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 Centre for Addictionand Mental Health |
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Publications
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Research updateCrossCurrentsMark de la Hey Substance use has no impact on cognition in early psychosis Despite high rates of comorbidity between substance use and psychosis, new research has come to the surprising conclusion
that substance use does not have a negative impact on cognition among individuals with early psychosis. Researchers at the
University of Calgary recruited individuals with a first episode of psychosis who had been admitted to the Calgary Early Psychosis
Program. In total, 183 participants were assessed at baseline, 147 after one year and 116 after two years, using the Case
Manager Rating Scale for Substance Use, plus a battery of cognitive tests. Approximately 50 per cent of participants were
abusing substances at baseline, 27 per cent after one year and 17 per cent after two years. Alcohol and cannabis were the
most commonly used substances. As a group, these first episode participants displayed cognitive impairment relative to normal
controls, but compared with non-users, the cognitive performance of those who used or misused substances was significantly
higher at baseline, an advantage that was maintained at the one- and two-year follow-ups. The authors suggest that one possible
explanation for these results is that those who use substances may have fewer cognitive deficits to begin with, as a certain
level of social skills, resources and planning is required to obtain illicit substances. The authors caution that substance
use remains a concern despite these findings, since it can seriously compromise physical and mental health. Brain can recover from alcohol-related damage New research indicates that the brains of people with alcohol dependence can recover from the physical damage caused by alcohol once they stop drinking. Researchers at the University of Würzburg in Germany followed 15 alcohol-dependent individuals (10 men, five women) over six to seven weeks of sobriety. Heavy smokers, those who had previously attempted alcohol withdrawal and those who used medication to achieve abstinence were excluded from the study. Magnetic resonance imaging indicated an average increase in brain volume of almost two per cent over the course of the study. The one individual who failed to show an increase in brain volume was the one with the longest history of alcohol dependence (25 years). Proton magnetic resonance spectroscopy showed increases in levels of both choline and N-acetylaspartate (NAA). Gains in brain volume were significantly related to increases in choline levels, but not to increases in NAA levels, indicating that brain volume rebound is mainly the result of increases in choline. Since the increases in choline and NAA took place while brain water and various metabolites remained stable, the authors conclude that changes in brain volume were not simply due to rehydration. Increases in NAA levels were not as great as the increases in choline, but were paralleled by improvements in cognitive function, as measured using the d2-test of attention. The authors conclude that “the adult human brain and particularly its white matter seems to possess genuine capabilities for regrowth.” However, they caution that prolonged alcohol dependence might limit the brain’s ability to recover. They call for further research into the precise mechanisms of brain recovery to aid in the treatment of people recovering from alcohol dependence, as well as other types of brain injury. Brain, January 2007, v. 130: 36–47. Andreas J. Bartsch et al., Department of Neuroradiology, University of Würzburg, Germany. Supportive mothers improve quality of life in schizophrenia A mother’s emotional support can significantly enhance the quality of life of her adult child with schizophrenia, according to research from the University of Wisconsin-Madison. Researchers selected 122 mother-adult child pairs from the third wave of a longitudinal study of aging parents caring for adult children with schizophrenia. Mothers were asked to complete an in-home interview and a questionnaire that measured the quality of their relationship with their adult child, while adult children completed a life satisfaction questionnaire. Adults with schizophrenia reported higher quality of life when their mothers exhibited more of what the researchers call “prosocial family processes” – maternal warmth, maternal praise and a close and mutually supportive relationship. Supportive mothers made greater efforts to support their adult child’s sense of being a competent adult and to support small steps toward recovery, and were less likely to express frustration with displays of negative symptoms. They also showed a greater capacity to separate the person from the illness. While there is a need to teach families better strategies for coping with the behavioural manifestations of schizophrenia, the authors note that families have much “practice wisdom” that can be drawn on. Whereas interventions have traditionally focused on getting families of people with schizophrenia to express less emotion, the authors assert that families have a positive role to play as a source of support for adult children with schizophrenia. They encourage research aimed at identifying prosocial family processes that can be incorporated in future interventions with adults with schizophrenia and their families. Psychiatric Services, December 2006, v. 57: 1771–1777. Jan S. Greenberg et al., Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin. Gender differences in binge drinking and depression The proportion of women who meet criteria for major depression rises rapidly with heavier alcohol consumption, especially
drinking large amounts per occasion (binge drinking), according to research from the Centre for Addiction and Mental Health
in London, Ontario. Telephone interviews were conducted with more than 14,000 Canadians (6,009 men, 8,054 women) aged 18 to
76, asking questions about their drinking habits and histories of depression. They found that among those who usually consumed
one drink per occasion, eight per cent of women and four per cent of men experienced major depression. This compares with
19 per cent for women versus seven per cent for men who typically consumed five drinks per occasion (the threshold for binge
drinking). Frequent consumption of smaller quantities of alcohol was not related to depression in either men or women. In
fact, it turned out that light drinking in both sexes was associated with a lower incidence of recent depressed affect compared
with lifetime abstainers, but that light drinking offered no protection against major depression compared with abstaining.
The authors point out that the lower incidence of recent depressed affect could be due to the psychological characteristics
of light drinkers, who may experience less psychological distress than abstainers, rather than necessarily any protective
effect of light drinking. The authors conclude that these findings indicate that a person’s drinking pattern, not just the
cumulative volume of alcohol consumed, is an important consideration in measuring the harm related to alcohol consumption. |
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Last updated: April 05, 2007 3:45 PM Published: July 04, 2008 3:11 PM ID#29692-R |