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This Month in Archives of General Psychiatry
April 2011

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2011;68(4):337. doi:10.1001/archgenpsychiatry.2011.18

Konradi et al Article demonstrate a marked abnormality of hippocampal interneurons in bipolar disorder. Using stereological tools and immunocytochemical analysis in whole hippocampal specimens, they show that somatostatin-positive interneurons are reduced by 40% and parvalbumin-positive interneurons are reduced by 30%. Similar reductions were found in messenger RNA levels.

Unrecognized bipolar spectrum illness may be a major contributor to treatment-resistant depression. Perlis et al Article analyzed data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study of major depression and report that psychotic-like symptoms at study entry are associated with poorer antidepressant treatment outcomes. However, bipolar spectrum illness does not appear strongly predictive of treatment resistance or other adverse outcomes.

Hahn et al Article developed an algorithm that integrates neuroimaging data associated with multiple symptom-related neural processes and identifies nonredundant sources of information relevant for biomarker-based classification. Applying this approach to a sample of depressed patients and healthy controls yielded high classification accuracies even with a medicated, unselected patient group.

Westlye et al Article used diffusion tensor imaging to show that the harm avoidance subscale from the Temperament and Character Inventory is associated with reduced white matter integrity in brain areas including corticolimbic pathways involved in emotional processing and reappraisal. Structural brain connectivity modulates anxiety-related aspects of personality in healthy individuals.

Craske et al Article examined cognitive behavior therapy and psychotropic medication for generalized anxiety disorder, panic disorder, social anxiety disorder, and posttraumatic stress disorder in primary care. One thousand four participants were randomized to treatment (Coordinated Anxiety Learning and Management) or usual care. Coordinated Anxiety Learning and Management was superior for each principal anxiety disorder (although not statistically significant for posttraumatic stress disorder), with lesser but similar effects for comorbid anxiety disorders.

King et al Article conducted an alcohol laboratory and follow-up study to assess the relationship of acute alcohol responses with future drinking. Greater positive and lower sedative effects predicted binge drinking frequency and alcohol use disorders. Results suggest important modifications in widely held theories on the role of alcohol effects on future problem drinking.

Kubzansky et al Article examined whether self-regulation is associated with reduced risk of developing coronary heart disease, using prospective data in an ongoing cohort of community-dwelling men. Among initially healthy individuals, those reporting higher levels of self-regulation had significantly reduced risk of developing coronary heart disease, and there was evidence of a dose-response relationship.

Via et al Article conducted a quantitative meta-analysis of 24 voxel-based morphometry studies exploring gray matter volume abnormalities in autism spectrum disorders. Participants with autism spectrum disorders had robust decreases of gray matter volume in the bilateral amygdala-hippocampus complex and bilateral precuneus, regions known to be important in social cognition. No significant differences in gray matter volume were found between autistic disorder and Asperger disorder, supporting the proposed changes in DSM-5.

Sareen et al Article examined the relationship between household income and mental illness using a US national survey. Both cross-sectional and longitudinal analyses demonstrated strong support for the social causation hypothesis; lower levels of income and reductions in income over a 3-year period were associated with increased risk for mental health problems. The data did not support the social selection hypothesis; that is, mental disorders at baseline were not associated with reductions in income.

Breslau et al Article bring new cross-national evidence to bear on the paradoxical finding of low risk for psychiatric disorder among immigrants to the United States relative to the US born. Comparing Mexican immigrants with nonmigrants in Mexico, they found that migration is associated with increased subsequent risk for depressive and anxiety disorders.