Journal Digest

Vision Loss Leads to Depression

Researchers at the National Institutes of Health said that self-reported loss of visual function was associated with depression in a study whose data came from a national survey of U.S. adults. The study analyzed data from the National Health and Nutrition Examination Survey (NHANES 2005-2008) and included 10,480 adults aged 20 or older. The estimated prevalence of depression was 11.3 percent among adults with self-reported visual function loss and 4.8 percent among adults without. The estimated prevalence of depression was 10.7 percent among adults with presenting visual acuity impairment compared with 6.8 percent among adults with normal visual acuity.

After controlling for age, sex, and general health status, self-reported visual function loss remained significantly associated with depression, whereas the association between presenting visual acuity impairment and depression was no longer statistically significant, according to the results.

“This study provides further evidence from a national sample to generalize the relationship between depression and vision loss to adults across the age spectrum. Better recognition of depression among people reporting reduced ability to perform routine activities of daily living due to vision loss is warranted,” the researchers said.

The study was supported by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC).

Black, Asian Women Most Affected by PTSD After Cancer Diagnosis

mangostock/Shutterstock.com

Nearly one-fourth of women newly diagnosed with breast cancer report symptoms consistent with posttraumatic stress disorder (PTSD), with increased risk among black and Asian women. Researchers at Columbia University recruited women with newly diagnosed nonmetastatic breast cancer from three U.S. sites. Telephone interviews were conducted within two to three months after diagnosis, and again at four and six months after diagnosis. Traumatic stress was measured in each interview using the Impact of Event Scale.

Of 1,139 participants, 23 percent reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5 percent at the first follow-up, and 12.6 percent at the second follow-up. Persistent PTSD, defined as having PTSD at two consecutive interviews, was observed among 12.1 percent of participants. Younger age at diagnosis and being black or Asian had a stronger association with PTSD.

The researchers hoped that their findings would foster identification of potential risk factors for PTSD at the time of diagnosis and present an opportunity to provide early prevention and intervention to minimize PTSD symptomatology. “This approach may improve the quality of patients’ lives and may also have an indirect impact on the observed racial disparity in breast cancer survival,” they wrote.

The study was supported by the Department of Defense, the National Cancer Institute, and the Environmental Health Foundation.

Study Links Firearm Laws With Fewer Fatalities

Researchers from Boston Children’s Hospital and Harvard Medical School and School of Public Health found that a higher number of firearm-control laws in a state are associated with a lower rate of firearm fatalities, both overall and for suicides and homicides individually. The group retrospectively analyzed all firearm-related deaths reported to the CDC’s Injury Statistics Query and Reporting System from 2007 through 2010.

Their outcome measures were state-level firearm-related fatalities per 100,000 individuals per year overall, for suicide, and for homicide. They controlled for age, sex, race/ethnicity, poverty, unemployment, college education, population density, nonfirearm violence-related deaths, and household firearm ownership.

The researchers said their study could not determine cause-and-effect relationships and that further studies are necessary to define the nature of the association.

Marijuana Exposure May Lead to Nicotine Addiction

Researchers from the National Institute on Drug Abuse have reported that rats previously exposed to tetrahydrocannabinol (THC), the main active ingredient in marijuana, found nicotine more rewarding than did rats not exposed to THC. Although the doses of THC used in the study were high, the researchers said their results suggest that marijuana use may increase the risk for nicotine dependence.

The study was part of a series of studies on “gateway drug” effects in animal models of drug abuse. Rats were exposed to THC, receiving two intraperitoneal injections a day for three days. Beginning one week later, they were allowed to self-administer nicotine intravenously. THC exposure increased the likelihood of acquiring the nicotine self-administration response from 65 percent in rats that did not receive THC, to 94 percent in THC-exposed rats. When the “price” of nicotine was manipulated by increasing the response requirement, THC-exposed rats maintained higher levels of intake than nonexposed rats, indicating that THC exposure increased the value of nicotine reward.

“These results contrast sharply with our earlier findings that prior THC exposure did not increase the likelihood of rats acquiring either heroin or cocaine by self-administration, nor did it increase the reward value of these drugs,” wrote the researchers, who said their findings suggest that a history of cannabis exposure might have lasting effects that increase the risk of becoming addicted to nicotine.

Escitalopram Appears To Reduce Symptoms of Night Eating Disorder

An open-label trial of escitalopram to treat night eating syndrome (NES) showed significant reduction in symptoms, according to researchers at the Perelman School of Medicine at the University of Pennsylvania. Thirty-one adults with NES participated in a 12-week trial in which outcome measures included the Night Eating Symptom Scale, percent of daily intake after the evening meal, number of nocturnal ingestions per week, weight, total awakenings a week, mood, and quality of life. Dosing of escitalopram began at 10 mg, with the dose cut to 5 mg for participants who experienced significant side effects and increased to 20 mg for participants whose symptoms were still present at week 4 of the study.

In addition to results that indicated significant decrease in all primary measures of NES by the end of the 12-week trial, the researchers reported that 58 percent of the participants were in remission at treatment end. The researchers said their results point to the need for a larger controlled trial to further test the efficacy of escitalopram for NES, given that the evidence for effective treatments for NES is still quite limited.

The study was supported by an investigator-initiated grant from Forest Laboratories.