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• Past Factoids (all volumes)

• Women with anorexia nervosa have increased plasma levels of the hormone cocaine- and amphetamine-regulated transcript (CART), suggesting that it might play a role in causing the eating disorder. CART is known to affect appetite in animal studies. CART affects appetite in rodents, and that it is present in the circulation of humans. This evidence alone does not prove that CART is a cause of anorexia nervosa. It could also be a result of the disease and leaves unanswered how the hormone might interact with the psychological aspects of the disorder. In an effort to clear up that confusion, the researchers are currently measuring CART levels in obese patients and patients with anorexia due to diseases such as cancer.
• Cocaine abuse is associated with increased susceptibility to infection and enhanced progression of HIV disease. The increased risk of infection among those who abuse drugs is assumed to be correlated with lifestyle, high-risk behaviors, poor nutrition, and dirty needles. The drug is silently altering how the immune system responds to a triggering event, engaging in high-risk sexual behavior because you're under the influence of the drug. The drug is priming tissue to not fight off infection right at the point when the individual is most in need of a strong immune response. If cocaine knocks down immune system by only 5%, but you add to that poor nutrition and high risk behaviors, that 5% could put you over the top--and you get HIV. J Clin Endocrinol Metab 2003;88:00-00.
• In some children hyperactivity that seems like a mild form of attention-deficit/hyperactivity disorder (ADHD) may actually be associated with sleep apnea or other disordered breathing linked with sleep disturbances, researchers report. When a diagnosis of ADHD can be ruled out in a hyperactive child, evaluating a child for a sleep disorder may uncover the true cause of the symptoms. There is some evidence that a considerable proportion of children who have sleep apnea or who snore may display hyperactive behavior and inattentiveness during the day.Children whose parents described them as hyperactive, but who did not have ADHD, were much more likely to have sleep apnea. The authors caution that the results need to be confirmed, but say the study "strongly suggests" that sleep apnea can cause hyperactive behavior. How sleep apnea may cause hyperactive behavior is unknown, but the authors suggest that the focus on this behavior may delay treatment for the underlying problem. In contrast, children with ADHD were not more likely to have sleep apnea. However, they were more likely than other children to have disturbances in REM sleep. These differences could have a mild effect on children's behavior, according to the report. Pediatrics 2003;111:554-563.
• Almost half of the money spent on alcohol in the US comes out of the pockets of underage drinkers or adults who drink excessive amounts. This finding indicates that half of the alcohol industry's revenues stem from misuse or abuse of their product. Previous research has shown that children of actively involved parents are less likely to abuse alcohol, she noted, and adolescents who avoid alcohol often credit their parents as a primary reason for doing so. In 1999, $116.2 billion was spent on alcohol in the US; $22.5 billion and $34.4 billion were linked to underage and adult excessive drinking, respectively, representing roughly half of the total amount. JAMA 2003;289:989-995,1031-1035.
• European researchers have identified a gene that might play a role in the tendency to sleepwalk. Scientists from Switzerland, Germany and France compared 60 Caucasian people who regularly walked around while sleeping and their families, and 60 people without the disorder. They looked specifically at HLA genes, which have also been associated with narcolepsy and other sleep disorders. 35% of the total, were positive for HLA-DQB1*0501, compared to 8, or 13.3%, of the controls. Up to one in five children sleepwalk, although that level drops to somewhere around 1%-3% in adulthood, the researchers said. Population studies had already suggested a strong genetic element. Mol Psychiatry 2003.
• People with serious depression seem to have an impaired ability to smell faint odors, German researchers have found. Their discovery strengthens indications that olfactory function and mood interact in some way. In this study, smell sensitivity was not affected by the nature of the odor used in the tests. Previous studies of schizophrenics have shown that they have confused perceptions of smell, reacting strongly to unpleasant smells but often not appreciating pleasant ones. Other work involving people with seasonal affective disorder (SAD) has shown they have a more acute sense of smell than those without the condition, adding to the growing body of evidence of a link between olfactory function and mental status.
• Older adults who have problems sleeping, as measured by EEG, appear to be at increased risk for death, new research suggests.The report shows that people who were seemingly healthy but spent more than 30 minutes trying to fall asleep were more than twice as likely to die within an average of 13 years than people of similar age who fell asleep more quickly. A shortage or excess of REM sleep was also tied to an increased risk of death, the investigators found. Psychosom Med 2003;65:63-74.
• Abnormal levels of metabolic activity in the prefrontal cortex (PFC) may identify individuals whose suicide attempts are most likely to be fatal. Specifically, researchers found metabolic differences in the PFC between depressed patients whose suicide attempts resulted in hospitalization and those whose self-inflicted injuries were less severe. Since the brain differences appear in a region linked to decision-making and planning, these qualities may play a strong role in how likely a suicide attempt will be fatal. The higher-risk patients also tended to be older, less impulsive and more intent on ending their lives. Arch Gen Psychiatry 2003;60:14-22.
• Adolescents who smoke marijuana at an early age are more likely than their siblings to abuse other drugs later on or become addicted to drugs or alcohol, according to findings from a recent study of twins. The findings indicate that a twin who smoked marijuana before the age of 17 years was up to 4 times more likely to use other drugs and up to 6 times more likely to abuse drugs or alcohol, compared to their sibling who did not use marijuana at an early age... possibility is that early and positive experiences with the drug encourage continued use and experimentation with other drugs. People who smoke marijuana might also have access to other drugs, according to the report.JAMA 2003;289:427-433,482-483.
• Smoking one cigarette, whether by a smoker or nonsmoker, causes an acute increase in arterial stiffness. Smoking reduces pulse pressure amplification largely as a consequence of increased arterial stiffness and increases arterial wave reflection, which leads to increased aortic systolic blood pressure. They say that the adverse hemodynamic consequences of chronic smoking have been underestimated. They note that smoking by young people is on the increase, and conclude: 'We now provide evidence that smoking-related hemodynamic changes and increased stiffness may be evident in subjects as young as 22 years." Hypertension 2003;41:183-187.
• From 1987 to 1997, the proportion of patients in the US who were treated by nonphysician clinicians increased. Despite this increase, patient visits to traditional physicians did not decrease during this time period, according to new study findings. Thus, physicians' fears that the increasingly greater scope of practice given to nonphysician clinicians would result in a reduced need for traditional medical care, did not appear to become reality. The overall proportion of patients who visited a nonphysician clinician rose from 30.6% to 36.1% between 1987 and 1997, the authors note. However, much of this increase was accounted for by patients who visited both a nonphysician clinician and a physician, the report indicates. N Engl J Med 2003;348:130-137.
• The selective serotonin reuptake inhibitor (SSRI) fluvoxamine improved rapid mood shifts in women with borderline personality disorder but did not improve impulsivity and aggression. Although SSRIs are used to treat lability, impulsivity, and aggression in people with borderline personality disorder, this study challenges the theory that targeting the central serotonergic system might improve these behaviors and raises questions about the benefits of these drugs in this population. Am J Psychiatry. 2002;159(12):2048-2054