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In This Issue of JAMA Psychiatry
April 2013

In This Issue of JAMA Psychiatry

JAMA Psychiatry. 2013;70(4):360. doi:10.1001/jamapsychiatry.2013.54

Posner et al Article found that the coherence of neural activity, or functional connectivity, within the brain's default mode network was increased in persons with dysthymia compared with healthy control participants. They found that a 10-week treatment with duloxetine, but not placebo, normalized the default mode network connectivity. This normalization of the default mode network suggests an important mechanism through which antidepressants may alleviate depressive disorders.

Asami et alArticle investigated gray matter volume (GMV) in 54 neuroleptic-naive men with schizotypal personality disorder who were recruited from the community and compared them with 54 matched healthy control subjects using voxel-based morphometry with the Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra tool. Subjects with schizotypal personality disorder showed significantly reduced GMV in the left superior temporal gyrus and in widespread frontal, frontolimbic, and parietal regions of interest. The degree of GMV reduction was significantly associated with severity of negative symptoms.

Brunoni et alArticle conducted a randomized, factorial, double-blind, sham-controlled trial for major depressive disorder using transcranial direct current stimulation (tDCS)/sham tDCS and sertraline/placebo. In 120 antidepressant-free participants with moderate to severe depression, they found that the combined nonpharmacological/pharmacological therapy was significantly more beneficial in ameliorating depressive symptoms than the other groups at all points (weeks 2, 4, and 6). In addition, sham tDCS/sertraline and active tDCS/placebo efficacy did not differ.

Although earlier studies have linked FKBP5, a gene that regulates glucocorticoid receptor sensitivity, with risk for affect disorder development, the mechanisms by which FKBP5 mediates this risk are still unknown. Fani et alArticle found that “risk” allele carriers for a presumably functional FKBP5 single-nucleotide polymorphism (rs1360780) demonstrated an attention bias toward threat cues and corresponding increases in hippocampal activation compared with those without this allele.

Wald et alArticle conducted a longitudinal study examining the interplay among attention to threat, combat exposure, and serotonin transporter genotype (5-HTTLPR) as risk factors for posttraumatic stress disorder (PTSD) symptoms in soldiers deployed to combat. The findings indicate that the interaction between threat-related attention, combat exposure, and genetics places soldiers at risk for PTSD. Bias toward threat at recruitment and bias away from threat before deployment predicted postcombat PTSD symptoms, which were moderated by 5-HTTLPR.

James et alArticle examined the impact of trauma on synchronous neural interactions for veterans with posttraumatic stress disorder and resilient control veterans using magnetoencephalography. The findings showed that synchronous neural interactions were significantly modulated downward, with increasing lifetime trauma scores in resilient control veterans but not in veterans with PTSD. This effect, which was primarily observed in the right superior temporal gyrus, is postulated to play an important role in healthy response to trauma.

Copeland et alArticle found that victims of bullying in childhood were at increased risk for anxiety, depression, and suicidality 5 to 10 years later in adulthood. These effects persisted after accounting for childhood psychiatric problems and family hardships. Those who were both bullies themselves and bullied others were worst off, with increased levels of depression, panic, agoraphobia, and suicidality. Those who bullied others only had higher rates of antisocial personality disorder.

Cantor-Graae and PedersenArticle investigated the full spectrum of psychiatric disorders associated with any type of foreign migration background in a Danish population-based cohort of 1.8 million persons. Increased risk of psychiatric disorder varied according to migration background, with greatest risks among foreign-born adoptees. Immigrants with both parents foreign born, whether first or second generation, had increased risks solely for schizophrenia and schizophrenia spectrum disorders, a pattern that was not observed in any of the other groups.

Ross et alArticle conducted a systematic literature review and meta-analysis to examine implications of prenatal antidepressant exposure for selected adverse pregnancy or delivery outcomes. They report statistically significant effects on gestational age, preterm delivery, birth weight, and Apgar scores and a trend toward increased risk for spontaneous abortion.