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This Month in Archives of General Psychiatry
January 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(1):10. doi:10.1001/archpsyc.64.1.10

Perälä et alArticle screened a large, Finnish, general population sample for psychotic disorders using multiple screens, including national registers. Those selected by screens were then interviewed with the Structured Clinical Interview for DSM-IV, and case notes from treatment contacts were obtained. Use of comprehensive case ascertainment and diagnostic methods revealed that the lifetime prevalence of psychotic disorders exceeds 3%.

Brown et alArticle examined the relationship between elevated prenatal homocysteine levels and risk of schizophrenia in a nested case-control design of a large birth cohort. Elevated third-trimester homocysteine levels, based on assays from archived maternal serum samples, were associated with a greater than 2-fold, statistically significant increase in schizophrenia risk in offspring.

Using Swedish National Registry data to identify all women delivering their first live birth between 1987 and 2001, Harlow et alArticle determined to what extent prior psychiatric hospitalization influenced the incidence of postpartum psychotic and bipolar disorder. Nearly 14% of women with a psychiatric hospitalization prior to first birth delivery developed postpartum psychosis or bipolar disorder.

In a large, prospective cohort design study of abused and neglected children and matched controls followed up into young adulthood, Widom et alArticle found that childhood physical abuse (but not sexual abuse) and experiencing multiple types of abuse were associated with lifetime major depression, while neglect was associated with current depression. Age at onset of depression was earlier and comorbidity was more likely in maltreated children as young adults compared with controls.

Cannabis abuse and dependence are common in bipolar disorder, although how the courses of these disorders interact is uncertain. Strakowski et alArticle studied 144 patients with first-episode bipolar disorder and found that the relative sequence of onset of cannabis use and bipolar disorder influenced the subsequent clinical course of both conditions.

Using long-term data from a randomized trial of systematic depression treatment for people with diabetes mellitus, Simon et alArticle found that clinical benefits continued for 24 months and that total outpatient costs were lower over 2 years in the intervention program than in patients receiving continued usual care. They argue that depression screening and treatment should become routine parts of diabetes care.

Using functional magnetic resonance imaging, Geuze et alArticle investigated pain processing in veterans with posttraumatic stress disorder (PTSD) and veterans without PTSD. Veterans with PTSD rated painful heat stimuli as less painful compared with controls. Patients showed altered neural responses to painful stimuli in the left hippocampus, bilateral ventrolateral prefrontal cortex, right amygdala, right putamen, and the bilateral insula. The witnessed neural activation pattern is proposed to be related to altered pain processing in patients with PTSD.

Analyzing a large US community hospital discharge survey, Case et alArticle found that length of stay for youth with mental illness fell more than 60% between 1990 and 2000, despite increasing illness severity and self-harm and declining transfers to intermediate and inpatient care. These trends prompt questions about diagnostic practices and quality of care for children and adolescents with mental disorders.

McClure et alArticle used functional magnetic resonance imaging to examine whether attention differentially modulates responses to facial threat cues in the amygdala and cortical structures within the “fear circuit” in 15 adolescents with generalized anxiety disorder and 20 healthy adolescents. The findings demonstrate that generalized anxiety disorder–associated patterns of pathological fear-circuit activation in youth are particularly evident when attention is focused on subjectively experienced fear.

Kubzansky et alArticle examined whether high levels of posttraumatic stress disorder symptoms are associated with increased risk of developing coronary heart disease using prospective data from the Normative Aging Study. Among men who served in the military and who were initially healthy at baseline, those reporting more posttraumatic stress disorder symptoms had significantly increased risk of developing coronary heart disease over follow-up relative to men reporting fewer posttraumatic stress disorder symptoms.