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This Month in Archives of General Psychiatry
January 2008

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2008;65(1):11. doi:10.1001/archgenpsychiatry.2007.12

Previous analyses of client data reported to the California Department of Developmental Services have been interpreted as supporting the hypothesis that autism is caused by exposure to the vaccine preservative thimerosal. Schechter and GretherArticle reviewed time trends in autism reported to the Department of Developmental Services from January 1995 to March 2007. The estimated prevalence of autism in children 3 years and older increased throughout the study period despite the synchronous exclusion of thimerosal from nearly all childhood vaccines.

Cannon et alArticle report on a multisite study of prospective follow-up of 291 youth at high clinical risk for psychosis, observing a cumulative conversion rate of 35% and decelerating rate of transition during the 2.5-year follow-up period. Five features assessed at baseline contributed uniquely to the prediction of psychosis, and algorithms combining 2 or 3 of these variables resulted in dramatic increases in positive predictive power (ie, to 68%-80%) compared with the prodromal criteria alone.

Using direct internal jugular venous blood sampling techniques, Barton et alArticle examined brain serotonin turnover in patients with major depressive disorder. Their investigation demonstrated elevated serotonin turnover in unmedicated patients with major depressive disorder. Analysis of the influence of serotonin transporter genotype indicated that carriage of the s allele was associated with a more than 2-fold increase in turnover. Following selective serotonin reuptake inhibitor therapy, serotonin turnover was substantially reduced.

Merikangas et alArticle followed up a population-based cohort from Zurich, Switzerland, for 20 years to investigate the associations between major depression and bipolar spectrum conditions on the incidence of alcohol, benzodiazepine, and cannabis use, abuse, and dependence. Bipolar spectrum conditions had a far stronger effect than major depression on use and progression of all 3 substances.

Perlis et alArticle examined a large set of genes related to lithium mechanism of action, as well as other recently proposed candidate genes, for association with bipolar disorder. None of the lithium genes, but 3 other novel candidate genes, showed suggestive evidence of association. In addition, the authors identified modest evidence supporting an association with DISC1, a gene initially associated with schizophrenia.

Frasure-Smith and LespéranceArticle examined the 2-year risk of major cardiac events associated with DSM-IV–based diagnoses and self-reports of anxiety and depression in 804 patients with stable coronary artery disease. Depression and anxiety symptoms both had prognostic significance, but most of the increased risk was in patients with current major depression or generalized anxiety disorder. The 2 diagnoses contributed comparable risk increases, but this risk was not augmented by comorbid anxiety and depression.

Holman et alArticle examined acute stress reactions to the 9/11 (September 11, 2001) terrorist attacks and cardiovascular ailments in a national probability sample. Using health data collected before 9/11 as a baseline, acute stress response to the attacks predicted increased reports of physician-diagnosed hypertension and heart problems over 3 years following 9/11. For individuals reporting ongoing worry about terrorism, high 9/11-related acute stress symptoms predicted the greatest increased risk of heart problems 2 and 3 years following 9/11.

Chen et alArticle used functional magnetic resonance imaging and voxel-based morphometry to investigate symptoms of depression following concussion in male athletes. Activations associated with a working memory task revealed that those athletes with depression symptoms showed reduced activation in the dorsolateral prefrontal cortex and striatum and attenuated deactivation in medial frontal and temporal regions. The severity of depression symptoms correlated with neural responses in brain areas that have been implicated in major depression. Voxel-based morphological study confirmed gray matter loss in those brain areas where abnormal activations were observed.

Olfson et alArticle analyzed national pharmacy data focusing on antidepressant use before and after the Food and Drug Administration youth paroxetine hydrochloride (June 2003) and black box (October 2004) advisories. Youth total antidepressant use was increasing significantly before the advisories and then began decreasing following the paroxetine and black box advisories. Greater decreases occurred for paroxetine. Among adults, these changes were less pronounced.

Bush et alArticle used functional magnetic resonance imaging to characterize the neural effects of methylphenidate hydrochloride osmotic-release oral system (MPH-OROS) in adults with attention-deficit/hyperactivity disorder. Group and individual analyses showed higher dorsal anterior midcingulate cortex activation in subjects taking MPH-OROS at 6 weeks compared with placebo. MPH-OROS also produced higher activation in other brain regions that subserve attention. The data suggested that MPH-OROS may act, in part, by normalizing dorsal anterior midcingulate cortex hypofunction in attention-deficit/hyperactivity disorder.

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