Research update: CrossCurrents Winter 2004/05

CrossCurrents

Hema Zbogar

Needle exchange users take fewer HIV risks
Injection drug users who take part in needle exchange programs are less likely than other injection drug users to engage in drug-related behaviours that increase the risk of HIV transmission, according to researchers at the University of Illinois at Chicago. The study examined 558 individuals who received at least half of their needles from a needle exchange program and 175 individuals who did not use an exchange program. Compared with those who did not use an exchange program, users were about one-third as likely to share needles and less than half as likely to lend used needles or share cookers or water. They were 85 per cent less likely to use a needle for more than one injection. Even among those who shared needles, exchange program users were more likely to do for so significantly fewer injections overall, and to always use bleach to clean used needles. The researchers conclude that "regular needle" exchange program use is associated with less frequent and lower risk of HIV injection risk practices.

Journal of Acquired Immune Deficiency Syndromes, September 2004, v. 37: 1187-1196. Lawrence Ouellet, Dezheng Huo and Susan L. Bailey, Division of Epidemiology and Biostatistics, Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago.

Early puberty linked to early substance use
Children who enter puberty at an early age are more likely to have issues with alcohol, cannabis and tobacco use, according to researchers in Melbourne, Australia. The researchers surveyed 5,769 10-to-15-year-olds in Washington, in the United States, and in Victoria, Australia. Participants completed questionnaires about their tobacco, alcohol and cannabis use. They were also asked to rate their biological development by providing information on breast and pubic hair development. The researchers found that the odds of youth using a substance in their lifetime were nearly twice as high in mid-puberty than early puberty, and three times as high in late puberty. Current substance misuse was 40 per cent higher for those in mid-puberty and more than twice as high for those in late puberty. The authors posit that since puberty marks the beginning of a much higher risk period for substance use and abuse, early puberty may widen the window of opportunity for experimentation. They suggest that anti-substance abuse messages geared to younger adolescents should be developed, but that efforts need to go beyond mere education and focus on strategies that restrict youth access to substances.

Pediatrics, September 2004, v. 114: e300-e306. George C. Patton et al., Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Australia.

Gene may link depression and alcohol dependency
Researchers at the Washington University School of Medicine have identified a gene that seems to be linked to both alcohol dependency and depression. Previous studies have suggested that common genes may underlie the two disorders and that they seem to run in families. But this is the first report of a specific gene that seems to increase risk for both depression and alcohol dependency. Follow-up research might help reveal the underlying biology that makes some people susceptible to alcohol dependency, others to depression, some to both and others to neither. The researchers suggest that a variation or alteration of the CHRM2 gene influences these four possible conditions. The finding may eventually help to identify individuals at higher risk for these problems and guide new treatments.

Human Molecular Genetics, 13: 1903-1911. Jen C. Wang et al., Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.

Therapy as effective as medication for social anxiety disorder
Antidepressants and talk therapy are equally effective in treating social anxiety disorder, according to researchers at Duke University in Durham, North Carolina. Previous studies have found that antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs) help to relieve social anxiety, as does cognitive behavioural therapy. This study examined whether combining the two therapies yields better results. Researchers recruited 295 participants diagnosed with social anxiety disorder for a 14-week study and randomly assigned them to one of five groups: Prozac® (an SSRI) alone, group therapy alone, Prozac plus therapy, placebo plus therapy or placebo alone. Results showed that all treatments were better than placebo alone but did not differ from each other: significant improvement was found for 54 per cent of the Prozac-plus-therapy group; 51 per cent of the Prozac-only group; 52 per cent of the therapy-only group; 51 per cent of the therapy-plus-placebo group; and 32 per cent of the placebo group. Substantial symptoms remained after treatment. The authors suggest that longer-term Prozac or individual therapy, rather than group therapy, may yield better results. There was also no evidence of greater efficacy of combined treatment. The authors suggest that sequential rather than simultaneous treatment may be more effective.

Archives of General Psychiatry, October 2004, v. 61: 1005-1013. Jonathan R.T. Davidson et al., Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.

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