The average PSA levels were 21.6 percent lower among men with a self-reported diagnosis of diabetes compared with men without diabetes.

This difference increased with years since the diabetes diagnosis was made. Men diagnosed more than 10 years ago had a 27.5 percent lower average PSA level. Overweight men who had been diagnosed with diabetes more than 10 years ago had a PSA level that was 40.8 percent lower than normal-weight men without diabetes.

"It is unclear whether the lowered PSA level in diabetic men accurately reflects a decreased risk of prostate cancer in the diabetic population or whether their lower PSA levels result in a reduced likelihood of receiving a diagnostic workup for detection of asymptomatic prostate cancers, as has been suggested for obese men," Saraiya and colleagues note.

"If the latter were true, diabetic men might well be diagnosed with later-stage tumors and have poorer treatment outcomes, and overweight diabetic men would have later-stage tumors than normal-weight diabetic men."

SOURCE: American Journal of Epidemiology, November 2006.

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Psychotic patients benefit from smoking cessation

Last Updated: 2006-11-22 14:32:08 -0400 (Reuters Health)

NEW YORK (Reuters Health) - People with a psychotic disorder can benefit from a smoking cessation intervention consisting of nicotine replacement therapy plus motivational interviewing and cognitive behavior therapy, according to a new study.

"Despite extremely high rates of smoking among individuals with psychotic disorders and the associated financial and health costs, few studies have investigated the efficacy of smoking cessation interventions among this group," Dr. Amanda Baker, of the University of Newcastle, Australia, and colleagues write in the current issue of the American Journal of Psychiatry.

The researchers compared a psychological and nicotine replacement therapy intervention with routine care alone among 298 regular smokers with a psychotic disorder. About half of the subjects were randomly assigned to an eight-session smoking cessation intervention and the other half to routine care.

The smoking cessation intervention consisted of nicotine replacement therapy, motivational interviewing and cognitive behavior therapy. Outcome measures included abstinence rates, smoking reduction, and changes in symptoms and functioning.

The participants were an average of 37 years old. Overall, 56.7 percent of the patients had a diagnosis of schizophrenia or a schizoaffective disorder. Of the patients assigned to the treatment group, 47.6 percent attended all eight sessions. One quarter of the patients (23.8 percent) attended less than five sessions.

There were no significant differences between the groups in abstinence rates. However, abstinence rates were significantly higher among smokers who completed all treatment sessions compared with those in the routine care group. Continuous abstinence after 3 months was also more likely to be achieved by smokers who completed all treatment sessions compared with those who did not (21.4 percent versus 4.0 percent).

The authors report a strong "dose-response" relationship between treatment session attendance and smoking reduction status. A 50 percent or greater reduction in daily cigarette consumption during the follow-up period was observed in half of those who completed the intervention program compared with less than 20 percent of those in the comparison group.

"In our study, nicotine replacement therapy commencement was associated with a net reduction of five to eight cigarettes per day, suggesting that higher doses or a longer duration of nicotine replacement therapy use may be necessary to obtain additional benefits," Baker's team concludes.

SOURCE: American Journal of Psychiatry, November 2006.

Copyright © 2006 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.