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This Month in Archives of General Psychiatry
Nov 2011

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2011;68(11):1089. doi:10.1001/archgenpsychiatry.2011.134

Hallmayer et alArticle report results from a new twin study of autism and autism spectrum disorder (ASD) involving direct clinical assessments in 192 pairs. For ASD, probandwise concordance for monozygotic twins was 0.77 for males and 0.50 for females. For dizygotic twins, concordance was 0.31 for males and 0.36 for females. The results support a model of ASD susceptibility with a substantial shared twin environmental component and moderate genetic heritability.

Croen et alArticle evaluated whether prenatal exposure to antidepressant medications is associated with increased risk of autism spectrum disorders (ASDs). Using a population-based case-control design, they found a 2-fold increased risk of ASD associated with maternal treatment with selective serotonin reuptake inhibitor antidepressants during the year before delivery, with the strongest effect associated with first-trimester treatment. The potential ASD risk must be balanced with risk to the mother or fetus of untreated mental health disorders.

In the largest twin study of autistic traits to date (n = 11 936 individuals), Robinson et alArticle provide evidence of shared etiology between extreme scores (including top 1%) and typical variation. A shift toward affectedness in the trait distribution, greater for monozygotic than dizygotic twins, was seen in co-twins of the top 1%. The heritability of autistic traits was similar across the range of scores (53% for females and 72% for males in the full sample).

Proal et alArticle examined structural brain abnormalities of adults with childhood attention-deficit/hyperactivity disorder (ADHD) followed up for 33 years. They found reductions in gray matter and cortical thickness in regions underpinning top-down control of attention and regulation of emotion in adults with childhood ADHD regardless of current diagnosis. Additionally, those with persistent ADHD differed from remitters in fronto-thalamic-cerebellar circuits, suggesting that these circuits may underlie symptom amelioration and diagnostic remission.

Shah et alArticle examined the association of unipolar and bipolar depression and history of attempted suicide with cardiovascular and ischemic heart disease mortality in young US adults aged 17 to 39 years from the 1988-1994 Third National Health and Nutrition Examination Survey. Both depression and history of attempted suicide were associated with substantially elevated ischemic heart disease risk independently of traditional risk factors and health behaviors, with relative risks of 3.23 (95% confidence interval, 1.16-9.02) and 5.69 (95% confidence interval, 2.16-15.0), respectively.

Kumar et alArticle examined protein binding in patients diagnosed with late-life major depression and controls using (2-(1-{6-[(2-[18F]fluoroethyl)(methyl)-amino]-2-naphthyl}ethylidene) malononitrile ([18F]FDDNP), a ligand that binds to bothβ-amyloid and tau in the brain. Binding of [18F]FDDNP was significantly higher in the posterior cingulate and lateral temporal areas in patients with major depressive disorder when compared with controls. These findings suggest that altered protein biology may be pathophysiologically relevant in elderly individuals with mood disorders.

Lapham et alArticle ascertained the prevalence of addictive disorders in 612 non-Hispanic white and Hispanic offenders 15 years after a first conviction for driving while impaired and compared these rates with those of a general population sample. They found exceedingly high rates of alcohol and drug use disorders and nicotine dependence in the impaired-drivers sample. These addictive disorders persisted over 10 years and greatly exceeded those in the general population.

Hasin et alArticle examined the role of DSM-IV Axis I and all 10 Axis II personality disorders in predicting a chronic, 3-year course of alcohol, cannabis, and nicotine use disorders in a large, prospectively observed, nationally representative US sample. Adjustments were made for multiple covariates and Axis I comorbidity. Antisocial, borderline, and schizotypal personality disorders all significantly predicted the fully symptomatic persistence of alcohol, cannabis, and nicotine use disorders across the 3 years of follow-up.

In a double-blind, randomized, controlled, 12-week trial of mirtazapine vs placebo added to weekly substance use counseling, Colfax et alArticle found that mirtazapine decreased methamphetamine use among methamphetamine-dependent, actively using men who had sex with men at high risk for acquiring or transmitting human immunodeficiency virus. Participants assigned to mirtazapine had significantly fewer methamphetamine-positive urine test results compared with participants assigned to placebo; sexual risk behavior also decreased more in the mirtazapine arm.

Wu et alArticle examined DSM-IV alcohol and drug use disorders in a national sample of adolescents aged 12 to 17 years (N = 72 561). Of the sample, 8% met criteria for an alcohol or drug use disorder, with Native Americans having the highest prevalence of use (48%) and disorder (15%). Among past-year alcohol or drug users (n = 27 705), Native Americans (32%), multiple-race adolescents (25%), white individuals (23%), and Hispanic individuals (21%) had an elevated rate of alcohol or drug use disorders.