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In This Issue of JAMA Psychiatry
August 2015


JAMA Psychiatry. 2015;72(8):741. doi:10.1001/jamapsychiatry.2014.1900

Alcohol use disorder, one of the most prevalent mental disorders worldwide, was reclassified in the DSM-5. Grant and colleagues used the National Comorbidity Survey Replication to present the epidemiology of DSM-5 alcohol use disorder. Twelve-month and lifetime prevalences of alcohol use disorder were 13.9% and 29.1%, respectively. Only 19.8% of respondents with lifetime alcohol use disorder were ever treated. Significant associations were found between alcohol use disorder and other mental disorders, especially bipolar, major depressive, and personality disorders.

More than half of youth with autism spectrum disorders (ASDs) experience an extreme negative reaction to sensory stimuli. Green and colleagues studied this sensory overresponsivity in 19 high-functioning youths with ASDs and 19 matched healthy control participants with functional magnetic resonance imaging. During exposure to sensory stimuli, youths with ASDs displayed stronger activation in primary sensory cortices and the amygdala, which was correlated with sensory overresponsivity symptoms. While youths with ASDs with sensory overresponsivity showed decreased neural habituation, those without sensory overresponsivity showed a pattern of amygdala downregulation.

Social anxiety disorder has been associated with abnormalities of the serotonergic system. Frick and colleagues used positron emission tomography to study serotonin synthesis and reuptake in 18 patients with social anxiety disorder and 18 matched healthy control individuals. They reported higher rates of serotonin synthesis and/or transporter availability in several brain regions, including the amygdala and raphe nuclei. The rate of serotonin synthesis was correlated positively with social anxiety symptoms. In a Neuroscience and Psychiatry article, Stein and Andrews discuss serotonin states and anxiety.

Related Article

Long-acting injectable antipsychotic medications have not been studied following the first episode of schizophrenia. In a randomized clinical trial, Subotnik and coauthors randomized 83 patients with recent onset of schizophrenia to long-acting injectable or oral risperidone. Adherence was higher and the relapse rate was lower for long-acting injectable than oral risperidone (relapse rate, 5.0% vs 32.7%, respectively), suggesting that long-acting injectable antipsychotic preparations may offer substantial benefit in early schizophrenia. In an Editorial, Carpenter and Buchanan discuss the role of injectable antipsychotics in our armamentarium.


Treatment nonadherence and subsequent relapse are common challenges for patients with schizophrenia; long-acting injectable antipsychotic formulations may help address this problem. In a randomized placebo-controlled double-blind multicenter clinical trial, Berwaerts and coauthors studied the safety and efficacy of a novel 3-month formulation of paliperidone palmitate in schizophrenia. This formulation, which requires only 4 administrations per year, significantly delayed relapse compared with the placebo and its tolerability was similar to other marketed paliperidone formulations. In an Editorial, Carpenter and Buchanan discuss the role of injectable antipsychotics in our armamentarium.


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