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Spring 2005, Vol 8 No 3

the front cover of a crosscurrents magazine- the main image is a vase with bold coloured flowers

Research Update

By Hema Zbogara

Spring 2005, Vol 8 No 3

 

Brain may explain gender differences in eating disorders

Differences in how males and females process information may explain why females are 10 times more likely than males to develop eating disorders, according to researchers at Japan’s Hiroshima University. Thirteen men and 13 women performed a series of tests in which they had to read two sets of words. One set consisted of unpleasant words that described body image; the other set included neutral words. Each participant scored the words in terms of how pleasant and unpleasant they were. At the same time, participants’ brains were scanned using magnetic resonance imaging to measure which parts of the brain were active. Among women, unpleasant words stimulated the amygdala, which is associated with stimuli signaling threat. Among men, there was no increase in activity in the amygdala; rather, the medial prefrontal cortex, which is associated with rationalizing information, was more active. The researchers posit that female participants processed the unpleasant words about body image as fearful information, whereas men processed it more cognitively. They suggest that this gender difference in cognitive style related to body image may contribute to the large gender discrepancy in susceptibility to eating disorders.

 

British Journal of Psychiatry, January 2005, v. 186: 48–53. Naoko Shirao et al., Department of Psychiatry and Neurosciences, Hiroshima University, Hiroshima, Japan.

 

Second-hand smoke may lower children’s IQ

Children exposed to environmental tobacco smoke (ETS) have mildly to moderately lower scores on reading, math and visuospatial tests than non-exposed children, according to the Cincinnati Children’s Environmental Health Center in Ohio. In the largest-ever study of its type, 4,399 children aged 6–16 who participated in the Third National Health and Nutrition Examination Survey provided blood samples and took reading, math and memory tests. This is the first study to use a biological marker – blood levels of cotinine, a breakdown product of nicotine – to measure exposure to ETS rather than relying on self-reports. The test scores showed a decrease of two to five iq points at varying levels of exposure after controlling for sex, race, region, poverty, parent education and marital status and blood lead concentration. Although children with the highest cotinine levels scored lower on math, reading and visuospatial tests than children with the lowest levels, the greatest proportional change in scores occurred at low levels of exposure. No significant differences were found on tests of short-term memory. Based on their findings, the researchers call for policies to further restrict children’s exposure to tobacco smoke.

 

Environmental Health Perspectives, January 2005, v. 113: 98–103. Kimberly Yolton et al., Cincinnati Children’s Environmental Health Center, Cincinnati, Ohio.

 

Overweight children suffer more than just ‘puppy fat’

Obese and even slightly overweight children can suffer socially and psychologically, according to researchers at Royal Children’s Hospital in Melbourne, Australia. Previous studies linking childhood obesity with quality of life used clinical samples of severely obese children, whereas the current study was community based and examined both obese and overweight children. The researchers followed 1,569 primary school children from the 2000 Health of Young Victorians Study over three years and found that their quality of life began to decline as soon as their weight went above average. Parent-proxy and child self-reports found that, in addition to having poorer health, overweight and obese children were more likely than average-weight children to be teased at school, to feel sad, angry and unpopular and to have lower self-esteem. The authors suggest that although children may later shed the extra weight, permanent damage may result from overweight children’s negative experiences.

 

Journal of the American Medical Association, January 2005, v. 293: 70–76. Joanne Williams et al., Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Australia.

 

Pediatric clients get poor follow-up for ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) who are prescribed stimulant medication rarely receive optimal follow-up care, according to a survey conducted by the Children’s Research Institute at Ohio State University. Parents and clinicians across the United States completed questionnaires, and parents completed another questionnaire six months later. Of 659 children aged four to 15, the median number of follow-up visits with a primary care clinician or mental health specialist in the six months after diagnosis was one. Children who had been prescribed medication (78%) were no more likely to have received follow-up care than children without medication. Only 26 per cent saw a mental health specialist for follow-up. Primary care clinicians who had training in mental health provided better follow-up care than those without training. The researchers claim that the visits occur too rarely to permit medication adjustment or to support adherence. They call for systematic efforts to improve quality of care and urge primary clinicians to establish practices that promote follow-up visits by families.

 

Journal of Pediatrics, December 2004, 145: 767–771. William Gardner et al, Children’s Research Institute and Department of Pediatrics, Ohio State University, Columbus, Ohio.

 

Psychiatric diagnosis facilitates AIDS treatment

People living with AIDS who are receiving treatment for a psychiatric disorder are more likely to start antiretroviral therapy earlier and to have it prescribed for at least six months than their counterparts without a psychiatric disorder, according to researchers at the University of Maryland School of Medicine. Researchers investigated whether a psychiatric diagnosis influenced the time to initiation of highly active antiretroviral therapy (HAART), duration of therapy and survival in 549 individuals with AIDS and no prior antiretroviral treatment. Individuals being treated for a psychiatric disorder were 37 per cent more likely to receive HAART and twice as likely to have it prescribed for at least six months than those without a psychiatric disorder. They also experienced a 40 per cent reduction in mortality after adjustment for demographic variables and known risk factors, but this advantage disappeared after adjusting for the effects of HAART. The researchers conclude that with appropriate treatment, Hiv-positive individuals with psychiatric disorders can do as well as Hiv-positive individuals without psychiatric disorders.

 

Journal of Acquired Immune Deficiency Syndromes, December 2004, v. 37: 1457–1463. Seth Himelhoch et al., Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.

 

Gamblers’ brains provide addiction clue

People with a gambling addiction have a pattern of brain activity similar to that of people with drug addiction, according to research from Germany’s Hamburg University Hospital. The parts of the brain that are active when people feel rewarded, curbing activity, were found to be less active in the gamblers. The brains of 12 people with gambling addiction and those of 12 non-gamblers were monitored using functional magnetic resonance imaging while participants played a card guessing game. The ventral striatum, a part of the brain that signals reward, was less active in participants with a gambling addiction. Reduced activity in this area is recognized as a hallmark of drug addiction. The researchers suggest that people with addiction cannot maintain the amount of the brain chemical dopamine (which produces feelings of satisfaction and pleasure) they need in the ventral striatum; thus, they may need stronger triggers, such as substance use or excessive gambling, to compensate.

 

Nature Neuroscience, January 9, 2005 online, doi:10.1038/nn1378. Jan Reuter et al., Department of Neurology, Hamburg University Hospital Eppendorf, Hamburg, Germany.

 

Seizure drug may help people with bipolar disorder and alcohol dependency

Valproate, an anti-convulsant drug, may be effective in decreasing heavy drinking among people with bipolar disorder and alcohol dependence, according to researchers at the University of Pittsburgh. In the double-blind study, researchers followed 54 clients diagnosed with both disorders for six months. Participants were given their standard treatment, usually lithium and weekly counselling, plus either divalproex sodium (valproate) or a placebo. After six months, 44 per cent of the valproate group reported heavy drinking (five or more drinks daily for men and four or more for women) compared with 68 per cent of the placebo group. The valproate group also had fewer heavy drinking days and consumed about half as many drinks on heavy drinking days as the placebo group. The valproate group relapsed to heavy drinking one month later on average than the placebo group. The research is the first to examine how to treat bipolar disorder and alcohol dependence together, which is important because medication adherence and substance interactions may be problematic among people with both disorders. The valproate group had more nausea and vomiting than the placebo group, but the researchers report that, overall, combining lithium and valproate appeared to be safe. The researchers call for future replications of the study using larger samples.

 

Archives of General Psychiatry, January 2005, v. 62: 37–45. Ihsan M. Salloum et al., Western Psychiatric Institute and Clinic of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

 

Depression in families may span many generations

Children whose parents and grandparents have a history of depression are more than twice as likely as children with no family history of depression to develop a psychiatric disorder before they reach their early teens, according to researchers at Columbia University Medical Center in New York. Previous studies have shown that children of a depressed parent are at greater risk for mood and anxiety disorders, but the current study, which took more than two decades to complete, is the first to illustrate how the risk intensifies across three generations. The researchers began studying 47 first-generation family members in 1982 and then interviewed 86 of their children four times as they approached adulthood. The researchers collected data from 161 members of the third generation, whose average age is now 12. The effect of parental depression on grandchildren’s outcomes differed significantly with grandparental depression status. Among children with two generations of major depression, 60 per cent have a psychiatric disorder. Among grandchildren with depressed parents and no depressed grandparents, there was no significant effect of parental depression on grandchildren diagnoses. However, parental depression had a significant impact on grandchildren’s overall functioning. The authors suggest early interventions for children with a family history of depression.

 

Archives of General Psychiatry, January 2005, v. 62: 29–36. Myrna M. Weissman et al., Department of Psychiatry, Columbia University, New York, New York.