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This Month in Archives of General Psychiatry
September 2009

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2009;66(9):929. doi:10.1001/archgenpsychiatry.2009.118

Deep brain stimulation is Food and Drug Administration–approved to treat Parkinson disease, dystonia, and essential tremor but may be effective for treatment-resistant major depression, obsessive-compulsive disorder, and Tourette syndrome. Rabins et alArticle identify scientific and ethical issues raised by the use of deep brain stimulation for disorders of mood, behavior, and thought and make 16 recommendations.

Schobel et alArticle applied a high-resolution variant of functional magnetic resonance to schizophrenia. They found abnormal basal hypermetabolism in the CA1 subfield of the hippocampus and orbitofrontal cortex and abnormal hypometabolism in the dorsolateral cortex. In individuals with prodromal signs of psychosis, CA1 subfield hypermetabolism selectively predicted clinical progression to psychosis. Psychotic symptom severity was also selectively associated with CA1 subfield hypermetabolism.

Studying a set of genomic rearrangements previously identified in rare patients with mental retardation, autism, or schizophrenia, Guilmatre et alArticle showed an increased collective frequency of these copy number variants in patients with mental retardation, autism, or schizophrenia as compared with healthy controls. These copy number variants, which target synaptic and neurodevelopmental genes, overlap between the disease groups, thus supporting the existence of shared biologic pathways in these 3 conditions.

Monocytes of patients with bipolar disorder are characterized by a proinflammatory state reflected by a specific gene expression signature. Padmos et alArticle used a sample of 41 twin pairs with bipolar disorder and 34 matched healthy twin pair controls to determine the contribution of genetic and environmental influences on the association of the monocyte signature with bipolar disorder and found evidence for the association primarily being the result of a common shared environmental factor.

From 2 genome-wide association studies, Ising et alArticle selected 328 markers showing concordant effects with antidepressant treatment outcome in depression. They generated a multilocus variable describing the individual number of marker alleles associated with beneficial treatment outcome. While the effects of the single markers did not replicate in a third sample, they demonstrated a significant contribution of the multilocus variable, indicating an additive genetic effect on antidepressant treatment outcome in all samples.

Studying 2 longitudinal cohorts, Polanczyk et alArticle demonstrated that a haplotype in the CRHR1 gene protects individuals who were maltreated in childhood from developing adult depression, only when maltreatment is assessed by a measure that elicits emotional memories. The results highlight the importance of evaluating stress exposure measurement in gene × environment interaction research.

Using structural magnetic resonance imaging, Yang et alArticle found reduced volumes and localized deformations in bilateral amygdala in individuals with psychopathy. Furthermore, reduced amygdala volumes were found to be associated most prominently with affective-interpersonal features of psychopathy.

In a longitudinal study of US Army soldiers deployed to the Iraq War, Marx et alArticle report that more extensive combat was associated with enhanced reaction time. Soldiers with more severe posttraumatic stress disorder (PTSD) symptoms, however, performed less proficiently on an attention task. The relationship between PTSD symptoms and attention was stronger among soldiers who had been back longer from the war, suggesting that as PTSD symptoms endure they may exert increasingly adverse effects on brain functioning.

Sourander et alArticle studied 5038 Finnish children born in 1981 with complete information about bullying and victimization at age 8 years from parents, teachers, and children themselves. Girls who were frequently victimized were at risk of long-term psychiatric outcome regardless of their psychiatric status at baseline. Boy bully-victims were at risk of a wide range of psychiatric outcomes. Boys and girls who display frequent bullying behavior should be evaluated for possible psychiatric problems.

Fristad et alArticle report the results of a randomized controlled trial of multifamily psychoeducational psychotherapy as an adjunctive treatment for children (aged 8-12 years) with mood disorders. Children continued treatment as usual (psychopharmacological and/or psychosocial) throughout the study. Compared with wait-list children, children who participated in multifamily psychoeducational psychotherapy showed decreased mood symptoms at 6-month follow-up, and treatment gains were maintained at 12 months.

Glassman et alArticle followed up participants of the Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) to identify features of major depressive disorder associated with mortality after acute coronary syndrome. Major depressive disorder severity measured a few weeks after hospitalization and failure of major depressive disorder to improve during 6-month treatment with either drug or placebo were independently associated with a doubling of mortality over 6.7 years.

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