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This Month in Archives of General Psychiatry
May 1999

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 1999;56(5):392. doi:10.1001/archpsyc.56.5.392

Although more than 30 years have passed since the origin of the catecholamine hypothesis of major depression, few trait markers related to this system have been reliably described. Using a paradigm of acute catecholamine depletion, Berman et alArticle found that euthymic, unmedicated subjects with a history of major depression commonly demonstrate marked, transient depressive symptoms during active, but not control, testing.

A commentary by Csernansky and Posener is included.

Omega-3 fatty acids are essential dietary lipids that share biochemical actions with lithium and divalproex, 2 known mood stabilizers effective for bipolar disorder. Stoll et alArticle describe their double-blind, placebo-controlled study of high-dose ω3 fatty acids from fish oil in recently ill patients with bipolar disorder. The patients with bipolar disorder who received ω3 fatty acids exhibited a significantly longer period of remission than the patients receiving placebo. In addition, for nearly every other outcome measure, the ω3 fatty acid group performed better than the placebo group.

A commentary by Calabrese et al is included along with a reply by Stoll and Marangell.

Among a community-based sample of premenopausal women aged 36 to 44 years, Harlow et alArticle found that 9% reported depressive symptoms consistent with major depression and 25% reported a lifetime prevalence of depression that required therapy. The reporting of depressive symptoms was largely unaffected by characteristics of the menstrual cycle or use of oral contraceptives. Fewer live births, marriage termination, cigarette smoking, and premenstrual symptoms were associated with the prevalence of depressive symptoms.

Yaffe et alArticle prospectively studied nondemented elderly women to explore whether those with depressive symptoms have worse cognitive function and greater decline than those with few symptoms. During the 4-year study, women with depressive symptoms were more likely to do poorly on cognitive testing and to show more decline over time.

Jarrett et alArticle completed a placebo-controlled, blinded, randomized trial evaluating a psychosocial treatment for patients with atypical depression. Both cognitive therapy (a psychotherapy) and phenelzine (a monoamine oxidase inhibitor) each reduced symptoms in 58% of the study participants, while only 28% responded to the pill placebo.

Pincus et alArticle conducted a survey via the American Psychiatric Practice Research Network to gather detailed information from a nationally representative panel of psychiatrists on the demographic and clinical characteristics of patients and the specific types and combinations of treatments provided. Findings demonstrate that psychiatrists treat a patient population with severe and complex disorders. Nearly two thirds of the patients had more than 1 psychiatric disorder and the overwhelming majority were receiving 1 or more psychotropic medications to treat these conditions.

To help elucidate the effect of stress on wound healing, Glaser et alArticle induced skin blisters on the forearms of a group of women. Using this approach, which allows the immune system to be studied directly at a wound site, women who had higher stress levels demonstrated significantly lower production of 2 cytokines important for wound healing, interleukin 1α and interleukin 8. They also had higher levels of salivary cortisol, a stress hormone known to inhibit wound healing.

Can later schizophrenia be predicted from elementary school performance? In an epidemiological sample of Finnish schoolchildren, Cannon et alArticle found that children who went on to develop schizophrenia performed just as well in academic subjects as their peers but performed significantly worse in nonacademic subjects (sports and handicrafts). These findings suggest that motor coordination deficits in childhood may be etiologically important in schizophrenia.

Little is known about the etiology of anorexia nervosa. Fairburn et alArticle compared women with anorexia nervosa with 3 groups—healthy controls, those with bulimia nervosa, and those with other psychiatric disorders. There was a broad range of risk factors for anorexia nervosa and bulimia nervosa, some of which were shared with other psychiatric disorders. Factors that increased the likelihood of dieting were less relevant to anorexia nervosa than bulimia nervosa, whereas perfectionism and low self-esteem were common antecedents of both disorders.