The latest generation of sleep hypnotics -- Ambien (zolpidem), Sonata (zaleplon), and Lunesta (zopiclone) -- have introduced new terms into the American lexicon. We now speak of people “sleep-driving” under the influence of these medications, for instance. The official guide that comes with Lunesta, to take one example, warns of the side effects this way: You may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night.
In 2003, a group of Italian university scientists and public health officials began sifting through the health records of shift workers at a factory in Apulia, Italy. The scientists had designed a cross-sectional study of 319 male workers with normal glucose and insulin levels, and were looking for metabolic and cardiovascular risk factors. Their study, published in the International Journal of Obesity, showed that workers on the night shift at the factory were significantly more likely to gain weight and show increases in systolic blood pressure than day workers.
Most people familiar with public health issues are aware of the challenges posed by “dual diagnosis” patients -- those with both a psychiatric diagnosis and a substance abuse diagnosis. But the special case of addicted bipolar disorder patients is particularly problematic. Writing in the August issue of Current Psychiatry, Bryan K. Tolliver lists the severe outcomes that plague the victims of bipolar disorder who are also substance abusers: “Poor treatment compliance, longer and more frequent mood episodes, more mixed episodes, more hospitalizations, more suicide attempts.”
The word comes from the Greek “boulimia,” for bous (ox) plus limos (hunger). Bulimia is ox hunger, which could mean something like “hungry as a horse.” In practice, it means “to gorge.” It is also known as bulimia nervosa, or binge-purge syndrome. Bulimia is a disorder marked by the consumption of large amounts of food over a short period of time, followed by “compensatory behavior,” usually in the form of vomiting, to rectify this loss of control. It is often grouped with anorexia, and while the two conditions share many symptoms --abnormal food consumption patterns, body image distortion, anxiety -- none is stranger than the ailment clinicians have dubbed “body dysmorphic disorder” or BDD. People with this disorder feel deeply unattractive because of a perceived flaw in skin, hair, or facial features -- minor flaws at best, or defects which demonstrably are not there -- and cannot be reasoned out of this core belief. What they see in the mirror is simply different from what others objectively see about them.
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