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This Month in Archives of General Psychiatry
December 1, 2008

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2008;65(12):1355. doi:10.1001/archpsyc.65.12.1355

In the large Netherlands Study of Depression and Anxiety cohort study, Licht et al(page 1358) investigated the association between depression and heart rate variability. They found a lower total heart rate variability with lower cardiac vagal control in 1849 depressed subjects compared with 524 healthy controls. However, this association was mainly driven by the effect of antidepressant use.

King et al (page 1368) developed a risk algorithm for prediction of major depression in family practice attendees in 6 European countries. They then tested the accuracy of this risk algorithm in a cohort of family practice attendees in Chile. The instrument performed as well as analogous risk algorithms for the prediction of cardiac events.

Although some evidence suggests that neuroanatomical abnormalities confer risk for depressive disorder, findings are inconsistent. One potential explanation for this inconsistency is that individuals may differ in their sensitivity to context. Yap et al(page 1377) measured adolescents' brain structure and mothers' aggressive behavior during a mother-adolescent interaction and found that maternal aggression moderated the associations between brain structure and the adolescent's depressive symptoms.

The hypothesis that depressive symptoms result in an accumulation of visceral fat was examined by Vogelzangs et al(page 1386). In a community-based sample of 2088 older persons, they found a (larger) 5-year increase in sagittal diameter and visceral fat among depressed persons compared with nondepressed persons.

Luijendijk et al (page 1394) studied incidence and recurrence rates of late-life depression in a large population-based cohort. The incidence rate of depressive syndromes was 7 per 1000 persons per year, but that more than doubled when clinically relevant depressive symptoms were included. Moreover, recurrence rates were up to 5 times as high as incidence rates depending on the definition of depression.

Rathore et al (page 1402) assessed the impact of comorbid mental illness on quality of care and outcomes in a national sample of 53 314 Medicare patients hospitalized with heart failure between 1998 and 1999 and 2000 and 2001. They found that comorbid mental illness is common (17%) in patients with heart failure and associated with lower rates of left ventricular assessment, higher 1-year readmission, and higher 1-year mortality.

Gale et al (page 1410) report on the relation between cognitive ability in early adulthood and risk of several forms of psychiatric disorder in midlife. Lower premorbid cognitive ability was associated with an increased risk of depression, generalized anxiety disorder, alcohol abuse or dependence, posttraumatic stress disorder, and some comorbid forms of this disorder.

Stanley et al (page 1419) measured membrane phospholipid precursor levels, which are sensitive to developmental changes of overproducing/pruning of synapses, in 6 brain regions of young psychostimulant-naive children with attention-deficit/hyperactivity disorder (ADHD) and healthy children using in vivo phosphorus spectroscopy. Results show basal ganglia deficits, suggesting an underdevelopment of dendritic branching and synaptic formations, and prefrontal cortex deficits, but only in the relatively older children with ADHD, suggesting that the maturational peaking of overproducing/pruning of synapses is impaired.

Blanco et al (page 1429) report on psychiatric disorders in US college students and their non–college-attending peers. Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non–college-attending peers, but college students were significantly less likely to receive past-year treatment for alcohol/drug use disorders.

Kendler et al (page 1438) apply multivariate twin modeling to interviews from 2794 young adult Norwegian twins to determine how genetic and environmental factors impact the pattern of comorbidity in DSM-IV personality disorders. Three genetic factors were identified that reflected a broad vulnerability to personality pathology, high impulsivity/low agreeableness, and introversion. Unexpectedly, the cluster A, B, and C personality disorder typology is well reflected in the structure of environmental risk factors.

Gorin et al (page 1447) examined the association between binge eating and weight loss in 5145 overweight and obese individuals with type 2 diabetes mellitus participating in the Look AHEAD trial. Individuals who stopped binge eating had 1-year weight losses equivalent to non–binge eaters and better weight losses than individuals who started or continued to binge eat. Binge eating was not exacerbated by behavioral weight loss treatment and was problematic for weight loss only if the behavior persisted.