Neuroendocrine and behavioral responses to dopaminergic agonists in adolescents with alcohol abuse.

RATIONALE: Dopaminergic systems are involved in the pathophysiology of alcohol use disorders, but there is little research investigating the role of these systems in adolescents. OBJECTIVES: In this study, we investigated dopaminergic systems in adolescents with alcohol abuse by determining neuroendocrine and behavioral responses to dopaminergic drug challenges. METHODS: Twenty-six participants (11 with DSM IV alcohol abuse and 15 controls) were enrolled in the study. Neuroendocrine and behavioral response to the dopaminergic indirect agonist methylphenidate (10 mg) and the direct agonist pergolide (50 mcg), were examined. The primary response measures were spontaneous eye-blink rate, plasma prolactin (PRL), and growth hormone (GH). Additionally, participants completed a visual analog mood scale (VAMS). RESULTS: The rate of increase in plasma GH level was blunted for adolescents with alcohol abuse compared to the control group, after methylphenidate administration [ t=-2.75, P=0.0066, 95% confidence interval (CI) -0.3, -0.048]. The rate of decrease in PRL level after pergolide administration was greater in adolescents with alcohol abuse as compared to the control group ( t=-3.05, P=0.0028, 95% CI -0.01923, -0.00409). Adolescents with alcohol abuse rated themselves as less "energized" in comparison to the control group after methylphenidate (rate difference=-0.4, P=0.0231). CONCLUSIONS: This preliminary study suggests that adolescents with alcohol abuse may have a differential response to dopaminergic agonists, as also reported for adults with alcohol use disorders. Further studies investigating gender differences, and other neurotransmitter systems are needed to understand the differential dopaminergic response in adolescents with alcohol use disorders.

Psychiatric disorders and cigarette smoking among child and adolescent psychiatry inpatients.

We surveyed 120 patients admitted to a child and adolescent psychiatric inpatient unit regarding their cigarette smoking history, reasons for smoking, patterns of use, and psychiatric comorbidity (chart review). We administered the Social Phobia and Anxiety Inventory and the modified Fagerstrom Tolerance Questionnaire. Only six of 47 current smokers had a chart diagnosis of nicotine dependence. Logistic regression derived that the odds ratio for being a current smoker was: Caucasian race=5.56,older age=1.3, depressive disorders=4.02, conduct disorder (CD)=12.96, cannabis abuse/dependence=24.6. Hence, cigarette smoking is highly prevalent but underdiagnosed in this population.