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Written and researched by Bob Murray, PhD
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ADHD Drugs Send Thousands to ERs
Sep 17, 2006
People who have suffered life's hard knocks while growing up tend to be more gullible than those who have been more sheltered, startling new findings from the University of Leicester reveal.
A six-month study in the University's School of Psychology found that rather than 'toughening up' individuals, adverse experiences in childhood and adolescence meant that these people were vulnerable to being mislead. The research analysing results from 60 participants suggest that such people could, for example, be more open to suggestion in police interrogations or to be influenced by the media or advertising campaigns.
The study found that while some people may indeed become more 'hard-nosed' through adversity, the majority become less trusting of their own judgment.
Kim Drake, a doctoral student at the University of Leicester, conducted the research with Professor Ray Bull and Dr Julian Boon of the School of Psychology. Kim said: "People who have experienced an adverse childhood and adolescence are more likely to come to believe information that isn't true--in short they are more suggestible, and easily mislead which may in turn impact upon their future life choices; they might succumb to peer pressure more readily."
'Adverse life experiences' examined included major personal illnesses/injuries, miscarriage (from the male and female perspective), difficulties at work (being fired/laid off), bullying at school, being a victim of crime (robbery, sexual violence), parental divorce, death of family member and others. Seventy percent of the variation across people in suggestibility can be explained by the different levels of negative life events that they have experienced, the study found.
"We also found that the way people cope with adversity had an impact on their psychological profile," said Kim. "The majority of people may learn through repeated exposure to adversity to distrust their own judgment; a person might believe something to be true, but when they, for example, read something in a newspaper that contradicts their opinion, or they talk to someone with a different view-point, that individual is more likely to take on that other person's view.
"This is because the person may have learned to distrust their actions, judgments and decisions due to the fact that the majority of the time their actions have been perceived to invite negative consequences. "Another example is in relationships. Women, as well as men, can become "brainwashed", and end up changing in their personality, their views and beliefs and in some extreme cases, they may even take on their views and ideas of the world and come to feel incompetent (in their partner's eyes)."
Kim added that there is already evidence to suggest that there is a relationship between intensity/frequency of negative life impacts and degree of vulnerability. Experience of adversity may have a knock-on effect on a person's mindset- they may come to believe that "they are no good", or "nothing they do is ever good enough". In contrast, the findings also suggest that early positive life events may have a protective influence over the effects of subsequent adversity: "If positive life events predate the negative life events then individuals may be more resilient in terms of, not being so badly affected, psychologically, by the subsequent adverse events. However, issues may arise if the reverse is the case; if the adverse life events precede the positive, those individuals may become, as a result, more susceptible to suggestion and misleading information.
The study found that the parental role is an important one. Parental education--showing parents functional ways of dealing with their children-leads to children will seeing positive role models, and learning "healthy" skills or ways of dealing with stress/negative life events. What's more this may help cultivate a positive mind-set within the child or adolescent which will stay with them throughout life.
Study not available on the web.
Read more in Raising an Optimistic Child (McGraw-Hill, 2004)
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Our Over-Drugged Children
Nov 1, 2005
For a long time we have been saying that pharmacology has been replacing adequate parenting as the preferred means of raising kids in the US and other Western countries. A new report adds weight to this argument.
Pediatric polypharmacy, the practice of prescribing two or more medications for psychiatric symptoms in children, is on the rise in the United States, raising concern about unknown side effects, according to a new study appearing in the August issue of the journal Psychiatry 2005.
"This is a critical issue -- it's not uncommon to find a child on an anti-depressant, a mood stabilizer, and a sleep agent all at the same time, but there's no research to see how these drugs interact with each other" says co-author Joseph Penn, MD a child psychiatrist with the Bradley Hasbro Children's Research Center (BHCRC) in Providence, RI and Brown Medical School.
The authors of the study reviewed 10 years of scholarly articles pertaining to polypharmacy in pediatric settings, and found that all the studies comparing these rates across time showed an increase in the practice. However, the authors warn there are almost no studies or published research on which to justify prescribing multiple medications for psychiatric disorders in children. Indeed many of the drugs - such as antidepressants - have been shown to be ineffective in people under 18.
According to the study, the most frequent combination were stimulants such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine, Adderall) commonly used to treat ADHD, with another psychotropic medication. And this despite the fact that ADHD is the most mis-diagnosed of all pediatric mental disorders and that Ritalin and other drugs have been shown to lead to long-term adult depression (arguably a much worse disorder than ADHD).
Another contributing factor to the increased risks of prescribing multiple drugs is the prevalence of off-label prescriptions -- the practice of prescribing a medication to children when there is not a FDA approved indication for that disorder in children.
"For example, aytpicals like risperidone are sometimes used to symptomatically treat psychosis or aggression in children, but most of these medications don't have FDA approval for use on psychiatric symptoms in the pediatric age group," says co-author Henrietta Leonard, MD, also a child psychiatrist with the Bradley Hasbro Children's Research Center and Brown Medical School. "We just don't have the efficacy or safety data to back up what is common clinical practice."
Because there are limits to the data available on the efficacy of a single medication in the pediatric age group, the authors express deep concern over the rise in polypharmacy because it could multiply the risk of adverse events. "The FDA recently questioned whether there is a link between the use of antidepressants in children and suicidal thoughts -- if there is so much concern over the effects of a single drug, how much riskier is it to prescribe multiple drugs?" Penn says.
The authors cite examples of a child on two medications for ADHD who died suddenly, and additionally describe serotonin syndrome, a serious and potentially fatal illness that can result when a child receives two medications with serotonergic properties.
In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) has issued a policy statement saying, "Little data exist to support advantageous efficacy for drug combinations, used primarily to treat co-morbid conditions." The authors concur. "We need more systematic studies to establish the safety and efficacy of medications in the pediatric age group," says Penn.
Amen to that!
Our next book Raising an Optimistic Child is to be published by McGraw-Hill in February, 2006 - BM
Read more in the Psychiatry 2005
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Consumer Demand Boosts Antidepressant Prescription
June 6, 2005
When we talk to doctors we're often told that the reason they reach for the prescription pad so often is that their patients' insist on having a pill for whatever is wrong with them. The media--especially advertising on television and in print--has made them enthusiastic consumers of certain medications. This is especially true of antidepressants and drugs for childhood ADHD.
Now researchers funded by the National Institute of Mental Health (NIMH), have found that is indeed the case. According to their study requests from patients for medications have a "profound effect" on physicians prescribing for major depression and adjustment disorder (where a person has abnormal difficulty getting over a major life stressor such as an auto accident). These findings indicate that direct-to-consumer (DTC) marketing of prescription medications for depression may exert significant influence on treatment decisions.
The study appears in the April 27, 2005, issue of the Journal of the American Medical Association.
"The use of direct marketing for treatment of depression may boost familiarity with potential treatments of the disorder," said Thomas R Insel, MD, director of the National Institute of Mental Health. "However, we must ensure that treatment is based on evidence-based science rather than evidence-based marketing."
Critics of direct-to-consumer marketing fear the advertisements lead to over-prescribing. Proponents believe they can serve a useful educational function. This study addresses this issue of over- or under-prescribing. The researchers randomly assigned actors portraying patients with symptoms of major depression or adjustment disorder to make 298 unannounced visits to 152 family physicians and general internists recruited from solo and group practices and health maintenance organizations in California and New York.
Actor-patients were randomly assigned a disorder and a type of medication request based on the assumption that the direct-market approach could encourage patients to seek effective care. They made brand-specific requests for Paxil, saying they learned about the medication from a commercial; or general requests for medication, not a specific brand, saying they viewed a television program about depression which "got them thinking." Actor-patients assigned "none" made no request concerning medications.
Two visits were spread over several months so as to avoid detection by the participating doctors; 13% of the time, the doctors suspected the actor-patient was from the study. Researchers collected results through a review of actor-patient written reports, audiotapes from the visits, medical charts, and written prescriptions or drug samples.
Actor-patients exhibiting major depression who made brand-specific requests (53%) or general requests for medication (76%) were more likely to receive a prescription than those who made no request (31%). Although both brand-specific and general requests significantly increased prescribing in both major depression and other disorders, brand-specific requests had a more pronounced effect on prescribing for adjustment disorder than for major depression.
"Although several small trials suggest that antidepressants may deliver modest benefits to patients with minor depression, there is no evidence to support their use in adjustment disorder, especially when patients describe a clear event as the cause of their depression, and exhibit mild symptoms for only a short period of time," says Dr Richard L Kravitz, lead investigator on the study.
In addition to prescribing practices, the study found that those who made a request for medication were more likely to receive minimally acceptable initial care (any combination of antidepressant, mental health referral, or follow-up visit within two weeks). And physicians were more likely to consider and record a mental health diagnosis (depression 88% compared to 65% and
adjustment disorder 50% compared to 18%) if the actor-patient made a request for medication.
Read more in JAMA
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Alcohol Affects Women Worse
June 6, 2005
Far more research has been done on male problem drinking and often the term alcoholic seems almost gender-specific! However researchers using powerful brain-imaging equipment have now found that women are far more vulnerable to alcohol-induced brain damage than men.
CT pictures of the brains of more than 150 volunteers revealed how women come to more harm and quicker than men when they drink heavily. In fact scientists have suspected for some time that men might be more resilient to booze than women. This German research gives visible evidence of this.
A team at the University of Heidelberg published their findings in Alcoholism.
In the study, around half of the volunteers were alcoholics. All of the volunteers had brain scans at the start and end of the six week study. Those who were alcoholic were helped to "dry out" during the six weeks. When the researchers analyzed the brain scan results they found obvious evidence of brain damage among the heavy drinkers.
Over all the drinkers had smaller brains, due to loss or atrophy, than the control group of non-drinkers. Women who were heavy drinkers lost the same amount of brain volume as the drinking men, but over a much shorter period of alcohol dependence.
Lead author Professor Karl Mann said although men generally drink more alcohol, women are more likely to develop alcohol dependence and suffer adverse consequences more readily. What's more other alcohol-related disorders, such as heart problems, depression and liver disease, also occurred earlier in women than men, he said.
"Women typically start drinking later in life, consume less...and one could reason that women are less affected by alcohol. But there is evidence for a faster progress of the events leading to dependence among female alcoholics and an earlier onset of adverse consequences of alcoholism. This suggests that women may be more vulnerable to chronic alcohol consumption."
For these reasons, he said it was even more important to spot and treat alcohol abuse early in women.
Read more in Alcoholism
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Personal Injury Suits Pose Health Risk
March 1, 2005
New medical research suggests hiring a personal injury lawyer in the event of an accident could be bad for your health. The study demonstrated an inverse relationship between litigation lawyers and the recovery rates of accident victims.
Dr Richard Gun, lead author of the research reported in this week's Medical Observer, has found patients who engage a lawyer after receiving their injury are five times less likely ever to return to work. He says they also appear to suffer more pain and for longer periods than accident victims who do not have lawyers.
"We did find that people who consulted a lawyer did certainly appear to have a delayed recovery," he said. "I suppose some lawyers may argue that people who have more disability--who feel more pain--are the ones who are more likely to have a prolonged recovery and also the ones who are more likely to consult a lawyer."
But he says the research suggests consulting a lawyer itself does have some independent effect of its own in prolonging recovery. Dr Gun does however caution that there are a number of factors that influence recovery time and lawyers are not the whole reason. He says the research may have implications for the insurance industry in terms of trying to reduce litigation and speed up the settlement period.
Read more in Medical Observer
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One More Reason to Quit, NOW
February 7, 2005
Cancer, emphysema, heart disease--all of these have been linked at one time or another to smoking. Now a new study shows that the harmful effects of the weed are not confined to the realm of the physical, but can attack the mind as well.
Adolescents who smoke show impairment of memory and other cognitive functions, according to a Yale study published in Biological Psychiatry.
More than 4.5 million teenagers smoke cigarettes in the United States, according to the Centers for Disease Control and the U.S. Census Bureau. Leslie Jacobsen, MD, associate professor of psychiatry and pediatrics at Yale School of Medicine, and her research team tested working memory of teens both smokers and non-smokers to see what the effects of smoking were on the brains of smokers.
This form of memory is used when keeping information in mind and manipulating it. They also evaluated verbal learning and memory, attention, mood, symptoms of nicotine withdrawal and tobacco cravings in 41 adolescent daily smokers and 32 nonsmokers. The groups were similar in age, gender and education.
"Adolescent smokers were found to have impairments in accuracy of working memory performance," Jacobsen said. Other studies show adult smokers have comparable focused, sustained and selective attention, and improved working memory, suggesting enhancement of performance by nicotine.
Male adolescents as a group begin smoking at an earlier age than female smokers and were significantly more impaired during tests of attention, she said. All of the adolescent smokers also showed further disruption of working memory when they stopped smoking. "These findings underscore the importance of efforts aimed at preventing smoking initiation in adolescents. They also show adolescents who are trying to quit smoking may need additional educational support," Jacobsen said.
Read more at Biological Psychiatry
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Young Cell Phone Users Drive like Old Folks
February 7, 2005
If you have been stuck in traffic behind a motorist yakking on a cellular phone, a new University of Utah study will sound familiar: When young motorists talk on cell phones, they drive like elderly people, moving and reacting more slowly and increasing their risk of accidents.
"If you put a 20-year-old driver behind the wheel with a cell phone, their reaction times are the same as a 70-year-old driver who is not using a cell phone. It's like instantly aging a large number of drivers," says David Strayer, a University of Utah psychology professor and principal author of the study.
The new study was published in this winter's issue of Human Factors.
The study found that when 18- to 25-year-olds were placed in a driving simulator and talked on a cellular phone, they reacted to brake lights from a car in front of them as slowly as 65- to 74-year-olds who were not using a cell phone.
The elderly drivers, meanwhile, became even slower to react to brake lights when they spoke on a cell phone. But the good news for elderly drivers was that their driving skills did not become as bad as had been predicted by earlier research showing that older people performing multiple tasks suffer additional impairment due to aging.
The study found that drivers who talked on cell phones -- regardless of whether they were young or old -- were 18 percent slower in hitting their brakes than drivers who didn't use cell phones. The drivers chatting on cell phones also had a 12 percent greater following distance -- an effort to compensate for paying less attention to road conditions -- and took 17 percent longer to regain the speed they lost when they braked.
In addition, "there was also a twofold increase in the number of [simulated] rear-end collisions when drivers were conversing on cell phones," the study says.
The psychologists had the young and older study participants drive in a high-tech driving simulator. Participants in the simulator used dashboard instruments, steering wheel and brake and gas pedals from a Ford Crown Victoria sedan, surrounded by three screens showing freeway scenes and traffic, including a pace car that intermittently hit its brakes 32 times as it appeared to drive in front of study participants. If a participant failed to hit their own brakes, they eventually would rear-end the pace car. Each participant drove four simulated 10-mile freeway trips lasting about 10 minutes each, talking on a cell phone with a research assistant during half the trips and driving without talking the other half.
Only hands-free phones were used to eliminate any possible distraction from manipulating a hand-held cell phone.
Thirty times each second, the simulator measured the participants' driving speed, following distance and -- if applicable -- how long it took them to hit the brakes and how long it took them to regain speed. Those factors "have been shown to affect the likelihood and severity of rear-end collisions," the researchers wrote.
Federal statistics show that the most accident-prone drivers are the young and old, with fatal accident rates high during teenage years, then declining until age 30 and staying relatively level until age 60, when accident rates climb again as age increases.
There were too few collisions for statistical analysis. But Strayer notes that twice as many accidents happened to motorists on cell phones compared with motorists who were not talking. And young drivers were in collisions twice as often as elderly drivers.
"Older drivers were slightly less likely to get into accidents than younger drivers," Strayer says. "Why? They tend to have a greater following distance. Their reactions are impaired, but they are driving so cautiously they were less likely to smash into somebody," although in real life, ""older drivers are significantly more likely to be rear-ended" because of their slow speed.
Read more in Human Factors.
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The Antidepressant Storm Rages On
January 11, 2005
The British Medical Journal said Friday of last week it had given US regulators confidential drug company documents suggesting a link between the popular antidepressant Prozac and a heightened risk of suicide attempts and violence.
The BMJ reported in its January 1 issue that documents it received from an anonymous source indicated that Prozac's manufacturer, Eli Lilly & Co, was aware in the 1980s that the drug could have potentially troubling side-effects.
The documents, reportedly missing for a decade, had formed part of a 1994 lawsuit against Eli Lilly on behalf of victims of a workplace shooting in Louisville, Kentucky. Joseph Wesbecker, the gunman who killed eight people and himself in 1989, had been prescribed Prozac a month before the shootings.
The BMJ said one of the records, dated November 1988, reported that fluoxetine, the generic name for Prozac, had caused "behavioral disturbances" in clinical trials. The journal had turned the documents over to the US Food and Drug Administration, which had agreed to review them. The journal said the office of US Congressman Maurice Hinchey, a Democrat from New York, also was examining the documents to determine whether Eli Lilly had withheld data from the public and the FDA.
"This is an alarming study that should have been shared with the public and the FDA from the get-go, not 16 years later," Hinchey was quoted as saying.
In October, FDA ordered that all antidepressants carry warnings that they "increase the risk of suicidal thinking and behavior" in children.
Separately a new book by Jerome Kessler, former editor of the New England Journal of Medicine claims that the major pharmaceutical comapnies have been hiding the true effects of their antidepressants for years and indeed have invented illnesses --such as "executive dysfunction", which has no medical basis at all--to sell more of the drugs. Prominent New York psychiatrist Peter Breggin goes even further and claims of SSRIs such as Prozac "Not only do these drugs not work, they are dangerous." He adds: "If anybody is up to their eyes in conflicts of interest it is the psychiatrists" who prescribe the drugs.
The NY District Attorney Eliot Spitzer is taking the large drug companies to court over their cover-ups.
Stay tuned, we are following this story.
Read more in the British Medical Journal
Read more in The Australian newspaper, December 16, 2004 "Busting Big Pharma" (not available online without payment)
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The Ritalin Debate Hots Up
January 11, 2005
If antidepressants don't work and are dangerous, what about that other terribly over-prescribed drug Ritalin? It, too, is coming under fire both for its efficacy, or lack of it, and also for its potentially dangerous side-effects. One of those side-effects has now been shown to be adult depression.
A new study conducted in rats by the National Institutes of Health (NIH) and McLean Hospital/Harvard Medical School suggests that the misdiagnosis of attention-deficit hyperactivity disorder (ADHD) combined with prescription drug use in children may lead to a higher risk of developing depressive symptoms in adulthood.
This work, released at the annual American College of Neuropsychopharmacology (ACNP) conference in Puerto Rico, is among the first to examine the effects of early Ritalin exposure on behavior and brain function during later periods of life.
"Attention-deficit hyperactivity disorder can be a serious medical problem for children and their parents," says lead researcher William Carlezon, PhD, director of McLean Hospital's Behavioral Genetics Laboratory and associate professor of psychiatry at Harvard Medical School. "While Ritalin is an effective medication that improves the quality of life for many children with ADHD, accurately diagnosing and identifying the correct treatment regimen for the disorder is essential, especially when considering health effects that can last through adulthood."
Ritalin is a generic medication prescribed for children with ADHD, a condition that consists of a persistent pattern of abnormally high level of activity, impulsivity, and/or inattention. Usually diagnosed in children of preschool or elementary school age, ADHD has been estimated to affect 3 to 12 percent of children and is twice as common among boys. Children with ADHD are also likely to have other disorders, such as a learning disability, oppositional defiant disorder, conduct disorder, depression, or anxiety.
Because most children show some of these behaviors of inattention and hyperactivity at times, the diagnosis of ADHD is a complex process that should involve specialists. It is critical to determine whether a child's behavior is simply immature or exuberant, related to another issue such as a vision problem or learning disability, or is characteristic of a disorder such as ADHD.
In the work funded by the NIH, Dr Carlezon and his chief collaborator, Dr Susan Andersen, examined the effects of exposing rats to Ritalin during early development on behaviors later in life. They exposed normal rats to twice-daily doses of Ritalin during a period that is equivalent to approximately 4-12 years of age in humans. Examining the behavior during adulthood, Carlezon and Andersen conducted several types of tests that all showed that the animals had a reduced ability to experience pleasure and reward. In addition, they found that the animals exposed to Ritalin during pre-adolescence were more prone to express despair-like behaviors in stressful situations (such as swim tests) as adults. Overall, the animals showed more evidence of dysfunctional brain reward systems and depressive-like behaviors in adulthood.
These findings are critical because they suggest that Ritalin can have long-term consequences on normal-functioning brains. The study is particularly relevant when considering the difficulty in correctly diagnosing children with ADHD. In 1999, approximately 90 percent of children diagnosed with the disorder were taking Ritalin, with children beginning drug therapy at younger ages today, even during preschool in some instances. There is increasing evidence to suggest that correct diagnosis of ADHD is of the highest importance--children who are misidentified as having ADHD and subsequently placed on prescription drug therapy could face possible impaired brain performance as adults.
This research paper is not available on the web.
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Drinking and Domestic Violence in the Military
January 11, 2005
Soldiers who drink heavily are more likely to abuse their spouses both when they are, and when they are not, drinking alcohol. Heavy drinking is also associated with subsequent episodes of spouse abuse even when drinking habits are measured years prior to the event.
Domestic violence is a significant and preventable cause of injury to women. The majority of cases involve violence perpetrated by a male partner, and heavy drinking has also been implicated as a risk factor.
A study in the December issue of Alcoholism: Clinical & Experimental Research looks at alcohol consumption and perpetration of spousal abuse by male US Army soldiers.
"Women are not only more likely than men to be victims of abuse at some point in their lifetime, but women are also more likely to sustain serious injury than are male victims of abuse," said Nicole S Bell, first author of the study. "However, it is important to note that married men and women are about equally likely to initiate physical abuse against each other. In fact, male victims of abuse may find it more difficult than female victims to come forward to report their
experience due to social stigmatization or shame."
Bell added that heavy drinking is clearly a risk factor for intimate partner violence (IPV). "Men who drink heavily are more likely to abuse their partners both when they are drinking and when they are not drinking than men who are light drinkers. Put another way, women who live with heavy drinkers are more likely to be victims of IPV. Furthermore, women who are themselves heavy drinkers are also more likely to be victims of IPV, though it is not always clear whether their heavy drinking preceded the abuse event or is adopted as a way to cope with an unpleasant home life."
"One of the unique things about this study is that it's able to link data from difference sources," added Gordon Smith, an associate public health professor at Johns Hopkins Bloomberg School of Public Health. "This study was able to measure baseline alcohol consumption of a group of soldiers, and then follow them over time to see if there's an increased risk of them being a perpetrator of spousal abuse. Most studies take more of a cross sectional approach, interviewing people who have already been accused of spousal abuse, and then looking at their drinking. Self reports of alcohol consumption at the time of the abuse event are likely unreliable; it's an emotional time, and some people may over or under report their alcohol consumption . we really don't know."
"We chose to focus on Army soldiers primarily because we have extensive data available to study them both before and after the abuse event," said Bell. "We were able to examine the stability of the relationship between drinking and perpetration of spousal abuse over a relatively long follow-up time. Furthermore, unlike some other studies of perpetrators that have examined populations with criminal backgrounds or those in treatment programs, this study population is relatively high functioning in that they're fully employed, have full access to healthcare, and hold a wide range of different occupations within the Army such as truck drivers, cooks, infantry soldiers, flight crew, and mechanics. Finally, the sheer size of this study population allowed us to explore variations in risk for abuse in different race and age subgroups."
The results showed that those classified as the heaviest drinkers (22 or more drinks per week) were 66 percent more likely to abuse their spouses than those classified as abstainers. In addition, self-reported moderate (8 to 14 drinks per week) and heavy drinkers (15 to 21 drinks per week) were three times as likely, and light drinkers (1 to 7 drinks per week) were twice as likely, as soldiers who report they typically consume less than one drink per week, to be drinking during the time of the abuse event.
"In short, we found that the enlisted, married, male Army soldiers who drink heavily are more likely to abuse their spouses both when they are and when they are not drinking alcohol," said Bell.
Researchers also found that heavy drinking is associated with subsequent episodes of spousal abuse even when drinking habits are measured years prior to the event. "The link between self-reported typical drinking habits and increased risk for spousal abuse appears to be stable even over long periods of time," said Bell. "That is, soldiers who report drinking heavily who are then followed for several years are still, years later, at greater risk for spousal-abuse events, particularly those involving alcohol during the event, but also those not involving alcohol."
Bell added that the study's findings have several implications. "First, it might be wise to evaluate soldiers identified as heavy drinkers during routine health screening tests for interpersonal violence," she said. "Likewise, soldiers identified as spouse-abuse perpetrators or victims should be carefully screened for alcohol abuse. Second, alcohol use is related to increased risk for spousal abuse when neither the perpetrator nor the victim has been drinking, and this is true even when alcohol-use habits are measured years before the event. Thus, there may be some behavioral or social factors that are associated with both drinking and the propensity to abuse a spouse--such as impulsivity or aggression--and these factors may not dissipate over time.
"Young men who are heavy drinkers may 'age out' of these drinking behaviors or at least moderate their drinking as they get older, but it is not clear if they will also 'age out' of other factors that may go along with heavy drinking behaviors, such as impulsivity or aggression."
"Many people assume you can't do anything about heavy drinking, but there are clearly studies that show if you can screen and identify people with problem drinking and get them into early treatment then you can significantly reduce the consequences of the drinking, including spousal abuse," added Smith. "Treatment for alcoholism or problem drinking has similar effectiveness to that for other chronic diseases like asthma and diabetes. If people have asthma, they will keep having recurring attacks of asthma no matter how good the treatment is, but treatment reduces the frequency and severity of the attacks. It's the same with people who have diabetes. Treatment for alcoholism does work, and can prevent or reduce the frequency of relapses in many people. However, like most chronic-disease therapies, treatment does not always work 100 percent of the time."
Read more in Alcoholism: Clinical & Experimental Research
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Adolescent Steroid Use Causes Long Term Aggression
December 2, 2003
With the recent revelations about steroid use in Major League Baseball and the bust a few weeks ago of several Oakland Raiders players for drug abuse, Northeastern University psychology professor Richard Melloni, who studies the link between steroid use and aggression, has recently found evidence that use of anabolic steroids may have long-term effects on players' behavior and aggression levels well after they stop abusing these performance enhancing drugs.
Melloni and doctoral student Jill Grimes have been studying how steroids used during adolescence may permanently alter the brain's ability to produce serotonin. In their experiments, adolescent Syrian hamsters--given their similar brain circuitry to human adolescents--were administered doses of anabolic steroids and then measured for aggressiveness over certain periods of time.
In their findings, published this week in Hormones and Behavior, they conclude that there is indeed a lengthy price--namely long-term aggression--to pay for drug abuse even after the ingestion of steroids ceases.
"We know testosterone or steroids affect the development of serotonin nerve cells, which, in turn, decreases serotonin availability in the brain," Melloni says. "The serotonin neural system is still developing during adolescence and the use of anabolic steroids during this critical period appears to have immediate and longer-term neural and behavioral consequences. What we know at this point is that aggressiveness doesn't simply cease after the ingestion of steroids does."
Read more in Hormones and Behavior
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Study Finds Drivers' Attention Easily Diverted
August 13, 2003
Even when they knew cameras were watching, drivers in a study were caught in all manner of distracting activities, from applying eye makeup to opening and reading their mail.
Thirty percent of the study subjects used cell phones while their vehicles were moving, but that was far from the most common distraction. Some 97 percent leaned over to reach for something, and 91 percent fiddled with radio controls.
Drivers were most likely to swerve when they were reaching, eating, using cell phones or tending to infants. Babies distracted drivers an average of 8.4 times per hour, compared with 1.1 times for adult passengers. In all, the study found that drivers were distracted 16.1 percent of the time their vehicles were moving.
The study, released by AAA, the auto club, and researchers at the University of North Carolina, tracked 70 drivers from North Carolina and Pennsylvania. The drivers, age 18 to 80, were told that the cameras were measuring their reactions to traffic conditions.
The drivers had miniature cameras placed in their cars for a week, and researchers randomly selected three hours to view their behavior. The first three hours of each tape were eliminated in the hope that drivers would act more naturally later in the week.
In Australia recently a woman was caught texting a message on her cell-phone and applying make-up while driving at over 100km ph (60 mph). She had her licence taken away, but was allowed to keep her cell-phone.
Read more in Intelihealth
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Portion Size Matters: Given Too Much, We Eat It
December 2, 2002
What's more this tendency, coupled with the spread of megaportions, may be contributing to the American obesity epidemic.
In the first systematic, controlled study of the response to portion size in adults, the researchers found that the bigger the portion, the more the participants ate. On average, they ate 30 percent more from a five-cup portion of macaroni and cheese than from one half its size without reporting feeling any fuller after eating. Dr Barbara Rolls, who holds the Guthrie Chair of Nutrition in Penn State's College of Health and Human Development, led the study.
She says, "Men and women, normal-weight and overweight individuals, restrained and unrestrained eaters, all responded to larger portion size by eating more."
The response to larger portions was not influenced by who determined the amount of food on the plate, the study participant or the researchers. The study is detailed in a paper, "Portion Size of Food Affects Energy Intake in Normal-weight and Overweight Men and Women," in the American Journal of Clinical Nutrition.
In the study, 51 normal-weight and overweight men and women, 21 to 30 years of age, had lunch one day a week for four weeks in Penn State's Laboratory for the Study of Human Ingestive Behavior. The lunch included water, carrot sticks and a snack-size chocolate bar as well as macaroni and cheese made in the "light" version from a well-known commercial mix.
Each week, the participants were served the macaroni and cheese in one of four portions ranging from two and a half to five cups. The participants were required to eat all of the carrots and chocolate bar but could eat as little or as much of the macaroni and cheese as they wanted.
One group received the different amounts of macaroni and cheese pre-portioned on a dinner plate from which they ate. Another group received the different portions in a serving dish and could scoop as much of the entre as they liked onto their plates. In both cases, the participants ate more when more food was available but didn't report feeling any fuller after eating.
Rolls says, "Our research shows that pretty much everyone is susceptible to the influence of portion size. However, it's not increased portion size alone that is contributing to the American obesity epidemic but rather eating large portions of high-calorie, high-fat foods. "Large portions of foods low in calories and fat such as vegetables, fruits and broth-based soups can aid weight management by providing satisfying portions with few calories," she adds.
Read more in the American Journal of Clinical Nutrition
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Changing Economic and Social Roles
December 2, 2002
The price of having multiple responsibilities within the family -- partner, parent, carer, paid worker -- is revealed in new research as particularly adverse for pension prospects, with women hit hardest.
Maria Evandrou and Karen Glaser, Institute of Gerontology, King's College London, undertook the study as part of the Growing Older Programme funded by the Economic and Social Research Council. First, they identify an increase in multiple roles; second, they highlight the adverse implications in terms of reduced income now and less opportunity to accumulate pensions for the future.
Occupational and private pensions are the problem. People who care for a sick or elderly dependent and are also a parent, for instance, or who combine paid work with being a parent are not greatly disadvantaged in terms of entitlement to the state pension once certain schemes are added in. But in private pension provision, only a little over half of women aged between 45-59 had paid into a fund. Among men, three-quarters were in a fund. And for women who are parents, or who combine parenting with caring, less than one third were covered.
Even women who had paid into a private pension were still at a disadvantage. On average, their contributions totaled only 13 years compared to 21 years for men. The extent of this disadvantage in so-called "second-tier" pensions will be all the greater, warn the researchers, as such pensions become even more important as the real value of the basic state pension -- not linked to earnings -- declines.
The researchers identified that for many women, being in paid employment and fulfilling caring responsibilities was not an option. One in five who had become a carer said that they had stopped work altogether, another one in five reduced their working hours, earned less money or worked only restricted hours. Both men and women who stopped work were less likely to be a member of an occupational pension scheme; where they were signed up to such a scheme, they had accumulated fewer years of contributions, with implications for the level of pension income that they will receive in later life.
Although this research is confined to the UK similar studies in the US and other countries have shown that carers face similar disadvantages in respect to pensions.
We are pack animals bereft of our packs. The care of old, the injured or the very young are group responsibilities. Individuals are not equipped to cope as carers. BM
Read more on the Economic & Social Research Council website www.esrc.ac.uk
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More People Turn to the Web for Health Advice
September 30, 2002
Women use the Internet to look for health information for themselves and their family significantly more than men, research has found. The study, by independent research company Datamonitor, says that for this reason health sites should make greater efforts to appeal to women by covering their health concerns. The researchers, who quizzed 4,531 adults across France, Germany, Italy, Spain, the UK and the US, found that websites have become just as important as some offline sources of health information. Fifty-seven percent of those who looked for health information in the past 12 months consulted Internet sources. The survey also found that the vast majority of people consider themselves highly health conscious -- making them a receptive audience for health information. Datamonitor says that the audience for health information online will grow naturally as the population ages, and more and more people grow up with the net. The present sources for health information are physicians -- 76%, books, magazines, television -- 73%, online -- 57%, friends and family -- 53%.
Read more in BBC News
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Female Physicians More Emotionally Focussed and Patient-Centered.
September 4, 2002
Female primary care physicians spend more time with their patients and engage in more positive, social, and emotionally focussed talk than their male colleagues, according to researchers at the Johns Hopkins Bloomberg School of Public Health and Northeastern University. Their conclusions are based on a systematic review of previous studies involving physician communication and are published in the Journal of the American Medical Association. "Our review found that female physicians more often engage in communication that we would consider more patient-centered and broadly relates to the larger life context of the patient's conditions. They do this by addressing psychosocial issues through questioning and counselling, and more emotional and positive talk," said Debra L Roter, PhD, lead author of the study and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.
Read more in JAMA
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Ginkgo Fails Important Memory Test
September 4, 2002
Ginkgo biloba has no beneficial effect on memory and related mental functions of healthy older adults when taken following manufacturer's instructions, according to a study in the Journal of the American Medical Association. Extract from leaves of the tree ginkgo biloba is marketed worldwide as an enhancer of memory and other mental functions. In 1998, $310 million dollars worth was sold in the US alone. Researchers identified 230 volunteers over the age of 60 who were physically and mentally healthy. They gave them 14 tests of learning, memory, attention and concentration. Participants were then randomly divided into two groups: one to take gingko and one placebo. The study was double-blind; neither the participants nor the researchers knew who was taking ginkgo and who was taking placebo. The manufacturer claims beneficial effects can be noticed after four weeks. After six weeks, participants in the study retook the 14 standardized tests. There were no significant differences between those taking ginkgo and those taking placebo on any of the measures.
Read more in JAMA
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For-Profit Hospitals Present Greatest Risk Of Dying
June 24, 2002
A study has shown that people treated in private for-profit hospitals in the US have a greater risk of dying than those cared for in private not-for-profit hospitals.The study was based on data from more than 26,000 hospitals covering outcomes of 38 million patients. It was carried out by researchers from McMaster University in Hamilton, the University at Buffalo and the University of Toronto. The researchers undertook the meta-analysis of mortality statistics to help inform the debate underway in Canada over whether to move into the for-profit healthcare-delivery arena. Results showed that for-profit hospitals were associated with significantly higher mortality. "Although the relative increase in risk amounts to 2 percent in our analysis, which may seem small, the absolute number is frightening," said Holger Schunemann, MD, PhD, University of Buffalo, the author of the study. "In Canada, this percent is equivalent to 2,200 deaths yearly, which equals Canadian death rates for suicide, colon cancer or motor vehicle accidents. The total numbers will be much higher in the US."
Read more in Uniscience
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Placebos as Good as Antidepressants
May 20, 2002
After thousands of studies, hundreds of millions of prescriptions and tens of billions of dollars in sales, two things are certain about pills that treat depression: Antidepressants like Prozac, Paxil and Zoloft work. And so do sugar pills.
First it was a study by London University, then the landmark study by researchers at the University of Connecticut. Now a new analysis published in the Journal of the American Medical Association has found that in the majority of trials conducted by drug companies in recent decades, sugar pills have done as well as -- or better than -- antidepressants.
What's more, the sugar pills, or placebos, cause profound changes in the same areas of the brain affected by the medicines, according to research published last week. One researcher has ruefully concluded that a higher percentage of depressed patients gets better on placebos today than 20 years ago.
Placebos -- or dud pills -- have long been used to help scientists separate the "real" effectiveness of medicines from the "illusory" feelings of patients. The placebo effect -- the phenomenon of patients feeling better after they have been treated with dud pills -- is seen throughout the field of medicine. But new research suggests that the placebo may play an extraordinary role in the treatment of depression -- where how people feel spells the difference between sickness and health.
The new research may shed light on findings such as those from a trial last month that compared the herbal remedy St John's Wort against Zoloft. St John's Wort fully cured 24 percent of the depressed people who received it, and Zoloft cured 25 percent -- but the placebo fully cured 32 percent.
The confounding and controversial findings do not mean that antidepressants do not work. But clinicians and researchers say the results do suggest that people may be overestimating the power of the drugs and that the medicines' greatest benefits may come from the care and concern shown to patients during a clinical trial -- a context that does not exist for millions of patients using the drugs in the real world.
"The drugs work, and I prescribe them, but they are not what they are cracked up to be," said Wayne Blackmon, a Washington psychiatrist told the Washington Post. "I know from clinical experience the drugs alone don't do the job."
Still, drugs may have become the reflexive treatment for the vast majority of Americans receiving medical attention for depression. As the number of doctor visits for depression rose from 14 million in 1987 to almost 25 million last year, medication was prescribed for nine in 10 patients, according to research published recently.
The average participant in an eight-week trial spends about 20 hours being examined by top experts and highly trained caregivers, said a Seattle psychiatrist, Arif Khan, who studied the placebo effect in trials submitted to the Food and Drug Administration. Participants -- including those being given sugar pills -- are asked detailed questions about how they are feeling, and their every psychological change is closely noted. In comparison, Khan noted, the average patient with depression sees a doctor perhaps 20 minutes a month.
His analysis of 96 antidepressant trials between 1979 and 1996 showed that in 52 percent of them, the effect of the antidepressant could not be distinguished from that of the placebo. Khan, who expects his research to be published later this year, said that the makers of Prozac had had to run five trials to obtain two that were positive, and that the makers of Paxil and Zoloft had had to run even more.
"It speaks to the difficulty we have in classifying and identifying the disorders we deal with," said Thomas Laughren, who heads the group of scientists at the Food and Drug Administration, which evaluates the medicines. "Psychiatric diagnosis is descriptive. We don't really understand psychiatric disorders at a biological level."
In January, Leuchter published a study in the American Journal of Psychiatry in which he tracked some of the brain changes associated with drugs such as Prozac and Effexor, which are called selective serotonin reuptake inhibitors. When Leuchter compared the brain changes in patients on placebos, he was amazed to find that many of them had changes in the same parts of the brain that are thought to control important facets of mood.
Patients who got better on placebos showed heightened activity in the prefrontal lobe, and that activity continued to rise during the eight weeks of the study. Those who responded to medicine initially showed a decline in prefrontal brain activity, then a rise that eventually tapered off. Thirty-eight percent of patients responded to the placebo, and 52 percent to the medicines.
Once the trial was over and the patients who had been given placebos were told as much, they quickly deteriorated. People's belief in the power of antidepressants may explain why they do well on placebos. Patients in trials are not told which they are receiving.
Some observers assert that the medicine itself works because of the placebo effect, but most psychiatrists believe the drugs do have an effect of their own. Drugs are a "placebo-plus" treatment, said Helen Mayberg, head of neuropsychiatry at the Rotman Research Institute at the University of Toronto.
Doubts cast on the effectiveness, safety of antidepressants
As we reported earlier, the prestigious UK Royal College of Psychiatrists has scaled back it's estimate for the number of people who can be helped by antidepressants from 70% to 50%. And recent studies have pointed to other, more serious problems with the drugs.
A study reported in the British Medical Journal claims that "the odds ratios for ischaemic heart disease were significantly raised for patients who had ever received a prescription for tricyclic antidepressants even after diabetes, hypertension, smoking, body mass index, and use of selective serotonin reuptake inhibitors had been adjusted for."
Recent studies, also previously reported, have linked Prozac to an increase in brain tumors and suicides.
We are not at all suggesting that people go off antidepressants, especially if they seem to be doing them good. In any case suddenly stopping, or drastically reducing the dosage, can be dangerous. What we do suggest is that you discuss your fears with your doctor.
Surveys indicate that the Uplift Program has a far higher success rate (94%) than either antidepressants or conventional therapy. The Uplift enables participants to create relationships that offer "care and concern" in all areas of their lives and to change life patterns at the emotional and physical level. The Uplift Audio-cassetes will allow you to enhance both your relationships and life patterns on your own. BM
Read more in the Journal of the American Medical Association
Read more in the Washington Post
Read more about risks associated with antidepressants in the British Medical Journal
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Low Tar, Light Cigarettes Called Deliberate Deception
March 11, 2002
Industry documents show that companies recognized that low tar products were as dangerous as regular cigarettes, yet marketed them as healthy alternatives.
Richard W Pollay, PhD, and colleagues at the University of British Columbia in Canada analyzed trade sources and internal US tobacco company documents. These show that the industry feared mounting evidence linking tobacco with lung cancer would discourage smokers from their habit, and devised "low tar/light" products in a bid to reassure them. Vast sums of money were spent on promotion -- $44 million in the case of Philip Morris for one brand in 1976 alone.
The authors chart the various tactics deployed by the industry. These included branding cigarettes as "hi-fi" or high filtration, the implication being their ability to reduce, if not totally eliminate, the health risks associated with smoking. The filtering ploy was variously described in industry documents as "an effective advertising gimmick," "merely cosmetic," and offering "the image of health reassurance." Low tar smokers were described as wanting "nothing less than to be conned with information," the researchers declare.
Some versions, including menthol or loosening filter cigarettes, actually delivered more tar and nicotine than unfiltered cigarettes. Other techniques included adding a "virtuous (filtered) product" to an existing line, which was heavily promoted but rarely available for sale, duping consumers into confusing the two products, say the authors.
"Virtuous brand names and descriptors," such as Merit, Life, True and "Mild," "Ultra," "Light" and "Superlight" were also used to convey a healthy image. British American Tobacco wrote of its marketing policy: "All work in this area should be directed towards providing consumer reassurance about cigarettes and the smoking habit... by claimed low deliveries, by the perception of low deliveries, and by the perception of mildness."
The industry used machine-derived tar yield figures which do not reflect the actual levels of smoke toxicity likely to be accrued during the act of smoking. "Such products could be advertised as 'tar-free,' 'zero milligrams tar' or the 'ultimate low tar cigarette' while actually delivering 20, 30, 40 mg or more tar when used by a human smoker. They will be extremely easy to design and produce," said a document from Brown and Williamson, a subsidiary of British American Tobacco.
Separately figures have just been released showing that the number of tobacco placements in films has actually increased despite Hollywood's "voluntary ban." Researchers at the University of California San Francisco have revealed, amongst other damaging information, that Sylvester Stallone signed an agreement with Brown and Williamson for $500,000 to guarantee to use their products in no less than five feature films. Twentieth Century Fox Licensing and Merchandising offered to promote Phillip Morris products in return for $100,000. The deal included the rights to script approval for placement of products.
Read more in the British Medical Journal Publication Tobacco Control
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Too Much Sleep Is Bad for You
February 25, 2002
Eight hours' sleep a night has long been touted as the ideal length of time to spend under the covers, but new research suggests it could shorten your life.
A study that included more than a million participants found people who sleep eight hours or more died younger. Those who only managed four or less hours in the land of nod were similarly affected, but six or seven hours a night was found to be conducive to a longer life.
The research, carried out by scientists at the University of California, showed a clear association between long duration sleep and high mortality rates.
However, the research team cannot explain why this happens. The report's author Dr Daniel Kripke, a professor of psychiatry, said: "We don't know if long sleep periods lead to death. Additional studies are needed to determine if setting your alarm clock earlier will actually improve your health. Individuals who now average six-and-a-half hours of sleep a night can be reassured this is a safe amount of sleep. From a health standpoint there is no reason to sleep longer."
The best survival rates were among those who slept seven hours a night, according a report published in the Archives of General Psychiatry.
Yippee! I shall live, as I fully expect to, until I am 111. I regularly sleep 6/7 hours a night. No wonder cats only live to 20 or so, they sleep over 20 hours a day. Tortoises, who can live over 200 years must sleep just the right amount of time. However, long sleeps may simply indicate depression, which is linked to a shorter life span. BM
Read more in the Archives of General Psychiatry
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Television: Good for Health?
February 25, 2002
Television has been blamed for everything from causing couch potato obesity, to harming IQ, to damaging the ability to create close personal friendships. Even Andy Warhol said that when he bought a TV set he no longer needed close friends -- not that he minded.
But according to researchers at the London School of Economics (LSE), television can actually be psychologically beneficial to people and help them create strong bonds with others. According to Dr Darrin Hodgetts, LSE lecturer in Media and Communications in the Department of Social Psychology, television does not stop viewers needing or making friends. "In fact, television can be used as a ritualistic meeting place to share thoughts and feelings," he argued. "There is over 40 years of literature in medicine on the problems of television and the media is a battleground on its effects. But television can be health reinforcing."
Hodgetts has just completed yet to be published studies on how men's psychological health can benefit from meeting and sharing feelings and strengthening friendships when, for example, watching sport.
Television has also been accused, among other things, of leading to the lowering of a person's IQ over time, allegedly due to a soporific effect on the brain. Other research has shown that while watching television, the brain is actually less active than when asleep.
But this is nothing to worry about, says LSE Professor of Social Psychology, Sonia Livingstone, who has been studying the effects of television and the Internet on children. "As long as children are taught to be screen wise there is no cause for a panic about television. The Internet too, can be positively beneficial for social interaction," she said.
And research from the US School of Communication, Information and Language Studies, Rutgers University, in New Jersey has found that e-mail and web chat rooms enhance and extend a sense of community. "Cyberspace involvement can create alternative communities that are just as valuable and useful as our familiar, physically located communities," wrote Rutgers University Professor Ronald Rice.
Read more on BBC News
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Obesity a Worldwide Epidemic
February 25, 2002
Obesity, considered until recently to be an exclusively "Western" disease, now poses a serious threat to the health of developing nations, particularly children, say scientists studying this emerging "global epidemic of fat."
"We want to alert the science community that people are not immune to this epidemic just because they live in non-industrial or poor populations," Marquisa La Velle of the University of Rhode Island said. La Velle was one of several researchers who discussed the biological and cultural factors behind the worldwide trend toward excessive fatness, during the recent American Association for the Advancement of Science (AAAS) Annual Meeting in Boston.
In December 2001, the United States Surgeon General released a report warning that obesity could soon kill more Americans than tobacco smoke. In industrialized nations, obesity is associated with an increased risk for diabetes, cancer, cardiovascular, and digestive diseases.
Until recently, these disorders have paled in comparison to the health challenges posed by famine and infectious disease to lower and middle income countries in Asia, Africa, the Middle East, and Latin America.
But now, the developing world faces rapid shifts in urbanization, technology, food processing, and even leisure time, and all these factors contribute to the rise of obesity in these countries, said Barry Popkin of the University of North Carolina at Chapel Hill. Popkin suggested that countries still addressing the problems of under-nutrition need to give "far greater emphasis" to the prevention of obesity-related diseases.
"The cultural conditions for obesity are often already there in these populations, but something is stopping them from causing obesity in younger individuals," said La Velle, who noted that a significant disease load might play some part in this "masking effect" in Australia. Obesity is also on the upswing among non-western immigrants to industrialized countries, as well as certain western groups undergoing rapid socioeconomic changes.
Barry Bogin of the University of Michigan Dearborn presented the case of the Maya in Guatemala and Maya in the United States, and discussed the impact of immigration on Mayan children. While Maya-American children are taller and have longer legs than their Guatemalan counterparts, "an alarming number of Maya-American children exhibit weight problems," said Bogin, who noted that 42 percent of Maya-American children would be classified as obese by the standards set by the Centers for Disease Control.
Bogin's recent survey of these children suggests that variables like time spent watching television and playing computer games, along with family size and the primary language spoken at home, are some of the factors that influence the children's risk of obesity.
Read more in American Association for the Advancement of Science
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Smoking in Movies Under Fire
January 7, 2002
The more teenagers watch actors smoking in films, the more likely they are to take up the habit themselves, research just published suggests.
The study, in the British Medical Journal, reaffirms previous findings linking teenage smoking to smoking in movies. Researchers at Dartmouth Medical School in New Hampshire, USA, found the likelihood of ever trying cigarettes increased with higher exposure to smoking in films.
Researchers surveyed almost 5,000 American children between the age of nine and 15. They found that among children who had watched films with 50 or fewer occurrences of smoking less than 5% had tried cigarettes. In comparison, among those who had watched films with more than 150 occurrences of smoking almost a third had tried cigarettes.
James Sargent, associate professor at Dartmouth Medical School and lead author of the study, said the research showed a link between teenage smoking and smoking in movies. "The results indicate that exposure to tobacco use in films is pervasive. More importantly, such exposure is associated with trying smoking, which supports the hypothesis that films have a role in the initiation of smoking."
In an accompanying editorial, Stanton Glantz, professor of medicine at the University of California, urged the film industry to take action saying it provided "powerful evidence" of a link between teenage smoking and smoking in movies. "It is time for the entertainment industry to accept responsibility for its actions and stop serving the interests of tobacco companies," he said.
Prof Glantz has launched a campaign called "Smoke Free Movies" challenging Hollywood to take effective steps to stop actors smoking in films. He has suggested that filmmakers certify in the credits that they have not received anything of value -- cash, cigarettes, or publicity -- in exchange for using or displaying tobacco.
Read more in the British Medical Journal online
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Research Explodes Male "Health Myths"
January 7, 2002
We all know Uncle Norman. He's the guy who "smoked like a chimney, drank like a fish and never exercised" and lived to a ripe old age. Now health researchers have produced evidence which they believe proves that the Uncle Normans of this world are largely mythical.
The team from Glasgow University said the fabled "Uncle Norman" was actually =ix times more likely to die from a heart attack than health conscious people.
Researchers compiled their findings from a 25-year study of 6,000 men from the west of Scotland aged between 45 and 64. They said the conclusion would help to put health stereotypes in perspective.
The Medical Research Council (MRC) Social and Public Health Sciences Unit surveyed men from the Paisley and Renfrew areas. They found that 48 of the 107 "Uncle Norman" figures, defined as overweight heavy smokers, in fact died before the age of 70. By contrast, only 12 of 337 lifelong non-smokers who were not overweight -- commonly referred to as "the last person you'd expect" -- died of heart disease before they reached 70.
The statistics also showed that one in 25 men in the "last person" category died of a heart attack, compared to a quarter of "Uncle Normans" -- four times the number.
Professor Graham Watt, from the Department of General Practice at Glasgow University, was quoted in the BBC News as saying: "These interesting results put lay stereotypes in perspective. 'The last person' and 'Uncle Norman' are both real people, but they are both rare.
"The most important finding from the study is the huge difference in coronary mortality between men at high and low risk. In betting parlance, 'Uncle Norman' and 'the last person' are both outsiders; one should not bet against the established coronary risk factors as predictors of deaths from heart disease."
Dr Kate Hunt, Senior Research Fellow at the MRC said "the last person" was a rare occurrence but often loomed looms large in public consciousness because such deaths were often "dramatic, unexpected and premature".
Read more in the BBC News
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About the Author
Dr Bob Murray is a widely published psychologist and expert on emotional health and optimal relationships. Together with his wife and long-term collaborator Alicia Fortinberry, he is founder of the highly successful Uplift Program, and author of Raising an Optimistic Child (McGraw-Hill, 2006) and Creating Optimism (McGraw-Hill, 2004).
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