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FACTOIDS
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  • Infants with snoring-related respiratory arousal have lower scores on standardized mental development assessments. Exposure to secondhand cigarette smoke may contribute to the deleterious effects of infant snoring. The link between sleep-disordered breathing and neurocognitive functioning in preschool and school-aged children now has been established clearly. Thirty-three percent of the infants were from a home in which at least one parent smoked. Infants from smoking households were more likely to snore and significantly more likely to have respiratory-related arousals. However, no significant differences on Mental Development Index scores were seen between infants from smoking or non-smoking households. This study and others clearly support the need for identification and evaluation of the youngest children with recognizable risk factors for sleep disordered breathing. This may pose a formidable challenge when we consider that the symptoms of sleep disordered breathing, such as snoring, are less frequently the presenting complaint in such children when compared with associated comorbidities, such as recurrent upper respiratory tract infections and delays in growth and development. Pediatrics 2006;117:e496-e501.
  • Maternal depression, especially in the third trimester, is associated with low birth weight in the offspring. While postnatal depression has been linked to malnutrition in infancy, the adverse effects of maternal depression on the neonate are still not clear. The odds for low birth weight increased to over three times among (depressed) mothers, indicating a link between severity of depression and low birth weight, the researchers noted. Lack of care due to depression is one possible cause. There are many others, including poor nutrition and altered maternal hormones due to depression. Treatment of psychiatric illness in pregnancy should be an important aspect of antenatal care, the researchers conclude. Br J Psychiatry 2006;188: 284-285.
  • Genetic factors account for 56% of the risk for developing anorexia nervosa. This information should provide some reassurance to patients and families that the disease is not the result of something they did wrong. The findings are based on a comparison of disease concordance between monozygotic and dizygotic twins. The overall prevalence of anorexia nervosa in women was 1.20% and in men, 0.29%...during the birth period there was a rise in the anorexia nervosa rate among women, but not men. The heritability of anorexia nervosa was estimated to be 0.56. The remaining liability was due to environmental factors. The variance attributable to shared environment was 0.05, and to unique environment it was 0.38. The presence of neuroticism at the 1972-1973 assessment increased the likelihood of later anorexia nervosa by 62%, the report indicates. By contrast, a low body mass index and excessive exercise levels were not predictive of later disease. Arch Gen Psychiatry 2006;63:305-312.
  • Children with pediatric immunodeficiency disorders have an increased likelihood of having behavioral and emotional problems.
    Children with     pediatric immunodeficiency disorders were noted to have poorer social skills, lower leadership skills, and an increased number of school days missed, the results indicate. Those children requiring special education reported increased stress in their personal relationships, difficulty relating to others, and low self-esteem. Compared to children with asthma, children with pediatric immunodeficiency disorders took significantly more routine medications, had more physician visits in the last year, and had significantly more hospitalizations in the previous year. Children with greater pediatric immunodeficiency disorders severity tend to have poorer psychosocial outcomes. Ann Allergy Asthma Immunol 2006;96:298-303,260-262.
  • Researchers have identified a neuropeptide called orexin A that seems to sensitize the brain to cocaine and may facilitate addiction to the drug. Orexins are produced by neurons in the lateral hypothalamus and are known to induce appetitive, feeding, and arousal behaviors. Thus far, two orexins have been discovered, orexin A and B, both of which act through G protein-coupled receptors. Previous reports have shown that orexin A-containing neurons project into an area of the brain that has been linked to addictive behaviors. Still, the role, if any, this peptide plays in the neural plasticity that may underlie drug addiction has been unclear. Orexin receptors may provide novel pharmacotherapeutic targets for motivational disorders such as addiction. Neuron 2006;49:589-601.
  • In patients with Alzheimer's disease (AD), a lifetime history of major depressive disorder is associated with increases in neuritic plaques and neurofibrillary tangles in the hippocampus. Neuropathological assessment of the brains showed that a history of MDD was associated with higher rates of neurofibrillary tangles and neuritic plaque in the hippocampus. Those who were depressed at the baseline exam had an even more pronounced neuropathology. People with depression have decreased levels of serotonin in the brain, which may shift the development of plaques and tangles in an unfavorable manner. Another possibility is that "depression is a risk factor for occurrence and maintenance of cardiovascular diseases," which may in turn increase the risk for AD. It's important to bear in mind that people with AD may have comorbid depression, and clinicians should not to label it as 'if I had cognitive problems like that I would be depressed also'. Arch Gen Psychiatry 2006;63:161-167.

  • Repetitive transcranial magnetic stimulation (rTMS) may be an effective and safe long-term maintenance therapy for some patients with major depressive disorder. There is growing evidence to support the short-term antidepressant effects of rTMS. Of the 10 subjects, five experienced marked benefit from rTMS therapy. These patients underwent a mean of 257 rTMS sessions at a session frequency of 2.1 per week. Three of the patients did not require any concurrent antidepressant medication. An additional two patients experienced moderate benefit. The investigators point out that the patients who responded most strongly to acute treatment tended to benefit most from maintenance rTMS, but more research is needed to identify patients who are likely be helped by the modality in the long term.
    J Clin Psychiatry 2005;66:1524-1528.

  • Fish oil supplements may be safer than eating fish, at least from the standpoint of toxic impurities...fish contain environmental toxins such as mercury, polychlorinated biphenyls, and organochlorine [OC] pesticides, which may negate the beneficial cardiovascular effects of fish meals...Fish oil supplements...provide the benefits of omega-3 fatty acids without the risk of toxicity. In addition, fish oil supplements have been helpful in a variety of diseases, including bipolar disorder and depression. .. PCBs produced in the U.S. before 1976, 1.2 billion pounds entered rivers, lakes, and oceans, where they accumulate in bottom-feeding fish and become more concentrated higher up on the food chain...Similarly, OC pesticides entered the air, water, and soil when they were sprayed on crops and forests and concentrate more than 1,000-fold in fish and marine mammals. These pesticides, including DDT, were banned in 1973 because of their neurotoxic properties. Although consumption of 200 to 400 g of oily fish each week has been recommended to protect against cardiovascular disease, regular fish intake presents potential problems, particularly in children and pregnant women...compared with fish oil supplementation, regular consumption of fish from the Great Lakes would expose humans to at least 70 times more PCBs and 120 times more OC pesticides. Arch Pathol Lab Med. 2005;129:74-77

  • Up to 20% of adolescents on psychiatric units have bipolar disorder, much higher than previous estimates. Most community studies have suggested that the prevalence of bipolar disorder among adolescents is just 1%, new research, however, suggests a rate of closer to 20%. The diagnosis of juvenile bipolar disorder is quite controversial because irritability is a component of the diagnosis and yet it is also a common feature of normal adolescence. Making the diagnosis is important to avoid giving teens with bipolar disorder antidepressants and to prevent the overtreatment of teens lacking the disease. J Child Adolesc Psychopharm 2005;15:918-930.

  • Patients being treated for depression hope for positive mental health and a return to normal functioning rather than solely a relief from symptoms. Among the 16 factors rated by the patients, the three most frequently judged to be very important in determining remission included the presence of features of positive mental health such as optimism and self-confidence; a return to one's usual, normal self; and a return to usual level of functioning....study suggests that depressed patients consider symptom resolution as only one factor in determining the state of remission...the investigators conclude. "In addition, patients indicated that the presence of positive features of mental health such as optimism, vigor, and self-confidence was a better indicator of remission than the absence of the symptoms of depression. Am J Psychiatry 2006;163:148-150.

  • Impairments in neurodevelopment caused by obstetric complications may be involved in the pathogenesis of anorexia nervosa and bulimia nervosa.  Idependent risk factors that predicted anorexia nervosa included maternal anemia, diabetes, preeclampsia, placental infarction, neonatal cardiac problems and hyporeactivity Anemia, diabetes and preeclampsia may cause insufficient supply of oxygen and nutrients to the central nervous system. Placental infarction and cardiac problems can cause acute hypoxia-ischemia that results in brain damage. For bulimia nervosa, independent risk factors included placental infarctions, hyporeactivity, low birth weight for gestational age and early feeding problems. Retarded fetal growth indicates a metabolic impairment due to malnutrition during a critical period of development, ultimately influencing appetite programming or the regulation of body weight.Arch Gen Psychiatry 2006;63:82-88.