Clinical Services / Educational Services / Organizations / E-Mail  

• Physicians, especially female physicians, face a higher suicide risk than that of the general population. Suicide rates were 41% higher in male physicians than in the general population. The suicide rate among female physicians was more than double that in the general population. Am J Psychiatry 2004;161:2295-2302.
• Men with schizophrenia have smaller nasal volumes than men without schizophrenia. Anatomical and functional deficits of the olfactory neural system have been previously observed in schizophrenic patients. The fact that olfactory structure development coincides with development of the palate and forebrain has fed the theory that schizophrenia patients might show structural abnormalities of the nasal cavity, "which could represent specific markers of embryological dysmorphogenesis underlying schizophrenia." They discovered that the schizophrenic patients had smaller posterior nasal volumes in both the left and the right nostrils. The difference persisted in analyses adjusting for height and smoking history, "confirms an early disruption in embryological development in males with schizophrenia and may represent a genetic or environmental 'first hit' that leaves the individual vulnerable to subsequent pathology." Evidence from a prior study showing similar olfactory and craniofacial abnormalities in otherwise healthy first-degree relatives of schizophrenic patients supports the genetic etiology. Am J Psychiatry 2004;161:2314-2316.
• The bone age to chronological age ratio was significantly lower in girls with anorexia nervosa than in healthy girls suggesting delayed pubertal maturation, and most girls with anorexia nervosa (94%) were above the mean age at menarche for white girls in the US. Girls with anorexia nervosa had lower heart rates, lower blood pressure, and lower white blood cell counts than did healthy controls, the report indicates. Estradiol and luteinizing hormone levels were lower in girls with anorexia nervosa than in healthy controls. A number of girls with anorexia nervosa had significant bone loss, mainly at the lumbar spine, the researchers note. Bone marrow density at all skeletal sites correlated directly with weight, lean body mass, and fat mass and inversely with age at menarche.
  Pediatrics 2004;114;1574-1583.
• "Symptoms of depression appear to increase the risk of stroke in men with risk factors for coronary heart disease. In fact, depression may have more influence on stroke mortality than smoking or cholesterol levels, Physicians' ability and willingness to assess depression in patients at higher risk for CHD and implement the corresponding psychosocial interventions as part of the medical management might thereby affect the clinical course of stroke. The authors observed a statistically significant linear trend between quintile of depressive symptoms and stroke mortality, indicating that any reduction in depressive symptoms in those at above average risk for CHD may potentially result in a corresponding decline in future stroke mortality. These findings suggest a couple of different potential mechanisms, One is that there is a direct effect of something like cortisol that affects both depression and stroke. The other alternative that needs to be ruled out is that there are 'microstrokes' that are now showing up clinically that lead to both depression and the increased risk of stroke mortality." Stroke 2004;36.
• Adults with diabetes are considerable more likely to experience depression, anxiety and other disorders that cause serious psychological distress (SPD) than those without diabetes. The authors found that the age-adjusted prevalence of diabetes was 9.0% and that of SPD was 5.0%. The prevalence of SPD was 10.4% among people with diabetes. Even after controlling for age, gender, ethnicity, marital status and income, the odds ratio for SPD was 1.9 among diabetics. Persons with comorbid diabetes and SPD face formidable economic and social obstacles to receiving appropriate health care. Mor Mortal Wkly Rep CDC Surveill Summ 2004;53:1089-1092.
• Brains obtained at autopsy from autism patients show widespread neuroglial activation and inflammation. Neuropathological examination of autistic brains revealed extensive neuroglial responses, along with patchy loss of neurons in the Purkinje cell layer and granular cell layer of the cerebellum. Marked neuroglial activity in the cerebellum is consistent with previous observations that the cerebellum is one focus of pathological abnormalities in autism. Cerebrospinal fluid from living autistic patients showed significant increases in proinflammatory cytokines and modulatory cytokines. These play important roles in immune mediated processes,At present, there is no indication for using anti-inflammatory medications in patients with autism. Their use in humans must await further evidence of their efficacy and safety."
  Ann Neurol 2004.
• The tobacco industry for many years claimed that it was unaware of biological evidence that smoking is harmful to health. However, documents made public as a result of a 1998 legal settlement show that Philip Morris sponsored secret research that revealed tobacco's addictive properties and the toxicity of sidestream smoke. Based on their findings, they caution that "those involved in reviewing evidence on smoking and health should be aware of what appears to be the selective nature of what is eventually published by some scientists with links to the industry, and the evidence that sometimes mechanisms appear to have been used to disguise these links." Executives of the company first identified a need to conduct its own biological research in 1968. Evidence showed that the company sought to maintain confidentiality over results of research conducted at INBIFO. In one memo from 1977 that the Lancet authors found, a senior Philip Morris executive stated, "we have gone to great pains to eliminate any written contact with INBIFO." Papers published in scientific journals during this time "appear to be of considerable value to the industry,casting doubt upon the value of markers of passive smoking and suggesting alternative explanations for the observed epidemiological association between passive smoking and lung cancer." Lancet 2004.
• Behavioral symptoms and mental disorders are prevalent among elderly individuals living in residential care/assisted living.
  Dementia was reported in 48%, while 14% had depression and 13% had psychotic symptoms. More than half were taking psychotropic medication, such as antipsychotics, antidepressants or anxiolytics.
  One or more behavioral symptoms were manifested at least once a week by 34% of residents, including 13% who were aggressive, with behaviors such as hitting and biting; 20% who exhibited physical nonaggressive behavioral symptoms, such as wandering, hoarding things, or disrobing inappropriately; and 22% who had at least one verbal behavioral symptom, such as screaming or constantly requesting attention. Altogether, less than 20% of residents in the sample did not have a mental health diagnosis and behavioral symptoms and were not taking psychotropic drugs. J Am Geriatr Soc 2004;52:1610-1617.
• The high concordance of bipolar I disorder among twins suggests a significant genetic component of the condition. Previous twin studies of bipolar disorder have shown a higher concordance of the disease in monozygotic than dizygotic twins. The concordance for bipolar I disorder was much higher for monozygotic twins (0.43) than for dizygotic twins (0.06), the authors report. Concordance rates were also higher among monozygotic twins than dizygotic twins for schizoaffective disorder, manic type (0.50 versus 0.05) and for the broad affective disorder spectrum (0.75 versus 0.11), the report indicates. Concordant and discordant pairs did not differ in problems during pregnancy or delivery, and there were no significant differences between affected and unaffected twins in postnatal complications, childhood infections, or preschool physical or behavioral complications. Am J Psychiatry 2004;161:1814-1821.
• The associations between cannabis use and major depressive disorder (MDD) probably arise from a combination of shared genetic and environmental vulnerabilities. Previous research has established a moderate degree of comorbidity between cannabis abuse and depressive disorders. Researchers examined the relationships between twins discordant in early cannabis use, cannabis dependence, MDD and suicide attempts.The odds of MDD, suicidal ideation and attempted suicide were 1.3 to 3.4 times more likely in the dependent twin compared with the co-twin who was not cannabis dependent. This latter finding "implies that shared or correlated genetic vulnerabilities make substantial contributions to the comorbidity between cannabis dependence and MDD. In contrast, there appeared to be no significant interaction between zygosity and cannabis use before age 17 or lifetime cannabis use on the risks of suicide attempts. The opposite situation, MDD onset before age 17 or early suicidal ideation in discordant dizygotic twin pairs, but not monozygotic pairs, was significantly associated with rates of cannabis dependence. Altogether, these results suggest that "depression does not cause people to use cannabis, or that cannabis use and dependence do not in themselves cause depression...from a clinical point of view, it is not necessarily the case that eliminating one of those will automatically get rid of the other."   Arch Gen Psychiatry 2004;61:1026-1032.

• Thirty years of follow-up show that overall mortality rates in Vietnam veterans are no higher than in veterans who did not serve in Vietnam. Those who served in Vietnam haave essentially the same types of things that the people in the US population are dying from.
  However, the increase in motor vehicle accidents seen within 5 years of their return suggests that this "should be something that is addressed in the group that is coming back from Iraq." Arch Internal Med 2004;164:1908-1916.

•