Research Highlights

Usoa Busto, Beth Sproule and colleagues published results on the risks and benefits of sedative hypnotics (sleeping pills) for treating insomnia in elderly people. This study showed that while sedative use improved sleep quality, it also increased the risk of adverse events. The authors concluded that in elderly people, particularly those at risk for falls or cognitive impairment, the benefits of sedative use are marginal and are outweighed by the risks.

John Cairney examined the associations between social position and mental health, and explored whether differences in distress and depression by social position can be accounted for by differences in the major components of the stress process model. The study showed that mental health in later life is determined in part by age, gender, marital status, education, and ethnocultural factors. This is because a person’s position in the social structure shapes the stressors he or she encounters and the resources the person has at his or her disposal to cope with stress.

Kate Graham released the results of the GENACIS (Gender, Alcohol and Culture: An International Study) Canada survey. This survey examined the relationship between gender and drinking patterns, as well as the interaction of gender and alcohol consumption in relation to issues such as social and health consequences of drinking, partner violence, depression and social roles—both at the national level and as part of cross-national comparisons. This work was part of a multinational collaboration involving about 30 countries around the world.

Umesh Jain chaired a group of Attention-Deficit/Hyperactivity Disorder  (ADHD) specialists who published the Canadian ADHD Practice Guidelines (CAP-Guidelines). This comprehensive document sets standards for assessing and treating ADHD patients across the life span.

Zachary Kaminsky, Arturas Petronis and colleagues developed a novel method for fast determination of DNA methylation status, using an adaptation of the SNaPshot technique. Using a degenerative primer design, the method was able to accurately determine the percentage of DNA methylation to within 5 per cent. Adapting the SnaPshot primer design in this way will allow epigenetics researchers to interrogate site-specific DNA methylation differences in GC-rich regions in a high throughput manner.

 Anh Dzung Lê and colleagues found experimental evidence to support the theory that a shared genetic determinant accounts for co-abuse of the most frequently used drugs in the world: nicotine and alcohol. The results of this study provide a better understanding about the co-abuse of these drugs. 

Robert Levitan, James Kennedy and colleagues investigated the serotonin-1Dbeta receptor gene and severity of obsessive-compulsive disorder (OCD) in women with bulimia nervosa (BN). Their study showed that in women with BN, the G861C polymorphism of the 5HT-1Dbeta receptor gene does not appear to be associated with the generation of OCD symptoms; however, it might directly or indirectly be associated with a modulatory effect on syndrome severity in individuals otherwise predisposed to OCD. While preliminary and in need of replication in other samples, this is the first association study to suggest how a particular gene might influence OCD pathology in an eating disorder population.

Elizabeth Lin, Paula Goering and colleagues released Hospital Report 2004: Mental Health. This is the second Hospital Report for adult inpatient mental health care in Ontario prepared by the Hospital Report Research Collaborative. Results show strength in the delivery of inpatient mental health care, consistent with the values of mental health reform.

Benoit Mulsant, Bruce Pollock and colleagues investigated maintenance treatment of major depression in elderly people. Their study showed that patients 70 years of age or older with major depression, who responded to initial treatment with paroxetine and psychotherapy, were less likely to have recurrent depression if they received two years of maintenance therapy with paroxetine. Monthly maintenance psychotherapy did not prevent recurrent depression. 

Carles Muntaner reported on the nature and prevalence of extended work schedules across the nursing profession. The study showed that one-quarter of the nurses with more than one job worked 50 or more hours per week, and they were more likely to work many days consecutively, without sufficient rest between shifts, and during scheduled time off. Single parents were as likely as those with more than one job to work 13 to 15 hours per day and many days consecutively. 

Sridhar Natesan, Shitij Kapur and colleagues compared loxapine, a typical antipsychotic, to isoloxapine, an antipsychotic that shows atypicality in some animal models. They conducted this study to understand the mechanisms underlying the differential typical/atypical profiles in these two drugs. Loxapine's behaviour as a typical antipsychotic is most likely due to its disproportionately high D2 occupancy. Appropriate action at D2 receptors in vivo, rather than the high 5-HT2/D2 ratio, seems to be critical in determining why isoloxapine behaves like an atypical antipsychotic.

Two clinical scientists who work with patients with schizophrenia, Gary Remington and Shitij Kapur, collaborated with animal behaviour expert José Nobrega to establish whether drug-dosing pattern might influence risk of motor movements in a rat model of tardive dyskinesia. The scientists found that when antipsychotic drugs were given by a single daily injection, relatively few motor movements developed even after many weeks of treatment. 

Zindel Segal contributed a chapter entitled “Mindfulness-Based Cognitive Therapy” to the book Innovations in Clinical Practice: Focus on Adults and Families. This chapter is a continuation of Dr. Segal’s extensive work in Mindfulness-Based Cognitive Therapy (MBCT), a sophisticated integrated treatment designed to prevent relapse and recurrence of depression in those who are in recovery. 

Laura Simich authored a knowledge translation (KT) case entitled “Expanding Established KT Networks to Respond to a Community in Distress.” This case study discusses Dr. Simich’s research and support for the Toronto Tamil community after the tsunami in 2004. The case study is part of the Canadian Institute of Health Information’s casebook Evidence in Action, Acting on Evidence.

Carol Strike was the lead author and principal investigator for the Ontario Needle Exchange Programs Best Practice Recommendations. The document synthesizes Canadian and international literature on needle exchange programs. It also provides concrete recommendations for the operational and practical challenges—and the challenge of controversy—faced by needle exchange programs.This document is the first of its kind in Canada.  Dr. Strike and colleagues investigated factors predicting two-year retention in methadone maintenance treatment (MMT), and the impact of repeat treatment episodes on retention. The study showed that the odds of remaining in treatment for 730 days or more increased with age, and varied by region and provider type, but decreased with increasing number of treatment episodes. In comparison with other studies, these analyses showed much higher rates of retention in MMT, but suggest that repeat episodes may not be as beneficial as existing research suggests. Retention in MMT beyond 12 or 24 months is important for positive treatment outcome.

 Tony Toneatto led a pilot investigation comparing two treatments for concurrent alcohol dependence, and panic disorder with agoraphobia. In the subject sample that completed the study, the results showed that there were no group differences in frequency or quantity of alcohol consumption or in anxiety symptoms, either post-treatment or at a one-year follow-up. Both groups showed within-group improvements on measures of both alcohol and anxiety symptomatology. About one-third of the subjects made clinically relevant gains in both alcohol and anxiety symptoms. A brief behaviour therapy for concurrent alcohol dependence and agoraphobia appears encouraging.

Dr. Toneatto, Brian Rush, Karen Urbanoski and colleague published an article describing the prevalence and overlap of psychiatric symptoms among clients at a substance use treatment facility. The data showed a high rate of co-morbidity between substance use and clustered psychiatric symptoms. Multi-morbidity was associated with selected social variables, in particular lower social support, higher rate of unemployment and female gender. Clients with more substance use disorders presented more psychiatric symptoms.

Rachel Tyndale and colleagues found that a variation in the CYP2A6 gene can affect the level of nicotine that people receive from nicotine patches. Her work indicated that people who metabolize nicotine slowly had higher levels of nicotine in their blood when using the patches than did those who metabolize it more quickly. These findings suggest that people with the gene for fast nicotine metabolism may need more of the smoking cessation chemical to calm cravings and help them stop smoking.  Dr. Tyndale and colleagues also found sex differences in response to nicotine. Using an animal model, this study showed that male mice that consumed high amounts of nicotine had higher levels of CYP2A4/5 protein levels (the mouse homologue of human CYP2A6). These mice also metabolized nicotine faster than the did those who consumed less nicotine. In contrast, female high- and low-nicotine consumers did not show pronounced differences in CYP2A4/5 protein levels or nicotine metabolism.

John Vincent and colleagues from the Hospital for Sick Children identified novel mutations in exon 1 of MECP2 in the gene that causes Rett syndrome, a disorder of mental retardation. This discovery has now been licensed as a test for the disorder and is available to the public.

Martin Zack investigated the effects of contingent gambling-drinking patterns, and the effects of problem drinking severity on implicit gambling-alcohol associations. The study showed that participants had a tendency to drink in response to gambling wins, and more severe alcohol problems coincided with stronger associations in memory between gambling wins and alcohol concepts. Such associations can promote drinking and its attendant effects (e.g., poor decision-making) in people with gambling problems. These associations may contribute to co-morbid gambling and alcohol use disorders

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