESDAY, May 7 (HealthDay News) -- Completing quality-of-life surveys at a doctor's office could help heart disease patients live longer and have better lives, according to a new statement from the American Heart Association.

The statement urged doctors to use these surveys to assess patients' heart health. The surveys reveal the impact of heart disease on patients, including their symptoms, quality of life, and ability to function physically and mentally.

Quality-of-life surveys can also help predict future events such as heart attack, hospitalization, costs of care and death, according to the statement published May 6 in the journal Circulation.

"Ultimately, efforts to improve the health care system will only be successful if they translate into better patient outcomes -- not just longevity, but also how well patients live," statement lead author Dr. John Rumsfeld said in an AHA news release.

"This statement recommends increasing the standardized measurement of patient health status -- so we can better understand, monitor and minimize the burden of disease on patients' lives," he explained.

Researchers have successfully used patient surveys in clinical trials and other studies, they but aren't used enough in routine health care, according to Rumsfeld, national director of cardiology for the U.S. Veterans Health Administration and a professor of medicine at the University of Colorado School of Medicine, in Denver.

He suggested that doctors should have patients complete health status surveys during their routine visits in order to assess their heart health. Along with changes in physical health that might indicate an increased risk for serious problems or death, surveys can help reveal depression, which is common among heart disease patients and can significantly worsen their heart health.

"Identification and treatment of depression in cardiovascular patients can improve their quality of life," Rumsfeld said in the news release.

More information

The U.S. National Institutes of Health outlines steps you can take to reduce heart risks.

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MONDAY, May 6 (HealthDay News) -- The vast majority of parents admit to being distracted in some way while driving their young child around, a new survey reveals.

Among roughly 600 parents surveyed, nearly 90 percent said that in the past month they had engaged in at least one type of technological interaction that distracted them while transporting a child between the ages of 1 and 12 years old.

The No. 1 such distraction: phone calls.

"A lot of the attention on the distracted-driving issue has focused on teens and new drivers," said lead author Dr. Michelle Macy, a clinical lecturer in the departments of emergency medicine and pediatrics at the University of Michigan. "But our study is showing that most parents say they were distracted an average of four times when driving their child in the last month, which is more frequent than I had expected.

"Nine in 10 admitted to being distracted by technology, but we also asked about other distractions, such as feeding a child and picking up a toy for a child," she said. "Those were pretty common as well. As were parents eating, drinking or smoking while driving, all of which were also up there in frequency."

Macy, also with the C.S. Mott Children's Hospital in Ann Arbor, Mich., discussed the findings Sunday and Monday at the annual meeting of the Pediatric Academic Societies in Washington, D.C.

Survey participants were all parents or caretakers who were questioned when their children were brought to one of two hospital emergency rooms in Michigan for any reason, not necessarily involving a car crash.

Parents were asked to indicate how often they had been distracted while driving with a child over the previous month. Possible distractions included: phone calls (both hands-free and not), texting, surfing the Web, grooming, eating, attending to their child, using a navigation system or map, and engaging with their vehicle's entertainment system.

The result: More than 70 percent said they had been distracted by phone calls, with more than half of those saying their mobile phone was a distraction the majority of trips they took.

Nearly as many said they had tried to feed their child or deal with their things while driving. Again, more than half of those parents said this happened the majority of times they got behind the wheel.

Self-grooming was a distraction for just shy of 70 percent of those polled, while more than half admitted to trying to sort out directions while driving.

Changing the music in their car had been a distraction for about half of parents. The least common distraction noted was texting, which a little more than 10 percent of parents said was an issue for them.

Those drivers who said such distractions were an issue also were more likely to have been in a car crash at some point.

Contributing to such risk was the question of proper use of child restraints. Those who drove while their child was not properly strapped into a car seat, booster or seat belt (depending on age) were two and a half times as likely to be distracted in some way by their child while driving.

Car-restraint use in kids varied by race, the researchers said, with age-appropriate use found among 86 percent of white parents, 65 percent of black parents and 70 percent of parents from other racial groups.

The authors also observed that parents with higher education and higher income levels were the most likely to be distracted while driving their child around.

"The message here is that a parent's eyes and hands need to be giving full attention to the most important job at the moment while driving their child around, and that is driving," Macy said. "It may be inconvenient, but it's a question of personal responsibility, and of staying focused. Because not everyone is able to self-regulate, it may be that more state and local legislation is needed to restrict things like phone-calling while driving, to make clear that driving while distracted is not OK."

For his part, Bill Hall, manager of the occupant protection program at the University of North Carolina Highway Safety Research Center, expressed little surprise at the degree of the problem unveiled by the survey.

"Quite frankly, all drivers of all ages tend to be distracted by a wide range of issues," Hall said. "The message that we always try to get across when we are talking to parents and dealing with children is that when you are driving, your primary job needs to be driving. If there is some need -- a child needs to be fed or you need to adjust a child's restraints -- then the prudent thing to do is find a safe place to pull over. What you should not do is try to tend to these things while driving."

Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more on distracted driving, visit the U.S. Department of Transportation.

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MONDAY, May 6 (HealthDay News) -- Nearly one-fifth of children and teens at risk for suicide say there are guns in their homes, and many know how to get their hands on both the guns and the bullets, a new study of U.S. emergency room patients found.

It included 524 patients, aged 10 to 21, who were seen for physical or mental health issues at three pediatric emergency departments. They were asked to complete a questionnaire designed to screen for suicide risk.

About 29 percent (151) of the patients were found to be at risk for suicide, and 17 percent of them said there were guns in or around their home. Of those who were at risk for suicide and reported guns in the home, 31 percent knew how to get the guns, 31 percent knew how to get bullets and 15 percent knew how to get both the guns and the bullets.

The findings are scheduled for Monday presentation at the Pediatric Academic Societies' annual meeting in Washington, D.C. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"This study highlights the importance of parents understanding the risks of having guns in their homes," study co-author and youth suicide expert Jeffrey Bridge said in an American Academy of Pediatrics news release.

"Being at risk for suicide and having access to firearms is a volatile mix. These conversations need to take place in the ED with families of children at risk for suicide," said Bridge, principal investigator at the Research Institute at Nationwide Children's Hospital and an associate professor of pediatrics at Ohio State University.

Suicide is the second leading cause of death among young people aged 10 to 24 in the United States, according to the U.S. Centers for Disease Control and Prevention. Guns are used by nearly half of young people who commit suicide.

"While many youths who kill themselves have mental health disorders, up to 40 percent of youths who kill themselves have no known mental illness," Bridge said. "Therefore, it is important to screen all children and adolescents for suicide, regardless of the reason they are visiting the ED."

More information

The Nemours Foundation has more about teen suicide.

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