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This Month in Archives of General Psychiatry
Dec 2012

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2012;69(12):1193. doi:10.1001/archgenpsychiatry.2011.1239

Nielsen et alArticle examined reward activity in 23 antipsychotic-naive schizophrenic patients before and after antipsychotic monotherapy. At baseline, a decreased signal in the ventral striatum was shown during reward anticipation in the patients. After 6 weeks of treatment, the patients showed a signal increase in the right ventral striatum while the healthy controls showed a decrease. Patients with the highest signal increase had the most pronounced improvement of psychotic symptoms.

Using transcriptome profiling and gene coexpression network analysis in 4 brain regions, Roussos et alArticle show that oligodendrocyte- and neuron-related modules were associated with schizophrenia and enriched for genetically associated variants. Furthermore, gene expression patterns that typically differentiate the frontal, temporal, and cingulate cortices in controls diminished significantly in schizophrenia.

Green et alArticle evaluated theoretically based pathways to functional outcome starting with early visual perception. The final structural equation model was a single pathway running from visual perception to ability to beliefs/motivation to functional outcome. Both ability and motivation appear necessary for community functioning in schizophrenia.

Mathews et alArticle demonstrate enhanced food reward activity in healthy nonobese subjects after 1 week of olanzapine treatment that correlated with weight gain, increased food consumption, and self-reports of disinhibited eating. Olanzapine treatment enhanced responses to both anticipation of food and the actual experience of food in brain reward areas.

Analyzing copy number variation from multiple sites, Ernst et alArticle tested the hypothesis that deletion of 1 copy of BDNF leads to psychopathology. They identified 5 subjects with deletions at the BDNF locus on chromosome 11, all of whom were obese, had mild to moderate intellectual delay, and had psychopathology in some form. These data link decreased BDNF to human behavioral and mood abnormalities.

Olfson et alArticle report a national increase in antipsychotic use in office-based medical practice. Between 1993-1998 and 2005-2009, the percentage of total visits including antipsychotic medications rose from 0.16% to 1.07% for youths and from 0.88% to 1.73% for adults. During the latter period, antipsychotics were included in 31.1% of youth visits and 28.8% of adult visits to psychiatrists.

Thomas et alArticle used a parametric emotional face processing paradigm to examine activation in the amygdala and across the brain in youth with bipolar disorder (BD) and severe mood dysregulation (SMD) and healthy volunteers (HVs). In HVs only, there was a positive association between amygdala activity and anger on the face. With increasing facial happiness, SMD increased, while BD decreased, activity in the parietal, temporal, and frontal regions.

Lyoo et alArticle used high-resolution brain magnetic resonance imaging to show that patients with type 1 diabetes have thickness reduction of the superior prefrontal cortical regions bilaterally and that this thickness reduction is likely to mediate the development of comorbid depression in diabetic patients.

Kelleher et alArticle report on 2 epidemiological studies of adolescents involving clinical assessments of suicidal behavior and psychotic symptoms. Both studies found that psychotic symptoms were strong markers of suicidal behavior risk. Prevalence of suicidal plans and acts was very high among young people with depressive or behavioral disorders with psychotic symptoms but low among those without symptoms.

Osypuk et alArticle examined whether the mental health effects of moving out of public housing into lower-poverty neighborhoods differed by gender or a family's baseline health burden within a randomized controlled trial of housing vouchers. Although a robust group of girls benefited, the mental health of adolescents in families with health problems did not improve from moving to a better neighborhood, and boys in such families were harmed by the move.

Klein et alArticle prospectively evaluated 135 children diagnosed with ADHD at a mean age of 8 years. Thirty-three years later, subjects had significantly more ongoing ADHD, antisocial personality disorder, and substance use disorders and higher lifetime rates of incarcerations and psychiatric hospitalizations than 136 men without childhood ADHD.

Keyes et alArticle examined the effect of birth cohort norms on trend in alcohol use and binge drinking among almost 1 million US adolescents sampled from 1976 to 2007. They found that individuals who matured in birth cohorts with more restrictive social norms were less likely to use alcohol compared with individuals in cohorts with more permissive norms.