The value of short-term dynamic psychotherapy in the treatment of major depression is a matter of debate. Connolly Gibbons and colleagues conducted a randomized noninferiority trial, comparing cognitive behavioral therapy and dynamic therapy in 237 adults with major depression treated in community mental health centers. Dynamic therapy was not inferior to cognitive behavioral therapy. In an editorial, Abbass and Town discuss the implications of this study for routine practice.
Research links childhood abuse to multiple adverse outcomes in adulthood, but little is known about association with all-cause mortality. Chen and colleagues studied a national sample of 6285 adults from the Midlife Development in the United States survey and found that women (but not men) who reported childhood emotional or physical abuse were at a significantly higher risk of all-cause mortality in adulthood. These results suggest that reported childhood abuse has long-term ramifications for health and longevity in women. In an editorial, Shalev and colleagues discuss implications for the field.
Antipsychotic-induced weight gain is a clinical challenge in the treatment of young people with autism spectrum disorders. Anagnostou and colleagues carried out a multicenter, 16-week double-blind randomized clinical trial to examine the impact of metformin on this condition. Metformin was associated with 3-kg lower weight and significantly reduced body mass index when compared with placebo; it was also well-tolerated except for some mild gastrointestinal symptoms. In an editorial, McDougle discusses strategies for treating antipsychotic-induced weight gain in children with autism spectrum disorder.
Continuing Medical Education
The frequency of antipsychotic medication use during pregnancy has doubled over the past decade. Huybrechts and colleagues studied a large cohort of Medicaid-insured pregnant women to assess the risk of congenital malformations overall and of cardiac malformations associated with antipsychotic medication use during the first trimester of pregnancy. The adjusted relative risk was not significantly increased, with the possible exception of risperidone. In an editorial, Wisner and colleagues discuss the use of antipsychotics in pregnancy.
Methylphenidate effectively treats attention-deficit/hyperactivity disorder, but the long-lasting effects on the brain are not well studied. Schrantee and colleagues measured cerebral blood flow changes in 99 male patients with attention-deficit/hyperactivity disorder during a 16-week randomized clinical trial of methylphenidate. Treatment with methylphenidate resulted in cerebral blood flow changes in thalamus and striatum of children, but not adults. This confirms evidence for age-dependent effects of methylphenidate treatment.
In This Issue. JAMA Psychiatry. 2016;73(9):887. doi:10.1001/jamapsychiatry.2015.1648