Mental Illness Can Have More Impact on Life Expectancy Than Smoking

According to researchers at Oxford University, mental illness has an effect on life expectancy that is equivalent or greater than smoking. A great deal of effort and spending has been invested into smoking cessation programs and smoking awareness campaigns. This new research should prompt the government, health care and social services to shift their focus in an effort to increase life expectancy for those living with mental illness.

Researchers reviewed 20 review papers from clinical studies that reported mortality risk among mental health problems, substance and alcohol abuse, dementia, autistic spectrum disorders, learning disability and childhood behavioral disorders. These studies included over 1.7 million individuals and over 250,000 deaths. They also used studies and reviews that reported life expectancy and risk of dying by suicide. All results were compared to data for heavy smoking.

According to their findings, “one in four people in the UK will experience some kind of mental health problem in the course of a year” while smokers consist of roughly 21% of British men and 19% of women. 

They discovered that all diagnoses studied had an increased mortality risk similar or greater than heavy smoking. Some of the estimated reductions in life expectancy were found to be as follows:

• Bipolar Disorder: 9 - 20 years
  
• Schizophrenia: 10 – 20 years
  
• Drug and Alcohol Abuse: 9 - 24 years
  
• Recurrent Depression: 7 - 11 years
  
• Heavy smoking: 8 - 10 years

Dr. Seena Fazel of the Department of Psychiatry at Oxford University said: "We found that many mental health diagnoses are associated with a drop in life expectancy as great as that associated with smoking 20 or more cigarettes a day."
Despite the fact that this study did not mention the prevalence of smoking among persons with mental illness, the results are still devastating.

There may be many reasons for this phenomenon. For example:

• Psychiatric patients and those with drug and/or alcohol dependence can be more likely to engage in high-risk behaviours.
  
• Physical health problems may not be taken seriously and treated properly due to the stigma attached to their mental illness.
  
• Many mental illnesses can create physical health problems and/or worsen pre-existing ones.
  
• People with serious mental illness may not access healthcare effectively.
  
• The de-medicalization of mental illness may increase the likelihood that physical health problems go untreated or neglected.
  

Life expectancy may increase if only we could make mental health a priority as we have with smoking. In addition to funding and advancing research on mental illness, we should improve health and social services to ensure that persons with mental illness have better access to health care, suitable employment and supports in their community.

Many mental illnesses reduce life expectancy more than heavy smoking

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Dad's Absence Affects Neurobiology of Offspring

Scientists at the Research Institute of the McGill University Health Centre (RI-MUHC) have discovered that an absent father during critical growth periods can lead to social and behavioral impairments in adults. This is the first study of its kind to correlate paternal deprivation and social attributes with physical changes in the brain.

"Although we used mice, the findings are extremely relevant to humans," says senior author Dr. Gabriella Gobbi, a researcher of the Mental Illness and Addiction Axis at the RI-MUHC and an associate professor at the Faculty of Medicine at McGill University. "We used California mice which, like in some human populations, are monogamous and raise their offspring together."

Researchers were able to control the environment in which the mice were raised, including the factors among the different groups.  As a result, mice studies may be clearer than human studies claims Francis Bambico, a former student of Dr. Gobbi at McGill and now a post-doc at the Centre for Addiction and Mental Health (CAMH) in Toronto.

Researchers compared the social behaviour and brain structure of mice in different groups; those raised with both parents and those raised by their mothers. Findings show that mice raised by single mothers experienced abnormal social interactions and were more aggressive than those raised with both parents present. In addition, these findings were more prevalent among female mice.  Furthermore, females also experienced an increased sensitivity to amphetamine.

"The behavioral deficits we observed are consistent with human studies of children raised without a father," says Dr. Gobbi, who is also a psychiatrist at the MUHC. "These children have been shown to have an increased risk for deviant behavior and in particular, girls have been shown to be at risk for substance abuse. This suggests that these mice are a good model for understanding how these effects arise in humans."

Further studies may uncover a clearer reasoning for such findings.  Is it merely the presence of a male role model?  Could it be that two parents, regardless of gender, have more influence than one?  Could male mice be more sensitive to amphetamine if raised by fathers alone?  Many questions remain for future studies to uncover, however this research demonstrates that the role of the father and/or the presence of both parents during critical stages of growth appear to be relatively important in children's mental health development. 

Dads: How Important Are They? New Research Highlights Value of Fathers in Both Neurobiology and Behavior of Offspring

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Fighting Addiction With Prescription Heroin

Former MP John Reynolds believes that Canada should start medicating addicts with prescription heroin; in the same manner it would any other health condition that is controlled with medication. Clearly, convincing Canadians of this presumption will not be an easy feat as addiction is hardly comparable to conditions like high blood pressure or diabetes.

“Mr. Reynolds, a member of the InnerChange Foundation in Vancouver, applauded the research arm of Health Canada for financing the Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), which will offer heroin and a legal substitute, Hydromorphone.”

And…“In a secondary phase, some of the 200 addicts who will be recruited to the program will be offered heroin in a pill form - another way of reducing the stigma and health risks associated with injecting drugs.”

"We really hope with SALOME that, if we can show (Hydromorphone) is as effective, there will be so many fewer obstacles to treatment - because it is not called heroin."

Surely society can perceive the benefits for the addict and the community as a whole; however the pill is not the answer. The addict no longer has to commit crimes and suffer various traumas associated with obtaining drugs. The addict can be slowly weaned off drugs in a more controlled manner with the assistance of health professionals in order to ease themselves into proper treatment. The addict would have much needed support during the path to recovery.

No one can deny these benefits; however is the main objective here not to make drug use safer and reduce crime? Many people, including addicts, will view this method as replacing one drug with another, therefore maintaining psychological dependence. In addition, side effects and withdrawal symptoms are not all that unlike those of heroin, morphine or other opiods. Although studies have shown that Hydromorphone can be more successful than methadone, the latter has also not proven to be the much needed solution for many addicts.

I must say that I’m not sold on the idea that addiction is merely a physical condition needing medication, Mr. Reynolds. Recovery requires treatment of both physical and psychological aspects, especially when addiction is so often combined with other mental health conditions.

Prescribe heroin to addicts, former Tory MP says

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Guidelines Finally Exist For Prescription Opioids

The current issue of The Journal of Pain has published a guideline to assist clinicians in prescribing opioid pain medications for patients experiencing chronic non-cancer pain.

“To create this guideline, researchers in the Oregon Evidence-based Practice Center (EPC) at Oregon Health & Science University collaborated with the APS and AAPM for two years, reviewing more than 8,000 published abstracts and nonpublished studies to assess clinical evidence on which the new recommendations are based”.

An extensive literature review revealed that much research is needed in this area; however conclusive evidence suggests that opioids are safe and effective for certain patients, if carefully monitored.

The guideline consists of 25 recommendations, some of which consider the growing concerns for opioid abuse and addiction. Opioids, such as oxycontin and morphine, have gradually become more commonly prescribed and accepted for treating various sorts of pain, including chronic low-back pain, arthritis, fibromyalgia etc., whereas previously opioids were mainly used for treating pain related to post-op, cancer and death.

This new guideline insists that clinicians rule out other possible medications as treatment options before prescribing opioids. However, if it is determined that opioid medication is the ideal choice, clinicians are expected to “conduct a thorough medical history and examination and assess potential risk for substance abuse, misuse or addiction”.

It is shocking to learn that this hasn’t already been considered common practice and that a guideline had to be introduced in order to put this in place! It’s no wonder there has been such an increase in opioid abuse and misuse. Seriously, is this not a typical task for a medical doctor? It seems like a fairly important step in any type of treatment.

Subsequently, with this guideline it will ensure that clinicians “continuously assess patients on chronic opioid therapy by monitoring pain intensity, level of functioning and adherence to prescribed treatments. Periodic drug screens should be ordered for patients at risk for aberrant drug behavior”.

The American Pain Society and the American Academy of Pain Medicine have ensured that patients will be well monitored. To read more about other recommendations in this guideline regarding such topics as methadone use, high dosages, abusers, pregnancy, driving safety, and more, please view the following article: New Guideline For Prescribing Opioid Pain Drugs.

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Nature vs Nurture: Supportive Parenting Can Prevent Substance Abuse

The University of Georgia has published a study in the Journal of Consulting and Clinical Psychology explaining that supportive parenting can actually counteract the effects of a genetic risk factor that increases the likelihood of substance use among youth. This long-term study examined how nature and nurture can influence the behaviour of youth with a genetic predisposition for substance abuse. “We found that involved and supportive parenting can completely override the effects of a genetic risk for substance abuse,” claims Professor Gene Brody.

The research focused on the 5HTT gene that transports serotonin in the brain. According to many studies, most people possess two copies of a long version of this gene, but the select few that possess one or two copies of a short version tend to be more likely to consume alcohol or other substances and partake in impulsive and risky behaviour.

Results were compiled over 4 years from interviews of 253 rural African-American families. Those with the long version of the 5HTT gene comprised of 60% of these youth. Obviously, the remaining 40% were plagued with the short version and a genetic risk factor for substance abuse. Evidently, substance use increased with age. Youth with the short version of the gene that received only minimal supportive parenting used at rate three times more than youth who had high levels of parental support. “In families that were characterized by strong relationships between children and their parents, the effect of the genetic risk was essentially zero” said UGA Institute for Behavioral Research director Steven Beach.

Regardless of the fact that parenting should already be supportive, knowing which version of the 5HTT gene your child possesses could be very helpful in preventing substance abuse. Spending more time with a child, providing emotional support or encouraging better communication seems like very minimal effort to ensure that possible substance abuse is avoided.

Genetic Risk For Substance Use Can Be Neutralized By Good Parenting

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Summit Helps Outpatient Treatment offers Drug and Alcohol Treatment Programs for Adults and Adolescents.

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