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This Month in Archives of General Psychiatry
Oct 2012

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2012;69(10):991. doi:10.1001/archgenpsychiatry.2011.1229

Kluetsch et alArticle report that during painful thermal stimulation, patients with borderline personality disorder show less integration than healthy control subjects of the left retrosplenial cortex and superior frontal gyrus into the default mode network and less posterior cingulate cortex seed region connectivity with the left dorsolateral prefrontal cortex. These alterations may reflect a deficiency in the switching between baseline and task-related processing.

Daly et alArticle investigated brain activity during processing of emotional facial expressions measured with functional magnetic resonance imaging in a double-blind, placebo-controlled trial of acute tryptophan depletion. Modulation of brain activity by tryptophan depletion during facial emotion processing significantly differs in people with autism spectrum disorder compared with controls in brain regions previously shown to differ in serotonin synthesis/receptor or transporter density.

Green et alArticle found that patients with remitted major depressive disorder exhibit a guilt-selective functional disconnection of the right superior anterior temporal lobe, previously demonstrated to represent social meaning, from the subgenual cingulate cortex and adjacent septal region, recently shown to be selectively involved in feelings of guilt. Lower anterior temporal lobe–subgenual cingulate cortex and adjacent septal region coupling was associated with higher self-hate scores. This provides a neural mechanism of major depressive disorder vulnerability that accounts for self-blaming biases.

Slopen et alArticle examined whether abnormalities in neural processing of facial stimuli are related to the high rates of psychopathology observed among institutionally reared children. Children with reduced event-related potential amplitudes to facial stimuli (mean age = 22 months), specifically P100 and P700, exhibited more attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms at 54 months, and P700 mediated the association between institutional rearing and ADHD symptoms. Findings suggest that ADHD symptoms among children exposed to early-life deprivation are partially attributable to atypical neurodevelopment.

Teplin et alArticle examined changes in the prevalence of psychiatric disorders in detained youth (N = 1829). Although prevalence rates of most psychiatric disorders declined over time, a substantial proportion of delinquent youth—more than 45% of males and nearly 30% of females—continue to have disorders 5 years after detention. There were notable sex and racial/ethnic differences in the prevalence and persistence of disorders.

Capuron et alArticle show that alteration in presynaptic dopamine function is a mechanism by which inflammatory stimuli can reduce hedonic tone and lead to symptoms of depression, fatigue, and neurotoxicity. Long-term exposure to the inflammatory cytokine interferon alfa was associated with reduced responsiveness in the ventral striatum to a functional neuroimaging task of hedonic reward while also leading to increased reuptake and decreased release of radiolabeled fluorodopa F 18 in the same brain region as measured by positron emission tomography.

Shahly et alArticle examined associations of insomnia with costly workplace accidents and errors among 4991 US workers. Current chronic insomnia significantly predicted workplace accidents and errors, controlling for 18 chronic conditions. Insomnia-related accidents and errors were significantly more costly ($32 062) than other accidents and errors ($21 914). Insomnia predicted 7.2% of all costly workplace accidents and errors and 23.7% of all associated costs.

Hoeft et alArticle show different resting-state functional brain connectivity patterns in high and low hypnotizable individuals. High hypnotizable individuals show more functional connectivity between 2 key brain areas, the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex. The results provide evidence for the functional brain basis of hypnotizability.

Byers et alArticle identified 4 trajectories of depressive symptoms among community-dwelling older women followed up for 20 years (ie, minimal depressive symptoms, persistently low symptoms, increasing symptoms, and persistently high symptoms). Approximately 20% of older women experienced persistently high or increasing depressive symptoms. In addition, these women had more comorbidities, physical impairment, and negative lifestyle factors at baseline.

In a structural magnetic resonance imaging study, Kuo et alArticle examined the relationship between amygdala volume and posttraumatic stress disorder (PTSD) in 99 combat-exposed veterans. Individuals with PTSD had significantly larger amygdala volume than those without PTSD. Further, severity of combat exposure and the interaction between the presence of early life trauma and severity of combat exposure were negatively associated with amygdala volume.

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