Insomnia and Anxiety May Be Genetically Linked

(HealthDay News) -- A genetic link between anxiety, depression and insomnia has been identified by U.S. researchers, who said adolescents who suffer from anxiety and depression should also be screened for insomnia. Read more

Thou Shalt Get Busy? Religious Leaders Ask Congregants to Have More Sex

By Sally Chew

Istockphoto/Health
When Fellowship Church Rev. Ed Young last month called for members of his evangelical mega-church to have seven days of sex, he said it was to foster intimacy and faithfulness. But I wondered what else the quirky young pastor might turn up—on purpose or not—with his new headline-grabbing campaign.

Having frequent sex is believed to help ward off prostate cancer, heart problems, depression depression, and even outward signs of aging. So even if just a core group of Fellowship’s 20,000 members manage to double their rates of “congregational copulation”—as Young suggested—they might reap some physical benefits too. Read More

Children of Centenarians Face Lower Heart Risks

(HealthDay News) -- Longevity runs in families, the saying goes, and new research shows there may be genetic and physiological reasons for the phenomenon.

The children of people who live to 100 and beyond are themselves much less likely to develop cardiovascular diseases, such as heart disease and stroke, and even diabetes, researchers found.

But they aren't impervious to non-cardiovascular health problems, such as cancer, dementia and depression.

The findings stem from an analysis of health data collected over a decade by the New England Centenarian Study, which focuses on people aged 97 and older and their family members. It's the first study to track the health of children of centenarians as they age.

"This confirms what we were already suspecting, and definitely suggests that there is a genetic component to the ability to create exceptional longevity," said study author Emily R. Adams, a third-year medical student at Boston University School of Medicine.

Adams and her Boston University colleagues, Dr. Dellara F. Terry and Dr. Thomas Perls, director of the New England Centenarian Study, presented their findings in the November issue of the Journal of the American Geriatrics Society.

For the 10-year study, initial and follow-up questionnaires regarding health status were presented to 440 children of centenarians, as well as to 192 men and women whose parents had not lived past 100. The average age of the participants was 72 when the study began in 1997.

The researchers found that compared to the average adult, children of centenarians had a 78 percent lower risk for a heart attack, an 83 percent lower risk for a stroke, and an 86 percent lower risk for developing diabetes.

They were also 81 percent less likely to die during the course of the study.

The researchers said the findings generally reinforce the important role that genetics play in reaching extreme old age, and specifically highlight the cardiovascular leg up children of centenarians appear to inherit from their parents.

But, Adams added, while good genetic lineage may portend a longer life, it doesn't guarantee protection against all diseases.

"You might expect that centenarian offspring would do better as they age, and that is true. They do follow a different trajectory, and go down a less steep slope," she said.

But, Adams noted that the study found that children of centenarians do not, for example, experience significantly lower rates of arrhythmias, cancer, macular degeneration, dementia, depression, fractures, osteoporosis and thyroid disease.

"It's really with the vascular diseases that they fared better," she said.

Jay Olshansky, a senior research scientist at the University of Chicago's Center on Aging, said future work in this arena will focus on trying to isolate the mechanism behind genetic longevity.

"This study looked at outcomes and is directly in line with what you would expect," said Olshansky, who's also a professor with the university's school of public health. "But that is where this research is going next -- to find out how this very strong genetic component to living long plays out.

"But the bottom line," he added, "is that we already know that the genes that are associated with exceptional longevity already exist, and that they are concentrated in subgroups of the population. And the rest of us don't have those genes, or don't have all of them. Those who do have won the genetic lottery for making it out to exceptional old age. And, unfortunately, if you haven't won, there's no chance you can make it."

More information
To learn more about centenarians, visit the Howard Hughes Medical Institute.

Brain Chemical Could Spur Lovesickness

(HealthDay News) -- Pity the lovelorn prairie vole. A new study finds that when this monogamous rodent is separated from a mate, its brain starts a process that ends in lovesickness.

The same mechanism might drive the feelings humans get when parted from a longtime mate, scientists say.

And it could also keep couples together -- even when it's not good for them.

"We all know of people who are in a long-term relationship where you can't imagine why they are together. It may be that we are getting glimpses of real brain mechanisms that are causing that," said study senior author Larry Young, a psychiatry professor at Emory University's Center for Behavioral Neuroscience, in Atlanta.

He and his colleagues published their findings Oct. 15 in the journal Neuropsychopharmacology.

It's not a stretch to compare the love life of the prairie vole to that of humans, say scientists who study the neuroscience of human coupling. The female vole lives less than two years and gives birth once every 21 days, but she spends her entire life with the same male. This kind of monogamy is rare in the animal kingdom, Young added.

"But in some species, there is something else that happens -- a bond forms between the two that can last one season or multiple seasons," he said. "It's not just about sex, it's about the relationship between the two."

So, the prairie vole has long been a relied-upon animal model for human coupling, which tends toward monogamy. In September, for example, researchers in Sweden announced they had found a "bonding gene" that seemed to encourage men to stay faithful. That work stemmed from previous studies conducted with male prairie voles.

In this latest work, Young and his group examined the brains of a variety of adult male voles. Some of the voles had lifelong female partners, while other hadn't had time to form such bonds and were best acquainted with brother or sister voles.

All of the voles were subjected to brief stress tests, such as a swimming challenge, or being placed in a maze.

"The ones who were [still] with a partner, or had just been separated from a sibling so they never formed a romantic bond in the first place, actively avoided the aversive or stressful situation," Young noted.

But what about male voles who had been recently separated from a longtime female partner?

These voles "basically were passive -- they gave up," Young said. "I would be hesitant to say that these animals were depressed, but their behavior is reminiscent of what you would see in a depressed person."

Examination of the brains of the lovesick voles revealed heightened activity of a chemical messenger called corticotropin releasing factor (CRF) in an area of the hypothalamus, a center for emotions in the brain.

When the researchers administered a drug that blocked CRF activity, voles who'd been separated from their mate began to perform just as vigorously in the stress tests as all the other voles tested. It seemed the drug "switched off" the mechanism -- and their lovesickness, as well.

Young's team said it's important to note that CRF activity kicked in only when the vole was separated from a longtime female partner, not a sibling companion.

That suggests a neurological mechanism that pushes monogamous males and females back together.

"Separating, you experience an aversive reaction. And you are driven to go back to the partner to alleviate that," Young said. "Maybe that plays an important role in maintaining relationships."

While the study is aimed at better understanding how the brain reacts to partner loss, the notion of a pharmaceutical fix for lovesickness isn't out of the question, experts said.

Drugs that suppress CRF "in some studies have been shown to function as antidepressants," noted Hasse Walum, a researcher at Sweden's Karolinska Institute who co-authored the bonding gene study.

According to Walum, it would be interesting now to see if anti-CRF drugs "would be more effective in reducing depression induced by partner loss than they would be helping patients suffering from depression caused by other factors."

He also noted that humans vary widely in how severely they react to the loss of a longtime romantic partner, perhaps because their genes govern CRF activity differently.

Another expert believes that lovesickness can lead to very real illness, so it's worth investigating.
"When it becomes detrimental to your functioning in life and health, that's when it's important to understand this and to find potential treatments," said Paul Sanberg, director of the Center of Excellence for Aging and Brain Repair at the University of South Florida, Tampa.

But the day when humans can take a pill to help forget a love affair gone bad is still far off, Young cautioned.

"I don't want to say that this is leading directly to any kind of treatment," he added. "What this will lead to is, perhaps, some investigations in humans to find if this system is involved and could it possibly be targeted, if we need to."

More information
There's more on how the mind works at The Whole Brain Atlas.

Tests May ID Older Patients at Risk for Post-Op Delirium

(HealthDay News) -- Two simple tests may predict which older patients have underlying depression or less cognitive flexibility, leaving them vulnerable to post-surgery delirium, a new study suggests.

Delirium, a state of extreme confusion that can be short-lived or more long-term, can be frightening to families and costly for the health-care system, explained study lead author Dr. Terri Monk, a professor of anesthesiology at Duke University School of Medicine.

A recent study showed that health-care costs go up another $2,500 for each patient with delirium following surgery, because of longer hospital stays, higher death rates and the need sometimes to admit patients to long-term care. The annual national cost may reach as high as $152 billion a year, Monk said.

"When you look at the increase in the aging population, this is going to be more of a problem," she added.

Dr. Arnold Berry, a professor of anesthesiology at Emory University School of Medicine, Atlanta, said the impact of the problem is already clear, considering that about 12 percent of the U.S. population is 65 or older and this group accounts for one-third of expenditures on surgery.

The Duke study of 100 patients, averaging 65 years of age, found that 16 percent experienced post-operative delirium after they'd received general anesthesia for non-cardiac surgery. Specific percentages can be as high as 50 percent or more for patients having surgery following a hip fracture, Monk noted.

The two pre-surgery tests -- the Geriatric Depression Scale-Short Form and the Trail Making Test -- can be administered by nurses and other health-care personnel in as little as 15 minutes, Monk said. The finding that these tests are effective screening tools could lead to further research to identify measures to prevent or reduce post-operative delirium, she said, adding that current interventions are limited.

For example, further research might show that treating depression in older patients prior to elective surgery reduces their likelihood of post-operative delirium, she said.

Monk is scheduled to present the study's findings Oct. 20 at the American Society of Anesthesiologists' annual meeting, in Orlando, Fla.

Emory's Berry, who leads a group of anesthesiologists interested in geriatric issues, said Monk's findings are "one piece to a big puzzle." Because of changes in the aging brain, it's difficult to determine how much the stress of surgery and how much anesthesia add to the risk of post-operative delirium, he said.

The Duke study identifies screening tools that could spur more research into ways of dealing with both factors as they relate to post-op delirium, Berry explained. He said he doesn't plan to add the screening tools used in the Duke study to his pre-operative work-ups -- at least not yet.

"They are something that's promising, but I think most people would wait until it has undergone peer review and has been published," he said.

Monk said the study has been submitted for publication.

In a related study, Canadian researchers reported last month that people who take cholesterol-lowering statin drugs -- such as Crestor, Lipitor, Pravachol and Zocor -- are more likely to suffer delirium after surgery. That finding was published in the Canadian Medical Association Journal.

More information
To learn more about anesthesia for older patients, visit the American Society of Anesthesiologists.

Panel: Heart patients should be screened for depression

DALLAS (AP) -- Heart patients should be regularly screened for signs of depression, the American Heart Association recommended Monday.

Depression is about three times more common in heart attack survivors and those hospitalized with heart problems than the general population, according to the recommendations published in the journal Circulation.

The authors said only about half of heart doctors say they treat depression in their patients -- and not all those diagnosed with depression are treated.

"I think we could reduce considerable suffering and improve outcomes," by screening, said Erika Froelicher, professor of nursing at the University of California, San Francisco. "I know we can do more."

While there's no direct evidence that heart patients who are screened fare better, depression can result in poorer outcomes and a poorer quality of life, the panel said. Depressed patients may skip their medications, not change their diet or exercise or take part in rehabilitation programs, they said.

Anyone from cardiologists to nurses to primary care doctors can and should be involved in determining whether a patient is depressed, said Froelicher, who was co-chair of the panel that wrote the recommendations. Continue Reading >>

Stress Disorder Affects 20% of Intensive Care Patients

(HealthDay News) -- About 20 percent of intensive care unit survivors experience symptoms of post-traumatic stress disorder.

That's the conclusion of a study by researchers who reviewed data from 15 previous studies that included 1,745 former ICU patients in the United States and a number of European countries.

The review authors concluded that the trauma of an ICU stay can trigger PTSD symptoms and negatively affect a person's quality of life after they leave the hospital. In studies that used questionnaires to evaluate patients' symptoms, 22 percent of former ICU patients developed PTSD symptoms. In studies that relied on clinician diagnosis, 19 percent of former ICU patients developed PTSD symptoms, the review found.

Nightmares, sleep problems, flashbacks, irritability, anger and feelings of emotional detachment or numbness werere among the symptoms of PTSD.

"Considering that about four million people visit the ICU every year in the United States alone, it's a significant public health issue," review lead author Dr. Dimitry Davydow, an assistant professor in the department of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle, said in a Center for the Advancement of Health news release.

Certain factors increased the risk of PTSD after an ICU stay, such as having a prior history of mental health disorders, especially anxiety or depression.

In such patients, "stressful situations can bring about exacerbations of their underlying psychiatric illness. To be treated in an ICU, a person is critically ill and often near death, so it's a very severe stressor. That combination may lead to a later exacerbation of their prior psychiatric disorder," Davydow said.

The review authors also found that patients sedated with benzodiazepine medications (such as Valium and Xanax) were more likely to develop PTSD symptoms, as were those who recalled frightening experiences while they were in the ICU.

"The use of sedatives in the ICU is important, because people need to be sedated if they require mechanical ventilation or other invasive procedures," Davydow said. But he noted that some sedatives, such as benzodiazepines, are more likely to cause disorientation, confusion and psychotic experiences that are so frightening that patients perceive them as an actual traumatic event.

The study was published in the September/October issue of the journal General Hospital Psychiatry.

More information
The U.S. National Institute of Mental Health has more about PTSD.

Brain's Serotonin May Explain Seasonal Mood Changes

(HealthDay News) -- Fluctuations in the actions of the serotonin transporter, which helps regulate the mood-altering neurotransmitter serotonin, may help explain seasonal affective disorder and related mood changes, researchers say.

In places where the weather changes with the seasons, people commonly feel happier and more energetic when the days are bright and sunny and more depressed and fatigue during the dark of winter. Scientists believe this is related to variations in brain levels of serotonin, a neurotransmitter involved in regulating functions such as mating, feeding, energy balance, and sleep.

In a study published in the September issue of the Archives of General Psychiatry, researchers from the Centre for Addiction and Mental Health and the University of Toronto had 88 healthy people undergo a positron emission tomography (PET) scan to assess serotonin binding potential, which indicates serotonin transporter density. The higher the serotonin binding potential, the less serotonin that is circulating in the brain.

To study seasonal fluctuations of serotonin binding potential, the researchers grouped the PET scans according to the season of the scan -- fall and winter or spring and summer.

The serotonin binding potentials were significantly higher during the fall and winter months than in the spring and summer, indicating that less serotonin circulates in the brain during the darker, colder time of the year. The researchers compared their findings to meterological data and found higher values of serotonin binding potentials during times when there were fewer hours of sunlight each day.

The researchers said that higher serotonin binding potential in the winter may help explain why people report lower mood, lack of energy, fatigue, overeating, and increased sleeping during the darker seasons.

"This offers a possible explanation for the regular reoccurrence of depressive episodes in fall and winter in some vulnerable individuals," the researchers wrote.

More information
The American Academy of Family Physicians has more about seasonal affective disorder.

The Feel-Good-Enough Drugs

Antidepressants are widely prescribed because they restore balance. But balance isn’t happiness
by Walter Armstrong

I’ve been taking antidepressants since 1994. That may seem like a long time, but since I expect to pop these pills every morning until I die, I’ve stopped keeping count. You could say I’m reconciled to the fact that I was born with bad brain chemistry and need a little extra push to reach that state familiar to everyone but the chronically depressed as well-being. I like it there and have no intention of leaving.

I remember vividly the moment when Prozac first kicked in, like switching from black-and-white to color. I was talking on the phone to a friend who was telling me about her problems, which included taking care of a husband who was dying of AIDS. I heard in the familiar tone of her sad voice how hopeless she felt, but for the first time it failed to find an echo inside me. I proceeded to deliver my first-ever pep talk to her, with all the annoying sincerity of a fresh convert to hope.

The novelty wore off soon enough.
Continue reading "The Feel-Good-Enough Drugs" »

Marijuana Use Among MS Patients Raises Risk for Cognitive, Mood Problems

(HealthDay News) -- Multiple sclerosis patients who smoke marijuana in search of symptom relief are more likely to suffer cognitive shortfalls and mood disorders, new Canadian research suggests.

A slowing down in the ability to process and remember information is one significant side effect, as is a rise in the rate of depression and anxiety.

"This is a small study, so our findings are preliminary, but the bottom line is that multiple sclerosis patients who smoke cannabis appear to be at an increased risk for cognitive issues, particularly with respect to the speed of their thinking," said study author Dr. Anthony Feinstein, a professor of psychiatry with the Sunnybrook Health Sciences Centre's department of psychiatry at the University of Toronto.

Feinstein's observations are published in the Feb. 13 online edition of Neurology and are focused exclusively on the impact of smoking marijuana illegally obtained by patients themselves. Medically prescribed marijuana was not studied.

The authors noted that a "significant minority" of multiple sclerosis patients smoke marijuana to combat the tingling, numbness, blindness and paralysis that can accompany the progressive and often disabling nervous system disease.

However, Feinstein's team stressed that scientists have yet to definitively prove that the psychoactive substance -- long linked to psychosis, anxiety and delirium among healthy users -- provides a measurable benefit to the more than 400,000 Americans and 2.5 million people worldwide who suffer from the disease.

The researchers therefore assessed the experience of 140 Toronto-based MS outpatients, 10 of whom had smoked the drug at least once in the previous month and were considered regular marijuana users.

All the patients -- three-quarters of them women -- underwent cognitive and mental health exams by a neurologist and a neuro-psychiatrist. Interviews were also conducted to assess disease severity and course, medications being used, and current disability.

Feinstein and his team observed that while pot smokers were younger, there were no differences between marijuana users and nonusers in terms of gender, education, or MS disease course or duration.

However, MS patients who used marijuana were found to perform 50 percent slower on tests tracking information-processing speed and were more likely than nonusers to have a mental disability of some kind.

Marijuana use was also associated with a greater risk for being depressed or experiencing anxiety. However, the authors were not able to determine whether the drug had triggered such conditions, or if patients had sought out marijuana to help deal with a preexisting emotional issue.

They nonetheless cautioned that smoking marijuana might further raise the risk for experiencing the kind of neuro-psychological impairment that typically occurs among 40 percent to 65 percent of all MS patients.

Feinstein said that he next hopes to gather a much larger pool of patients, while exploring possible differences in the health impact of street-purchased marijuana versus prescribed cannabis.

Meanwhile, Dr. Marshall Keilson, director of neurology at Maimonides Medical Center in Brooklyn, N.Y., said he thinks it best to proceed on a case-by-case basis.

"There are some MS patients who are emotionally disabled from their disease, and if we can use cannabis to help them feel better about the world or life, we should," he said. "We need to always err on the side of doing what's best for our patients. And I don't necessarily believe there is a permanent damage to the brain, based on occasional marijuana use. If they're smoking 10 times a day, yes, there will be damage done. But this goes for excessive alcohol use, too. So, I think we're going to end up somewhere in the middle with this."

More information
For more on multiple sclerosis, visit the National Multiple Sclerosis Society.

Health Tip: Don't Suddenly Stop Taking an Antidepressant

(HealthDay News) - If you want to stop taking an antidepressant, it's important to speak with your doctor first, the American Academy of Family Physicians says. The doctor may recommend weaning your body off the medication gradually.

People who stop an antidepressant too quickly may trigger a host of symptoms that doctors call antidepressant discontinuation syndrome. Symptoms may include:

• Anxiety.
• Feelings of depression or sadness.
• Moodiness and irritability.
• Tiredness.
• Headaches and dizziness.
• Nausea and vomiting.
• Diarrhea.

If an antidepressant is causing an unpleasant side effect, your doctor may opt to lower your dose or prescribe a different type of antidepressant altogether.

Breast Is Best for Reducing Stress

(HealthDay News) -- Breast-feeding is considered a great way for a mother to form a close bond with her infant. And now there's evidence to suggest it may also help kids be more resilient to stress.

Researchers in Sweden and the United Kingdom examined data on almost 9,000 children born in Great Britain in 1970. Relevant information was collected at birth and again at ages 5 and 10 from parents, teachers, health-care workers and midwives.

Teachers were asked to rate the kids' anxiety levels on a zero-to-50 scale at age 10. And parents were asked about major life events -- including divorce or separation -- that occurred when their children were between 5 and 10 years old.

Not surprisingly, children whose parents had divorced or separated were more likely to have high anxiety. But what the researchers found striking was the difference in stress levels between breast-fed and bottle-fed kids. Breast-fed children were significantly less anxious than kids who hadn't nursed at their mother's breast.

Lead author Scott Montgomery, an associate professor at the Karolinska Institutet in Stockholm, said the research team was interested in examining whether there are any specific early-life exposures that make children better able to cope with stress later in life. The study attempted to replicate animal studies that showed close physical contact between a mother and her offspring may have a positive impact on the development of the offspring's stress response, he said.

"The best marker of maternal physical contact in the first month of life that we could find among the research information at our disposal was breast-feeding," Montgomery said.

The American Academy of Pediatrics recommends that healthy women exclusively breast-feed their infants for at least the first six months of life and continue breast-feeding "for at least the first year of life and beyond for as long as mutually desired by mother and child."

Breast-feeding offers many health and development benefits for baby, says the National Institute of Child Health & Human Development. Kids get the right balance of nutrients to support optimal growth, fatty acids to promote brain development and protection against many childhood illnesses. And there are important emotional and physical benefits for moms as well.

"There is no question that breast-feeding is better for the health of mothers and children," said Nicole Else-Quest, an assistant professor of psychology at Villanova University in Pennsylvania, "but it is less clear how breast-feeding affects the mother-child relationship." Breast-feeding may help to establish an early bond, she added, but "it is only one of many ways to do so."
As for why there might be differences in stress between breast-fed and bottle-fed kids, Else-Quest said it is difficult to speculate "given that many factors influence the decisions to breast-feed in the first place."

The research team considered factors that might affect a child's reaction to stress and ability to cope, such as maternal depression, parental education levels, social class, and smoking habits. Even after accounting for those factors, breast-fed children were less anxious than their peers. In addition, bottle-fed children whose parents divorced were more anxious than breast-fed kids.
Yet the study findings don't prove that breast-feeding itself reduces anxiety. It may be a mark of close, early physical contact, the researchers noted.

"A child without such regular contact may perceive greater danger reacting to stress -- indicating a potentially dangerous situation -- with a more reactive and less well-controlled stress response," Montgomery said.

It's also possible, he added, that mothers who breast-fed simply have a better relationship with their child.

"The parent-child relationship influences the child's health and development in many ways," Montgomery said. "A good relationship with parents is important, and this relationship begins in infancy, so good early contact with the child is important."

The study findings were published in the journal Archives of Disease in Childhood.

More information
The National Institute of Child Health & Human Development has the latest research on breast-feeding.

Relatives of Parkinson's Patients at Higher Psychiatric Risk

(HealthDay News) -- The close relatives of people with Parkinson's disease are at increased risk for depression and anxiety disorders, new research suggests.

The risk is particularly high in the brothers, sisters, parents and children of people who develop Parkinson's before age 75, said a team from the Mayo Clinic in Rochester, Minn.

The study included 1,000 immediate relatives of 162 Parkinson's patients and 850 immediate relatives of 147 people without Parkinson's. It's the first large population-based study to identify this kind of association.

"Studies by our group and others have shown that relatives of patients with Parkinson's disease have an increased risk of Parkinson's disease. Recently, we showed they also have increased risk of essential tremor and of cognitive impairment or dementia. However, the risk of psychiatric disorders was unknown," senior author Dr. Walter Rocca, a neurologist and epidemiologist, said in a prepared statement.

"Because many patients with Parkinson's disease develop anxiety and depression after and even before the onset of the disease, we explored whether this tendency was present to a greater extent in family members of people with Parkinson's disease compared with people without the disease. We found that, indeed, relatives of patients with Parkinson's disease are at increased risk for anxiety and depressive disorders, which suggests a genetic or other relationship between those disorders and Parkinson's disease," Rocca said.

Further research is needed to determine the exact cause or causes that boost the risk, he said.

The study was published in the December issue of the journal Archives of General Psychiatry.

More information
There's more on Parkinson's disease at We Move.

'Easy Does It' Eases Holiday Stress

(HealthDay News) -- It's supposed to be the happiest time of the year, but don't tell that to the patients who mob the offices of San Diego cardiologist Dr. Mimi Guarneri between Thanksgiving and New Year's.

Some complain of what doctors call "holiday heart" -- skipped beats, high blood pressure and angina due to stress or overindulgence. Others feel physically and emotionally overwhelmed, distracted by thoughts of difficult relatives or missing loved ones.

Guarneri, medical director of the Scripps Center for Integrative Medicine, has different advice for her patients, depending on their situations. But she's always sure to emphasize one theme: relaxation.

"The one thing is do is to take time out, take a deep breath, connect your mind with your body by simple breathing," she said. "And remember to not sweat the small stuff."

Easier said than done, of course. But when it comes to crippling holiday stress, specialists say the simplest pieces of advice are also the best.

Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University in Durham, N.C., advises people to be reasonable with their expectations from the season, and to anticipate trouble -- ranging from long lines at stores and airports, to bouts of sadness when images of absent loved ones come to mind.

By readying yourself for these moments, "they won't come as a shock when you realize, 'I'm getting ready to honk my horn or get steamed over this person who just pulled in front of me.' If you can do that, you can probably head off some of it," Williams explained.

He said it's not clear how many people get the blues around the holidays, but it's probably not uncommon. "It's perfectly normal to get a little bit depressed or a little sad during the holidays at one point or another," Williams said.

However, it may not be as bad as some might assume. In recent years, American researchers have looked at local statistics and debunked the long-held assumption that suicide rates shoot up around the holidays.

Not every episode of Christmastime depression is minor, however. If you find yourself early in the new year having trouble with sleeping or eating -- doing either one too much or too little -- it's possible that you've fallen into a clinical depression.

If that might be the case, "You should seek some professional evaluation and possibly treatment," Williams said.

In other cases, a little self-help can be key. "In the grand scheme of life, we say, 'Don't sweat the small stuff,'" Guarneri said. "We have to realize that a lot of stress is what we put on ourselves, not what other people are putting on us."

If you're alone and feeling isolated, she said, "get out and do service work, which brings joy to people." And, if you have the opposite problem -- too much to do and too many people to worry about pleasing -- learn to do less. "None of this is worth dying for," she said.

More information
Learn more about holiday stress from the American Psychological Association.

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Depression Linked to Bone Loss in Younger Women

(HealthDay News) -- Premenopausal women struggling with depression have lower bone mass than do non-depressed women in the same age range, a new study found.

The bone loss was most pronounced in certain regions of the hip, which is troubling given that hip fractures are one of the most serious -- and potentially fatal -- consequences of osteoporosis.

The level of bone loss seen in the depressed women was the same or higher than that associated with other, established risk factors for osteoporosis, including smoking, low calcium intake and lack of physical exercise, the researchers said.

The findings, published in the Nov. 26 issue of the Archives of Internal Medicine, could have implications for the prevention of osteoporosis.

"Premenopausal women with depression should be screened for low bone mass," said Dr. Giovanni Cizza, senior author of the study who conducted the research while at the U.S. National Institute of Mental Health. "They should do a bone mineral density measurement, because osteoporosis is a silent condition. Until someone fractures, you don't know you have osteoporosis."

Cizza is now a staff clinician at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

A woman's bone mass peaks during youth then thins after menopause. Previous, preliminary studies had suggested that depression might be a risk factor for low bone mass in older women.

For this study, Cizza and his colleagues looked at 89 women with depression and 44 women without depression. The women ranged in age from 21 to 45. The depressed women were taking antidepressant medications.

Seventeen percent of the depressed women had thinner bone density in the femoral neck, a vulnerable part of the hip. Only 2 percent of non-depressed women, by contrast, had thinner bone in this area.

Twenty percent of depressed women also had low bone density in the lumbar spine, compared with 9 percent of the non-depressed women.

Blood and urine samples also revealed that the depressed women had lower levels of "good" proteins called cytokines. "The bad cytokines that may cause bone loss are higher," Cizza said.

It's not clear what role antidepressants might play, but by relieving the depression, the drugs may also help bone mineral density, the researchers said.

More information
To learn more about bone health, visit the National Osteoporosis Foundation.

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Sleep Problems Plague the Older Set

(HealthDay News) -- Older Americans often have difficulty getting a good night's rest. It's a huge quality-of-life problem, experts say, because contrary to popular belief, seniors require about the same amount of sleep as younger adults.

"Sleep problems and sleep disorders are not an inherent part of aging," said Dr. Harrison G. Bloom, a senior associate at the International Longevity Center-USA and associate clinical professor of geriatrics and medicine at the Mount Sinai School of Medicine in New York City.

"It's pretty much of a myth that older people need less sleep than younger people."

Yet, in a study published recently in The American Journal of Medicine, researchers found that more than half of older Americans have problems getting the shuteye they need.

Older people tend to have "sleep fragmentation," meaning they wake up more often during the night, said study author Dr. Julie Gammack, an assistant professor of medicine in the Division of Geriatric Medicine at St. Louis University.

They also seem to get less "REM" sleep, the type of sleep during which rapid eye movement occurs, Bloom added.

It's unclear what role these naturally occurring changes in sleep patterns have on a person's quality of life, Bloom said. "What is important, though, is that older people often have actual sleep disorders and problems with sleep," he said.

And, experts say, there is usually more than one cause.

"Sleep disturbance in older adults is typically associated with acute and chronic illnesses, including specific sleep disorders like sleep apnea and restless leg syndrome that appear with greater frequency in older populations," said Michael V. Vitiello, a professor of psychiatry and behavioral sciences and associate director of the University of Washington's Northwest Geriatric Education Center.

As people age, they typically develop more diseases and suffer from aches and pains. "These things can disrupt sleep, so what they may perceive as a sleep disorder may actually relate to the effects of some of their other medical problems," Gammack noted.

Taking multiple medications, as many older people do, can also lead to fatigue and "hypersomnia," or being tired all the time, Bloom added.

Another big problem, he noted, is depression and anxiety. "Those are very commonly associated with sleep problems."

Despite the prevalence of sleep difficulties in older adults, many patients aren't getting the help they need.

"The average physician receives very little training about sleep disorders and typically does not routinely screen patients for them," said Vitiello, who serves on the board of directors of the National Sleep Foundation. This may be due to a lack of time or training or the belief that there is little that can be done to improve sleep, he explained.

As a result, problems like insomnia, restless leg syndrome, sleep apnea and circadian rhythm disorders are underdiagnosed and undertreated, Bloom said.

To rectify the problem, a national coalition of aging, geriatric medicine and sleep organizations is currently developing guidelines to promote prevention, diagnosis and treatment of sleep problems in older adults. The National Coalition for Sleep Disorders in Older People expects to publish its recommendations by mid-2008.

"The reason we're concerned with these [problems], besides a major issue on quality of life and being tired the next day and not functioning properly, is that these sleep disorders are associated with hypertension, diabetes, pulmonary disease, heart disease, depression and anxiety," said Bloom, chairman of coalition's expert task force.

A cause-and-effect relationship has yet to be established between sleep disorders and these chronic health problems, but Bloom suspects they at least contribute to each other. And he believes a causal relationship may be found in years to come.

"This is very, very much a tip-of-the-iceberg problem," he said.

More information
For tips on better sleep, visit the National Sleep Foundation.

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Follow-Up Exams Uncover More Iraq Vets With Emotional Woes

(HealthDay News) -- The number of Iraq war veterans needing mental-health care has risen sharply since the U.S. Defense Department began screening them a second time for emotional problems, U.S. military researchers reported Tuesday.

Initial screenings of veterans uncovered 4.4 percent who needed treatment for problems such as depression or post-traumatic stress disorder (PTSD). But six months later, a second screening found 11.7 percent were in need of mental health care, indicating that it might take several months for emotional disorders to emerge, the study suggested.

"We know mental health problems are a problem for soldiers who have been to war," said lead researcher Dr. Charles S. Milliken, of the Walter Reed Army Institute of Research at the U.S. Army Medical Research and Materiel Command. "We are doing a good thing by having erected these screening programs. Between the two screenings, we are finding a large group of soldiers that are having problems."

The findings are published in the Nov. 14 issue of the Journal of the American Medical Association.

For the study, Milliken and his colleagues collected data on the mental health of 88,235 Iraq war veterans who completed an initial screening and a second screening about six months later. Both screenings included a questionnaire and a short interview with a clinician.

"In the second screening, you do find a larger group of soldiers the first screening completely missed," Milliken said. "It's about twice as big."

The researchers found that more soldiers had mental health problems -- such as PTSD, major depression or alcohol abuse -- during the later screening. In the first screening, 4.4 percent of the soldiers were referred for mental health care, but, after the second screening, 11.7 percent were referred.

Milliken thinks the two-step screening process helps remove the stigma attached to seeking help for emotional problems. "Soldiers are like other young males, they have a stigma about seeking mental health care," he said.

Among all the soldiers screened, 20.3 percent of active duty personnel were referred for mental health care, as were 42.4 percent of reserve soldiers, the study found.

Milliken said he didn't know why the difference exists between the active duty soldiers and the reservists. He speculated, however, that it might have to do with the VA's insurance structure that allows reservists access to free care for service-related health problems.

One expert thinks the new, two-tier system for identifying soldiers with emotional problems is working, but the shear numbers of affected veterans could overburden the VA's health-care system.

"I am not surprised by the rates of PTSD among Iraqi vets," said Dr. Randall Marshall, director of Trauma Studies at the New York State Psychiatric Institute and an associate professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.

Marshall said the difference in PTSD rates among active duty and reserve personnel is expected. "Part of what training is meant to do is desensitize soldiers to all the potential experiences on the battlefield, and the reservists have less training and are therefore more vulnerable to war experiences," he said.

Marshall also said that many reservists have had several tours of duty, "which is something they had not signed up for."

Also, many of these part-time soldiers were split from their units, which means they didn't have as much of a support system as active duty personnel, he said.

Marshall sees another major problem developing for returning veterans. Most psychotherapists aren't trained in the best ways to treat PTSD, he said. "You can't assume because it's a VA hospital everyone there has had this kind of training," he said.

In addition, the number of soldiers needing mental health care is straining an already overburdened system.
"If 20 percent of the veterans realize they need help and start to seek treatment, the system will be overwhelmed. Signs are, it already is," Marshall said.

More information
To learn more, visit the U.S. Department of Veterans Affairs.

Health Tip: Understanding Compulsive Overeating

(HealthDay News) - Compulsive overeating occurs when a person uncontrollably binges on large amounts of food. The affected person usually is overcome with feelings of guilt and shame.
Brown University offers these common reasons for why people compulsively overeat:

• To satisfy an obsession or preoccupation with food, weight and eating.
• To cope with other issues that the person can't control.
• To deal with stress, anxiety or depression.
• To mask low self-esteem.

Advantages and Disadvantages of Alcohol Intake on Cardiovascular Health Reviewed

News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD

The latest American Heart Association guidelines caution people not to start drinking alcohol if they do not already drink alcohol, according to a review of the advantages and disadvantages of alcohol intake on cardiovascular health published in the August 23 Online First issue of the Journal of the American College of Cardiology.

"Accumulating scientific evidence indicates that light to moderate drinking done on a daily basis may significantly reduce the risks of coronary heart disease (CHD) and all-cause mortality," write James H. O'Keefe, MD, FACC, and colleagues from the Mid America Heart Institute in Kansas City, Missouri. "In contrast, excessive alcohol intake and binge drinking are toxic to both the heart and overall health and are the third leading cause of premature death among Americans.

The purpose of the present review is to:
1) outline the specific benefits and risks of alcohol, and the threshold of intake at which drinking becomes a health danger rather than an advantage;
2) detail the mechanisms whereby alcohol confers cardioprotection; and
3) discuss the ideal quantities, drinking patterns, and beverages, and which individuals are most likely to benefit."

Research to date has shown J-shaped relationships between alcohol consumption and several adverse health outcomes, including all-cause mortality, CHD, diabetes, hypertension, congestive heart failure, stroke, dementia, and Raynaud's phenomenon.

Some cardioprotective benefits have been demonstrated for light to moderate alcohol consumption (up to 1 drink daily for women and 1 or 2 drinks daily for men). Most studies have shown that light to moderate drinking is associated with risk reductions for CHD of approximately 30% to 35%.

Alcohol consumed in moderation seems to have an antiatherosclerotic effect, with decreased incidence of peripheral arterial disease and decreased atherosclerotic burden shown by coronary angiography, computerized tomography-detected coronary calcium, and carotid ultrasound.
Like exercise, alcohol consumption seems to be most cardioprotective when done daily and in moderation. However, increasingly excessive consumption is associated with proportional worsening of outcomes.

Because of the beneficial effects on high-density lipoprotein (HDL) cholesterol, insulin action, and inflammation, light to moderate alcohol intake may be particularly helpful for patients with abnormal glucose metabolism and/or insulin resistance. Light to moderate alcohol intake may be associated with reductions in the prevalence and incidence of diabetes, and a large meta-analysis with 12-year follow-up showed a 30% reduction in new diabetes in those who consumed 1 to 2 drinks daily.

The cardiovascular benefits associated with alcohol consumption protection are thought to be mediated by improvements in insulin sensitivity and HDL cholesterol. The major protective component seems to be the ethanol itself, and not the other ingredients found in different types of alcoholic beverages.

In a meta-analysis incorporating data from more than 1 million participants, consumption of 1 drink daily by women and 1 or 2 drinks daily by men was associated with an 18% reduction in total mortality, but daily intakes of more than 2 drinks in women and 3 drinks in men were associated with dose-dependent increased mortality.

Although low-dose, daily alcohol consumption has been linked to better health than less frequent use, binge drinking increases cardiovascular events and mortality, even in otherwise light drinkers.

"Alcohol should not be universally prescribed for health enhancement to nondrinking individuals owing to the lack of randomized outcome data and the potential for problem drinking," the study authors note. "Alcohol (ethanol) consumption is analogous to the proverbial double-edged sword, and perhaps no other factor in cardiovascular (CV) health is capable of cutting so deeply in either direction depending on how it is used."

Guidelines from the United Kingdom suggest that middle-aged or elderly men and postmenopausal women who drink seldom or never might consider the possibility that light drinking would benefit their health. On occasion, the reviewers have made a similar recommendation to patients who do not smoke and who have no personal or family history of substance abuse and no history of depression or bipolar disorder. However, they argue that light to moderate drinking should not be universally recommended to the general public or even to patients with cardiovascular disease.

As an analogy, they point out that observational data and findings from randomized trials using surrogate endpoints suggested that hormone replacement therapy for women and antioxidant vitamins improved cardiovascular outcomes, whereas later randomized trials with larger samples led to the opposite conclusions. They note that no randomized trials of alcohol for improving clinical outcomes have yet been performed. In observational studies, residual unmeasured confounding factors could be contributing to apparent benefits that seem to be associated with light to moderate drinking.

The investigators further note that heavy drinking has caused significant individual and societal problems and morbidity. In the past 15 years, the rates of alcohol abuse and binge drinking have been increasing, according to the findings of some studies. Alcohol abuse causes 100,000 deaths each year in the United States, and it has been deemed the third largest preventable cause of death.

Excessive alcohol consumption has been associated with increased risks for all-cause mortality, motor vehicle crashes, stroke, cardiomyopathy, cardiac dysrhythmia, sudden cardiac arrest, suicide, cancer (particularly of the breast and gastrointestinal tract), cirrhosis, fetal alcohol syndrome and sleep apnea.

"Sobering statistics warn that moderate daily drinking is a slippery slope that many individuals cannot safely navigate," the study authors conclude. "The latest American Heart Association guidelines caution people not to start drinking if they do not already drink alcohol, because it is not possible to predict in which people alcohol abuse will become a problem. Until we have more randomized outcome data, and tools for predicting susceptibility to problem drinking, it would seem prudent to encourage physicians and patients to focus on more innocuous interventions to prevent CHD."

J Am Coll Cardiol. Published online August 23, 2007.
2007;50:1009-1014.

Gene Mutation Linked to Parkinson's Disease

(HealthDay News) -- People who carry a certain gene mutation appear to have a greater risk for getting Parkinson's disease and for getting it at a relatively early age, new research suggests.

The study authors also found that because Ashkenazi Jews -- those with an Eastern European background-- are more likely to carry this gene mutation, this population may run an even higher risk for the disease. An estimated 90 percent of American Jews are of Ashkenazi lineage.

Study lead author Lorraine N. Clark, a researcher at Columbia University, described her team's findings as "unique and different."

"We specifically compared patients who had an early onset Parkinson's before age 50 with patients who had a later onset after age 50, and also with patients with and without Jewish ancestry," she said. "And we showed that mutations are twice as common among early onset Parkinson's and also that they're more frequent among patients with Jewish ancestry."

Clark serves as an assistant professor in the department of clinical pathology with the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, as well as the Center for Human Genetics, both at Columbia University.

The findings are published in the Sept. 18 issue of the journal Neurology.

Parkinson's disease is a brain disorder that affects 1.5 million Americans, according to National Parkinson Foundation estimates. Approximately 60,000 news cases occur each year, striking men and women equally, usually over the age of 65.

The disease is characterized by widespread damage to dopamine-producing nerve cells, impeding their ability to regulate body movement and muscle control. Key signs of the disease include tremors, stiffness, balance problems, and slowness of movement. Patients may also experience difficulty with speech and depression. There is no known cure.

To explore potential genetic underpinnings to the onset of Parkinson's, Clark and her colleagues decided to focus on the GBA gene. Mutations of this gene have already been identified as the cause of Gaucher disease, a rare fat-storage disorder that disrupts spleen and brain function.

Gaucher's and Parkinson's have some links, the study authors noted. In some cases, Gaucher's patients have a family history of Parkinson's, while others actually develop neurological features of Parkinson's. It is also one of the most prevalent genetic illnesses among Ashkenazi Jews.

For the new study, the researchers conducted a sequencing analysis of the GBA gene among 278 Parkinson's patients, 178 of who were of Jewish ancestry dating back to all four grandparents. A similar analysis was done among 179 men and women without Parkinson's.

Clark and her team found that 14 percent of the Parkinson's patients had GBA mutations, compared to just 5 percent of the healthy patients. And, while GBA mutations were found among 22 percent of Parkinson's patients who were diagnosed with their illness before the age of 50, only 10 percent of patients diagnosed after 50 had such abnormalities.

Teasing out information on Jewish patients, the researchers found that while nearly 17 percent of Jewish Parkinson's patients had GBA mutations, the figure was 8 percent among non-Jewish Parkinson's patients.

Clark called the study findings preliminary, and she cautioned that it remains unclear whether a single GBA mutation is a cause of Parkinson's or merely a part of a larger puzzle.

Still, she believes the findings could prove helpful in opening up new avenues of research into the disease.

"This is a gene we hadn't really thought about before," she said. "And it implicates new pathways that might be important in the pathogenesis of Parkinson's disease which could lead to the development of new treatment strategies. I do think, however, that further studies are needed in larger patient populations before we could use this work in diagnostic testing and counseling."

Robin Elliott, executive director of the Parkinson's Disease Foundation in New York City, called the new research "very interesting and very worthwhile, solid work in one of the most fruitful areas of Parkinson's research.

"Genetics and the study of genetics has been one of the most exciting areas of Parkinson's in the last 10 years," he said. "In 1996, we had not a single gene associated with the disease, and now it's up to 12 or 13. So, this is a very important study that pushes the science even further, and gives us the basis for more work."

More information
To learn more, visit the Parkinson's Disease Foundation.