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This Month in Archives of General Psychiatry
July 2011

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2011;68(7):652. doi:10.1001/archgenpsychiatry.2011.63

Dias et alArticle used electroencephalography recordings to show diminished activity in the visual cortex of schizophrenic patients performing variations of a cognitive continuous performance task. This reduced activation correlated with activity in the frontal cortex, suggesting that loss of input from early sensory areas may contribute to the reduced activation of cognitive areas. Correlations with behavior performance also suggest that deficits in early sensory processing contribute to the impaired cognitive behavior of schizophrenic patients.

Wonodi et alArticle demonstrate a significantly correlated reduction of kynurenine 3-monooxygenase (KMO) messenger RNA expression and enzyme activity in a cortical region associated with eye-tracking impairments in schizophrenia. On finding a KMO single-nucleotide polymorphism (SNP) association with messenger RNA expression, they examined the SNP's effects on eye-tracking endophenotypes in a clinical sample and showed association between this SNP and impaired eye tracking and spatial working memory. These converging lines of evidence further implicate KMO impairment in schizophrenia-related neurocognitive deficits.

Kempton et alArticle conducted a meta-analysis of 145 structural imaging studies in major depressive disorder and compared the results with their previous meta-analysis in bipolar disorder. Both disorders were associated with ventricular enlargement and subcortical gray matter hyperintensities; however, only major depression was associated with a volumetric reduction of the hippocampus and basal ganglia, while bipolar disorder was associated with deep white matter hyperintensities and a smaller corpus callosum.

Stangier et alArticle compared the efficacy of cognitive therapy and interpersonal psychotherapy in the treatment of social anxiety disorder. One hundred seventeen patients were randomized to treatments or a waiting-list control condition. At posttreatment, both treatments showed significantly stronger reductions in social anxiety than the waiting-list control condition. However, cognitive therapy was superior to interpersonal psychotherapy on the primary outcome measure both at posttreatment and 1-year follow-up.

Lyoo et alArticle conducted a multiwave longitudinal neuroimaging study in survivors from a South Korean subway disaster during their natural course of improvement of posttraumatic stress disorder symptoms to investigate brain correlates of recovery from a severe psychological trauma. They found that regions of the dorsolateral prefrontal cortex were thicker in trauma-exposed subjects than in controls early after trauma, which was associated with improvement of posttraumatic stress disorder symptoms. This greater dorsolateral prefrontal cortex thickness in trauma-exposed subjects gradually normalized during the course of recovery.

Swanson et alArticle analyzed data from the National Comorbidity Survey Replication Adolescent Supplement, a nationally representative, face-to-face survey of more than 10 000 teens aged 13 to 18 years, for the presence and features of eating disorders. The findings suggest that anorexia nervosa, bulimia nervosa, and binge-eating disorder have discrete sociodemographic and clinical correlates.

Arcelus et alArticle systematically compiled and analyzed the rates of mortality in people with eating disorders and showed that individuals with anorexia nervosa had a significantly elevated mortality rate (standardized mortality ratio, 5.86). The mortality rates for eating disorder not otherwise specified and bulimia nervosa were found to be very similar (standardized mortality ratio, 1.92 and 1.93, respectively). The study found age at assessment to be a significant predictor of mortality for patients with anorexia nervosa, which was due to suicide 70% of the time.

Using positron emission tomography, Berney et alArticle describe elevated normalizedα-[11C]methyl-L-tryptophan trapping, an index of brain serotonin synthesis, in the right hippocampus, left inferior temporal gyrus, and bilateral caudate nucleus in medication-free patients with obsessive-compulsive disorder relative to age- and sex-matched controls. The findings point to the critical role played by serotonergic innervation of brain structures involved in automatic cognition and meta-memory.

Whitaker et alArticle examined the relation of perinatal brain injury to adolescent psychiatric disorders in a regional birth cohort (birth weight<2000 g) systematically screened neonatally with serial head ultrasonography. Neonatal head ultrasonography abnormalities increased adolescent risk for obsessive-compulsive, tic, attention-deficit/hyperactivity, and major depressive disorders, all disorders in which subcortical-cortical circuit dysfunction is implicated. This prospective, longitudinal epidemiological study provides strong empirical evidence that perinatal brain injury impacts risk for later psychiatric disorder.

Using family study methods to examine the familiality of borderline personality disorder and its component affective, interpersonal, behavioral, and cognitive endophenotypes, Gunderson et alArticle found that the disorder is more familial than the endophenotypes and that a common pathway model was stronger than an individual pathway model. These results indicate that borderline personality disorder may have a unitary core to its psychopathology that overrides and accounts for the aggregation of its endophenotypes.