Beginning Of Adolescence Research Articles

Bedeutung der familialen Lebenswelt für die Gesundheit von Kindern und Jugendlichen

Family is the central place of socialization during childhood and adolescence. What are the determining factors of family life that are important for the health of children and adolescents and in which stages of their life do these factors take effect? The question is answered with reference to the general health of children and adolescents as rated by their parents. The analysis is conducted with data from the KiGGS study 2003–2006 which is representative of Germany (n = 17641, age: 0–17 years). The gender-specific effects of different family factors on good health are analysed in five age groups using binary logistic regression analysis including structural, socioeconomic and origin-related factors of family as well as housing conditions and family cohesion. Bivariate analysis indicates significant effects on general health for almost all included factors (at least in some age groups). Multivariate analysis shows family cohesion to be the most important factor for good health. In boys a bilateral migration background also has an adverse effect on good general health until the beginning of adolescence.

Altered anxiety-like behavior and long-term potentiation in the bed nucleus of the stria terminalis in adult mice exposed to chronic social isolation, unpredictable stress, and ethanol beginning in adolescence

Alcohol and chronic stress exposure, especially during adolescence, can lead to an increased risk in adulthood of developing alcohol use disorders. To date, however, no study has assessed the potential long-term effects of chronic intermittent and unpredictable ethanol (EtOH) exposure in mice chronically stressed beginning in adolescence on brain function and anxiety-like behaviors in adulthood. In particular, alterations in function of the bed nucleus of the stria terminalis (BNST), a brain region heavily implicated in anxiety-related behaviors and altered plasticity following EtOH exposure, may play a key role in the pathological responses to chronic stress and EtOH. In the present study, adolescent and adult C57Bl/6J mice were exposed to a regimen of chronic social isolation and unpredictable stressors and EtOH (or air [sham]; CSI-CUS-EtOH and CSI-CUS-Sham, respectively) for 8–10 weeks. In adulthood, mice were tested for altered anxiety-like behavior (elevated plus maze [EPM] and modified social interaction [SI] test). Following behavioral testing, mice were reexposed to CSI-CUS-EtOH (and CSI-CUS-Sham for controls) for an additional 3 days. Four to six hours following the final EtOH (or air) exposure, field potential recordings of the dorsal-lateral (dl)BNST were performed. Mice first exposed during adolescence to CSI-CUS-EtOH displayed lower levels of anxiety-like behavior on the EPM compared with mice first exposed to CSI-CUS-EtOH during adulthood and control mice only exposed to CSI-CUS-Sham, regardless of age of first exposure. However, mice first exposed to CSI-CUS-EtOH during adulthood displayed lower levels of anxiety-like behavior on the SI test compared with mice first exposed during adolescence and control CSI-CUS-Sham mice. CSI-CUS-EtOH exposure, regardless of age, produced blunted expression of long-term potentiation (LTP) in the dlBNST compared with CSI-CUS-Sham mice. This study demonstrates age-dependent effects of chronic unpredictable ethanol exposure in chronically stressed mice on anxiety-like behaviors during adulthood. Further, CSI-CUS-EtOH exposure results in blunted LTP expression in the adult dlBNST.

External Genital Proportions in Prepubertal Girls: A Morphometric Reference for Female Genitoplasty

An understanding of normal genital anatomy is essential for a successful surgical approach and outcome in feminizing genitoplasty. We sought to establish genital standards in female children through external genital measurements taken from the end of the neonatal period until the beginning of adolescence. This prospective study included 205 females who were anesthetized for surgery for various diagnoses between January 2007 and March 2008. Patient age ranged from 1 month to 10 years. Patients were divided into 4 age groups-1 to 12, 13 to 24, 25 to 60 and 61 to 120 months. Information on patient age, height, weight and, for patients younger than 1 year, head circumference was retrieved from patient charts. Measurements of clitoris length, clitoris width, labia majora length, left and right labia minora length and width, and perineal distance were recorded. Specific equations were generated using these values to estimate the expected external genital structure dimensions in girls. Length of labia majora vs age, length of labia majora vs body weight, perineal distance vs body weight, clitoral width vs body weight and clitoral length vs age reference percentile curves were prepared. The equations and percentile curves generated can be used as a guide in prospective feminizing genitoplasty. Furthermore, patients and their families can be informed regarding the variability of external genitalia dimensions. This information should ensure a healthier appreciation of the postoperative genitalia by patients and their families.

Estudio cualitativo de las conductas de salud en la primera adolescencia

The goal of the current qualitative case study is multiple: (1) to know what young people thought at the beginning of adolescence with regard to health related behaviours; (2) to explore if they followed these behaviours; (3) to find out what their motives were for following them; and (4) to detect their future predictions with regard to those behaviours. Eight boys and eight girls between the ages of 11 and 12 years-old participated in two discussion groups (one for boys and one for girls). Each session lasted one hour. The transcriptions of these discussions were analyzed by three researchers and were codified using the computer programme, Nudist Vivo, version 2.0.163. The main topics identified were the “classical” health behaviours, the contexts where the behaviours took place, and the health-related behavioural patterns. The relationships among these three topics indicated that there were differences between girls and boys, specifically on what it meant to be healthy, their current behaviours, and their predicted future behaviours.

The role of puberty in the developing adolescent brain

Adolescence refers to the period of physical and psychological development between childhood and adulthood. The beginning of adolescence is loosely anchored to the onset of puberty, which brings dramatic alterations in hormone levels and a number of consequent physical changes. Puberty onset is also associated with profound changes in drives, motivations, psychology, and social life; these changes continue throughout adolescence. There is an increasing number of neuroimaging studies looking at the development of the brain, both structurally and functionally, during adolescence. Almost all of these studies have defined development by chronological age, which shows a strong—but not unitary—correlation with pubertal stage. Very few neuroimaging studies have associated brain development with pubertal stage, and yet there is tentative evidence to suggest that puberty might play an important role in some aspects of brain and cognitive development. In this paper we describe this research, and we suggest that, in the future, developmental neuroimaging studies of adolescence should consider the role of puberty. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.

Mitigating micro- and macro-vascular complications of diabetes beginning in adolescence

Diabetes is a chronic disorder, which manifests when insulin levels or resistance to insulin action becomes insufficient to control systemic glucose levels. Although the number of available agents to manage diabetes continues to expand rapidly, the maintenance of euglycemia by individuals with diabetes remains a substantial challenge. Unfortunately, many patients with type 1 and type 2 diabetes will ultimately experience diabetes complications. These complications result from the toxic effects of chronic hyperglycemia combined with other metabolic derangements that afflict persons with diabetes. This review will present a comprehensive look at the complications of diabetes, the risk factors for their progression, the mechanistic basis for their development, and the clinical approach to screening for, preventing, and treating these sequelae. In addition, since diabetes is commonly diagnosed in childhood, we will provide a special focus on the care of the adolescent patient.

Genetic differences in oxidative stress and inflammatory responses to diet‐induced obesity do not alter liver fibrosis in mice

To determine how genetic factors might influence the progression of nonalcoholic fatty liver disease (NAFLD). Beginning in adolescence, male C57BL6 (BL6) and 129/SVJ mice were fed control (n=15/group) or high-fat (HF) diets (n=30/group) for 6 months. Assessed were body weight, insulin resistance, hepatic production of free radicals, expression of cytokines and fibrosis-related genes and severity of hepatic steatosis, injury and fibrosis. High-fat diets induced comparable obesity, hepatic steatosis and insulin resistance in the two strains. Compared with BL6 mice, 129/SVJ mice had impaired induction of antioxidant genes, generated three- to four-fold more free radicals and exhibited two-fold greater induction of profibrogenic cytokines (interleukin-4 and transforming growth factor-beta1) and fibrosis-related genes (fibronectin and tissue inhibitor of metalloproteinase-1) (all P<0.05 for 129 vs BL6). Surprisingly, however, induction of collagen I alpha1 mRNA and accumulation of Sirius red-stained fibrils and hepatic hydroxyproline were similar in BL6 and 129/SVJ mice, and although patchy sinusoidal fibrosis emerged in both strains, neither developed bridging fibrosis. Although BL6 and 129/SVJ mice with diet-induced obesity, insulin resistance and steatosis differed with respect to several factors that are thought to influence human NAFLD progression, they developed comparable liver fibrosis. Moreover, none of the risk factors for NAFLD-related cirrhosis in humans, including obesity, insulin resistance, chronic inflammatory and oxidant stress, steatohepatitis or activation of fibrogenic genes, proved to be sufficient to cause cirrhosis in these mice, even when exposure to one or more of these insults was very prolonged.

Epidermolysis bullosa and the risk of life-threatening cancers: The National EB Registry experience, 1986-2006

Case series have demonstrated that potentially lethal cutaneous squamous cell carcinomas arise in patients with recessive dystrophic epidermolysis bullosa (RDEB), although the magnitude of this risk is undefined. Systematic case finding and data collection were performed throughout the continental United States (1986-2002) by the National EB Registry on 3280 EB patients to determine cumulative and conditional risks for squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM) within each major EB subtype, as well as the cumulative risk of death from each tumor. Study design was cross-sectional, with a nested randomly sampled longitudinal subcohort (N = 450). SCCs arose primarily in RDEB, especially the Hallopeau-Siemens subtype (RDEB-HS), first beginning in adolescence. Less frequently, SCCs occurred in junctional EB (JEB). Cumulative risks rose steeply in RDEB-HS, from 7.5% by age 20 to 67.8%, 80.2%, and 90.1% by ages 35, 45, and 55, respectively. In Herlitz JEB, the risk was 18.2% by age 25. SCC deaths occurred only in RDEB, with cumulative risks in RDEB-HS of 38.7%, 70.0%, and 78.7% by ages 35, 45, and 55, respectively. MM arose in RDEB-HS, with a cumulative risk of 2.5% by age 12. BCCs arose almost exclusively in the most severe EB simplex subtype (Dowling-Meara) (cumulative risk = 43.6% by age 55). Mutational analyses were performed on only a minority of enrollees in the National EB Registry, preventing evaluation of the possible influence of specific genotypes on the risk of developing or dying from cutaneous SCCs. SCC is the most serious complication of EB within adults, especially those with RDEB-HS. By mid-adulthood, nearly all will have had at least one SCC, and nearly 80% will have died of metastatic SCC despite aggressive surgical resection. When compared with SCCs arising within the normal population, the remarkably high risk of occurrence of and then death from SCCs among RDEB patients suggests likely differences in pathogenesis. Additional studies of EB-derived tumors and SCC cell lines may not only provide new insights into the mechanisms of carcinogenesis but also means whereby these particular tumors may be prevented or more effectively treated.

The Relationships of Body Weight Perceptions with Energy Balance among College Freshmen

An individual's perception and acceptance of body image develops early in life, and may be related to attempts to lose or maintain weight beginning in adolescence and early adulthood. PURPOSE: To examine how body weight perceptions relate to energy balance regulation achieved through diet and physical activity (PA) among a sample of freshmen university students. METHODS: A quasi-randomized sample of freshmen (N=103; males=59; females=44) from a university population agreed to assess energy expenditure (7-day PA recall) and intake (7 24-hour food diaries) for 1 week. The dependent variable for this study was a continuous measure of energy balance (positive or negative Kcal/d) based on food diaries and PA recall. Participants answered 3 questions related to perceptions of body weight and image: self-perception of weight (overweight, right weight, underweight), desired weight (lose weight, stay the same, or gain weight) and current weight control status (trying to lose weight, stay the same, or gain weight). Statistical analysis used one-way ANOVA and multiple regressions. RESULTS: 46.6% (N=48) of freshmen reported currently 'trying to lose weight'. The majority (68.7%) of freshmen matched their 'desired' weight goals with weight control behaviors. Significant differences of energy balance were found in all three body weight perception questions. Negative energy balance was found among freshman who perceived themselves to be overweight (−839 kcal), would like to weigh less (−727 kcal), and were trying to lose weight (−575 kcal). Positive energy balance was found among those who thought they were underweight (384 kcal), wanted to gain weight (352 kcal), and were trying to gain weight (304 kcal). Equal energy balance was found for those comfortable with their weight and who were trying to stay the same weight. In multiple regression, after controlling for all covariates, only 'self-perception of weight' (Beta: −674.0; p = 0.0433) was significantly related to energy balance (Overall Model: F6,80=5.05, p < 0.0002; Adjusted R2=0.22). CONCLUSIONS: Among freshmen, energy balance is closely related to self-perceptions of body weight. Self-awareness activities focusing on body weight and image might be an important component of weight management interventions focusing on energy balance.

The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression.

In adulthood, twice as many women as men are depressed, a pattern that holds in most nations. In childhood, girls are no more depressed than boys, but more girls than boys are depressed by ages 13 to 15. Although many influences on this emergent gender difference in depression have been proposed, a truly integrated, developmental model is lacking. The authors propose a model that integrates affective (emotional reactivity), biological (genetic vulnerability, pubertal hormones, pubertal timing and development) and cognitive (cognitive style, objectified body consciousness, rumination) factors as vulnerabilities to depression that, in interaction with negative life events, heighten girls' rates of depression beginning in adolescence and account for the gender difference in depression.

Development of the Social Brain during Adolescence

Adolescence is usually defined as the period of psychological and social transition between childhood and adulthood. The beginning of adolescence, around the onset of puberty, is characterized by large hormonal and physical changes. The transition from childhood to adulthood is also characterized by psychological changes in terms of identity, self-consciousness, and cognitive flexibility. In the past decade, it has been demonstrated that various regions of the human brain undergo development during adolescence and beyond. Some of the brain regions that undergo particularly protracted development are involved in social cognitive function in adults. In the first section of this paper, I briefly describe evidence for a circumscribed network of brain regions involved in understanding other people. Next, I describe evidence that some of these brain regions undergo structural development during adolescence. Finally, I discuss recent studies that have investigated social cognitive development during adolescence.

Daily patterns of ethanol drinking in peri-adolescent and adult alcohol-preferring (P) rats

Alcohol abuse among adolescents continues to be a major health problem for our society. Our laboratory has used the peri-adolescent alcohol-preferring, P, rat as an animal model of adolescent alcohol abuse. Even though peri-adolescent P rats consume more alcohol (g/kg/day) than their adult counterparts, it is uncertain whether their drinking is sufficiently aggregated to result in measurable blood ethanol concentrations (BECs). The objectives of this study were to examine daily alcohol drinking patterns of adolescent and adult, male and female P rats, and to determine whether alcohol drinking episodes were sufficiently aggregated to result in meaningful BECs. Male and female P rats were given 30 days of 24 h free-choice access to alcohol (15%, v / v) and water, with ad lib access to food, starting at the beginning of adolescence (PND 30) or adulthood (PND 90). Water and alcohol drinking patterns were monitored 22 h/day with a “lickometer” set-up. The results indicated that (a) peri-adolescent P rats consumed more water and total fluids than adult P rats, (b) female P rats consumed more water and total fluids than male P rats, (c) there were differences in alcohol, and water, licking patterns between peri-adolescent and adult and female and male P rats, (d) individual licking patterns revealed that alcohol was consumed in bouts often exceeding the amount required to self-administer 1 g/kg of alcohol, and (e) BECs at the end of the dark cycle, on the 30th day of alcohol access, averaged 50 mg%, with alcohol intakes during the last 1 to 2 h averaging 1.2 g/kg. Overall, these findings indicate that alcohol drinking patterns differ across the age and sex of P rats. This suggests that the effectiveness of treatments for reducing excessive alcohol intake may vary depending upon the age and/or sex of the subjects being tested.

Effects of concurrent access to a single concentration or multiple concentrations of ethanol on ethanol intake by periadolescent high-alcohol-drinking rats

The objectives of the current study were to assess the effects of access to different concentrations of ethanol and sex of the animal on ethanol consumption of high-alcohol-drinking (HAD-1 and HAD-2) rats during adolescence [postnatal days (PNDs) 30 through 60]. At the beginning of adolescence (PND 30), the rats were given concurrent access to either a single concentration [15% volume/volume (vol./vol.)] or multiple concentrations [10%, 20%, and 30% (vol./vol.)] of ethanol and water. Analyses of ethanol consumption data revealed significant ( P < .025) main effects of line, ethanol condition, and week, and a significant line by sex by ethanol condition by week interaction. For the first week, both male and female HAD-1 and HAD-2 rats consumed more ethanol under the multiple ethanol concentration condition than under the single ethanol concentration condition. However, across the second through fourth weeks, this pattern was seen primarily in male and female HAD-1 rats and to a lesser degree in female HAD-2 rats. In general, female rats consumed more fluids than consumed by male rats, and male rats displayed a higher preference for ethanol over water ratio than observed for their female counterparts. In addition, in comparison with HAD-2 rats, HAD-1 rats drank more ethanol and displayed a higher preference for ethanol ratio. Overall, the current study results indicate that, compared with access to a single concentration (which is used in most studies), concurrent access to multiple concentrations of ethanol produced significantly higher ethanol intakes in periadolescent HAD rats, supporting the suggestion that this ethanol drinking condition would have a greater impact on neuronal development. In addition, although the replicate lines were selectively bred by using the same criteria and foundation stock, the higher ethanol intakes of the HAD-1 line, compared with intakes for the HAD-2 line, seen in the current study support the suggestion that there are some differences in their genetic make-up, affecting ethanol intake, which are expressed during periadolescence.

Sex hormones in hereditary angioneurotic oedema.

The fluctuations in sex hormone levels at the beginning of adolescence, in the perimenopausal period, during pregnancy or during the use of oral contraceptives can precipitate oedematous attacks in hereditary angioneurotic oedema (HANO). Attacks usually disappear after the onset of menopause. This study was undertaken to establish any relationship between the serum levels of sex hormones and the incidence of HANO attacks. Serum levels of LH, FSH, progesterone, oestradiol, testosterone, PRL and SHBG were measured in 78 patients [mean age 30.3 years (range 4-70 years)] with HANO. A questionnaire was used to explore the medical history of adult patients to characterize the evolution and the characteristics of attacks. The number of attacks was significantly higher [odds ratio (OR) 6.36 (1.31-30.81); P = 0.022] in females with high progesterone levels (> or = 4 nmol/l), irrespective of age, menstrual cycle and danazol dose. The OR was even higher [13.4 (2.2-81.4); P = 0.005] when only subcutaneous attacks were considered. Multiple logistic regression analysis demonstrated a significantly lower attack frequency during 1-year follow-up in patients with a higher (40 nmol/l) SHBG level (OR 0.25 (0.07-0.90); P = 0.034). This difference existed independently of age and danazol dose. In view of these results, the monitoring of progesterone and SHBG levels can prove useful in the prediction of attacks in hereditary angioneurotic oedema.

Assessment and Development of Executive Function (EF) During Childhood

This review paper outlines the issues associated with the assessment of executive function (EF) in children and adolescents, and describes the developmental profile of executive processes across childhood. At the outset, EF is defined, and cognitive and behavioral impairments associated with executive dysfunction (EDF) are described. A developmental model of EF is proposed incorporating four discrete but inter-related executive domains (attentional control, cognitive flexibility, goal setting, and information processing) which operate in an integrative manner to enable “executive control”. Characteristics that constitute traditional EF measures are discussed, as are the problems associated with test interpretation. The ecological validity of EF tests and neuropsychological assessment procedures are examined, and adjunct methods of measurement are presented to enable a more comprehensive and valid assessment of EF. Based on developmental and normative studies, the maturation of executive domains is mapped. Attentional control appears to emerge in infancy and develop rapidly in early childhood. In contrast, cognitive flexibility, goal setting, and information processing experience a critical period of development between 7 and 9 years of age, and are relatively mature by 12 years of age. A transitional period is thought to occur at the beginning of adolescence, and shortly after “executive control” is likely to emerge. In order to confirm our current understanding of EF development and further enhance our understanding of brain-behavior relationships, longitudinal studies incorporating structural and functional neuroimaging are required.

Nível de informação sobre adolescência, puberdade e sexualidade entre adolescentes

The objective of this research was to evaluate the level of knowledge about adolescence, pubertal development and sexuality among adolescents from 10 to 14 years old at municipal public schools in Feira de Santana-Bahia, 2000. Cross-sectional study, with a randomized and proportional sample out of a population of 6,419 students in the municipal Public System. The level of knowledge was analyzed according to age, sex and educational level. Data was collected by means of a specific confidential questionnaire, which was pre-tested. A scale of values (score--satisfactory, reasonable and unsatisfactory) was established according to the percentage and proportional number of right answers regarding general and specific topics. Statistical inference was calculated by chi-square with a significance of 5% as well as the bivariate and multivariate analysis, calculating the simple and adjusted prevalence, through stratified analysis. Adolescents showed unsatisfactory level of information about terms, particularly those at the age of 10 (69.2%) and 11 years (70.6%), female (61.7%) and the ones in the 4th (82.8%) and 5th (61.1%) grades. The level of knowledge according to sex, adjusted by age and educational level, showed that females are 1.3 and 1.27 times more likely to present an unsatisfactory level of knowledge than males. The level of knowledge according to educational level, adjusted by age, showed that those subjects between 4th and 5th grades are 2.32 times more likely to present an unsatisfactory level of knowledge if compared to students of 6th and 8th grades, with significant differences (p<0.05). The high prevalence of unsatisfactory level of knowledge with significant association between 4th and 5th grades and females points to the necessity of educative actions regarding health and sexuality in the beginning of adolescence at municipal public schools.

Maturação, composição corporal e aptidão cardiorrespiratória em crianças e adolescentes na área do grande Porto, Portugal

OBJETIVOS: determinar, em escolares portugueses de oito a 16 anos (256 do sexo masculino e 268 do sexo feminino): os padrões de mudanças na composição corporal e no VO2máx; a relação entre o percentual de massa gorda (%MG), índice de massa corporal (IMC) e o somatório de dobras de adiposidade subcutânea (SSKF) com o VO2máx; a percentagem de obesos. MÉTODOS: o percentual de massa gorda foi estimado do SSKF (subescapular e tricipital). A amostra foi subdividida em estágios maturacionais de Tanner. A aptidão cardiorrespiratória foi avaliada através do teste Shutlle-run de 20 metros. RESULTADOS: as variáveis antropométricas e o percentual de massa gorda estiveram de acordo com dados já publicados. Os rapazes apresentaram VO2máx mais elevado (p &lt; 0,05) do que as moças na maioria dos estágios. Correlações negativas, moderadas e significativas (p &lt; 0,05) entre o percentual de massa gorda o VO2máx foram obtidas em ambos os sexos, em todos os estágios. Na análise dos três indicadores de obesidade (IMC, %MG e SSKF), 11,2% dos rapazes e 14,3% das moças apresentaram valores acima dos padrões normativos. CONCLUSES: padrões normais de crescimento foram verificados em ambos os sexos. Crianças que apresentaram menor VO2máx também apresentaram maior percentual de massa gorda. Ambos os sexos apresentaram valores sugerindo excesso de gordura corporal no início da adolescência.

Pathophysiological aspects of Landau-Kleffner syndrome: From the active epileptic phase to recovery

In their original description of the syndrome of “acquired aphasia with convulsive disorder,” Landau and Kleffner (1957) suggested “that persistent convulsive discharges in brain tissue largely concerned with linguistic communication result in the functional ablation of these areas for normal linguistic behavior.” In further case studies, the observation of continuous epileptic discharges in electroencephalograms (EEGs) recorded during sleep agreed with this early suggestion. Although several group studies emphasized the almost parallel fluctuation of aphasic disorders and EEG abnormalities, the causal relationship between epileptiform EEG discharges and the language defect remains a matter of debate. Another subject of discussion concerns the outcome of aphasia after recovery of epilepsy that typically occurs at the beginning of adolescence. In the Landau-Kleffner syndrome (LKS), the prognosis of aphasia varies in a manner opposite that observed after structural lesions of the left hemisphere. To further elucidate the pathophysiological basis of aphasia and its poor outcome in LKS, this chapter reexamines five clinical studies of LKS with particular emphasis on electrophysiological and metabolic findings and their relationship to neuropsychological deficits. The data presented and discussed covers a follow-up period extending for each case from the active period to the late recovery phase of epilepsy lasting from 7 to 15 years. The chapter summarizes the clinical histories and neuropsychological findings gathered during the period when the children were aphasic and epileptic and after recovery and focuses on the experimental data supporting focal or regional cerebral dysfunction underlying this particular acquired childhood aphasia.

The Influence of Schizophrenia and Standard or Atypical Neuroleptics on Sexual and Sociosexual Functioning: A Review

It is difficult to dissociate the influence of schizophrenia and neuroleptics on sexuality since the majority of schizophrenic patients are treated with neuroleptic medication. Standard neuroleptics can cause sexual dysfunctions. However, atypical neuroleptics minimally influence sexual function. Hypoactive sexual desire is the most commonly reported sexual difficulty by schizophrenics, treated or not, with neuroleptic medications. The majority of patients notice a progressive deterioration of their sexual and sociosexual functioning beginning in adolescence or young adulthood. This article focuses on the sexual and sociosexual differences reported by schizophrenics.

Gender Differences in Major Depressive Disorder and Bipolar Disorder

This paper reviews the literature on gender differences in major depressive disorder (MDD) and bipolar disorder (BPD). Beginning in adolescence, women are at a higher risk than men of becoming depressed. Avenues of investigation that might ultimately help to explain this phenomenon include studies of gender differences in the processing of emotional stimuli, the psychotropic effects of gonadal steroids, and environment/gene interactions in men and women. With the exception of the elevated suicide rate among men, consistent gender differences in the course and symptoms of MDD have not been found. In BPD, women are more likely than men to develop a rapid-cycling course. Gender differences in treatment response, particularly in regard to mood stabilizing medications, warrant further study.