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In This Issue of JAMA Psychiatry
September 2015


JAMA Psychiatry. 2015;72(9):857. doi:10.1001/jamapsychiatry.2014.1906

Antipsychotic medication use is common among young people in the United States, although these medications are associated with adverse effects. Olfson and coauthors used a large pharmacy prescription database to examine antipsychotic medication use patterns and trends among individuals 24 years and younger across the population. Antipsychotic use has increased among young people but not for children 12 years and younger and use appears primarily directed at impulsive and aggressive behaviors rather than psychotic symptoms. In an Editorial, Correll and Blader discuss the implications of widespread antipsychotic use among young people.


Military personnel deployed to war zones are at risk of experiencing long-term consequences, including posttraumatic stress disorder (PTSD). Marmar and coauthors used the National Vietnam Veterans Longitudinal Study to explore how military service 40 or more years earlier affected adjustment in later life. Lifetime and current war-zone PTSD prevalences were 17.0 % and 4.5%, respectively, in male veterans and 15.2% and 6.1% in female veterans. In an Editorial, Hoge discusses the contribution of this unique longitudinal study for a better understanding of the long-term consequences of war-zone military service.


Author Audio Interview

Continuing Medical Education

Predicting progression from an at-risk mental state to a psychotic disorder would be invaluable for prevention and early intervention. Anticevic and coauthors examined whole-brain thalamic connectivity using resting state functional magnetic resonance imaging scans from 243 at-risk and 154 healthy individuals drawn from the North American Prodromal Longitudinal Study. They report that 21 individuals who later progressed to psychosis had reduced thalamic connectivity with the prefrontal cortex and cerebellum and elevated thalamic connectivity with sensorimotor cortices at baseline. In an Editorial, Fusar-Poli discusses the state of research on biomarkers predictive of future psychosis.


Most psychiatric disorders present first in childhood and are a leading cause of disease burden in adolescents. Copeland and coauthors assessed participants of the Great Smoky Mountains Study aged 19 to 26 years for adverse outcomes of childhood psychiatric diagnoses and subthreshold psychiatric problems. Participants with a childhood disorder had a 6 times higher odds of at least 1 adverse adult outcome and those with subthreshold psychiatric problems had a 3 times higher odds. In an Editorial, Lahey discusses what these findings mean for a causal link between childhood and adult psychopathology.


The rate of suicide attempts in the US Army increased sharply during the wars in Afghanistan and Iraq. Ursano and coauthors used the Army Study to Assess Risk and Resilience in Servicemembers for a comprehensive analysis of documented suicide attempts. Greater risk was predicted by female sex, being younger, non-Hispanic white race/ethnicity, and having a lower educational attainment. Enlisted soldiers in their first tour of duty and those with a recent mental health diagnosis were at greatest risk.