Relationships between aggression, depression, and alcohol, tobacco: implications for healthcare providers in student health.

PURPOSE: To determine the prevalence of aggression, depression, and at-risk health behaviors in a random sample of undergraduate college students and to explore the relationship between these variables. DATA SOURCES: The study survey was sent to 2500 undergraduate students; 428 participated, responding to items from the National College Health Risk Behavior Survey about alcohol, drug and tobacco, violence and aggression, the Beck Depression Inventory II, and items adapted from the Overt Aggression Scale. CONCLUSIONS: Almost one third of the sample reported cigarette smoking, 22% moderate depression, 81% drink alcohol, with 58% drinking more than five drinks at least once in the last month. Reports of verbal and physical aggression were also common. Moderate depression was related to cigarette smoking, physical, and verbal aggression, but not to heavy alcohol use. An understanding of these relationships can be utilized to screen and intervene with students at risk. IMPLICATIONS FOR PRACTICE: The results call for increased screening and treatment of depression in college students, and suggest that students with aggressive behaviors are at the highest risk for depression, and should be a group to receive specific attention for screening.

Glutamine and glutamate levels in children and adolescents with bipolar disorder: a 4.0-T proton magnetic resonance spectroscopy study of the anterior cingulate cortex.

OBJECTIVE: The purpose of this study was to use proton magnetic resonance spectroscopy, at 4.0 T, to explore the glutamine and glutamate levels in the anterior cingulate cortex of children and adolescents with bipolar disorder (BPD; medicated and unmedicated) and healthy comparison subjects (HCSs). We hypothesized that unmedicated children with BPD would have reduced glutamine and glutamate levels compared with HCSs and medicated children with BPD. METHOD: Spectra were acquired from the anterior cingulate cortex in 22 children and adolescents with DSM-IV-TR BPD, type 1 (13 female: age 12.6 +/- 4.4 years: 7 of the subjects with BPD were unmedicated at the time of the scan) and 10 HCSs (7 female: age 12.3 +/- 2.5 years). RESULTS: Unmedicated subjects with BPD had significantly lower glutamine levels than HCSs or medicated subjects with BPD. There were no differences in glutamate levels between the three groups. CONCLUSIONS: These results are consistent with there being an abnormality in anterior cingulate cortex glia in untreated children and adolescents with BPD. The results of this pilot study may be important in helping us better understand the pathophysiology of child and adolescent BPD. In addition, this observation may help to develop better and more targeted treatments, in particular those affecting the metabolism of glutamine, perhaps by regulation of glutamine synthetase activity.

Mild traumatic brain injury in psychiatric inpatients.

The purpose of this study was to compare psychiatric inpatients with and without mild traumatic brain injury (MTBI) on the variables of length of stay (LOS), number of psychiatric admissions, and change from admission to discharge on Global Assessment of Functioning (GAF). The study sample included 54 psychiatric inpatients, 18 to 65 years old, with a history of MTBI and 52 comparison psychiatric inpatients absent histories of MTBI, matched on age, sex and diagnostic category. LOS was longer for those with MTBI than for those without MTBI. This difference was statistically significant, after adjustment for matching. When adjusted for baseline GAF, this LOS difference remained statistically significant. The number of prior psychiatric admissions was 19% higher for participants with MTBI than for comparison participants, and when the LOS analysis was adjusted for this factor, it remained statistically significant. GAF change-from-baseline did not differ between the MTBI and comparison groups. Data from this study suggest that psychiatric inpatients with a history of MTBI may differ in frequency and length of hospitalization from otherwise similar inpatients without MTBI history.

Open trial of bupropion SR in adolescent major depression.

PROBLEM: There are few studies of sustained-release bupropion in adolescents with major depression. METHODS: Twenty-one adolescents with DSM-IV major depression were recruited through advertisement and self-referral; 11 began study medication and were rated weekly with an expanded Hamilton Depression Rating Scale (SIGH-SAD), as well as Clinical Global Impression-Improvement (CGI-I). RESULTS: Of 11 subjects enrolled, 8 completed an 8-week trial of bupropion SR. Mean baseline SIGH-SAD scores of 31.3 decreased significantly by 74% to mean endpoint score of 8.2. Improvement on CGI-I that agreed closely between raters and patients was found in 8 of 11 subjects (72.3%). The mean daily dose of bupropion SR was 362 mg +/- 52 mg and was well tolerated; insomnia and weight loss were experienced by 55%; other adverse effects of dry mouth, headache, agitation, light-headedness, diarrhea, or rash were noted in a minority of subjects. CONCLUSIONS: In this preliminary, small open study, depressed adolescents showed a marked response to bupropion SR.