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This Month in Archives of General Psychiatry
January 2002

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2002;59(1):9. doi:10.1001/archpsyc.59.1.9

The sequelae from head injuries can be psychological, physical, and cognitive. Rates of depression are high soon after a head injury, but little is known about the long-term prevalence of depression after injury. Holsinger et al Article report that rates of depression are also elevated decades after a head injury and that lifetime risk of depression increased with severity of head injury.

A commentary by Robinson and Jorge is included.

Suhara et al Article used positron emission tomography to examine the extrastriatal D2receptors in schizophrenic patients. Drug-naive schizophrenics showed a regional decrease in D2 receptors in the anterior cingulate cortex with negative correlation to the positive symptom score on the Brief Psychiatric Rating Scale. These findings suggest that alterations in D2 receptor function in the cerebral cortex may play a role in the causation of schizophrenia.

A commentary by Wong is included.

In a magnetic resonance imaging study of schizophrenic patients, their siblings, and controls, Cannon et al Article found that a history of fetal hypoxia is associated with greater structural brain pathology among patients with schizophrenia and their nonschizophrenic siblings than among controls at low genetic risk for the disorder.

In a community-based study of a large and ethnically diverse sample of young adults, Turner and Gil Article found that more than 60% have experienced a psychiatric or substance disorder at some time in their lives. African Americans were found to have substantially lower lifetime rates of depressive and substance disorders than other groups and, among Hispanics, rates tend to be lower among the foreign-born than among their US-born counterparts. These results suggest the importance of intervention efforts during early adolescence.

By combining information from a psychiatric examination, a key informant interview, and medical records, Östling and Skoog Article found that 10% of nondemented 85-year-olds experienced hallucinations or delusions and 6% had paranoid ideation. These symptoms were associated with sensory impairments, cardiovascular disorders, development of dementia, and increased mortality. They conclude that psychotic symptoms in old age are more frequent than previously thought and that it is crucial to obtain information from multiple sources in the clinical evaluation of elderly patients.

A commentary by Breitner is included.

Tohen et al Article compared the efficacy and safety of treatment of bipolar disorder with either of 2 conventionally used drugs, lithium or valproate, vs combined therapy consisting of either drug added to the atypical antipsychotic olanzapine. The olanzapine cotherapies were found to improve patients' levels of mania significantly more than the monotherapies, and levels of depression were dramatically improved by cotherapy. These findings show that the addition of olanzapine may provide superior efficacy in the treatment of manic or mixed bipolar episodes.

Posternak and Zimmerman Article rigorously evaluated a large cohort of depressed psychiatric outpatients and tested multiple hypotheses regarding how depressed patients with atypical features would differ from those without atypical features. The results offer some support for the validity of the atypical features subtype but suggest that the diagnostic criteria set may require further modification.

Mojtabai et al Article examine factors beyond severity and comorbidity in pathways to mental health specialty care. They show that different factors affect perceived need, decisions to seek help and professional mental health utilization. They illustrate the need for more targeted educational and behavioral change strategies to close the gap between need and appropriate care.

Despite its long use in clinical settings, the infamous reputation of hypnosis has darkened its research potential to cognitive science. Current techniques open new opportunities to use hypnosis and posthypnotic suggestion as probes into neural mechanisms and reciprocally provide a means of studying hypnosis itself. Raz and Shapiro Article describe not only how hypnotism can provide a way to tap neurocognitive questions but also how cognitive assays can in turn shed new light on the neural bases of hypnosis.

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