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This Month in Archives of General Psychiatry
Sep 2012

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2012;69(9):873. doi:10.1001/archgenpsychiatry.2011.1224

Gogtay et alArticle report the discovery of a delayed white matter growth trajectory in young nonpsychotic siblings of patients with childhood-onset schizophrenia. This longitudinal magnetic resonance imaging study reveals that patients' unaffected first-degree relatives initially show abnormally slowed white matter growth, although these at-risk relatives seem to catch up with healthy matched controls at older ages.

Wassink et alArticle investigated the effects of the schizophrenia-associated single-nucleotide polymorphism rs1344706 from the ZNF804a gene on brain structure, volume, and symptoms in schizophrenia. They found that the risk allele is associated with increased white matter volume in individuals with schizophrenia and healthy controls.

Using Pavlovian fear conditioning and functional magnetic resonance imaging, Holt et alArticle found that patients with schizophrenia learned and then extinguished conditioned fear but showed impaired retrieval of these associations after a 24-hour delay. This impairment was associated with dysfunction of the ventromedial prefrontal cortex.

Malhotra et alArticle conducted a genomewide association study assessing weight gain associated with antipsychotic drug treatment in patients undergoing their first exposure to antipsychotic treatment. They identified a locus near the melanocortin 4 receptor (MC4R) gene that overlaps a region previously detected in obesity studies in the general population that is associated with antipsychotic drug–induced weight gain.

Siegle et alArticle report that low pretreatment subgenual anterior cingulate (sgACC) responses to negative words, measured using functional magnetic resonance imaging, are prognostic for increased symptom change, response, and remission from unipolar depression in cognitive therapy. This finding was true in multiple samples on different scanners. Yet, sgACC activity did not change in treatment among those who responded or remitted.

In a study of structural and functional connectivity, Tromp et alArticle identified convergent evidence of altered frontolimbic connectivity in generalized anxiety disorder. Patients with generalized anxiety disorder demonstrated lower microstructural integrity of the uncinate fasciculus. Individual differences in structural connectivity were correlated with functional coupling of the pregenual anterior cingulate and amygdala during the anticipation of aversion.

Walsh et alArticle examined prevalence of sexual revictimization and posttraumatic stress disorder in 3 national female samples (adolescent, college, and adult household probability). More than 50% of victims in each sample reported revictimization, and odds ratios for current and lifetime posttraumatic stress disorder were significantly higher among revictimized girls and women.

Merikangas et alArticle report on the prevalence of mania in a nationally representative sample of US adolescents from the National Comorbidity Survey Adolescent Supplement. The prevalence of DSM-IV bipolar disorder in adolescents approximates that of adults. The substantial prevalence and clinical significance of mania uncoupled with major depression also highlight the importance of evaluating mania as a distinct entity.

Schulz et alArticle found that treatment with methylphenidate hydrochloride (stimulant) and atomoxetine hydrochloride (nonstimulant) in youth with attention-deficit/hyperactivity disorder produced symptomatic improvement via common and unique actions on functional magnetic resonance imaging obtained during a go/no-go task. While both medications produced decreased activation in the bilateral motor cortex, there were divergent effects in the right inferior frontal, left anterior cingulate, and bilateral posterior cingulate cortex.

Using structured magnetic resonance imaging, Gregory et alArticle studied 44 violent offending men with and without antisocial personality disorder (ASPD) as compared with 22 nonoffending men. Those with ASPD exhibited significantly reduced gray matter volumes bilaterally in the anterior rostral prefrontal cortex and temporal poles, whereas those without ASPD did not differ from controls.

Krupitsky et alArticle conducted a 6-month trial where 306 detoxified opioid-dependent patients were randomized to naltrexone implant and oral naltrexone placebo; placebo implant and oral naltrexone; or double placebo, all with biweekly counseling (102/group). By month 6, 54 of 102 implant patients (53%) remained in treatment without relapsing vs 16 of 102 (16%) receiving oral naltrexone (P < .001) and 11 of 102 (11%) receiving placebo (P < .001). No increased risk for overdose death after naltrexone treatment ended was detected.