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This Month in Archives of General Psychiatry
June 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(6):629. doi:10.1001/archpsyc.64.6.629

Keefe et al60087 report the effects of antipsychotic treatment on neurocognition in 817 patients with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) treatment study. After 2 months of double-blind, randomized treatment with olanzapine, perphenazine, quetiapine fumarate, risperidone, or ziprasidone hydrochloride, neurocognitive improvements were significant but small, with no significant differences among groups.

Moffitt et al60088 describe the relationship between major depressive disorder (MDD) and generalized anxiety disorder (GAD) as it unfolds in a birth cohort of 1000 individuals diagnosed on repeated prospective occasions. Comorbid GAD + MDD affected one tenth of participants, suggesting that GAD + MDD constitutes a greater health burden than estimated by retrospective surveys. Contrary to the prevailing notion that generalized anxiety onset occurs before depression, the reverse sequence occurred almost as often.

Clark et al60089 used data from a large British prospective cohort study to examine associations between childhood and adulthood psychological ill health and midlife affective and anxiety disorders. Childhood psychological ill health was independently associated with a one-fifth– to 2-fold increase in risk, while adulthood psychological ill health was associated with a 2- to 7-fold increase in risk. Early adulthood associations were significantly stronger for men.

Cooper-Kazaz et al60092 investigated the antidepressant effect of liothyronine sodium in euthyroid patients with major depressive disorder treated with sertraline hydrochloride. In the context of a randomized, double-blind, placebo-controlled trial, addition of liothyronine from the outset of treatment significantly increased both response and remission rates without increasing adverse effects.

Perlis et al60097 examined the emergence of suicidal thoughts and behaviors following citalopram hydrobromide treatment in a large cohort of patients participating in the multicenter Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study of major depressive disorder. They identified an association between single nucleotide polymorphisms in the CREB1 gene, whose product has been previously implicated in major depressive disorder, suicide, and antidepressant response, and the emergence of suicidality among men.

Wang et al60093 examined whether instructions to attend to social cues when interpreting communicative intent would normalize brain activity in children with autism spectrum disorders. When instructed simply to pay attention, children with autism spectrum disorders showed no significant activity in the medial prefrontal cortex, a region typically involved in understanding others' mental states. In contrast, normative medial prefrontal cortex activity was observed when attention was explicitly directed toward the speaker's facial expression and tone of voice.

Wassink et al60094 examined whether the serotonin transporter promoter polymorphism 5-HTTLPR influenced brain structure volumes in young male children with autism. They found that the short allele was additively associated with increasing cerebral cortical gray matter volumes in 2 independent samples of such children. These results thus establish a link between a genetic variant and a biological trait that had both been previously associated with autism.

Zhong et al60098 measured β-site amyloid precursor protein–cleaving enzyme 1 (BACE1) activity in cerebrospinal fluid (CSF) and found that patients with mild cognitive impairment (MCI) showed increased CSF BACE1 activity. Moreover, they also found that increased CSF levels of BACE1 in patients with MCI were associated with an increased risk ratio for MCI.

Schilt et al60083 conducted prospective neuropsychological tests before and after first Ecstasy use. The findings suggest that even a low cumulative dose of Ecstasy negatively affects verbal memory performance.

Schiltz et al60091 examined with magnetic resonance imaging whether pedophilic offenders show structural neuronal alterations in brain regions that are critical for sexual behavior. They found a reduced volume of the right amygdala as well as reduced gray matter in closely related brain structures, predicting how focused sexual offenses were on uniform pedophilic activity.