Children who have trouble sleeping may be at greater risk for drinking, smoking and using other drugs as teenagers, according to researchers at the University of Michigan. Researchers interviewed the mothers of 257 boys between the ages of three and five about their sleep habits. Follow-up interviews were conducted with families at three-year intervals until the children were between the ages of 12 and 14. The children were given a confidential written questionnaire, asking about alcohol, cigarettes and other drug use. The study found that one-third of the boys had trouble sleeping or were overtired as children. They were more than twice as likely as other boys to experiment with alcohol, cannabis and any illicit drugs as teenagers. The link between sleep problems and substance use held even after depression, anxiety, attention problems and parental alcohol use were taken into account. The researchers suggest that some as-yet unknown brain mechanism may be involved in both sleeplessness and a tendency to addiction. The authors caution, however, that poor sleep does not necessarily cause later addiction problems.
Alcoholism: Clinical and Experimental Research, April 2004, v. 28: 578–587. Maria M. Wong et al., Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
People who drink are more likely to smoke because alcohol enhances the pleasurable effects of nicotine, say researchers at Duke University Medical Center in Durham, North Carolina. The findings provide a physiological explanation for the observation that people smoke more in bars. Researchers recruited 48 regular smokers who drank at least four alcoholic beverages per week. Participants were given either an alcoholic or placebo beverage, and either regular or nicotine-free cigarettes. According to participant ratings, ethanol enhanced many of the rewarding effects of nicotine compared to placebos. Smoking nicotine-free cigarettes did not elicit the same positive response from those receiving alcohol, indicating that nicotine itself, rather than other aspects of smoking, was the critical ingredient underlying the interaction. The researchers also compared participants’ responses to nicotine after they took mecamylamine, a nicotine agonist. Participants on mecamylamine smoked more initially to off-set the drug’s action, but reported reduced satisfaction from smoking. This result further supports the idea that ethanol enhances nicotine’s effects. The research supports statistics that people with alcohol dependency smoke more than others and that smokers are 10 times more likely than non-smokers to have alcohol dependency. The researchers say the findings may explain why people who have quit smoking often relapse when they drink alcohol, and may lead to new smoking cessation methods that take the drugs’ interaction into account.
Nicotine & Tobacco Research, February 2004, v. 6: 133–144. Jed E. Rose et al., VA Medical Center and Department of Psychiatry, Duke University Medical Center, Durham, North Carolina.
Two variants of a single gene have been found that may at least double a child’s risk of developing autism, according to researchers at the Mount Sinai School of Medicine in New York. The variation was found with two single nucleitide polymorphisms within the SLC25A12 gene. The variants are fairly common and cannot bring on the disease by themselves, say the researchers, who indicate that between five and 10 genes may need to work together to produce autism. The study looked at 411 families, analyzing DNA from more than 2,000 people. Of those, 720 had autism. The study found that the two gene variants had been inherited by family members with autism more often than could be expected by chance, which implicates the variants in the disease. Previous studies have identified variants in other genes that may contribute to the disease, but none has been proven to do so. Autism, which normally appears by age three, and usually in boys, interferes with a child’s ability to communicate and interact with others. Since the gene is involved in providing energy to brain cells, the researchers speculate that variant versions may hamper the operation of those cells.
American Journal of Psychiatry, April 2004, v. 161: 662–669. Nicolas Ramoz et al., Mount Sinai School of Medicine, New York.
The rate of cognitive decline in smokers may be five times higher than among non-smokers, according to researchers at the Erasmus Medical Center in Rotterdam, the Netherlands. The study also found that smokers who quit significantly slowed their cognitive decline. Researchers conducted a mini-mental-state examination (MMSE), which measures cognitive function, on 9,209 men and women aged 65 and older from the European Community Concerted Action Epidemiology of Dementia incidence research group. For current smokers, the MMSE declined .16 points per year. For recent quitters it was .06 per year and for non-smokers it declined .03 per year. The study contradicts earlier research that found that nicotine may protect against Alzheimer’s disease. The authors conclude that beyond causing damage to the heart and lungs, tobacco use causes atherosclerosis and hypertension, which increase the risk of stroke and small areas of tissue damage in the brain.
Neurology, March 23, 2004, v. 62: 920–924. Ott et al., Department of Epidemiology and Biostatistics, Erasmus University Medical Centre, Rotterdam, the Netherlands.
People with good parental support during childhood are likely to have better health throughout adulthood than those who received inadequate support, according to a study conducted at the University of Albany in New York and the University of Michigan. Researchers analyzed responses from 2,905 adults, aged 25–74, who participated in the National Survey of Midlife Development in the United States. Although previous research has linked childhood support with adult psychological and physical health, this is the first study to examine whether the health effects of parental support persist into old age. Participants completed a survey asking about childhood support and current mental health. The researchers found that a lack of parental support during childhood was associated with increased levels of depressive symptoms and chronic health conditions such as hypertension and arthritis in adulthood that continue into early old age. The association was stronger for mental than physical health problems. The researchers say these findings may help predict early in life who is at elevated risk for ill health in late life and for improving the physical and mental health of older adults.
Psychology and Aging, March 2004, v. 19: 4–12. Benjamin A. Shaw et al., Department of Health Policy, Management, and Behaviour, School of Public Health, State University of New York at Albany.
A primary care intervention can reduce suicidal ideation in older adults with depression, according to research out of Cornell University in White Plains, New York. Between 1999 and 2001, the Prevention of Suicide in Primary Care Elderly: Collaborative Trial took place at 20 primary care practices in New York City, Philadelphia and Pittsburgh. After a two-stage, age-stratified depression screening of randomly sampled participants, aged 60 to 74–75 years and older, the researchers enrolled participants who screened positive and a random sample of those who screened negative. The study involved 598 individuals diagnosed with depression. The intervention included a trial of the antidepressant citralopram and treatment management by depression care managers. Degree and speed of symptom reduction were better in the intervention group than the control group. At four months, participants in the intervention group reported a decrease in suicidal ideation from 29 per cent to 17 per cent, while the rate among those who did not receive the intervention fell from 20 per cent to 17 per cent. At eight months, 70 per cent of the intervention group no longer reported suicidal ideation, compared with 44 per cent of the control group. The authors conclude that the intervention may be an effective preventive strategy to reduce risk factors for suicide in later life.
Journal of the American Medical Association, March 3, 2004, v. 291: 1081–1091. Martha L. Bruce et al., Department of Psychiatry, Weill Medical College of Cornell University, White Plains, New York.
A randomized clinical trial has found that cognitive-behavioural therapy (CBT) may successfully treat hypochondriasis. Researchers at the Harvard Medical School in Boston state that no existing treatment had been found for hypochondriasis, the belief and fear of serious illness despite medical reassurance. One hundred and two individuals with hypochondriasis were randomized to receive six weekly 90-minute session of CBT, and 85 individuals received usual care. At six- and 12-month follow-up, the CBT group had significantly lower levels of hypochondriacal symptoms, beliefs and attitudes and health-related anxiety than the control group. They also had less impairment of social role functioning and activities of daily living. However, somatic symptoms did not improve significantly. The authors suggest that integrating treatment into a primary care setting may be most effective and attractive to clients.
Journal of the American Medical Association, March 24, 2004, v. 291: 1464–1470. Arthur J. Barsky and David K. Ahern, Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts.