Population Sample Of Adolescents Research Articles

Recognition of Asthma in Adolescents and Young Adults: Which Objective Measure is Best?

Background. Objective assessment of airway function is important in epidemiologic studies of asthma to facilitate comparison between studies. Airway hyperresponsiveness (AHR), peak expiratory flow (PEF) variability, and bronchodilator reversibility (BR) are widely used as markers of airway lability in such studies. Data from a survey of a population sample of adolescents and young adults (n = 609; 288 males), aged 13–23 years, were analyzed to investigate whether AHR, PEF variability, and BR can be used interchangeably as markers of asthma in an epidemiological setting. Methods. Case history, including self-reported and doctor-diagnosed asthma, smoking habits, and use of asthma medication, was obtained by interview and questionnaire. Lung function, airway responsiveness (positive test: PC20 FEV1< 16 mg/mL histamine), PEF variability (positive test: amplitude percentage mean > 20%), BR (positive test: ΔFEV1 [(FEV1max − FEV1min)/FEV1max) 100]> 10%), blood eosinophil count, and skin prick test reactivity were measured by using standard techniques. Results. The prevalence of a positive test was AHR 16.4%, PEFpos 13.3%, and BRpos 7.2%, respectively; 73.5% of the sample had three negative tests. Among the 74 participants with current self-reported asthma (12.2%), 34 subjects (46%) had more than one positive test. Using AHR as the only objective marker of asthma identified 93% of the participants with current asthma, whereas PEF and BR identified 45% and 10%, respectively. Confining the analysis to participants with only one positive test revealed that 61% of the subjects with isolated AHR had current asthma, whereas none of the subjects with isolated BRpos had asthma, and only one participant with isolated PEFpos had current asthma. Degree of histamine responsiveness was closer associated with other asthma-related factors, including self-reported asthma, use of asthma medication, and level of lung function, than PEF variability and bronchodilator responsiveness. Conclusions. Airway responsiveness to histamine, diurnal peak-flow variability, and bronchodilator reversibility cannot be used interchangeably as objective markers of asthma in epidemiologic studies. On the basis of the present findings, airway hyperresponsiveness to a nonspecific bronchoconstrictor is recommended as the objective marker of asthma-related airway lability.

Quality of life of adolescents suffering from epilepsy living in the community

. Benavente‐Aguilar, I., Morales‐Blánquez, C., Rubio, E.A. &amp; Rey, J.M. ( 2004 ) 40 , 110 – 113 . Objectives To examine the quality of life of a population sample of adolescents suffering from epilepsy.Methods All people aged 10–19 years diagnosed with epilepsy and without comorbid conditions in the Spanish province of Huesca were considered for the study. Quality of life was measured with the Spanish version of the Qolie‐AD‐48.Results A total of 66 young people with a mean age of 15 years had active epilepsy and agreed to participate; 30.3% had experienced seizures during the previous year. There were some differences in quality of life according to gender and socio‐economic status. Quality of life decreased with increasing severity of epilepsy (r = −0.63, P &lt; 0.01). Medication neurotoxicity was associated with a lower quality of life over and above the effect of severity of the illness (partial r = −0.58, P &lt; 0.01). Quality of life was negatively associated with the number of seizures per year (r = −0.64, P &lt; 0.01), longer duration of the illness (r = −0.36, P &lt; 0.01) and earlier age of onset (r = −0.29, P &lt; 0.05).Conclusions The quality of life of young people with epilepsy in community samples varies according to gender and socio‐economic status, but severity of the epilepsy and side‐effects of medication are the main influence. This highlights the importance of optimal control of the seizures with medications with few side‐effects.

Quality of life of adolescents suffering from epilepsy living in the community.

To examine the quality of life of a population sample of adolescents suffering from epilepsy. All people aged 10-19 years diagnosed with epilepsy and without comorbid conditions in the Spanish province of Huesca were considered for the study. Quality of life was measured with the Spanish version of the Qolie-AD-48. A total of 66 young people with a mean age of 15 years had active epilepsy and agreed to participate; 30.3% had experienced seizures during the previous year. There were some differences in quality of life according to gender and socioeconomic status. Quality of life decreased with increasing severity of epilepsy (r = -0.63, P < 0.01). Medication neurotoxicity was associated with a lower quality of life over and above the effect of severity of the illness (partial r = -0.58, P < 0.01). Quality of life was negatively associated with the number of seizures per year (r = -0.64, P < 0.01), longer duration of the illness (r = -0.36, P < 0.01) and earlier age of onset (r = -0.29, P < 0.05). The quality of life of young people with epilepsy in community samples varies according to gender and socioeconomic status, but severity of the epilepsy and side-effects of medication are the main influence. This highlights the importance of optimal control of the seizures with medications with few side-effects.

A longitudinal study of the effects of adolescent cannabis use on high school completion.

To examine the extent to which weekly cannabis use during mid-adolescence may increase the risk of early school-leaving. A prospective study of a general population sample of adolescents studied from ages 15-21 years in Melbourne, Australia. Computer-assisted self-completion questionnaires and telephone interviews conducted in six waves at ages 15-18 and again at age 21 in a sample of 1601 male and female school students. Weekly cannabis use, assessed prospectively, was associated with significantly increased risk of early school-leaving. This effect remained after adjustment for a range of prospectively assessed covariates including demographic characteristics, other substance use, psychiatric morbidity and antisocial behavior. There was suggestive evidence of an interaction between weekly cannabis use and age with the effects of weekly cannabis use on early school-leaving being strongest at the youngest ages and diminishing progressively with age. Early regular cannabis use (weekly use at age 15) is associated with increased risk of early school-leaving. These effects of regular cannabis use may diminish with increasing age and are likely to operate through the social context within which cannabis is used and obtained.

Gender differences in the association between conduct problems and other problems among adolescents

The present paper examines whether there are gender differences in the associations between various dimensions of conduct problems and other problems in adolescence. Other problems studied are both of an externalizing nature (substance use) and an internalizing nature (suicidal behavior and emotional problems). Data stemmed from a large general population sample of Norwegian adolescents (N=9 342). On the basis of earlier studies, conduct problems were decomposed into three dimensions, labeled ‘Theft and vandalism’, ‘School opposition’ and ‘Covert behavior’. The first dimension includes different kinds of stealing and violence against objects, whereas the second includes school-related conduct problems of an overt aggressive kind. The last dimension reflects avoidance of arenas under adult control. Whether or not gender differences were detected, depended on the kind of conduct problems considered. We observed stronger associations between two dimensions of conduct problems, theft and vandalism and school opposition, and other problems among girls than among boys. There were no male/female differences in the associations between covert behavior and other problems.

Bulimia and Impulsive Behaviour in Middle Adolescence

Background: In clinical samples, bulimia seems to be associated with various dyscontrol behaviours suggesting weakness in impulse control. Population studies of adolescents, however, are needed. We evaluated the association between self-reported bulimic behaviour and a number of dyscontrol behaviours, namely bullying, truancy, excessive drinking and sexual disinhibition among adolescents aged 14–16. This is the first study on bulimia and impulsivity in a large non-selected adolescent population sample. Methods: A self-report questionnaire was administered to a representative population sample of 14- to 16-year-old adolescents (pupils of the 8th and the 9th grades of secondary school in four different regions in Finland). 4,453 girls and 4,334 boys aged 14–16 participated. The participation rate was 85.5%. Results: Bulimic behaviour was associated with bullying, truancy, excessive drinking and sexual disinhibition among both sexes. Odds ratios for bulimic-type eating pathology according to each of these behaviours varied between 1.7 and 4.1. The more dyscontrol behaviours occurred simultaneously, the more likely was bulimic-type eating pathology. Conclusions: There is an association between bulimic behaviour and dyscontrol behaviours in the general population of adolescent girls and boys.

Structure of conduct problems in adolescence

Scholars disagree about whether adolescent conduct problems (CPs) form a single behavioral syndrome or whether such problems are better conceptualized as different dimensions. The arguments raised by both sides are addressed and tested empirically by analysing data from a large general population sample of Norwegian adolescents (n = 9,342). Confirmatory factor analyses show that a single syndrome of CPs may be subdivided into three highly correlated factors. The first dimension, destructive covert, includes theft and vandalism, whereas the second, nondestructive covert, reflects avoidance of arenas under adult control. The last dimension, overt, includes school opposition and fighting. This three-factor model fits well for both girls and boys, and individuals in their early and late teens. Results from scale analyses are modestly to moderately indicative of a developmental continuum of severity of CPs ranging from nondestructive covert to overt to destructive covert. Taken together the findings imply that both a unidimensional and a multidimensional perspective on CPs are applicable in the general youth population.

The 12-month prevalence and characteristics of major depressive episode in a representative nationwide sample of adolescents and young adults.

This study set out to estimate the 12-month prevalence of DSM-III-R major depressive episode (MDE) and to analyse factors associating with psychosocial impairment, episode duration, phenomenology and symptom severity in a representative general population sample of adolescents (15-19-year-olds) and young adults (20-24-year-olds). The Finnish Health Care Survey '96 (FINHCS '96) was a cross-sectional nationwide epidemiological study. A random sample of 509 adolescents and 433 young adults was interviewed in 1996. MDE was assessed by University of Michigan Composite Diagnostic Interview Short-Form. The 12-month prevalence of MDE was 5.3 % for adolescents (females 6.0%, males 4.4%) and 9.4% for young adults (females 10.7%, males 8.1%). When moderate psychosocial impairment was included in case definition, the prevalences were lowered by 20-25%. Increased impairment was associated with drunkenness at least twice a month, a higher mean number of depressive symptoms and impaired concentration. The median episode duration was 1 month. No factors associating with duration were found. With the exception of symptoms related to appetite being more common among females than males, the phenomenology of MDE was mainly independent of age and gender. Episodes of major depression among adolescents and young adults in the general population are short but often associated with psychosocial impairment, especially if frequent drunkenness coexists.

Sleep-Related Breathing Disorders in Adolescents Aged 12 to 16 Years: Clinical and Polygraphic Findings

To determine the frequency, symptoms, and polygraphic features of sleep-related breathing disorders (SRBD) in adolescents aged 12 to 16 years. Cross-sectional study. Randomly selected secondary schools in the city of Seville, SPAIN: A general population sample of adolescents (n = 101; mean [+/- SD] age, 13.2 +/- 0.8 years). An 82-item questionnaire regarding anthropometric data and nocturnal and daytime symptoms suggestive of SRBD was administered. Symptoms were evaluated according to a 4-point frequency scale. Snorers answered "sometimes" or "often" in the question about snoring, and nonsnorers answered "never" or "rarely." All subjects underwent an overnight cardiorespiratory polygraphy at home. Twenty-nine percent of the subjects were snorers. Excessive daytime sleepiness was present in 14% of subjects, and sleep apnea was present in 3%. Polygraphy showed a respiratory disturbance index > or = 10 in 18 subjects (17.8%), but concurrent symptoms highly suggestive of SRBD were found in only 2 subjects (1.9%). Snorers had higher waist-to-hip ratios and a higher frequency of witnessed apnea or labored breathing as well as higher values of respiratory events as compared with nonsnorers. However, oximetry data were similar in both groups. In a nonselected group of adolescents aged 12 to 16 years, the frequency of symptoms potentially associated with SRBD was similar to that reported for younger children. Snoring was associated with a higher occurrence of other nocturnal symptoms, a more central pattern of body fat distribution, and a higher respiratory disturbance index as compared with nonsnorers. Although polygraphic abnormalities were mild, two cases of probable SRBD were found with a prevalence rate of 1.9%.

Adolescent Victims of Violence in a Welfare State : Sociodemography, Ethnicity and Risk Behaviours

In a normal population sample of Norwegian adolescents, 6 per cent reported to have been victims of violent victimization during the last year. The sample consisted of three cohorts of adolescents from Oslo, aged 13–18, who had filled out a survey at school. Further, we had at our disposal community-level indicators of welfare in the home city districts of the adolescents. Boys were more often victimized than girls. Individual level demographic indicators (immigrant, working-class background, parents unemployed or on social welfare), were associated with victimization risk. However, the impact of community-level sociodemographic variables (education, income, single parenthood, death rates) were of greater magnitude. Further, there were effects from general lifestyle (unorganized leisure, evenings in town), but risk behaviours were more important. In particular alcohol problems, own aggression and carrying a weapon were associated with high risk for victimization. There were small differences in predictors between genders, but adolescents with immigrant background were less vulnerable for contextual level factors than adolescents without such a background. The findings are discussed in relation to other recent findings and theoretical developments as regards research on violent victimization.

Prevalence and predictors of rhinitis in Danish children and adolescents.

The prevalence of self-reported symptoms of allergic rhinitis is increasing in many countries, but the reasons for this trend are not well understood. Data from a 6-year follow-up study of a population sample of children and adolescents (n=408), aged 7-17 years at enrolment in 1986, were analyzed to investigate the prevalence and predictors of self-reported rhinitis. Case history was used to assess the presence or absence of rhinitis (sneezing and running or blocked nose not associated with a cold), asthma, and eczema. Pulmonary function, skin prick test reactivity, and airway responsiveness to histamine were measured in all participants; a screening test for IgE antibodies to common allergens (Magic Lite SQ, Allergy Screen, ALK, Denmark) was performed in 237 (58%) of the participants. The point prevalence of rhinitis increased from the first to the second survey, 14% and 22%, respectively; 54 (13%) of the subjects reported rhinitis only at the second survey (new rhinitis). Confining the analysis to participants without symptoms of rhinitis at the first survey showed that self-reported eczema (relative risk [RR] 2.3, 95% confidence interval [CI] 1.2-4.7), airway hyperresponsiveness (RR 2.5, CI 1.8-3.0), atopy to grass pollen (RR 2.6, CI 1.7-3.3), atopy to dog dander (RR 2.4, CI 1.6-3.3), and atopy to house-dust mite (RR 2.7, CI 1.4-5.2) at the first survey predicted an increased risk of the presence of rhinitis at the second survey. A positive Allergy Screen test at enrollment was associated with an increased risk of self-reported rhinitis at follow-up (RR 2.4, CI 1.4-3.4). This longitudinal population study of children and adolescents showed an age-related increase in the point prevalence of self-reported rhinitis; furthermore, sensitization to common aeroallergens, airway hyperresponsiveness, and the presence of self-reported eczema were significantly associated with an increased risk of subsequent development of rhinitis.

Atopy in Danish children and adolescents: results from a longitudinal population study

Atopy is an objectively measurable trait related to the presence of rhinitis and asthma, but our knowledge about its longitudinal predictors is limited. Data from a 6-year follow-up study of a population sample of children and adolescents (n = 408), aged 7 to 17 years at enrollment, were analyzed to investigate the prevalence and predictors of atopy. Case history, including allergic diseases and smoking habits, was obtained by interview and questionnaire. Skin prick test reactivity to common allergens, total serum IgE, airway responsiveness, and pulmonary function were measured using standard techniques. The point prevalence of atopy increased from the first to the second survey, 26% and 44%, respectively; 23% of the participants had a positive skin prick test only at the second survey. Sensitization to house dust mite (HDM) (P < .001), grass (P < .001), dog (P < .001), cat (P < .001), and birch (P = .02) increased significantly in both males and females. No gender differences in the prevalence of positive reactions were found at the first survey, whereas atopy to grass (P = .01) and HDM (P = .02) were more prevalent in males than in females at the second survey. Confining the analysis to participants who were found to be non-atopic at the first survey showed that exposure to maternal smoking (OR 2, CI 1.3 to 3.1; P = .002), increased serum IgE (OR 1.7, CI 1.2 to 2.3; P = .001), new asthma (OR 1.6, CI 1.2 to 2.7; P = .03), and new rhinitis (OR 2.1, CI 1.2 to 3.6; P = .01), but not active smoking, were associated with an increased risk for the presence of a positive skin prick test at the second survey. This longitudinal population study showed an increase in the point prevalence of atopy in Danish children and adolescents; and, furthermore, that exposure to maternal smoking during childhood, increased serum IgE, and new symptoms of asthma or rhinitis were associated with an increased risk for developing sensitization to common aeroallergens in late adolescence.

Somatoform syndromes and disordersin a representative population sample of adolescents and young adults: prevalence, comorbidity and impairments

Objective: To present prevalence findings of DSM-IV somatoform symptoms, syndromes and disorders in a representative sample of adolescents and young adults. Method: Data come from the Early Developmental Stages of Psychopathology (EDSP) study, in which a total of 3021 respondents aged 14–24 years were assessed by the Munich-Composite International Diagnostic Interview. Results: Although specific DSM-IV somatoform disorders were relatively rare with a lifetime rate of 2.7%, a considerably higher proportion of respondents met criteria for clinically significant somatoform syndromes as defined by the Somatic Symptom Index SSI4, 6 (lifetime: 1.7%), as well as the undifferentiated somatoform/dissociative syndrome USDS (lifetime: 9.1%), resulting in an overall prevalence rate of 12.6%. Somatoform conditions are often comorbid with other mental disorders and were found to be associated with remarkable impairments and disabilities. Conclusions: Somatoform disorders and syndromes in young adults are frequent, impairing and often associated with the development of other mental disorders.

Somatoform syndromes and disordersin a representative population sample of adolescents and young adults: prevalence, comorbidity and impairments

To present prevalence findings of DSM-IV somatoform symptoms, syndromes and disorders in a representative sample of adolescents and young adults. Data come from the Early Developmental Stages of Psychopathology (EDSP) study, in which a total of 3021 respondents aged 14-24 years were assessed by the Munich-Composite International Diagnostic Interview. Although specific DSM-IV somatoform disorders were relatively rare with a lifetime rate of 2.7%, a considerably higher proportion of respondents met criteria for clinically significant somatoform syndromes as defined by the Somatic Symptom Index SSI4, 6 (lifetime: 1.7%), as well as the undifferentiated somatoform/dissociative syndrome USDS (lifetime: 9.1%), resulting in an overall prevalence rate of 12.6%. Somatoform conditions are often comorbid with other mental disorders and were found to be associated with remarkable impairments and disabilities. Somatoform disorders and syndromes in young adults are frequent, impairing and often associated with the development of other mental disorders.

Ecstasy and new patterns of drug use: a normal population study.

(i) To describe illegal drug use patterns in an adolescent normal population sample with special emphasis on MDMA, ecstasy; (ii) to investigate where ecstasy is introduced in a hypothesized drug use sequence, and (iii) to contrast the predictors of ecstasy use with those of other illegal substances. Special attention was given to the relationship to subcultural music preferences and house-party-going. A school-based survey of the total cohort of adolescents enrolled in the school system in a city. 10,812 adolescents, age 14-17 years, response rate 94.3%. Oslo, the capital and only metropolitan town in Norway. Social class was measured by the occupation standard ISCO 88, questions were posed as regards frequency of alcohol use and alcohol intoxication, cigarette smoking and use of cannabis, amphetamines, ecstasy and heroin. Alcohol problems were measured by a shortened version of Rutgers Alcohol Problem Index (RAPI), conduct problems were measured according to the four categories of acts forming the basis of the diagnosis conduct disorder in DSM-IV, internalizing mental health problems were measured using items from Hopkins Symptoms Checklist (HCL). A number of questions were asked as regards subcultural music preferences and house-party-going. STATISTICAL MODELS: A hypothesized cumulative sequence in drug use was investigated by means of latent class analysis, and the predictors of the various patterns of drug use were estimated and compared by means of multinominal logistic regression analysis. The use of ecstasy was often intermingled with the use of cannabis, amphetamines and heroin, in a pattern of polydrug use. The latent class analysis revealed the following drug use sequence: (1) alcohol, (2) cigarettes, (3) cannabis, (4) amphetamines, (5) ecstasy and (6) heroin. There was no significant association between ecstasy use and parental social class or residential area of the town. All patterns of illegal drug use were highly associated with cigarette smoking, alcohol use, alcohol problems and conduct problems, whereas the associations with internalizing mental health problems were of less magnitude. Multinominal logistic regression analysis revealed that the use of ecstasy (E) was significantly more weakly associated with cigarette smoking than were the use of cannabis only (C), amphetamines (A) and the combination of ecstasy and amphetamines (A + E). The association between E and conduct problems (CP) was weaker than the association between CP and A and A + E. Finally, there were associations between E and A + E and House/Techno preferences and house-party-going, which were not found for C and A. Ecstasy is used by adolescents who use other legal and illegal substances in a polydrug-use pattern. The substance is introduced late in a hypothesized drug use sequence. Even so, ecstasy use seems to differ from the use of, e.g. amphetamines, in that the association with smoking and conduct problems is weaker and that the associations with subcultural music preferences and house-party-going are much stronger.

Covariates of cannabis use progression in a representative population sample of adolescents: a prospective examination of vulnerability and risk factors.

AIMS/DESIGN: This study reports findings concerning risk factors for first, "repeated" and "regular" use of cannabis in respondents (N = 1228) who were aged 14-17 years at the outset (i.e. at "baseline") as part of a longitudinal prospective community study (EDSP). Risk factors were assessed at baseline or by separate interviews with the respondents' parents. Cumulative life-time cannabis use was the main outcome measure in this study--assessed by information from both the baseline and the follow-up investigation at an average of 19.7 months later. A cumulative logistic regression model was used to estimate associations. Using seven of a total of 25 variables examined, the final model classified 72.1% of respondents correctly. Family history of substance use disorders, self-esteem and competence, unconditional commitment to not using drugs, immediate availability of drugs, peer group drug use and previous history of nicotine dependence and alcohol use disorders all contributed significantly to the final model, predicting the progression to cannabis use from "no use", to "one time only", "repeated use", and "regular use". In addition to well-documented risk factors such as peer group pressure, availability, low self-esteem and competence, findings suggest that family history and prior experiences with legal drugs play a significant role in the early development of cannabis consumption in teenagers.

DSM-IV alcohol disorders in a general population sample of adolescents and young adults.

AIMS/DESIGNS: As part of the Early Developmental Stages of Psychopathology (EDSP) study, results from the baseline cross-sectional assessment of DSM-IV alcohol disorders are presented for a sample of 14-24-year-olds residents in Munich, Germany (N = 3021; 71% response rate). Life-time prevalence of DSM-IV alcohol abuse (men: 15.1%; women; 4.5%) was found to be considerably more prevalent than dependence (men: 10.0%; women 2.5%) with few cases among respondents younger than 16 years of age; 12-month prevalence of abuse was 8.4% among men and 2.7% among women and of dependence was 7.3% among men and 2.2% among women. Results show that peak incidence of alcohol disorders occurs at 16-17 years of age and that early initiation into alcohol use is associated with an increasing odds of disorder onset, especially for dependence among women. Exploratory analysis of retrospectively assessed diagnostic stability show: a temporal progression to abuse and then dependence, that nearly half of past abuse diagnoses are in remission, abuse remission is more common than progression to dependence, and dependence is highly persistent, especially among women. Alcohol disorders are frequent in adolescent and young adults being characterized by transient abuse and less prevalent but persistent dependence syndromes. The relatively high prevalence of dependence diagnoses in this young population wit few years of alcohol use is discussed with regard to the clinical validity of DSM-IV criteria in adolescents and young adults.

Risk factors for development of asthma in children and adolescents: findings from a longitudinal population study

Background: The prevalence of asthma appears to be on the increase, and risk factors are not well established. To investigate risk factors for the development of asthma, a population sample of children and adolescents, aged 7–17 years at enrolment, were studied in 1986. Initial examinations were repeated at follow-up in 1992; complete data was available for 408 subjects (199 males). Methods: Obtained case histories were used to assess the presence of asthma; pulmonary function, skin prick test reactivity, total serum IgE and bronchial responsiveness to inhaled histamine were measured using standard techniques. Results: The 12-month period prevalence of asthma increased significantly from the first to the second examination in both males ( P<0·001) and females ( P<0·001), whereas the number of subjects with a positive histamine challenge test declined in both sexes, although this was only statistically significant in males ( P<0·001). The prevalence of a positive skin prick test was higher at the second examination (26% and 44%, respectively, P<0·001); the proportion of subjects with a positive skin reaction to house dust mite (HDM pos) increased from 14% to 26%. Bronchial hyper-responsiveness to inhaled histamine (BHR), HDM allergy, a history of wheezy bronchitis and symptoms of asthma at first examination were more prevalent among subjects reporting asthma at the second examination than among subjects without respiratory symptoms. Confining the analysis to subjects without a history of asthma at the first examination showed that asymptomatic BHR {Odds ratio [OR] 3·8 [95% confidence interval (CI) 2·5–5·1], P=0·0002}, HDM pos [OR 2·6 (95% CI 1·9–3·3), P=0·005], a history of wheezy bronchitis before the age of 2 years [OR 3·8 (95% CI 2·4–5·2), P=0·006] and a history of rhinitis and/or eczema [OR 2·8 (95% CI 1·7–3·9), P=0·007] at first examination were associated with an increased risk for development of symptomatic asthma at some point between the two examinations. No significant relationship could be demonstrated between smoking (passive or active) and the risk for development of asthmatic symptoms. Conclusions: In conclusion, this longitudinal population study showed an increase in the 12-month period prevalence of asthma with sensitization to HDM and asymptomatic BHR as important risk factors for development of asthma; the temporal relationship between sensitization to HDM and presence of airway abnormalities needs to be explored further.

Increased bronchial responsiveness to exercise as a risk factor for symptomatic asthma: findings from a longitudinal population study of children and adolescents.

The prevalence of asthma seems to be on the increase and risk factors are not well-established. To investigate the relationship between asymptomatic increased bronchial responsiveness to exercise (BRE) and subsequent development of asthma, we studied a population sample of children and adolescents, aged 7-17 yrs at enrollment, examined twice 6 yrs apart (54 and 68%, respectively, of the original sample participated in the two examinations). Complete information was available for 383 subjects (191 males and 192 females). Case history and questionnaire data were obtained and were used to assess the presence or absence of symptomatic asthma. Exercise testing, performed at enrolment only, consisted of steady running on a 10% sloping treadmill for 6 min in a climate chamber. BRE was recorded as percentage fall in forced expiratory volume in one second (FEV1) from pre-exercise FEV1, within 15 min after exercise. Twenty subjects (5%) had asthma at enrolment, whereas 58 subjects (15%) had current asthma (i.e. symptoms within the preceding 12 months) at the time of follow-up, of whom 40 were asymptomatic at enrolment (new asthma). In general, increased BRE at enrolment was significantly associated with symptomatic asthma at follow-up. Analysing the data for subjects who were asymptomatic at enrolment (n=363), showed that new asthma at follow-up was not predicted by increased BRE at enrolment, whether BRE was evaluated as a continuous (R2=0.06, p=0.13) or dichotomous (cut-off: BRE =10% decline in FEV1; odds ratio (OR) 0.8 (0.4-1.2); p=0.11) variable. However, the data do not exclude the possibility that asymptomatic subjects with BRE >15% have an increased risk for subsequent development of asthma. The findings of the present study suggest that increased bronchial responsiveness to exercise in asymptomatic children and adolescents is not a strong predictor for subsequent development of symptomatic asthma. Further studies, preferably of larger samples, are needed to confirm these findings.

Alcohol and sexual victimization: a longitudinal study of Norwegian girls

In a study of sexual victimization and alcohol consumption, a population sample of Norwegian adolescents from the Oslo area was followed-up through five data collections over a 6-year time span. By means of generalized structural equation modeling, alcohol-related predictors and consequences of sexual assaults were investigated; 17% of the girls reported that they had been sexually assaulted at some time: 7% in childhood, 6% in early adolescence (13-16 years) and 4% in late adolescence (17-19 years). Only 1% of the boys reported having been sexually victimized. Female childhood sex victims reported increased alcohol consumption from their mid-teens, with dramatic increase in alcohol-related problems (using DSM-III-R criteria) at the end of their teens. However, the analyses showed that alcohol consumption was not influenced by childhood sexual abuse when parental use of tobacco and alcohol and normative standards imparted to their children were taken into consideration as confounding variables. There was, on the other hand, a strong effect on alcohol problems. Thus, the victims of childhood sexual abuse seem to be at high risk for alcohol abuse and dependency. Further, early alcohol debut and high alcohol consumption combined with permissive parental norms increased the risk of sexual assault in early adolescence. The girls who were assaulted in early adolescence also reported a high number of sexual partners and early intercourse debut. There was no increase in subsequent alcohol consumption after assaults in this group. Late adolescent victims did not report increased alcohol consumption either prior to or after the assault.