By Hema Zbogar
Summer 2005, Vol 8 No 4
Changes in chemical activity in certain regions of the brains of former methamphetamine users who have not used the drug for a year or more suggest some recovery of neuronal structure and function, according to researchers at the University of California. Researchers compared eight methamphetamine users who had not used the drug for one to five years and 16 users who had not used the drug for one to six months with 13 non-users using proton magnetic resonance spectroscopy, which allows visualization of biochemical markers that are linked with brain neuron damage and recovery. The researchers measured markers in the anterior congulum cortex, which is associated with selective attention. Levels of Nacetylaspartate (NAA) were measured as a marker of the amount of damage. Choline (Cho), which is generated by the creation of new membranes, was measured as a marker of recovery. NAA levels were abnormally low in users and were relative to the length of use, but did not change relative to the amount of time users had been abstinent. Elevated Cho levels were found among users who had not used the drug in one to six months and normalized levels occurred in longer abstainers. The authors conclude, “When drug exposure is terminated, adaptive changes occur, which may contribute to some degree of normalization of neuronal structure and function.”
Archives of General Psychiatry, April 2005, v. 62: 444–452. Thomas E. Nordahl et al., Department of Psychiatry and Behavioral Sciences, University of California, Davis.
Children whose mothers spend less time with them because they work outside the home display no differences in social and intellectual development during the first three years of life than children whose mothers spend a lot of time with them, according to researchers at the University of Texas at Austin. Researchers analyzed 24-hour diaries of time use from 1,053 mothers of infants collected in the National Institute of Child Health and Human Development Study of Early Child Care. They also examined videotaped observations of mothers interacting with their infants to measure how sensitive mothers were to their children’s needs, and visited the mothers’ homes to observe the quality of the home environment. It was found that although mothers who worked outside the home spent less time with their infants than non-employed mothers, they compensated by spending more time with their children on weekends and decreasing time spent on housework, leisure, outside organizations, travel and social activities. Mothers who spent more time with their children (regardless of employment status) were slightly more sensitive and provided higher quality home environments. Mothers’ personalities, beliefs and family circumstances were much more important than time as predictors of parenting.
Child Development, March/April 2005, v. 76: 467–482. Aletha C. Huston and Stacey Rosenkrantz Aronson, Department of Human Ecology, University of Texas, Austin.
There appears to be a high prevalence of anxiety and depression among patients with chronic breathing disorders, according to researchers at Baylor College of Medicine in Houston. Researchers conducted a cross-sectional analysis in which Primary Care Evaluation of Mental Disorders (PRIME-MD) screening questions were used to measure the prevalence of anxiety and depression in 1,334 individuals who received care for chronic breathing disorders at a veterans’ medical centre in Houston. Of these individuals, 862 (65%) screened positive for depression and anxiety, 133 (10%) for anxiety only and 72 (5%) for depression only. A total of 267 (20%) screened negative for depression and anxiety. The predictive value of a positive screen according to the PRIME-MD for either depression or anxiety was 80 per cent. A subset of 204 study participants who had chronic obstructive pulmonary disease underwent the Structured Clinical Interview for DSM-IV. It was found that 132 participants (65%) received an anxiety and/or depressive disorder diagnosis, 77 (39%) received a depressive disorder diagnosis, and 101 (51%) had an anxiety disorder. The researchers conclude that practical screening instruments may increase the recognition of anxiety and depression in medical clients.
Chest, April 2005, v. 127: 1205–1211. Mark E. Kunik et al., Houston Center for Quality of Care and Utilization Studies, Baylor College of Medicine, Houston, Texas.
Client and counselor characteristics may predict the quality of therapeutic alliances, according to researchers at Manchester Metropolitan University. The study recruited 187 clients aged 18–52 starting residential rehabilitation treatment in three UK services. Counselor and client information was assessed at intake, and client and counselor ratings of the alliance were obtained during weeks 1, 2 and 3. The intake assessment battery included scales on psychological well-being, treatment motivation, coping strategies and attachment style. Client and counselor versions of the Working Alliance Inventory were used weekly. The study found that clients who had better motivation, coping strategies and social support and a secure attachment were more likely to develop good alliances. Findings around counselor characteristics were less clear cut: Clients rated their relationships with ex-user counselors, experienced counselors and male counselors as better, but more experienced counselors rated their alliances as worse. The authors suggest that further studies need to establish whether the therapeutic alliance and treatment outcomes can be enhanced by working on improving clients’ motivation and psychosocial resources.
Addiction, April, 2005, v. 100: 500–511. Petra S. Meier et al., Department of Psychology and Speech Pathology, Manchester Metropolitan University, Manchester, United Kingdom.
Effectively treating depression in older adults improves physical function, according to researchers at the Indiana University Center for Aging Research. In their randomized control trial, researchers assigned 1,801 participants at least 60 years of age with major depressive disorder to an intervention or usual care control group. Overall, 45 per cent rated their health as fair or poor. Participants in the control group had access to all health services available as part of usual care. Those in the intervention group had access to a depression specialist for one year. Depression care was coordinated with the participants’ primary care physicians. At least a 50 per cent reduction in depressive symptoms was observed in 45 per cent of the intervention group, compared to 19 per cent of the control group. At one year, 37 per cent of intervention participants and 52 per cent of controls rated their health as fair or poor. Combining both groups, the researchers found that participants whose depression improved were significantly more likely to improve in physical functioning. The authors conclude that collaborative care management for late-life depression reduces depression and improves physical health.
Journal of the American Geriatrics Society, March 2005, v. 53: 367–373. Christopher M. Callahan et al., Indiana University Center for Aging Research, Indianapolis, Indiana.
Smoking nicotine-free cigarettes may be sufficient for suppressing some tobacco withdrawal symptoms such as a desire for sweets, hunger and the urge to smoke, suggesting that the withdrawal smokers feel when trying to quit may not all be due to nicotine. Researchers at Virginia Commonwealth University studied 13 women and 19 men, aged 18–50, who participated in three, five-day conditions, in which they smoked either no cigarettes, nicotine-free cigarettes or cigarettes containing nicotine. Participants responded daily to a questionnaire assessing their urge to smoke, irritability, concentration, restlessness, craving, insomnia, increased eating and desire for sweets. Researchers also recorded heart rate, skin temperature and blood pressure. Researchers compared how participants felt when they did not smoke to how they felt when they smoked nicotinized cigarettes or nicotine-free cigarettes. When participants did not smoke, they experienced withdrawal and did not feel well. Participants who smoked nicotine-free cigarettes felt better but not as good as they felt when smoking nicotinized cigarettes. The authors conclude that non-nicotine factors play an important role in suppressing withdrawal and may be a valuable adjunct to nicotine replacement products.
Addiction, April 2005, v. 100: 550–559. August R. Buchhalter et al., Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia.
College students are more likely to binge drink and drive drunk than their peers who are not in school, according to researchers at Boston University. To determine whether more college students are putting themselves at risk by drinking, researchers reviewed data collected by various surveys and federal agencies on 18–24-year-olds in 1998 and 2001 about drinking habits, injury rates and accidental death. They found that an estimated 2.8 million college students drive while intoxicated and one in four say they regularly binge drink (for men, five or more drinks in one sitting; for women, four or more). In 2001, 1,717 students died from alcohol-related injuries, up from 1,575 in 1998 – a six per cent increase when factoring in the change in the number of student enrolled in college. In 2001, almost 600,000 students were injured as a result of alcohol and even more were assaulted by another intoxicated student. The authors state that colleges need to change their approach to student drinking, including working with local police to enforce drunk-driving laws and underage drinking laws and screening students for alcohol problems.
Addiction, April 2005, v. 100: 543–549. B.J.M.H. Hefferis, C. Power and O. Manor, Centre for Pediatric Epidemiology and Biostatistics, Institute of Child Health, London, United Kingdom.
People with mental health issues are more likely to seek help from friends and family than health professionals, according to researchers at the Health Protection Agency South West in the United Kingdom. Researchers mailed the 12-item General Health Questionnaire (GHQ) to 15,222 members of the general population, aged 16 to 64. The response rate was 80 per cent for women and 71 per cent for men. Only 28 per cent of people with extremely high GHQ scores (eight or higher) sought help from their physician, although 78 per cent had sought some form of help. Of these, 67 per cent sought help from friends or family and 16 per cent turned to other health professionals or work-related individuals. Males, young people and people living in affluent areas were the least likely to seek help. The researchers suggest that health promotion interventions to encourage appropriate help-seeking in young people, particularly males, may lead to improvements in mental health.
British Journal of Psychiatry, April 2005, v. 186: 297–301. Maria Isabel Oliver et al., Health Protection Agency South West, Gloucestershire, United Kingdom.