Long-term Outcome Of Adolescents Research Articles

Long-Term Outcomes of Adolescents With Juvenile-Onset Fibromyalgia in Early Adulthood

This prospective longitudinal study examined the long-term physical and psychosocial outcomes of adolescents with juvenile-onset fibromyalgia (JFM), compared with healthy control subjects, into early adulthood. Adolescent patients with JFM initially seen at a pediatric rheumatology clinic (n = 94) and age- and gender-matched healthy control subjects (n = 33) completed online measures of demographic characteristics, pain, physical functioning, mood symptoms, and health care utilization at ∼6 years' follow-up (mean age: 21 years). A standard in-person tender-point examination was conducted. Patients with JFM had significantly higher pain (P < .001), poorer physical function (P < .001), greater anxiety (P < .001) and depressive symptoms (P < .001), and more medical visits (P < .001)than control subjects. The majority (>80%) of JFM patients continued to experience fibromyalgia symptoms into early adulthood, and 51.1% of the JFM sample met American College of Rheumatology criteria for adult fibromyalgia at follow-up. Patients with JFM were more likely than control subjects to be married and less likely to obtain a college education. Adolescent patients with JFM have a high likelihood of continued fibromyalgia symptoms into young adulthood. Those who met criteria for fibromyalgia in adulthood exhibited the highest levels of physical and emotional impairment. Emerging differences in educational attainment and marital status were also found in the JFM group. JFM is likely to be a long-term condition for many patients, and this study for the first time describes the wide-ranging impact of JFM on a variety of physical and psychosocial outcomes that seem to diverge from their same-age peers.

Long-Term Outcomes of Adolescents With Juvenile-Onset Fibromyalgia in Early Adulthood

Long-Term Outcomes of Adolescents With Juvenile-Onset Fibromyalgia in Early Adulthood

A controlling family environment predicts long-term emotional and social functioning in adolescents with juvenile fibromyalgia

Juvenile fibromyalgia (JFM) is a chronic pain condition characterized by widespread musculoskeletal pain, depressed mood, fatigue, and sleep difficulty. Research has shown that adolescents with JFM have poorer family functioning than healthy matched peers. Specifically, JFM families were found to be more conflicted and less supportive, but not more controlling compared to families of healthy children. The impact of family characteristics on long-term outcomes of adolescents with JFM is poorly understood.

Children with Fetal Alcohol Spectrum Disorders in the Dependency Court System: Challenges and Recommendations

Children with Fetal Alcohol Spectrum Disorders (FASD) are at a greatly increased risk for developmental delays, learning disabilities, and behavioral, social, and emotional problems. High rates of secondary disabilities have been reported in this population, including mental health problems, school failure, delinquency, plus alcohol and substance abuse problems. Long-term outcomes for adolescents and adults with FASD include increased risk for unemployment, suicidal ideation and behavior, and confinement in psychiatric facilities and correctional institutions. Many children impacted by prenatal alcohol exposure are raised in out-of-home placements, and thus will likely have extensive involvement with the child welfare and dependency court systems. However, child welfare agencies and dependency courts are often not well-equipped to handle cases involving these children. This article will address the challenges that children with FASD and their families face in those systems, as well as recommendations for improvements in how those systems respond to the needs of these highly vulnerable children.

Maintenance of Weight Loss in Adolescents: Current Status and Future Directions

There is a dearth of research on the long-term efficacy and safety of treatments for adolescent obesity. This narrative review examined several approaches to treatment, focusing on long-term effectiveness data in adolescents, as well as relevant findings from studies of adults. The available research suggests that lifestyle modification has promise in obese adolescents, although it is not clear that any particular dietary or physical activity approach is more effective than another. Meal replacements are quite effective in adults and deserve further research in adolescents. Extending the length of treatment to teach weight loss maintenance skills is likely to improve long-term outcomes in adolescents, and delivering treatment via the Internet or telephone is a novel way of doing so. Treatment that combines lifestyle modification with the medication orlistat generally appears to be safe but only marginally superior to lifestyle modification alone. More research is needed on the management of adolescent obesity, which has been overlooked when compared with research on the treatment of obesity in children and adults.

Pediatric Lung Transplantation

Pediatric lung and heart-lung transplantation are viable therapeutic interventions for end stage pulmonary parenchymal or pulmonary vascular diseases. Issues specific to pediatrics include unique diagnoses and increased need for mechanical ventilation before transplant and increased complications related to infection both before and after transplant. Although outcomes for children as a group are similar to those for adults, young children often fare better, perhaps in part due to reduced incidence of acute and chronic rejection. As in other solid organs, long-term outcomes in adolescents are poor. Increased focus on improving adherence in this age group will be important. Similar to adults, bronchiolitis obliterans remains the major late complication. Uniform treatment protocols and multicenter pediatric studies will be required to ultimately overcome this pervasive problem and improve pediatric lung transplant outcomes.

Long-term Outcome of Adolescents and Young Adults with Cervical Dysplasia

Long-term Outcome of Adolescents and Young Adults with Cervical Dysplasia

Comparison of Long-Term Outcomes in Adolescents With Anorexia Nervosa Treated With Family Therapy

To describe the relative effectiveness of a short versus long course of family-based therapy (FBT) for adolescent anorexia nervosa at long-term follow-up. This study used clinical and structured interviews to assess psychological and psychosocial outcomes of adolescents (ages 12-18 years at baseline) who were previously treated in a randomized clinical trial using family therapy between 1999 and 2002. Eighty-three percent (71/86) of subjects participated in follow-up assessments of current psychological and psychosocial functioning. In addition, 49% (35) were interviewed using the Eating Disorder Examination. Mean length of follow-up was 3.96 years (range 2.3-6.0 years). There were no statistically significant differences between the two groups on any measure at long-term follow-up. As a whole, the group was doing well with 89% above 90% ideal body weight, 74% with Eating Disorder Examination scores within the normal range, and 91% of postmenarcheal females not on birth control had menstrual return. A short course of family therapy is as effective as a longer course at follow-up.

Time trends in adolescent mental health.

Existing evidence points to a substantial rise in psychosocial disorders affecting young people over the past 50 years (Rutter & Smith, 1995). However, there are major methodological challenges in providing conclusive answers about secular changes in disorder. Comparisons of rates of disorder at different time points are often affected by changes in diagnostic criteria, differences in assessment methods, and changes in official reporting practices. Few studies have examined this issue using the same instruments at each time point. The current study assessed the extent to which conduct, hyperactive and emotional problems have become more common over a 25-year period in three general population samples of UK adolescents. The samples used in this study were the adolescent sweeps of the National Child Development Study and the 1970 Birth Cohort Study, and the 1999 British Child and Adolescent Mental Health Survey. Comparable questionnaires were completed by parents of 15-16-year-olds at each time point (1974, 1986, and 1999). Results showed a substantial increase in adolescent conduct problems over the 25-year study period that has affected males and females, all social classes and all family types. There was also evidence for a recent rise in emotional problems, but mixed evidence in relation to rates of hyperactive behaviour. Further analyses using longitudinal data from the first two cohorts showed that long-term outcomes for adolescents with conduct problems were closely similar. This provided evidence that observed trends were unaffected by possible changes in reporting thresholds.

Long Term Outcome in Adolescents with Hodgkin's Lymphoma: Poor Results using Regimens Designed for Adults

It is unclear whether the outcome in adolescents with Hodgkin's lymphoma is as good as that in children and there are no prospective randomized trials comparing regimes used in children and adults in this setting. We have therefore performed an analysis of 210 adolescent patients diagnosed with Hodgkin's lymphoma between 1970-1997 and registered on the database held by the British National Lymphoma Investigation. Patients were treated according to adult regimens current at the time of their diagnosis. The complete response rate recorded in 209 patients was 76%. This was highly dependent on disease stage being 95% in patients with localized disease but 63% in those with advanced disease. The 5 year event free survival for the whole cohort was 50% falling to 41% at 20 years with overall survival of 81% falling to 68% at 5 and 20 years respectively. There is no significant difference in the 3 decades pertaining to this analysis. Of the 62 deaths in this cohort, 70% were due to Hodgkin's lymphoma but of the 13 deaths occurring beyond 10 years, only 3 were due to Hodgkin's lymphoma, the reminder being attributable to the late effects of therapy. Results from paediatric groups have been much more encouraging than those presented from this cohort. It seems the use of risk-adjusted combined modality therapy with minimization of radiation fields and doses and reduction of anthracycline and alkylator exposure has been successful in children and should be used in adolescents.

Clinical relevance of electroconvulsive therapy (ECT) in adolescents with severe mood disorder: evidence from a follow-up study

Given the limited knowledge on the long-term outcome of adolescents who receive electroconvulsive therapy (ECT), the study aimed to follow-up adolescents treated with ECT for severe mood disorder. Eleven subjects treated during adolescence with bilateral ECT for psychotic depression ( n = 6) or mania ( n = 5), and ten psychiatric controls matched for sex, age, school level, and clinical diagnosis, completed at least 1 year after treatment a clinical and social evaluation. Mean duration between time of index episode and time of follow-up evaluation was 5.2 years (range 2–9 years). At follow-up: (1) all patients except two in the control group received a diagnosis of bipolar disorder. (2) Fifteen patients had had more than one episode of mood disorder. (3) The two groups did not differ in social functioning nor school achievement. (4) Impact on school achievement was related to the severity of the mood disorder rather than ECT treatment. The results suggest that adolescents given ECT for bipolar disorder, depressed or manic, do not differ in subsequent school and social functioning from carefully matched controls.

Long Term Outcome of Adolescents with Anorexia Nervosa

Long Term Outcome of Adolescents with Anorexia Nervosa

Long Term Outcome of Adolescents with Anorexia Nervosa

Long Term Outcome of Adolescents with Anorexia Nervosa

Poverty, Paternal Involvement, and Adolescent Well-Being

In this article, we explore the role that parents play in family processes in poor and nonpoor two-parent families and the extent to which paternal participation varies across family income. Using longitudinal data from the National Survey of Children, we observe patterns of poverty over time in childhood and adolescence and examine whether father involvement buffers the effects of poverty on long-term outcomes of adolescents. We measure emotional and behavioral dimensions of parenting and contrast levels of father involvement with levels of mother involvement in their relations with adolescents across poverty experiences. Fathers in poor and welfare families are less involved with youth in adolescence and the greater the persistence of poverty, the less involvement by fathers. Although we document some buffering effects of fathers in poor families, mother involvement plays a more important role in protecting low-income youth from adverse outcomes.