Binge Drinkers May Risk Mood Disorders as Adults

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on November 16, 2010

PRESS ASSOCIATION Photo.
PRESS ASSOCIATION Photo.

A new study on rats suggests binge-drinking teenagers may be putting themselves at higher risk in adulthood for common mental disorders such as anxiety and depression.

Loyola University (Chicago) Health System researchers found that exposing adolescent rats to binge amounts of alcohol permanently altered the system that produces hormones in response to stress.

This disruption in stress hormones “might lead to behavioral and/or mood disorders in adulthood,” researchers reported.

Senior author Toni Pak, Ph.D., and colleagues reported their findings at the annual meeting of the Society for Neuroscience in San Diego.

While results from animal studies don’t directly translate to people, the findings do suggest a mechanism by which teenage binge drinking could cause mental health problems in adulthood, Pak said.

“Exposing young people to alcohol could permanently disrupt normal connections in the brain that need to be made to ensure healthy adult brain function,” Pak said.

Binge drinking is defined as a woman having at least four drinks or a man having at least five drinks on one occasion. Heavy binge drinkers can consume 10 to 15 drinks. Binge drinking typically begins around age 13 and peaks between 18 and 22, before gradually decreasing.

Thirty-six percent of youths ages 18 to 20 reported at least one binge-drinking episode during the past 30 days, according to the federal Substance Abuse and Mental Health Services Administration.

The Loyola study examined the long-term effects of alcohol on the production of the stress hormone corticosterone in rats. The equivalent stress hormone in humans is cortisol.

Humans and rats produce stress hormones in response to physical or psychological stress. For example, in a “fight-or-flight” situation, a jolt of cortisol provides a burst of energy and a lower sensitivity to pain, while suppressing functions that aren’t immediately needed, such as digestion.

However, chronic exposure to cortisol and other stress hormones has been linked to depression, cardiovascular disease and other problems.

In the study, researchers exposed adolescent rats to an 8-day binge drinking pattern: three days of alcohol binging, two days off, then three more days of binging.

On binge days, rats were injected with enough alcohol to raise their blood alcohol concentration to between 0.15 percent and 0.2 percent. (In humans such concentrations would be roughly 2 to 2.5 times higher than the 0.08 legal limit for driving.) A control group of rats received injections of saline.

One month later, when the rats were young adults, they were exposed to one of three regimens: saline injections, a one-time alcohol injection or a binge-pattern of alcohol exposure. Alcohol is a form of stress, so not surprisingly, the animals that had either a one-time or binge alcohol exposure produced more of the corticosterone stress hormone.

A more significant finding is that among rats that had received alcohol during adolescence, there was a significantly larger spike in corticosterone when they received alcohol during adulthood. These rats also had a lower base level of corticosterone than rats that had remained sober during adolescence.

These findings suggest that alcohol exposure during puberty permanently alters the system by which the brain triggers the body to produce stress hormones.

Source: Loyola University Health System

Alcohol Damages Much More Than The Liver

alcohol.jpg
alcohol.jpg

Alcohol does much more harm to the body than just damaging the liver. Drinking also can weaken the immune system, slow healing, impair bone formation, increase the risk of HIV transmission and hinder recovery from burns, trauma, bleeding and surgery.

Researchers will release the latest findings on such negative effects of alcohol during a meeting Nov. 19 of the Alcohol and Immunology Research Interest Group at Loyola University Medical Center.

At Loyola, about 50 faculty members, technicians, post-doctoral fellows and students are conducting alcohol research. Studies at Loyola and other centers could lead to therapies to boost the immune system or otherwise minimize the effects of alcohol, said Elizabeth J. Kovacs, PhD, director of Loyola’s Alcohol Research Program and associate director of Loyola’s Burn & Shock Trauma Institute.

“Of course, the best way to prevent the damaging effects of alcohol is to not drink in the first place,” Kovacs said. “But it is very difficult to get people to do this.”

Sessions at the conference include Alcohol and Infection, Alcohol and Oxidative Stress and Alcohol and Organ Inflammation. Findings will be presented by researchers from centers around the country, including Loyola, Cleveland Clinic, University of Iowa, University of Colorado, University of Massachusetts, Mississippi State University, Chicago State University and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The conference is supported by Loyola’s Alcohol Research Program and Department of Surgery at Loyola University Chicago Stritch School of Medicine, the Society for Leukocyte Biology and the NIAAA

Technorati Tags: ,,

Brain Scan Can Predict Therapy Response for Anxious Kids

By RICK NAUERT PHD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on November 15, 2010


Experts say a brain scan can predict which kids with anxiety disorders will respond to one form of psychotherapy. As a consequence, Georgetown University neuroscientists say the use of psychiatric medication is not necessary for certain children.

Their study, presented at the annual meeting of the Society for Neuroscience in San Diego, utilized functional Magentic Resonance Imaging (fMRI) to map regions of brain activity. The results showed that children and adolescents, ages 8 to 16, who show fear when looking at happy faces on a screen were those who had least success with an eight-week course of cognitive-behavioral therapy.

Conversely, children who showed fear while looking at fearful faces benefitted from the treatment, the researchers found.

“Anxiety and fear are intrinsically linked, so how the brain’s fear center responds would naturally affect how anxiety disorders manifest,” said the study’s lead author, Steve Rich, a fourth year medical student.

“Indeed, the impact on their responses to therapy was impressive,” he said.

“Past studies have shown that many people react to fearful faces with fear themselves, but our most robust finding indicated that some anxiety disorder patients have more anxiety towards happy faces than fearful ones, and those patients were the least likely to respond to cognitive-behavioral therapy.”

The study enrolled 13 boys and 10 girls in this study, all of whom had been diagnosed with pediatric anxiety disorder.

While inside the fMRI machine, the participants were shown pictures of faces that expressed certain emotions strongly.

“The questions we were trying to answer were: What emotions make people afraid when they witness them on others’ faces, and does that pattern predict response to talk therapy,” Rich says.

An fMRI records changes in blood flow in the brain, thus showing levels of activity. In this study, the researchers zeroed in on the amygdala, a brain structure involved in fear responses. 

They then correlated the differing responses they saw in the amygdala with outcomes from an eight-week course in cognitive-behavioral therapy.

The researchers found a significant correlation, indicating that pre-treatment fMRI can be used to select patients who likely do well with psychotherapy alone, and those that may require other therapy, such as medication.

Rich said that one explanation for the results is that those patients who have greater anxiety towards happy faces than towards fearful ones have a subtly different disorder, one that is very similar but cannot be treated by cognitive-behavioral therapy.

“In this subset of patients, that support may actually elicit even more anxiety, thus alienating them from the therapist,” he said.

“Further study is required to determine whether this is indeed a unique disease subtype, or whether a modified approach to cognitive-behavioral therapy that requires the therapist to stay completely neutral could make therapy more effective for these patients.”

Rich and his co-authors do not expect that every pediatric anxiety disorder patient should receive an fMRI diagnosis.

“fMRI is expensive, and this study does not by any means suggest that it should be used as a universal screening tool,” he said.

“Even so, once the field develops further, our results suggest that neuroimaging studies like fMRI may be able to help us understand why a given patient might not be responding to the first-line treatment. In other words, when routine care is not enough, we can focus on the nuances of the individual.”

Source: Georgetown University Medical Center

After the Battle: 7 Health Problems Facing Veterans: Psychological, Psychosocial and Physical

By Maureen Salamon, MyHealthNewsDaily Contributor

disabled-veterans-01.jpg
disabled-veterans-01.jpg

The wounds of war can go far beyond what meets the eye. From mental health issues to pain and illness that persist long after they’ve left the battlefield, veterans face a multitude of health troubles either unique to their service or more frequent among them than the general population.

“Folks returning from combat have a constellation of health concerns, including physical issues, psychological issues and psychosocial issues concerning things like work and family,” said Dr. Stephen Hunt, national director of the U.S. Department of Veterans Affairs Post Deployment Integrative Care Initiative.

“This is a population that has unique health care needs that need to be addressed,” added Hunt, who is based in Seattle. “It’s something that really needs to be done by a team. We can’t do it without the collaboration of other providers, and the knowledge and presence of the community.”

Some of the most common physical complaints of returning soldiers cannot be classified into a single disorder, Hunt said. They include nonspecific symptoms such as fatigue, pain and cognitive disturbances such as memory and concentration problems.

“The interesting thing is, we see this after all wars,” he said. “We think it’s a reflection of the duress and intensity of the situation. They’re worn out, hurting and it’s kind of hard to think straight.”

Here are seven health conditions confronting veterans:

Musculoskeletal injuries and pain

Just over half of all veterans’ post-deployment health visits address lingering pain in their backs, necks, knees or shoulders, Hunt said. And according to an August study in the Journal of Pain, about 100,000 veterans of the Gulf War nearly 20 years ago have reported chronic muscle pain. Previous research indicated that regular, sustained exercise can help reduce that pain, which doctors encourage to help avoid disability.

Mental health issues

While post-traumatic stress disorder (PTSD) among soldiers has been well publicized, other mental woes can also result from the trauma of war. A June study in the journal Archives of General Psychiatry found that one in 10 Iraq war vets develop serious mental problems, including violent behavior, depression and alcohol abuse. The study found that PTSD or depression seriously impaired daily functioning in 8.5 percent to 14 percent of these vets.

Disabling on its own, PTSD is also linked to the development of physical illnesses for veterans as years pass. Researchers from Walter Reed Army Medical Center in Washington, D.C., reported this year that 54 percent of veterans with PTSD also had sleep apnea, compared with 20 percent of PTSD patients in the general population. PTSD in vets is also associated with a greater risk of developing dementia, according to a June study in Archives of General Psychiatry.

Chemical exposure

Research by the American Heart Association found that exposure to nerve agents such as sarin— which can trigger convulsions and death on the battlefield— may cause long-term heart damage in Gulf War veterans. The damage can include an enlarged left ventricle, heart rhythm abnormalities or a reduction in the pumping strength of the heart.

“Environmental agents and toxic chemicals are very common in combat theaters,” Hunt said, “and we need to watch [these vets] closely.”

Infectious diseases

As a rule, all military personnel are given routine vaccinations before deployment. Yet veterans suffer disproportionately from certain infections that civilians almost never experience for which vaccines are not available, according to the U.S. Department of Veterans Affairs. They include bacterial infections such as brucellosis, which may persist for years; campylobacter jejuni, which causes abdominal pain, fever and diarrhea; and Coxiella burnetii, which in chronic cases can inflame the heart.

Leishmaniasis, a parasitic disease caused by the bite of a sand fly native to the Middle East, is a particularly brutal condition veterans experience. Those infected suffer weight loss, fevers, headaches, muscle pain and weakness, anemia, and enlargement of the spleen and liver. It can be fatal if untreated, according to the VA.

Noise and vibration exposure

Hearing loss and impairment — including persistent ringing and buzzing in the ears — are common effects of harmful noise from gunfire, heavy weapons, noisy engine rooms and aircraft, Hunt said. Additionally, vets who regularly worked with machinery can suffer vibration exposure, which can prompt irreversible lower back pain or numbness and pain in the hands and fingers, according to the VA.

Traumatic Brain Injury (TBI)

TBI, often brought on by a blow or jolt to the head, disrupts brain function and has been called the signature wound of the fighting in Iraq and Afghanistan, according to the National Academy of Sciences. Blast exposures and other combat-related activities put service members at greater risk for sustaining a TBI compared to their civilian counterparts, according to the Defense and Veterans Brain Injury Center.

Common effects of TBIs include cognitive issues such as shorter attention span, language disabilities, and an inability to process information. Vets can also suffer from lack of motivation, irritability, anxiety and depression, headaches, memory loss and PTSD.

“Between 70 and 80 percent of combat deaths are from blast-related exposure,” Hunt said, “and of survivors, 20 percent report that they may have had an event that resulted in a mild concussion. Whether there will be any long-term effects is difficult to ascertain.”

Urologic injuries

Penetrating injuries to the groin area during battle are often treated only after life-threatening injuries have been dealt with, said Dr. Arthur Smith, a Medical College of Georgia urologist who spoke at the Warrior Health Symposium last month. Injuries to the bladder, ureters, kidneys and genitalia usually require complex surgery, Smith said, but complications often arise because treatment must be put off.

This article was provided by MyHealthNewsDaily, a sister site to LiveScience.

Screening Test Validated For Depression In Adolescents

Primary-care clinicians know teen depression is common, but they’ve lacked a reliable screening test for it. Now researchers at the University of Washington (UW), Seattle Children’s, and Group Health report the PHQ-9 (Patient Health Questionnaire – 9 item) is a good screening test for major depression in adolescents.

Led by Laura P. Richardson, MD, MPH, the team tested the PHQ-9 as a screening tool for depression in 442 teenage patients, age 13-17, at Group Health. The test is brief, available free of charge, easy to score and understand, and proven to find major depression (meeting DSM-IV criteria) in adults. This study, the first to assess it in teens, is in the November 2010 Pediatrics.

“This is important not only because depression is relatively common among adolescents, but also because we have effective treatment for them,” said Dr. Richardson. She is an associate professor of pediatrics at the UW, an adolescent medicine specialist at Seattle Children’s, and an affiliate investigator at Group Health Research Institute. “Primary care clinicians are advised to screen teens for depression,” she said, “and they need a convenient tool like this.”

The team compared the PHQ-9 to the more labor-intensive gold standard, an independent structured mental health interview (the Child Diagnostic Interview Schedule, DISC-IV)-and to published data on use of the screening test in adults. They found the best cut point for maximizing the PHQ-9 screening test’s sensitivity without losing specificity (11) is higher among teens than in adults. But its sensitivity (89.5%) and specificity (77.5%) in teens are similar to those in adults. So the team concluded that the PHQ-9 is an excellent choice for providers and researchers who want to screen for depression in teens in primary care.

Source:
Rebecca Hughes
Group Health Research Institute