Research Roundup 1993

Low cholesterol and depression
Dementia in AIDS patients
Prevalence of depressive symptoms in primary care
Anxiety predicting hypertension in Framingham Study
Blood flow in Broca's area during hallucinations in schizophrenia


Plasma cholesterol and depressive symptoms
(Morgan RE; Palinkas LA; Barrett-Connor EL; Wingard DL. Lancet 1993 Jan 9;341(8837):75-9)

Reductions in coronary heart disease mortality by reducing cholesterol have been offset by an unexplained rise in suicides and other violent deaths isn some studies. This study looked at whether depressive illness is related to low plasma cholesterol concentrations in men of 50 years and older. In 1985-87, Beck depression inventories were obtained from 1020 white men, aged 50-89 years, in the Rancho Bernardo, California, cohort. Disease history and behaviours were assessed by standard questionnaires. Plasma cholesterol and weight were measured at this time, as they had been in 1972-74. Among men aged 70 years and older, categorically defined depression was three times more common in the group with low plasma cholesterol than in those with higher concentrations ( p = 0.033). The association held true even after adjustment for age, health status, number of chronic illnesses, number of medications, and exercise, as well as measured weight loss and change in plasma cholesterol in the previous 13 years.

Dementia in AIDS patients
(McArthur JC; Hoover DR; Bacellar H et al. Neurology 1993 Nov;43(11):2245-52)

This study determined incidence and future projections of dementia after AIDS onset in 492 homosexual men with AIDS in a US Multicenter AIDS Cohort Study, 64 of whom developed dementia. During the first 2 years after AIDS, HIV dementia developed at an annual rate of 7%. Overall, 15% of the cohort followed to their deaths developed dementia. The median survival after dementia was six months. Using a proportional hazards model, risk factors for more rapid development of dementia included anaemia and low body mass index and older age at AIDS onset. In a multivariate model, pre-AIDS hemoglobin remained the most significant predictor of dementia.

Prevalence of depressive symptoms in primary care.
(Zung WW; Broadhead WE; Roth ME. Journal of Family Practice 1993 Oct;37(4):337-44)

Depression is one of the most common disorders seen in primary care. This study attempted to estimate the prevalence of depressive symptoms in primary care across the United States. Survey data were obtained from a sample of 75,858 patients who visited one of 765 participating primary care physicians for any reason from February 1991 to September 1991. The outcome measurement used was the Zung Self-rating Depression Scale. The overall prevalence of clinically significant depressive symptoms was found to be 20.9%, but the percentage of patients citing depression as a reason for visit (1.2%) was markedly lower.Women, those in older age groups, and those with lower educational attainment were more likely to have clinically significant depressive symptoms. Married men and women were the least likely to have clinically significant depressive symptoms.

Anxiety predicting hypertension in the Framingham Study.
(Markovitz JH; Matthews KA; Kannel WB et al. JAMA 1993 Nov 24;270(20):2439-43)

A cohort of 1123 men and women without evidence of hypertension at baseline were followed up for 18 to 20 years. Baseline measures of anxiety (tension), anger symptoms, and expression of anger were taken, along with biological and behavioral predictors of hypertension (eg initial systolic blood pressure, heart rate, relative weight, age and smoking amongst others). Hypertension was defined as either taking medication for hypertension or blood pressures higher than 160/95 mm Hg at a biennial examination. In univariate analyses, middle-aged men who went on to develop hypertension had greater baseline anxiety levels than men who remained normotensive (P = .04). Older hypertensive men had fewer anger symptoms at baseline (P = .04) and were less likely to hold their anger in (P = .01) than normotensives. In multivariate Cox regression analysis including biological predictors, anxiety remained an independent predictor of hypertension in middle-aged men (P = .02).

Increased blood flow in Broca's area during auditory hallucinations
(McGuire PK; Shah GM; Murray RM. Lancet 1993 Sep 18;342(8873):703-6)

Verbal auditory hallucinations are common in schizophrenia.In this study single photon emission tomography (SPET) was used to measure regional cerebral blood flow to locate brain areas that are especially active during auditory hallucinations. We scanned twelve men with schizophrenia while they were experiencing hallucinations. The subjects were rescanned under identical conditions when their hallucinations had resolved (mean 19 weeks later). Blood flow was significantly greater during hallucinations than in the non-hallucinating state in Broca's area (mean count density on SPET 1.18 [SD 0.04] vs 1.13 [0.06]; p < 0.001); flow was also higher during hallucinations in the left anterior cingulate cortex and regions in the left temporal lobe, but these differences did not achieve significance.

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