SAN FRANCISCO, July 23 (UPI) -- Despite many pediatric medicines' power to defeat disease and defer death, concerns persist about what critics see as an overselling of remedies that fail to do their job.
One recurring question centers around the dearth of data on the extent to which different therapies help young people with psychiatric disorders transition successfully to adulthood.
Studies have shown adolescents with mental disturbances are 14 times less likely to complete high school, four times less likely to be employed or in trade school, three times more likely to participate in criminal activity and seven times more likely to become or get someone pregnant than their psychologically healthy peers.
Researchers note despite tens of thousands of children -- 103,000 youngsters under 15 in 2000 -- being hospitalized for psychiatric treatment each year, little is known about the long-term effects of this strategy.
One group checked up on such patients 11 and 20 years after their discharge and compared them with economically equivalent high school students on such measures as deaths, emotional distress and educational attainment.
"Outcome differences for hospitalized and high school youth are striking given that the hospitalized group received state-of-the-art psychiatric care at a university teaching hospital, including psychoeducational testing, family therapy and extensive individualized discharge planning," the investigators wrote in the Archives of Pediatrics and Adolescent Medicine.
"Increased mortality and emotional distress and decreased high school, college and graduate school completion highlight the ongoing individual and social costs associated with adolescent psychiatric symptoms sufficient to result in hospitalization."
Although numerous improvements have been implemented since the study was completed in 2004, the real-life results of the updated approach remain largely unknown, researchers said.
Critics contend, in many instances, the findings of a 1994 analysis continue to apply.
That report, published in the Journal of Mental Health Administration, concluded that "child care and treatment agencies continue decade after decade to provide services that are of unknown effect, even though they cost tens of thousands of dollars a year per child, sometimes over $100,000."
"More than ever, promises are being made as to independence, empowerment and recovery when there is often no more than anecdotal evidence to support these outcomes as regularly realized in the mental-health system at large," said Joseph Gutstein of Cliffside Park, N.J., a former member of the Bergen County Mental Health Board and the National Alliance on Mental Illness, New Jersey, Public Policy Committee who spent three years in children's residential treatment.
Such doubts resonate with particular force among critics of mandatory vaccine policies.
Outbreaks of mumps in the Midwest -- where more than 1,000 cases were reported by April 2006 among largely vaccinated teens and young adults -- fueled concerns about the long-term effectiveness of the immunization that was supposed to forestall such a scenario.
"The only people who don't have to worry about the mumps in the Midwest outbreak, which is occurring primarily among college students who have two doses of MMR (measles-mumps-rubella) vaccine, are older Americans who recovered from mumps as children," Barbara Loe Fisher, co-founder and president of the country's largest and oldest vaccine safety and consumer watchdog organization, the National Vaccine Information Center, wrote in her newsletter.
"Vaccines provide temporary, qualitatively inferior immunity compared to the qualitatively superior immunity achieved by recovering from the disease, which in most cases is permanent for once routine childhood diseases such as mumps."
For their part, health officials said some of the young people who fell ill may not have had the second recommended shot, the vaccine is not 100 percent effective, and without the immunization program the outbreak could have turned into an epidemic.
Sometimes a solution to one problem can evoke another.
For example, the addition of a vaccine against pneumococcal disease -- including sepsis, or blood poisoning, meningitis, pneumonia and otitis media, or inflammation of the middle ear -- to the childhood immunization schedule, with four doses recommended in the first 18 months of life, has put a dent in the rate of sickness and of cases that fail to respond to treatment.
At the same time, however, researchers have observed a dramatic shift in the microbial varieties that most often cause recurrent ear infections, the most common bacterial illness in young U.S. children.
Since the Prevnar shot, formally known as conjugated heptavalent pneumococcal vaccine, or PCV7, was licensed in 2000, the bacteria it targets, Streptococcus pneumoniae, have taken a backseat to another type, Haemophilus influenzae. This flu bug now has become the predominant culprit in persistent ear infections as well, researchers reported in The Pediatric Infectious Disease Journal.
Prior to the routine use of the vaccine and high-dose antibiotics, S. pneumoniae was implicated in nearly half of the cases, but now it is H. influenzae that brings on the malady 57 percent of the time, scientists said.
Because this new pathogenic arch-villain is impervious to such traditional disease-decimating weapons as the stalwart penicillin class of drugs and because not all of the antibiotics in the current arsenal are effective against both types of bacteria, doctors may have to revise their plan of attack to keep up with the changing health threats, the researchers advised.
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(Note: This column is based on dozens of reports, conferences and more than 200 interviews with specialists in children's health issues. Wasowicz is the author of the new book, "Suffer the Child: How the Healthcare System Is Failing Our Future," published by Capital Books.)
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(e-mail: [email protected])
