This week in the BMJ
Volume 330, Number 7481, Issue of 1 Jan 2005Risk of psychosis is linked to frequency of cannabis use
Risk of psychosis is linked to frequency of cannabis use
Young cannabis users are more likely than non-users to develop psychosis, particularly if they also have other risk factors. Following 2437 German people aged 14-24 for four years, Henquet and colleagues (p 11) found a dose-response relation between frequency of cannabis use and risk of psychosis. The effect of cannabis use was much stronger in those with predisposition for psychosis at baseline than in those without (adjusted difference in risk 23.8% and 5.6%, respectively).
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Cognitive behaviour therapy tackles fatigue in adolescents
Cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome in adolescents. Stulemeijer and colleagues (p 14) randomised 71 patients aged 10-17 years to immediate therapy or the waiting list. After five months, patients who received therapy reported a significantly greater decrease in severity of fatigue and functional impairment than those on the waiting list, and their school attendance increased significantly. Accompanying symptoms, such as impaired concentration, unrefreshing sleep, muscle pain, and headache, were also reduced.
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Miniature telescopes may be the future for restoring vision
Several artificial components for the retina are being investigated as possible solutions to restoring vision in people with age related macular degeneration and retinitis pigmentosa. Hossain and colleagues (p 30) explore ophthalmological advances undergoing research that in the future might restore vision, although no visual prosthesis has yet been able to do so. Current research includes intraocular electrodes, microelectrodes, implants with photosensitive dyes, neural prostheses, and implantable miniature intraocular telescopes in patients with stable, age related macular degeneration.
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Hiding drugs in food is not rare in nursing homes
Covertly giving medicines in food and beverages is common in Norwegian nursing homes. Interviewing professional carers of 1362 patients in nursing home units and 564 in special care units for people with dementia, Kirkevold and Engedal (p 20) found that 11% of the patients in regular nursing homes and 17% of the patients in special care units were given concealed drugs at least once a week. The practice was documented in patients' medical records in 40% of the cases, and in 95% it was used routinely.
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National surveillance of congenital anomalies is deficient
The National Congenital Anomaly System is not adequate for surveillance of congenital anomalies in England. Boyd and colleagues (p 27) compared the system with four local congenital anomaly registers, covering about 109 000 births annually, and found that the national system registers only 40% of congenital anomalies captured by the local registers. This varied considerably by defect, local register, and hospital catchment area. Also, the system does not include data on terminations of pregnancy after prenatal diagnosis of fetal anomaly.
Prescribers are increasingly circumvented
What roles do pharmaceutical firms, healthcare organisations, and government regulatory agencies play in switching prescription drugs to over the counter drugs? Cohen and colleagues, prompted by increased numbers of prescription drugs being made available over the counter worldwide, analyse three recent controversial switches: simvastin in the United Kingdom, omeprazole in Sweden, and loratadine in the United States (p 39). They argue that the main motives are pharmaceutical firms' desire to expand their market, attempts to reduce drug bills, and the self care movement.
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