Alcohol abuse kills some 75,000 Americans each year and shortens the lives of these people by an average of 30 years, a U.S. government study suggested on Thursday. Excessive alcohol consumption is the third leading cause of preventable death in the United States after tobacco use and poor eating and exercise habits. The Centers for Disease Control and Prevention, which published the study, estimated that 34,833 people in 2001 died from cirrhosis of the liver, cancer and other diseases linked to drinking too much beer, wine and spirits. Another 40,933 died from car crashes and other mishaps caused by excessive alcohol use.
Researchers considered any man who averaged more than two drinks per day or more than four drinks per occasion to be an excessive drinker. For women it was more than one drink per day or more than three drinks per occasion. Men accounted for 72% of the excessive drinking deaths in 2001, and those 21 or younger made up 6% of the death toll. The United States aims to cut the rate of alcohol-related driving fatalities to 4 deaths per 100,000 people by 2010, a 32% drop from 1998.

The patterns and prevalence of schizophrenia and suicide are markedly different in China than in many other countries. In China, schizophrenia is more common in women than in men, and in urban communities than rural areas. Suicide rates are higher in rural areas, and among women. This is in contrast to results of the Global Burden of Disease study by the World Bank, which suggests a consistently higher rate of schizophrenia in men than women worldwide, and a uniform prevalence across cultures. Data on suicides revealed that 93% took place in rural areas, and that 55% were in women. In rural areas, the suicide rate among residents with schizophrenia was 0.86% per year, compared with 0.27% per year in urban areas Although suicides were less likely to be accompanied by mental illness than in other countries (63% versus 90%), schizophrenia was more common in those who committed suicide (10.1% versus 6.4%). Compared with suicides in people with schizophrenia in other countries, those in China were more likely to involve married women. They were less likely to have had a previous psychiatric admission, comorbid depressive disorder or to have abused alcohol. Lancet 2004;364:1016-1017,1062-1068.

Most of the health problems reported after the Sept. 11, 2001, attacks in New York and Washington have involved respiratory difficulties and mental distress, according to a U.S. government report published on Wednesday. Firefighters and other emergency workers showed long-term respiratory problems, including a syndrome called "WTC cough." A separate study published also showed subtle but significant effects on pregnant women and their babies. The hijacked plane attacks that destroyed the World Trade Center created infernos that enveloped much of New York in a pall of smoke and dust loaded with toxic chemicals. Nearly 3,000 people were killed in the attacks and a similar one on the Pentagon in Washington. A range of respiratory conditions have been reported, including wheezing, shortness of breath, sinusitis, asthma, and a new syndrome called WTC cough, which consists of persistent cough accompanied by severe respiratory symptoms. Almost all the firefighters who responded to the attack experienced respiratory effects, and hundreds had to end their firefighting careers due to WTC-related respiratory illness. The most commonly reported mental health effects include symptoms associated with depression, stress, anxiety, and post-traumatic stress disorder," according to the report. Researchers found that pregnant women who were close to the twin towers at the time of the attack were more likely to give birth to lighter babies. The Columbia Center for Children's Environmental Health surveyed 300 nonsmoking women who delivered babies at three hospitals in lower Manhattan. Babies born to the women living within two-miles of the site weighed on average 149 grams less at birth compared to infants born to the other pregnant women.

People who drink alcohol frequently in middle age are twice as likely as less regular drinkers to develop mild cognitive impairment in later life. The study authors also found that non-drinkers were at increased risk of mild cognitive impairment. Compared with infrequent drinkers, frequent drinkers and non-drinkers were twice as likely to develop mild cognitive impairment in old age, the report shows. The risk of dementia related to alcohol was affected by the presence of the apolipoprotein e4 allele. Carriers were at increased risk of dementia with increasing alcohol consumption. The fact that apolipoprotein e4 may modify the effect of alcohol in dementia corresponds with the view that cognitive status is a product of environmental and genetic factors. Bottom line is never to encourage people to drink more alcohol in the belief that they are medicating themselves against dementia. BMJ 2004; 329:539-542.

Depression in patients with mild cognitive impairment appears to raise the risk of development of Alzheimer's-type dementia.
Mild cognitive impairment has been regarded as a precursor to dementia of Alzheimer's type, but not all patients with mild cognitive impairment develop dementia. Depressed patients were more than twice as likely to develop dementia. The researchers conclude that patients with depression and mild cognitive impairment "deserve more attention and should be closely observed." Arch Neurol 2004;61:1290-1293.

Teens who say at least half their friends are having sex are more likely to report having tried marijuana, alcohol and cigarettes.
Parents who become aware of certain dating and sexual behavior by their children should be alert to the increased likelihood of substance abuse," he said. Researchers compared teens who reported at least half their friends are sexually active with those who said none of their friends are. About one in four teens reported at least half their friends are sexually active; about four in ten said none are. The study found the first group is: More likely to have tried alcohol, 66 percent vs. 10 percent of those whose friends don't have sex. More likely to have gotten drunk at least once in the past month, 31 percent vs. 1 percent.  More likely to have tried marijuana, 45 percent vs. 2 percent.  More likely to have tried cigarettes, 45 percent vs. 8 percent. The survey also found that the more time teens spend with their boyfriends or girlfriends, the more likely they are to smoke, drink and use drugs.  No matter what their behavior, teens said smoking, using illegal drugs and getting drunk are not cool. More than 80 percent said each activity makes a teen" seem like a loser."

Low cholesterol levels may be associated with suicidality in patients with anorexia nervosa. Cholesterol levels were significantly lower in subjects who reported previous suicide attempts, impulsive self-injurious behavior, or current suicidal ideation than in those without suicidality. This was true for patients with restricting anorexia nervosa or binge eating/purging-type anorexia nervosa. A negative correlation was observed between cholesterol levels and the severity of depressive symptoms in all patients except those with recurrent binge eating. Psychosom Med 2004;66:548-552.

Benzodiazepine use (Valium, etc) is associated with an increased risk of hip fracture in the elderly. Benzodiazepine use was associated with a 24% increased rate of hip fracture compared with no benzodiazepine use after adjusting for age, sex, race, Medicaid nursing home residence, exposure to other psychoactive medications, dementia, and recent hospitalization. Exposure to short half-life, high-potency benzodiazepine was associated with and 27% increased rate of hip fracture. The corresponding rate for longer half-life benzodiazepines was 13%. The hip fracture rate was greatest during the first 2 weeks of starting a benzodiazepine, but decreased thereafter. Arch Intern Med 2004;164:1567-1572.

Infantile reflexes that persist too long are associated with abnormal movement patterns in children with Asperger's syndrome or autism.
Identifying these abnormalities in infancy may help physicians to diagnose Asperger's syndrome before the appearance of aberrant social skills, which are currently used to diagnose autistic spectrum disorders. No single aberrant movement was present in all subjects, and infants were unlikely to exhibit all the abnormalities. However, pediatricians should be alert to the delayed appearance of motor milestones in development, especially if there is autism in the family or if parents are concerned that their child is not developing properly.
The "tilting test" recommended parents and physicians use to evaluate infants' "head verticalization response," beginning at about 6 months of age.The baby is held vertically, then slowly tilted sideways to about 45 degrees, then slowly brought back to vertical, then tilted to the opposite side. In normal development, the head will maintain a vertical position. A child with an autistic spectrum disorder will often fail to keep his head vertical, instead holding the head in line with the rest of the body. Proc Natl Acad Sci USA Early Edition, July 26, 2004.

In HIV-positive women, chronic depressive symptoms appear to increase the risk of AIDS-related death. However, the relationship between depression and HIV disease progression is not well understood. Women who had chronic depressive symptoms were more than twice as likely to die of AIDS-related causes than were women who had few or no such symptoms. These findings are line with those of another large multi-center study. Moreover, AIDS mortality was less likely in women who reported mental health service use. Among other factors that reduced mortality were being on a HAART regimen or on non-HAART combination therapy.
Am J Public Health 2004;94:1133-1140.

Maternal anxiety during the first 12 to 22 weeks of pregnancy is associated with enhanced susceptibility of the child to disorders such as attention deficit/hyperactivity disorder (ADHD)...It has long...been known that neurodevelopmental impairments seen in some of these disorders...are caused by the deleterious effect of prenatal factors on developmental processes of the brain. The "fetal programming hypothesis" states that disturbing factors during sensitive periods of in-utero development can program the set-points of a variety of systems in the fetus. The set-points constrain the adaptive plasticity of the child to their environment, resulting in maladaptive physiology and a predisposition to disease or disorder.
Maternal anxiety during the first 12 to 22 weeks of pregnancy was a significant independent predictor, while factors such as the child's sex, parents' educational level, smoking during pregnancy, birth weight, and postnatal maternal anxiety were not. These programs could include stress reduction instructions and behavioral treatments to reduce anxiety and neuroendocrine reactions to stress from early gestation on. Child Dev. 2004;75:4

Thousands of mentally ill American children, some as young as seven, are locked up in juvenile detention centers because there is nowhere else for them to go. Many families struggle to afford mental health care. Health insurers often provide little or no mental health coverage, or pay so little doctors don't want to take part in the health plans. Community clinics are stretched and cannot meet demand. The study found that 33 states hold youths who have no charges against them of any kind in juvenile detention centers. On any given day, about 2,000 such young people are incarcerated, and over six months, the number is 15,000.