Journal Digest

The largest ever DNA-sequencing study of anorexia nervosa (AN) links the eating disorder to genetic variance in epoxide hydrolase 2 EPHX2—a gene that regulates cholesterol metabolism.

Sequencing multiple genes from blood samples of approximately 3,000 patients with and without AN, the researchers found that EPHX2 occurred more frequently in people with AN, in addition to being associated with low body mass index.

The study, published in Molecular Psychiatry, noted that previous work has shown an association between high cholesterol levels, weight loss, and improved mood. According to the authors, certain individuals with AN, for genetic reasons, may not eat due to euphoria attributed to high circulating levels of cholesterol. They emphasized that more work must be done to assess the biological effects of EPHX2 variance.

Scott-Van Zeeland, A, Bloss, A, et al. “Evidence for the Role of EPHX2 Gene Variants in Anorexia Nervosa.” 2013. Mol Psychiatry. Sep 3 [Epub ahead of print] http://www.nature.com/mp/journal/vaop/ncurrent/abs/mp201391a.html.

Researchers from the University of Auckland in New Zealand published in the Lancet the first trial comparing the efficacy of electronic cigarettes (e-cigarettes) with nicotine patches in achieving smoking cessation.

Broken into three groups, nearly 700 smokers received a 13-week supply of commercially available e-cigarettes, 13 weeks’ supply of nicotine patches, or placebo e-cigarettes. After six months, cigarette consumption was markedly reduced in the nicotine e-cigarette group, compared with nicotine-patch and placebo groups. In addition, subjects in both the nicotine and the placebo e-cigarette groups were almost four times as likely to be adherent to treatment as those receiving patch therapy. Though the success rate for absolute cessation was higher in the e-cigarette group, it did not differ significantly from that of those administered nicotine patches.

The authors concluded, “Our study establishes a critical benchmark for e-cigarette performance compared to nicotine patches and placebo e-cigarettes, but there is still so much that is unknown about the effectiveness and long-term effects of e-cigarettes. Given the increasing popularity of these devices in many countries, and the accompanying regulatory uncertainty and inconsistency, larger [and] longer-term trials are urgently needed to establish whether these devices might be able to fulfill their potential as effective and popular smoking-cessation aids.”

Bullen C, Howe C, Laugesen M, et al. ”First Trial to Compare e-Cigarettes With Nicotine Patches.” 2013. Lancet. Sep 9. [Epub ahead of print] http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(13)61842-59.

A recent study in Pediatrics assessed whether adoption status poses a greater risk for suicide attempt among adopted offspring than nonadopted offspring. The study, conducted by the Minnesota Center for Twins and Family Research at the University of Minnesota, investigated suicide-attempt records and suicidal behavioral factors—including psychiatric and substance abuse disorders—in 692 adopted and 540 nonadopted teenagers.

The results showed that adoptees were four times as likely to attempt suicide than nonadopted individuals. The relationship between adoption status and suicide attempt was also influenced by suicidal behavioral factors.

The authors said that the study’s results could be useful for clinicians treating adopted individuals who already show other signs of being at risk for suicide.

Keyes, M, Malone, S, Sharma, A. et al. “Risk of Suicide Attempt in Adopted and Nonadopted Offspring.” 2013. Pediatrics. Sep 9. [Epub ahead of print] http://pediatrics.aappublications.org/content/early/2013/09/04/peds.2012-3251.long.

According to a study published in Annals of Family Medicine, characteristics of the Medicaid-eligible population will begin to look quite different at the beginning of 2014 in states that choose to expand the program to millions of their uninsured citizens. Tammy Chang, M.D., an assistant professor in the Department of Family Medicine at the University of Michigan, conducted a national study projecting the demographic and health characteristics of potentially eligible Medicaid beneficiaries.

The study outcome projected that new Medicaid beneficiaries who gain coverage under the Affordable Care Act are more likely to be younger, white, and male and have a diagnosis of substance abuse—particularly alcohol and smoking—than current beneficiaries.

“Based on our analysis, Medicaid expansion represents a key opportunity to improve the health of millions of uninsured individuals and reduce national costs associated with smoking and excessive alcohol use,” Chang said. “Coverage for these Americans may be coming at just the right time to provide access to health care that can help keep these Americans healthy through prevention and improving healthy behaviors.”

Chang T, Davis M. “Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries.” 2013. Annals of Family Medicine. 11(5)406-411. http://www.annfammed.org/content/11/5/406.long.

While studies have pointed to negative consequences of children’s excessive video-game playing, when adults try their hand at these games, it may increase their cognitive control, a recent study in Nature suggests.

Researchers at the University of California, San Francisco, created a 3-D racecar video game that measured cognitive control in adults who were instructed to notice specific road signs while driving full speed—virtually. After one month of video-game participation, adults aged 60 to 85 were evaluated for alterations in multitasking, working memory, and attention sustainment.

Results showed that multitasking capabilities, working memory, and attention sustainment were dramatically increased and sustained six months after the video-game training. In addition, multitasking capabilities of seniors surpassed that of young adults who played the game for the first time.

The authors noted that this is the first study to show how custom-designed video games can be used to assess cognitive abilities across the lifespan. If the research is replicated, this could be a beneficial application to other brain-related disorders such as attention-deficit/hyperactivity disorder, depression, and dementia, which are also associated with deficits in cognitive control, the authors concluded.

 Anguera J, Boccanfuso J, Rintoul J, et al. “Video Game Training Enhances Cognitive Control in Older Adults.” Nature. Sep 5. [Epub ahead of print] http://www.nature.com/nature/journal/v501/n7465/full/nature12486.html.

Researchers at the University of Arkansas for Medical Science assessed the well-being of children living in households with disabled siblings. The study divided 6,800 children and adolescents into two groups—those who lived with a sibling with a disability and those who did not. Functional impairment—as reported by parents—was measured by the Columbia Impairment Scale.

After adjusting for demographic characteristics, 20 percent of individuals growing up with disabled siblings were documented as having significant functional impairment, compared with 10 percent in the cohort without disabled siblings.

The researchers noted that functional impairment is a critical indicator of the need for mental health services and that health care professionals need to consider a family-based care approach for those in households with disabled children.

Goudie A, Havercamp S. “Assessing Functional Impairment in Siblings Living With Children With Disability.” Aug 2013. Pediatrics. 132(2):476-83. http://pediatrics.aappublications.org/content/132/2/e476.long. ■