Impact of hepatitis C treatment initiation on adherence to concomitant medications.

Our study investigated whether initiating hepatitis C virus (HCV) treatment affected adherence to concomitant medications. Mixed-effects linear regression was used to analyze data from 57 patients (29 co-infected with HIV) in a prospective study of HCV treatment-naïve patients initiating HCV treatment. Adherence was assessed using structured self-report at the time of treatment initiation, and at 12 weeks and 24 weeks into treatment. There was no change in adherence to concomitant medications over the first 24 weeks of HCV treatment. There was a significant interaction effect such that the change in adherence to concomitant medications between baseline and 12 weeks differed between the HIV-infected and HIV-uninfected patients. Adherence to concomitant medications in the HIV-infected patients was found to decrease, whereas adherence in the HIV-uninfected patients was found to increase. HIV-infected patients may be more at risk for adherence problems in the first 12 weeks of HCV treatment as compared to HIV-uninfected patients.

Adverse childhood experiences, smoking and mental illness in adulthood: a preliminary study.

BACKGROUND: Adverse childhood experiences (ACE) are associated with mental illness and smoking in adulthood, but ACE has not been studied as a determinant of this comorbidity. This study was designed to examine effects of ACE on the expression of smoking behavior and mental illness in adulthood. METHODS: We examined the relationship between ACE, smoking status, and the expression of serious mental illness in adults (n = 101). Subjects were evaluated with a semi-structured interview that included psychiatric status, smoking status, substance abuse and presence and severity of ACE. Subjects were grouped into four categories based on psychiatric and smoking status: psychiatric smokers (PS), psychiatric nonsmokers (PNS), control smokers (CS) and control nonsmokers (CNS). RESULTS: ACE was associated with serious mental illness or smoking behaviors in adulthood, and to a lesser extent with co-morbid mental illness and smoking. Cumulative number of ACE was highest in the order of PS > PNS > CS > CNS. CONCLUSIONS: These preliminary results suggest an association between the presence of ACE and the expression of severe mental illness in adulthood, and possibly to comorbid smoking and mental illness. Longitudinal research using larger samples is needed to determine the causal relationship between ACE and co-morbid smoking and mental illness.

Effects of smoking abstinence on visuospatial working memory function in schizophrenia.

Schizophrenic patients have impairments in cognitive function, including deficits in visuospatial working memory (VSWM). VSWM is mediated, in part, by prefrontal cortical dopamine (DA) function, and dysregulation of prefrontal cortical DA systems may contribute to the pathophysiology of schizophrenia. Nicotine has complex effects on spatial working memory (SWM) in animal studies, with most studies demonstrating enhancement of SWM. Cigarette smoking is highly prevalent in schizophrenia, and these patients may smoke cigarettes to remediate cognitive deficits. The present study examined the effects of acute (<1 week) and prolonged (8-10 weeks) smoking abstinence on VSWM in schizophrenic (n = 23) and control (n = 29) nicotine-dependent cigarette smokers during placebo-controlled smoking cessation trials. Schizophrenic and control smoking patients had significant impairments in VSWM compared to non-smoking controls, after adjusting for differences in age, education and depressive symptoms. Schizophrenic smokers who quit smoking had further impairments in VSWM, and control quitters had improvements in VSWM. Abstinence-induced changes in VSWM varied as a function of gender in controls, but not in schizophrenics. These changes in VSWM appeared to be independent of study medications, and smoking abstinence did not significantly alter performance on the Stroop Color Word Test in either group. These results suggest that smoking abstinence differentially alters VSWM in schizophrenic vs. control smokers, and that cigarette smoking has beneficial effects on VSWM in schizophrenic, but not control, smokers.