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This Month in Archives of General Psychiatry
Apr 2012

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2012;69(4):336. doi:10.1001/archgenpsychiatry.2011.1199

Schellekens et alArticle studied central dopamine receptor sensitivity as an intermediate phenotype for alcohol dependence. Their findings suggest that COMT Val158Met and DRD2 Taq1A affect the intermediate phenotype of central dopamine sensitivity. These genes may confer their risk on alcohol dependence through reduced dopamine sensitivity in the prefrontal cortex and the hindbrain, respectively.

The nosological dichotomy between schizophrenia and bipolar disorder as formulated by Kraepelin is currently questioned based on their shared common genetic origin. Using magnetic resonance imaging in 158 twin pairs, Hulshoff Pol et alArticle found that brain structures reflect both overlapping and segregating genetic liabilities in these disorders. Smaller white matter volume and common areas of mostly thinner cortex suggest that both disorders share genetic (neurodevelopmental) roots.

Aupperle et alArticle examined neural responses during emotional anticipation (using functional magnetic resonance imaging) and neuropsychological performance of women with (n = 37) and without (n = 34) posttraumatic stress disorder (PTSD). In PTSD, greater dorsolateral prefrontal cortex (PFC) activation related to lower PTSD symptom severity and better neuropsychological performance. Greater medial PFC and amygdala activation related to slower processing speed. Results suggest that dorsolateral PFC function may play a role in both the cognitive and emotional symptoms of PTSD.

Kessler et alArticle report prevalence estimates of recent disorders among US adolescents in a national epidemiological survey of DSM-IV anxiety, mood, behavior, and substance disorders. Results showed that these DSM-IV disorders are highly prevalent (40.3% 12-month prevalence and 23.4% 30-day prevalence) and persistent. Anxiety disorders were most common followed by behavior, mood, and substance disorders. The 30-day and 12-month prevalence ratios were generally lower than the 12-month and lifetime ratios, suggesting that persistence is due more to episode recurrence than chronicity.

Kessler et alArticle report data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED) among adolescents in a US national epidemiological survey. Estimated SED prevalence was 8.0%. Most SED was due to behavior (54.5%) or mood (31.4%) disorders and associated with high comorbidity (63.5%). Sociodemographic variables were generally nonsignificantly related to SED after controlling disorder type and number. Kessler et al discuss public health implications of the significant between-disorder differences and high comorbidity of SED.

Swendsen et alArticle describe the lifetime prevalence of multiple stages of alcohol and drug use and abuse among US adolescents and examine the sociodemographic predictors of transitions among these stages. Rates of both use and abuse were high and illicit drug abuse was even slightly more prevalent than alcohol abuse. The risks conferred by age, sex, and race/ethnicity varied significantly by previous stage of use.

Di Iorio et alArticle sought to determine whether recreational use of the serotonin neurotoxin ecstasy (MDMA) was associated with chronic reductions in cortical serotonin function in abstinent female ecstasy users, as measured by increased serotonin2A receptor levels. They found that serotonin2A receptors were higher in MDMA users and that lifetime MDMA use was positively correlated with serotonin receptor levels.

In a prospective cohort study of approximately 20 000 patients with diabetes mellitus followed up over a 5-year period, Katon et alArticle found that those with comorbid depression and diabetes had an approximately 2-fold higher risk of dementia during the 3 to 5 years postbaseline compared with patients with diabetes alone.

Using single-photon emission computed tomography brain imaging, Cosgrove et alArticle found sex differences in β2*-nicotinic acetylcholine receptor availability in smokers compared with nonsmokers, and in female smokers, sex hormones were correlated with mood and craving levels. The effects of nicotine in the brain appear to be distinctly different between men and women and suggest that to treat female smokers more effectively, it is critical that nonnicotine-mediated medications are explored.

Munk-Olsen et alArticle conducted a population-based register cohort study to examine to which extent psychiatric disorders with postpartum onset are early manifestations of an underlying bipolar affective disorder. It is well known that childbirth has an important influence on the onset of bipolar disorder, confirmed in the present study because Munk-Olsen et al found that 14% of women with first-time psychiatric contacts during the first postpartum month converted to a bipolar diagnosis within the 15-year follow-up period.