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This Month in Archives of General Psychiatry
Aug 2011

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2011;68(8):769. doi:10.1001/archgenpsychiatry.2011.79

IoannidisArticle examined 461 study data sets included in 41 meta-analyses of brain volume abnormalities in diverse mental disorders. Even though the vast majority of these studies are very small, 31% of the data sets had nominally statistically significant results, far too many compared with the expected number of“positive” studies even if the summary effect sizes of the meta-analyses were unbiased. This pattern suggests strong biases in this literature.

Bakken et alArticle conducted a genome-wide association study of cortical thickness among individuals with schizophrenia and bipolar disorder and healthy controls. Two closely linked single-nucleotide polymorphisms on chromosome 15q12 reached genome-wide significance among patients diagnosed as having schizophrenia and were also associated with neurocognitive performance. Cortical thickness may be an intermediate phenotype for neuropsychiatric diseases.

Angst et alArticle applied modified DSM-IV bipolar specifier criteria in a study of 5635 depressed patients in 18 countries. Specifier criteria identified significant associations for family history of mania, more than 2 mood episodes, manic/hypomanic states while taking antidepressants, mixed mood symptoms, and substance use disorder. Specifier criteria identified an additional 31% of DSM-IV-TR depressed patients as having bipolar disorder.

Robinson et alArticle examined the role of self-medication with alcohol or drugs in the development of incident anxiety and substance use disorders. Using a longitudinal, nationally representative sample, they found that among those with existing anxiety disorders, self-medication conferred risk of new-onset substance use disorders. Conversely, among those with substance use disorders, self-medication predicted incident social phobia.

Gearhardt et alArticle examined the relation between elevated food addiction scores and functional magnetic resonance imaging activation in response to food cues and food receipt. Similar patterns of neural activation are implicated in addictive-like eating and substance dependence; elevated reward-related activation in response to food cues; and reduced activation of inhibitory regions in response to food intake.

Bacher et alArticle applied carbon 11–labeled harmine positron emission tomography to measure MAO-A VT, an index of monoamine oxidase A density, in cigarette-smoking subjects during withdrawal and active smoking and in healthy controls. Within heavy-smoking subjects, prefrontal and anterior cingulate cortex MAO-A VT was greater during withdrawal as compared with active smoking (23.7% and 33.3%, respectively). In addition, prefrontal and anterior cingulate cortex MAO-A VT was significantly greater during withdrawal from heavy smoking compared with healthy controls.

The Collaborative Longitudinal Personality Disorders Study reports on how the psychopathology and social functioning of subjects with borderline personality disorder compares with that of major depressive disorder and cluster C personality disorders. Gunderson et alArticle identify a distinctive course of frequent remissions with infrequent relapse and of persistent and often severe social impairment. These results validate the diagnosis, underscore its public health implications, and give important prognostic information for clinicians, patients, and families.

The study by Scott et alArticle, based on survival analyses of retrospective data from the World Mental Health Survey (n = 18 303), investigated associations between childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions. A history of 3 or more childhood adversities was independently associated with increased risk of onset of 6 physical conditions in adulthood, and a history of early-onset mental disorders was independently associated with onset of 5 physical conditions.

Erk et alArticle examined brain activation during episodic memory processing in individuals reporting subjective memory impairment (SMI) without objective cognitive deficits. Compared with healthy controls, subjects with SMI exhibited reduced hippocampal activation during recall. This was accompanied by an increased activation of the dorsolateral prefrontal cortex, suggesting a compensatory mechanism that provides preserved memory performance. These results support the concept of SMI as a compensated state in the continuum of Alzheimer disease manifestation.

Tariot et alArticle report on a 2-year multicenter clinical trial of divalproex sodium in 313 study participants with Alzheimer disease who had not yet experienced agitation or psychosis. Divalproex was chosen because of possible neuroprotective potential as well as possible symptom suppression potential. The aims were to delay emergence of these symptoms and/or slow progression of cognitive or functional decline. No clinical benefit was seen, and there were significant toxic effects resulting from treatment.

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