Journal Digest

Exposure to secondhand smoke can lead to symptoms of major depressive disorder, generalized anxiety disorder, attention-deficit/hyperactivity disorder, and conduct disorder in children and adolescents, according to a report in the April Archives of Pediatric and Adolescent Medicine. The results were gleaned from the National Health and Nutrition Examination Survey (NHANES), a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations. NHANES is a major program of the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

Frank Bandiera, M.P.H., of the Department of Epidemiology and Public Health at the University of Miami Miller School of Medicine, and his colleagues looked at children and adolescents aged 8 to 15 who participated in the NHANES from 2001 to 2004. Serum levels of cotinine, a metabolite of nicotine that serves as a biomarker for exposure to tobacco smoke, were determined to confirm secondhand smoke exposure among nonsmokers. Information on mental disorders in the study participants was derived from the National Institute of Mental Health's Diagnostic Interview Schedule for Children Version IV.

The association of serum cotinine levels with symptoms of mental health disorders remained even after adjusting for survey design, age, sex, race/ethnicity, poverty, migraine, asthma, hay fever, maternal smoking during pregnancy, and allostatic load. These associations were more apparent for boys and for subjects of non-Hispanic white race/ethnicity.

"Future research is warranted to establish the biological or psychological mechanisms of association," said Bandiera and colleagues.

For many patients, weight gain poses a serious threat to successful treatment for psychosis. Especially in women, it can lead to other morbidities, including type II diabetes mellitus, hypertension, and other cardiovascular diseases. It may also contribute to reduced treatment compliance. While the atypical antipsychotics olanzapine and clozapine are the more well-known culprits in weight gain, almost none of the atypical and typical antipsychotics are free of this side effect. The idea that certain genetic risk factors may be important to produce weight gain and therefore enable individualized treatment in patients receiving antipsychotics is supported by the substantial interindividual and interracial differences in antipsychotic-induced weight gain.

One gene possibly involved in the multifaceted development of antipsychotic-induced obesity is the roundabout axon guidance receptor, homolog 1 (ROBO1) gene. In a recently published cross-sectional study of a pooled sample of Dutch Caucasian psychiatric patients, 435 patients—335 of whom had a diagnosis in the schizophrenia spectrum, 77 of whom had schizoaffective disorder, two of whom had schizophreniform disorder, and 21 of whom had a psychotic disorder not otherwise specified—were evaluated for a single nucleotide polymorphism (rs1455832) of ROBO1. Investigators then investigated the association between body mass index (BMI) of the subjects and the presence of rs1455832.

The results were gender specific: The rs1455832 polymorphism studied was significantly associated with BMI and obesity in female patients and therefore may play a role in inducing obesity in female patients using antipsychotics. This association was not exhibited in male patients.

The study was conducted by Jelle Vehof, M.D., of the departments of Psychiatry and Epidemiology of the University Medical Center Groningen, Groningen, the Netherlands, and colleagues.

A new study has determined that migrants from Mexico to the United States are more prone to depressive or anxiety disorders than are the nonmigrant family members they left behind. Researchers in California and Mexico performed a population survey of 554 Mexican migrants to the United States and 2,519 nonmigrant family members in Mexico, looking for the first onset of any depressive or anxiety disorder.

Results indicated that, after arrival in the United States, migrants had a significantly higher risk for first onset of any depressive or anxiety disorder than did nonmigrant family members of migrants in Mexico. The associations between migration and disorder varied with age, but the elevated risk was restricted to those aged 18 to 35, with particularly strong association in the youngest migrants, aged 18 to 25.

"The findings are consistent with the hypothesized adverse effect of migration from Mexico to the United States on the mental health of migrants, but only among migrants in recent birth cohorts," said Joshua Breslau, Ph.D., of the Department of Internal Medicine at the University of California, Davis, School of Medicine and colleagues.

A study published in the March 8 Neurology examined the use of ibuprofen in relation to the risk for Parkinson's disease (PD). The study, conducted in Boston, sought to determine whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in general, and ibuprofen in particular, might mediate the neuroinflammation that contributes to the pathogenesis of PD. Researchers prospectively examined whether use of ibuprofen or other NSAIDs was associated with lower risk for PD among 136,197 participants in the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) free of PD at baseline (1998 for NHS, and 2000 for HPFS). During six years of follow-up, 291 incident PD cases were identified. Users of ibuprofen had a significantly lower risk than nonusers after adjustment for age, smoking, caffeine intake, and other covariates. Use of other types of analgesics was not associated with lower risk. "The association between use of ibuprofen and lower PD risks, not shared by other NSAIDS or acetaminophen, suggests ibuprofen should be further investigated as a potential neuroprotective agent against PD," concluded the researchers.