Head clash: Footballers and administrators have been warned of the dangers of concussions. Picture: Michael Dodge Source: Herald Sun

MEDICAL experts have said Australian football codes must investigate the long-term impact of head injuries and concussions.

Concerns are intensifying over the potential for concussions to cause long-term harm after autopsies on brains of American National Football League players showed evidence of chronic traumatic encephalopathy (CTE), two Australian researchers say.

CTE is a degenerative brain disease with similar symptoms to early onset dementia.

Players of Australia’s three major football codes regularly sustain concussions, raising concerns about possible brain damage, cognitive impairment and mental health problems, the researchers say in an article published on the Medical Journal of Australia (MJA) website today.

The University of Tasmania’s Frederic Gilbert and the University of Queensland’s Bradley Partridge say there is an urgent need to investigate the cumulative effects of head traumas over long periods by tracking athletes’ playing history and recording head injuries.

They say the research would require the co-operation of all three codes – Australian rules, rugby league and rugby union – and the findings could prove controversial.

"This research may raise uncomfortable questions about how head injuries are managed but it is crucial for the football codes to facilitate such research to ensure the safety and future welfare of their players," the article said.

Reducing the risk of concussive impacts was even more important in amateur leagues to protect vulnerable young players, Dr Gilbert and Dr Partridge said.

In an editorial in the MJA, director of neurosurgery at Royal Melbourne Hospital, Andrew Kaye, said athletes, referees, administrators, parents and coaches all had a responsibility to learn about when it was safe to play again after injury.

Prof Kaye, a board director of AFL club Hawthorn, said the AFL and NRL had developed their own concussion guidelines in line with the Zurich consensus statement, considered world’s best practice.

However, he said there was a danger that links between CTE and the playing history of American footballers and ice hockey players had been overstated.

Media interest had centred on a handful of reported cases, some of which involved a family history of dementia and illicit drug use, he said.

"Critically, the detection of pathological change in the brains of former athletes does not necessarily support a causal relationship with their sporting careers or history of head impacts," he said.

All three medical experts said the use of protective headgear was problematic in sport as athletes altered their playing behaviour, with some American footballers using their helmets as "weapons". 

The smoke is clearing on the link between cannabis and mental health problems, as latest research shows how the drug can hasten the onset of schizophrenia by several years.

The study which took in data from 20,000 patients with a psychotic illness has found those who smoked cannabis were diagnosed almost three years ahead of those who did not use the drug.

Dr Matthew Large, from the University of NSW’s School of Psychiatry and Prince of Wales Hospital, said the study was unique in scale and it should settle debate on whether cannabis could trigger earlier mental health problems.

‘Results of this study are conclusive and clarify previously conflicting evidence of a relationship between cannabis use and the earlier onset of a psychotic illness,’ Dr Large said.

‘The results … provide strong evidence that stopping or reducing cannabis use could delay or even prevent some cases of psychosis.’

Dr Large, in a partnership with Melbourne’s St Vincent’s Hospital and the US-based George Washington University School of Medicine and Health Sciences, pooled patient data from more than 80 studies which had probed the link between psychotic illness and substance abuse.

The earlier studies had looked at the role played by cannabis, alcohol and other psychoactive substances but Dr Large’s meta-analysis was looking for an effect caused by cannabis alone.

Most of the patients involved had schizophrenia and, of those who were cannabis smokers, their diagnoses were seen to occur an average of 2.7 years earlier in their lives.

This time difference could be critical, Dr Large said, as it ensured psychotic symptoms were more likely to emerge during a person’s formative years and so compounded the life-long impact.

‘When you see people who develop schizophrenia in their 40s and they have family around them, and an occupation, often it is a much more simple matter of prescribing some medication and providing some education … it is not nearly as disabling,’ Dr Large said.

‘People who get it at 15 are much less likely to be able to hold down a job, to sustain relationships or complete their education.’

Cannabis is the most widely used illicit drug in Australia with a third of the population (33.5 per cent) reporting use at some time, according to a 2007 National Drug Household Survey.

Dr Large said it was also estimated about one third of those Australians with a diagnosed psychotic illness also report a history of cannabis use.

Just how cannabis use could trigger a psychotic illness was not yet known, though it could hinge on genetic as well as environmental factors or be the result of ‘disrupting’ the brain during a period of ‘important neurological maturation’.

Dr Large also said it was also suspected, but not yet proven, that cannabis use made more people prone to psychotic illness.

He said those cannabis smokers who developed psychotic illness early could still have done so later in life had they never used the drug, and more research was needed.

‘It took a long time to prove cigarette smoking caused lung cancer – it wasn’t really until 1965 that that information was firmly established,’ Dr Large said.

‘We are in that process of examining epidemiological associations of cannabis and this is another piece – quite a big piece – of the jigsaw.’

The research is published in the journal Archives of General Psychiatry.

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Alarming new research shows smoking cannabis can trigger psychotic illness such as schizophrenia almost three years earlier.

A new report which analysed 83 studies involving 22,000 people found people vulnerable to mental health problems are likely to suffer symptoms at a much younger age by using the illicit drug.

The findings confirm that cannabis accelerates the onset of full-blown mental illness, which makes it harder to treat successfully.

A man rolls a joint: Experts claim ‘overwhelming evidence’ shows cannabis triggers schizophrenia and other psychotic disorders

Researchers in Australia behind the latest analysis in the Archives of General Psychiatry journal and British experts are calling for renewed public health warnings about the dangers of cannabis.

They claim ‘overwhelming evidence’ shows it triggers schizophrenia and other psychotic disorders, perhaps through an interaction between genetic and environmental disorders or by disrupting brain development.

Dr Matthew Large and colleagues at the Prince of Wales Hospital, New South Wales, looked at 83 studies involving 8,000 people who used cannabis and other substances and 14,000 people who did not.

They found those who used cannabis developed psychosis about 2.7 years younger than those who did not.

Those who used any type of substance developed psychosis about two years younger, whereas the use of alcohol did not affect the age at which psychosis began.

Typical psychotic events among cannabis users are paranoid ideas, hallucinations, hearing voices or bizarre behaviour.

Dr Large said ‘The results of this study provide strong evidence that reducing cannabis use could delay or even prevent some cases of psychosis.

‘Reducing the use of cannabis could be one of the few ways of altering the outcome of the illness because earlier onset of schizophrenia is associated with a worse prognosis and because other factors associated with age at onset, such as family history and sex, cannot be changed.

‘The results of this study confirm the need for a renewed public health warning about the potential for cannabis use to bring on psychotic illness.’

Previous research shows one-quarter of the population has a strong genetic predisposition to develop psychosis and other schizophrenia-like symptoms after smoking cannabis.

The risk increases more than 10-fold in these people.

Experts warn that anyone with pre-existing mental health problems or family history is at increased risk of mental illness if they use cannabis.

Mary Brett, a trustee of CanSS (Cannabis Skunk Support), said the study’s conclusions provided ‘overwhelming evidence’ of the link between cannabis use and psychosis.

She said ‘We know from research done by the Institute of Psychiatry that adolescents who carry a particular copy of a gene are five times more likely to develop psychosis after smoking cannabis – 10 times if they carry two copies.

‘We’ve been trying to campaign for more awareness and a public health campaign is long overdue.

‘People are not listening to the evidence that psychosis happens quicker and younger to cannabis users, and it’s heartbreaking to see the consequences for individuals and families.’

It was reported yesterday that respected GP Dr Hans-Christian Raabe claims he was sacked as a government drugs adviser for holding ‘embarrassing’ views about homosexuality.

Dr Raabe, a ‘traditional Christian’, was appointed to the Advisory Council on the Misuse of Drugs less than a month ago and has not had the chance to attend a meeting.

Home Office officials said he had failed to disclose being a co-author of a study suggesting a link between homosexuality and paedophilia.

The Advisory Council was the centre of controversy in 2009 when its chairman David Nutt was sacked for insisting cannabis was less harmful than alcohol and tobacco.

DURHAM, N.C.–(BUSINESS WIRE)–An article published recently in Psychosomatic Medicine 72:(November) 897-904) showed that the Williams LifeSkills video training program can reduce stress in individuals who care for a relative with Alzheimer’s disease. The impact of the 5-week video training was significant: depressive symptoms, perceived stress, anxiety and blood pressure were all reduced. These improvements were maintained or even enhanced six months after the video training was delivered. in this controlled study, caregivers were alternately assigned to two groups: one that participated in a video-delivered plus telephone coaching coping skills training program and another group that was wait-listed and received the training later.

“People who care for the 5 million Americans afflicted by Alzheimer’s disease are usually family members and they have been found to be at increased risk of developing both physical and mental health problems”

“People who care for the 5 million Americans afflicted by Alzheimer’s disease are usually family members and they have been found to be at increased risk of developing both physical and mental health problems”, commented Virginia Williams, President of Williams LifeSkills, the developer of the program and lead author on this paper. “These individuals are extremely stressed, and usually don’t have the time or the financial resources to attend more formally delivered coping skills programs. The advantage of the Williams LifeSkills video training is that is not only less costly, but can be viewed and studied in their home at times most convenient for the caregiver”.

Redford Williams, a co-developer of the training program and Professor of Psychiatry and Medicine at Duke University, added, “few stress reduction programs for caregivers have been shown to produce improvements in both psychological and biological stress markers. in this study, 116 caregivers were recruited over a 2-year period and were assessed before and up to six months later for both psychosocial and biological markers of stress. Compared to those in the wait list group, caregivers receiving video coping skills training not only reported lower levels of anxiety, perceived stress and depression, but were also found to have clinically meaningful reductions in blood pressure.”

Williams LifeSkills is a North Carolina based company that develops coping skills training programs to reduce physical and emotional stress in a wide variety of populations, including medical personnel, cardiac patients, teens and law enforcement officers. more information about Williams LifeSkills and its coping skills programs can be found at williamslifeskills.com

Reference: Psychosomatic Medicine 73:000–000 (2011)