Pot Ups Risk for Mental Illness

(HealthDay News) -- Smoking marijuana can raise your risk of developing a psychotic illness by 40 percent, British researchers say.

Marijuana is the most commonly used illegal substance in most countries, including the United States. In fact, some 20 percent of young people report using it at least once a week or more, according to the article in the July 28 issue of The Lancet.

"People who used cannabis had a greater risk of developing psychotic outcome then people who didn't use cannabis," said study author Stanley Zammit, a clinical lecturer in psychiatric epidemiology at Cardiff University.

In the study, Zammit's group analyzed 35 studies that looked at whether marijuana was linked to mental health disorders.

They found that people who had used marijuana were 41 percent more likely to have a psychosis compared with people who had never used the drug. They also found that the risk increased as the amount of marijuana used and the length of time someone used the drug increased.

Those who smoked the most marijuana had a twofold to threefold increase in the risk of developing a psychotic problem, Zammit said.

Part of the explanation for this effect is that people who use marijuana are at higher risk for mental problems even without the drug, Zammit explained. "Nevertheless, even when these factors were adjusted for, there still remained an association between marijuana and psychosis, which suggests that there is a causal relationship there," he added.

Recent estimates are that 40 percent of young adults and adolescents have used marijuana at some time in their lives, the researchers noted.

"People who are thinking about using cannabis or are already using cannabis need to be made aware of this risk," Zammit said. "People who experience any problems when using cannabis -- say if they become anxious or paranoid when they use cannabis -- those are warning signs, and people should be aware that they ought to be considering either stopping use or cutting down how often they use or the amount of cannabis they use."

One expert believes the link between marijuana and the risk for psychosis is real, and needs to be viewed as a problem much like tobacco and its health risks.

"This seems to be the best of studies conducted so far, and although this issue could never be proven directly, due to ethical limitations of a prospective exposure study, it provides a solid evidence that smoking cannabis increases risk for the development of psychosis later in life," said Dr. Adam Bisaga, an associate professor of clinical psychiatry in the Department of Psychiatry, Division on Substance Abuse, at Columbia University College of Physicians and Surgeons, in New York City.

The study should change the view of risks involved in smoking cannabis, which until now has been considered by many to be a relatively benign substance, with low addiction potential and few long-term risks, Bisaga said.

"We should change our approach and screen for cannabis use in the primary-care setting, counsel those who use it about increased risk of developing a potentially devastating psychotic illness and recommend stopping smoking," Bisaga said. "For those that are not able to stop using because of cannabis addiction, we should refer them to treatment."

Cannabis addiction can be effectively treated, which may reduce the risk of psychosis, Bisaga said.

"It appears that we are repeating the process we went through with tobacco use, initially considered to be benign, but as long-term risks were recognized, societal attitudes have changed, effective prevention strategies and treatments were developed, and rates of use and associated risks have diminished," he said. "We should now think about adopting some of these strategies to help cannabis smokers."

More information
To learn more about drug addiction, try the U.S. National Institute on Drug Abuse.

Brain Chemical Could Help Beat Back Despair

(HealthDay News) -- A natural brain protein may make people less susceptible to depression and other emotional disorders, a new study suggests.

Previous research on mice has shown that a brain protein called deltaFosB increases in response to stress.

The current study, which was expected to be published in the July 19 issue of Neuron, used mice to explore the role of deltaFosB in coping with stress.

In the study, a team led by Eric Nestler, of the University of Texas Southwestern Medical Center at Dallas, exposed mice to random shocks from which the animals could not escape. Then they measured the lag time for the mice to escape subsequent shocks when they were given the chance to do so. This lag time represents the animals' level of "behavioral despair."

This experimental approach is often used to model human emotional disorders, including depression, post-traumatic stress disorder (PTSD) and bipolar disorder. Like humans with such disorders, behavioral despair in mice responds to antidepressants.

The mice with the shortest lag time (i.e., the least despair) also had higher levels of deltaFosB in a brain region involved in processing of pain signals and defense responses. The animals with longer escape times or failure to escape, however, showed lower deltaFosB levels.

The researchers also found that introducing higher levels of the gene for deltaFosB into the mice reduced the animals' level of despair.

Furthermore, increased levels of deltaFosB were associated with decreased activity of the gene for a protein called substance P, which is known to regulate mood, pain sensitivity, anxiety and stress.

The researchers hope that their future research will test the theory that antidepressants may enhance resiliency to stress by improving a person's ability to cope with chronic stress.

More information
The American Academy of Family Physicians has more about antidepressants.

Fertility Technique Common, Despite Doubts

(HealthDay News) -- The use of a fertility technique called intracytoplasmic sperm injection, which involves injecting a sperm directly into an egg, has increased dramatically in the United States since 1995, despite uncertainty about its effectiveness and risks, researchers say.

A study published in the July 19 issue of the New England Journal of Medicine analyzed data on fertility treatments from 1995 to 2004. The study included all in vitro fertilization (IVF) cycles involving fresh embryos from non-donor eggs in women younger than 43.

The team found that while the proportion of patients receiving treatment for male factor infertility has remained stable, the percentage of IVF cycles that used intracytoplasmic sperm injection (ICSI) increased from 11 percent to 57.5 percent during the 10-year time span.

"Despite its added cost and uncertain efficacy and risk, the use of ICSI has been extended to include patients without documented male-factor infertility," the study's lead author Dr. Tarun Jain, assistant professor of reproductive endocrinology and infertility at the University of Illinois at Chicago, said in a prepared statement.

When compared to states without mandated insurance coverage, states with mandated coverage for infertility (Illinois, Massachusetts and Rhode Island), had higher rates of ICSI for reasons other than male-factor infertility.

Jain said some physicians may feel ICSI is appropriate for patients who had prior IVF cycles that failed, for those who have very few eggs available, or to overcome barriers to the normal fertilization process.

But, according to Jain, the largest study to compare traditional IVF with ICSI in patients without male-factor infertility found that patients who underwent ICSI had lower rates of embryo implantation and pregnancy than patients who did not have ICSI.

There is also limited research evaluating the routine use of ICSI and the possibility of associated risks, such as genetic disorders and congenital abnormalities in babies conceived with this technology.

"Further studies are needed to better understand the proper role of ICSI, and perhaps guidelines may be useful to determine what the best indications are for the use of the technology in patients without male-factor infertility," Jain said.

In addition to their findings on ICSI, the researchers found that the number of fertility clinics and number of fresh-embryo cycles has increased, as have pregnancy and live-birth rates.

More information
There's more on ICSI at Cornell University.

Traffic Pollution Could Raise Heart Risks

(HealthDay News) -- People who regularly breathe in fumes from heavy traffic are more likely to get the hardening of the arteries that boosts heart attack risk, a German study finds.

"It's not limited to freeways," said lead researcher Barbara Hoffmann, head of the unit of environmental epidemiology at the University of Duisburg-Essen. "We see it in inner-city dwellings on heavily traveled streets as well."

Her team published the findings in the July 17 issue of Circulation.

The damage to the arteries seen in such people is similar to that produced by inhaling secondhand tobacco smoke, "although the effect we see here in this study is even larger than that caused by secondhand smoke," Hoffmann said.

Most of the blood vessel damage is due to high levels of particulate pollutants in vehicle exhaust fumes, Hoffmann speculated, although there might be other contributing factors, such as the constant noise of heavy traffic "which can contribute to high blood pressure."

The journal report is based on data from a continuing study done in three cities in the industrialized Ruhr area of Germany. Hoffmann and her colleagues got the home addresses of almost 4,500 adults to determine the distance of their living quarters from heavy traffic. They were also assessed for cardiovascular risk factors such as diabetes and smoking.

A technology called electron-beam automated tomography was then used to measure the degree of vessel calcification -- the buildup of calcium deposits that cause arteries to harden and become more vulnerable to blockages.

The amount of calcification was found to be related directly to the distance of living quarters from heavy traffic. Compared to participants living more than 200 meters (642 feet) from heavy traffic, calcification was 63 percent higher for those living less than 50 meters (160 feet) from heavy traffic, 34 percent higher for those whose distance was 51 to 100 meters (164 to 328 feet) and 8 percent higher for those whose distance was 100 to 200 meters (328 to 642 feet).

This is the first study to show such a relationship between traffic-based air pollution and damage to the arteries, Hoffmann said. The participants will be followed to see whether the traffic-related damage worsens and whether it is associated with a higher incidence of heart attack and other cardiovascular problems.

"The follow-up data will be important to have," said Dr. Sidney Smith, professor of medicine at the University of North Carolina and a former president of the American Heart Association.

Smith was a member of a committee of experts assembled by the association in 2004 to review the literature on air pollution and cardiovascular disease. Among the committee's recommendations was that people at high risk of cardiovascular disease limit outdoor activities when air pollution is high.

However, Smith said, "this current study is incomplete, because it just looks at calcification." He added, "The follow-up, which will look at the incidence of [cardiovascular] events, will provide important information."

The only immediate protective action that can be taken by people living close to heavy traffic is increased attention to known cardiac risk factors, such as obesity and high blood pressure, Hoffmann said. Over the longer run, community action is needed, she and Smith agreed.

For example, "When they build roads, communities should consider the location of residential buildings and schools," Hoffmann said.

"There is increased concern about environmental pollutants worldwide, and I don't think we should neglect opportunities to reduce this as a global risk factor," Smith said. "Communities need to look at how to reduce ambient pollution levels."

More information
There is more on air pollution at the U.S. National Library of Medicine.

Meditation Won't Boost Health: Study

(HealthDay News) -- There's no evidence that meditation eases health problems, according to an exhaustive review of the accumulated data by Canadian researchers.

"There is an enormous amount of interest in using meditation as a form of therapy to cope with a variety of modern-day health problems, especially hypertension, stress and chronic pain, but the majority of evidence that seems to support this notion is anecdotal, or it comes from poor quality studies," concluded researchers Maria Ospina and Kenneth Bond of the University of Alberta/Capital Health Evidence-based Practice Centre, in Edmonton.

They analyzed 813 studies focused on the impact of meditation on various conditions, including high blood pressure, cardiovascular disease and substance abuse.

Released Monday, the report looked at studies on five types of meditation practices: mantra meditation; mindfulness meditation; yoga, Tai Chi and Qi Gong.

Some of the studies suggested that certain types of meditation could help reduce blood pressure and stress and that yoga and other practices increased verbal creativity and reduced heart rate, blood pressure and cholesterol in healthy people.

However, the report authors said it isn't possible to draw any firm conclusions about the effects of meditation on health, because the existing studies are characterized by poor methodologies and other problems.

"Future research on meditation practices must be more rigorous in the design and execution of studies and in the analysis and reporting of results," Ospina said in a prepared statement.

Bond added that the new report doesn't prove that meditation has no therapeutic value, but it can inform medical practitioners that the "evidence is inconclusive regarding its effectiveness."

For the general public, the report "highlights that choosing to practice a particular meditation technique continues to rely solely on individual experiences and personal preferences, until more conclusive scientific evidence is produced," Ospina said.

The study was funded by the U.S. National Center for Complementary and Alternative Medicine in Bethesda, Md., part of the National Institutes of Health.

More information
The U.S. National Center for Complementary and Alternative Medicine has more about meditation for health purposes.

Dementia Gene Mutation Identified

(HealthDay News) -- Researchers have discovered a new gene mutation linked to frontotemporal dementia, a disease that affects language abilities and socially appropriate behavior in the people who have it.

Frontotemporal dementia is the second most common form of dementia after Alzheimer's disease.

After a decade of work on the question, researchers at the Regional Neurogenetic Centre in Lamezia Terme, Italy, and the Centre for Research in Neurodegenerative Diseases at the University of Toronto identified the mutation in a gene named progranulin by studying the genealogy of 15 generations of an extended Italian family. Thirty-six members of the family have had frontotemporal dementia. Researchers conducted DNA tests on 70 family members, including 13 with the disease.

The mutation is in a gene on chromosome 17, which leads to a loss of progranulin, a protein growth factor that helps brain cells survive. The mutation limits production of the protein to half the normal amount, because only one copy of the gene is active. While reduced production of progranulin is related to dementia, an excess has been tied to cancer.

The researchers reported finding the mutation in nine of the family members with the disease and in 10 people who were too young to have the disease. They noted that four people who have the disease did not have the mutation, but were descendants of a line of the family in which three generations had frontotemporal dementia, indicating a second possible genetic link.

They also noted that the age at which people with the mutation began to see symptoms of frontotemporal dementia varied between 35 and 78 years old.

The findings are published in the July 10 issue of Neurology.

More information
To learn about frontotemporal dementia, visit the National Institute of Neurological Disorders and Stroke.

Suicide Attempts Fall After Depression Treatment Begins

(HealthDay News) -- Suicide attempts dropped among people with depression soon after they started treatment, either with antidepressant drugs or psychotherapy, a study of more than 109,000 patients shows.

The study results come after a controversial 2004 recommendation on antidepressant labeling from the U.S. Food and Drug Administration (FDA). That move slapped a strong "black box" warning on the labeling of drugs called selective serotonin reuptake inhibitors (SSRIs), which include Celexa, Paxil, Prozac and Zoloft.

The warning outlined the potential for an increase in suicidal thoughts among teenagers and young adults prescribed the medications. The warning also urged closer clinical monitoring of these patients.

However, "the FDA warning was based on placebo-controlled trials," noted lead researcher Dr. Greg Simon, a psychiatrist and researcher at Group Health, a Seattle-based nonprofit health care system. "They did not look at suicide attempts, because they were too rare. In the whole group of studies the FDA looked at, there were only two suicide attempts," Simon said.

The current trial, published in the July issue of the American Journal of Psychiatry, does focus on suicide attempts. It finds that pharmaceutical and psychotherapy treatments aimed at fighting depression reduce those attempts.

Simon's study looked at suicide attempts among more than 70,000 people who got an antidepressant prescription from their primary care physicians, almost 7,300 people who got prescriptions from a psychiatrist and more than 54,000 who started psychotherapy for the treatment of depression.

"The pattern of [suicide] attempts over time was the same in all three groups: highest in the month before starting treatment, next highest in the month after starting treatment, and declining thereafter," the report said. "Results were unchanged after eliminating patients receiving overlapping treatment with medication and psychotherapy. Overall incidence of suicide attempts was higher in adolescents and young adults, but the time pattern was the same across all three treatments," the study authors found.

The overall incidence of suicide attempts in the first six months was highest in those taking antidepressant drugs prescribed by a psychiatrist (1,124 attempts per 100,000), lower among those starting psychotherapy (778 per 100,000) and lowest of all among those who were taking antidepressants prescribed by a general practitioner (301 per 100,000).

The bottom line: "Our study indicates there is nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves or protect them from suicidal thoughts," Simon said.

"Instead, we think that on average, starting any kind of treatment medication, psychotherapy or both, helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it," he said.

The new report "is one of a couple showing that prescribing antidepressant medication for people who are depressed has the potential for reducing the number of suicide attempts," said Dr. J. John Mann, chief of the department of neuroscience at the New York Psychiatric Institute, New York City.

Mann co-authored one such report, which relied on U.S. Veterans Administration data. "We found exactly the same thing" as the Simon report, Mann said. "Antidepressant treatment resulted in lower rates of suicide attempts after people went on to treatment."

Such studies "suggest that these medications may be more beneficial than has been thought in the past," Mann said. "If there is a risk in these medications, it clearly is outweighed by the benefits. No treatment is the worst option of all."

Simon also pointed out that the FDA warning reduced use of SSRI drugs for treatment of depression, but it has not appeared to increase doctors' monitoring of young people who are taking the drugs. The standing recommendation for three follow-up visits to the therapist prescribing antidepressant drugs was observed in only 21 percent of cases, the researcher said.

"That is where we are poor in practice," Simon said. "My concern is that the practical impact of the warning was [only in] reduced rates of treatment."

More information
There is more on suicide prevention at the U.S. National Institute of Mental Health.