Excessive Screen Time in Toddlers Linked to Autism Diagnosis in Early Adolescence

Toddlers who have more than 14 hours per week of screen time have nearly twice the odds of having a diagnosis of autism spectrum disorder when they are 12 years old, a research letter in JAMA Psychiatry has found.

Ping-I. Lin, M.D., Ph.D., of St. Louis University, and colleagues examined data amassed from parents of 5,107 children in the Longitudinal Study of Australian Children, a study examining how children's social, economic, and cultural environments affect their wellbeing over the life course. The researchers defined early childhood screen time as the weekly number of hours of exposure to television, videos, or other internet-based programs at 2 years of age.

A total of 145 children had a parent-reported diagnosis of autism spectrum disorder at 12 years. Children who had more than 14 hours of weekly screen time when they were two years old had 1.79 times the odds of having a diagnosis of autism spectrum disorder when they were 12 years old than those who had less than 14 hours of weekly screen time. Children were more likely to have more than 14 hours of screen time when they were 2 years old if they were boys, their mothers had less than 13 years of education or less, or they lived in households with a family income of $60,000 or less.

“Although our findings suggest that the association between screen time and ASD risk is not causal, there are still important clinical and policy implications,” the researchers wrote. “Screen time can be a useful marker for identifying families needing additional support. Interventions should address underlying socioeconomic factors, providing resources to reduce adverse health impacts of screen time.”

For related information, see the Psychiatric News Alert “Early Childhood Tablet Use Linked to Angry Outbursts.”

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Older Physicians Experience Less Work-Related Stress, Psychological Distress Than Younger Colleagues

Physicians experience higher rates of psychological distress and suicidal ideation than the general population, but the experience of age may act as a buffer for older physicians, a study in the American Journal of Geriatric Psychiatry suggests. The study also found that work-life conflict declined as physicians grew older.

Chanaka Wijeratne, M.D., of the University of Notre Dame, Australia, and colleagues analyzed data from 10,038 physicians who responded to the National Mental Health Survey of Doctors and Medical Students, which was conducted in Australia. They divided responses into three groups according to physician age: younger (40 years old and younger), middle aged (41 to 60 years old), and older (61 years old or older). Physicians were asked whether they had experienced suicidal ideation and/or had been given a diagnosis of anxiety or depression over the preceding 12 months. They were also asked if they were distressed over work stressors such as conflict between study/career and family/personal responsibilities, finances and debt, long work hours, sleep deprivation, and difficult relations with senior colleagues, among others. They were asked to rate their distress over these stressors as “not at all stressed,” “not that stressed,” or “very stressed.” Physicians also answered questions about feelings of exhaustion, cynicism toward their work, whether they felt they were effective at work, and their drinking habits.

Compared with middle-aged and younger physicians, older physicians reported fewer workplace stressors that made them feel “very stressed,” and they were less likely to report distress over work-life conflict. As a group, older physicians felt less distress over work-related stressors in general, less exhaustion, less cynicism toward their work, and greater personal efficacy at work compared with their younger and middle-aged peers, and they were less likely to report suicidal ideation or a diagnosis of anxiety or depression over the preceding 12 months. However, their likelihood of reporting distress increased if they had a history of mental illness. There were no significant differences in high-risk drinking between groups, although younger physicians were more likely to engage in moderate-risk drinking compared with their middle-aged and older colleagues.

“Whilst the extant literature has suggested that physicians experience poor mental health, it can be seen that it needs to be considered more broadly in the context of age and career stage as there is an improvement in physicians’ reporting of psychological distress, suicidal ideation, burnout, and experience of workplace stress as they age,” the researchers wrote.

For related information, see the American Journal of Psychiatry article “Well-Being, Burnout, and Depression Among North American Psychiatrists: The State of Our Profession.”

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Depression in Older Men Not Causally Linked to Dementia, Study Suggests

Older men with a history of depression may be at greater risk of developing dementia than those without current or past depression, but it appears that depression in later life is more likely a marker of incipient dementia rather than a truly modifiable risk factor, according to a report in Translational Psychiatry.

Surprisingly, the authors noted that the use of antidepressants did not decrease the risk of dementia associated with depression.

“Older people with depression may be better viewed as potential targets of indicated prevention strategies [for dementia], rather like people with mild cognitive impairment,” Osvaldo Almeida, M.D., Ph.D., of the University of Western Australia and colleagues wrote.

Data were drawn from the Health In Men Study, a community-based cohort study based in Western Australia. Researchers used voting rolls to recruit a sample of 12,203 men aged 65 to 84 years living in Perth in 1996. During a second wave of assessments between 2001 and 2004, 5,514 participants provided information about depressive symptoms and past history of depression. The final study sample consisted of 4,922 men aged 71 to 89 years who were free of dementia/cognitive impairment. They were followed until the onset of dementia, death, or through the end of June 2015, whichever occurred first.

Participants were followed, on average, for 8.9 years. During this time, 903 men received the diagnosis of dementia (18.3%) and 1,884 died free of dementia (38.3%). The adjusted hazard ratio of dementia among men who had ever been depressed (past or current), men with a past history of depression only, and men with current depression was 1.3, 1.3, and 1.5, respectively. Moreover, the researchers also found that there was a graded association between the severity of depressive symptoms and the risk of dementia, with the risk being more pronounced for men with severe depression. 

Importantly, however, the association between depression and dementia was limited to the first five years of follow-up—a finding the authors wrote “suggest[s] that depression may represent a prodromal manifestation of cognitive impairment, rather than one of its causes.” A total of 302 men (6.1%) were using antidepressants at the time of the assessment, but the use of antidepressants did not appear to decrease the risk of dementia.

“It is conceivable that depression with onset in early or mid-life could contribute to modulate the risk of dementia later in life, whereas depression arising in older age may be more frequently an early manifestation of an underlying neurodegenerative process,” Almeida and colleagues wrote.

For related information, see the Psychiatric News article “Neuropsychiatric Symptoms Implicated in Conversion from MCI to Dementia.”

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