Research update: CrossCurrents Autumn 2004
CrossCurrents
Cocaine-exposed children benefit from healthy home environment
Babies born to mothers who used cocaine heavily during pregnancy do not have lower IQ scores than other children, although
they may have problems with specific skills. Researchers at Case Western Reserve University in Cleveland, Ohio, tracked 190
cocaine-exposed children and 186 non-exposed children from birth until age four. The researchers found that both groups had
similar IQ scores at age four, but the cocaine-exposed children performed worse on tasks involving visual-spatial skills,
as well as on general knowledge and arithmetic tests. However, cocaine-exposed children placed in foster care or adoptive
homes appeared to overcome those problems. Adoptive and foster parents tended to be better educated and had a more stimulating
home environment than parents or relatives of cocaine-exposed children. Previous studies have found developmental problems
among such children, but few have taken into account the child's home environment. The authors conclude that a positive home
environment may compensate for some of the negative effects of prenatal cocaine exposure. They suggest that early environmental
intervention may prevent developmental disabilities among some cocaine-exposed children.
Journal of the American Medical Association, May 24, 2004, v. 291: 2448-2456. Lynn T. Singer et al., Department of General Medical Sciences and Pediatrics, Case Western
Reserved University, Cleveland, Ohio.
Food additives linked to ADHD symptoms
Food additives may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD), according to researchers
at the University of Southampton in the United Kingdom. The study was conducted over a four-week period on 277 three-year-olds.
All children underwent baseline testing for hyperactivity. During the first week, all children were put on a diet free of
artificial colourings and preservatives. During the next three weeks, the children were given either a drink containing artificial
colourings and the preservative sodium benzoate or a placebo mixture. Parents, who were blind to which drink their children
were getting, kept a daily journal of their children's behaviour. Parents of children taking the additive drink reported that
their children were more active, inattentive and short-tempered than parents whose children received the placebo. The number
of children identified as hyperactive fell to six per cent from 15 per cent with the change in diet. Children who had been
diagnosed as hyperactive at baseline were not found to be more affected by the additives than children without the diagnosis.
However, the differences between the additive and placebo group were not observed on formal tests by researchers. The authors
recommend further studies using general population samples and extending the study to older age groups.
Archives of Diseases in Childhood, June 2004, v. 89: 506-511. B. Bateman et al., Infection, Inflammation and Repair Division, University of Southampton, United
Kingdom.
Mental illness under-treated globally
Mental illnesses, including anxiety disorders and depression, are common and under-treated in many developed and developing
countries, according to the World Health Organization Mental Health Survey Consortium. The study was based on a face-to-face,
two-hour survey in the homes of 60,463 adults in 14 countries: Belgium, China, Colombia, France, Germany, Italy, Japan, Lebanon,
Mexico, the Netherlands, Nigeria, Spain, Ukraine and the United States. The study found that mental illness affected more
than 10 per cent of respondents in more than half the countries surveyed. Rates of illness ranged from 26 per cent in the
United States to five per cent in Nigeria. In developed countries, between 36 and 50 per cent of people with serious symptoms
were untreated. In developing nations, that rate was between 76 and 85 per cent. The researchers caution that the prevalence
of mental illness may be underestimated because the survey used subjective data, and questions about certain disorders were
not asked in all countries. In all countries, a substantial proportion of people with less severe cases received treatment,
suggesting a "misallocation of treatment resources." The authors call for better health care systems and training, stating
that reasons for under-treatment include lack of access to health care and lack of insurance coverage for mental health treatment
in some countries.
Journal of the American Medical Association, June 2004, v. 291: 2581-2590. The WHO World Mental Health Survey Consortium.
Concurrent disorders prevalent among needle exchange program users
Psychiatric and substance use comorbidity is common among users of syringe exchange programs, according to a study at Johns
Hopkins University in Baltimore, Maryland. Participants were 422 male and female intravenous opioid users who accessed a community
needle exchange program in Baltimore. Participants were over age 18, with an average age of 38. Researchers administered the
Structured Clinical Interview for the DSM-IV for Axis I disorders and antisocial personality disorder (APD). Major depression
was the most common current (6%) and lifetime (21%) psychiatric disorder. APD was diagnosed among 37 per cent of participants.
More than 50 per cent were diagnosed with at least one psychiatric disorder or APD. In addition to opioid dependence, cocaine
dependence was the most common current (68%) and lifetime (78%) substance use disorder, followed by alcohol (68%, 33%) and
cannabis dependence (51%, 8%). Participants reported an average of one current and more than three lifetime substance use
disorders in addition to opioid dependence. Presence of a psychiatric disorder was associated with increased prevalence of
a substance use disorder for all drug classes. The authors conclude that the high comorbidity rates suggest that needle exchange
programs can enhance their harm reduction efforts by referring participants to programs that treat substance use and psychiatric
disorders.
Drug and Alcohol Dependence, May 2004, v. 74: 115-122. Michael Kidorf et al., Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland.
Centre for Addiction
