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This Month in Archives of General Psychiatry
April 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(4):397. doi:10.1001/archpsyc.64.4.397

Ettinger et alArticle carried out a magnetic resonance imaging investigation of the thalamus in monozygotic twins with or without schizophrenia. Twin pairs concordant for schizophrenia but not twin pairs discordant for schizophrenia showed significant volumetric reductions of the thalamus, suggesting that this abnormality may reflect the increased genetic liability seen in the concordant group.

Frodl et alArticle examined the impact of the BDNF Val66Met polymorphism on hippocampal and amygdala volumes. Sixty patients with major depression had smaller hippocampal volumes as compared with 60 healthy controls. Moreover, patients, as well as controls, carrying the Met-BDNF allele showed smaller hippocampal volumes than subjects homozygous for the Val-BDNF allele. Therefore, the BDNF polymorphism may be involved in hippocampal development and a smaller hippocampal volume may be a risk factor for major depression.

Miklowitz et alArticle evaluated the effectiveness of intensive psychotherapy (in combination with pharmacotherapy) in 293 outpatients with bipolar I or II depression. Patients randomly assigned to intensive psychotherapy (30 sessions of family-focused therapy, interpersonal and social rhythm therapy, or cognitive-behavioral therapy) had more rapid recoveries and were more likely to remain well during the 1-year study than patients assigned to 3 sessions of psychoeducation.

Wakefield et alArticle, using National Comorbidity Survey data, compared uncomplicated bereavement with uncomplicated reactions to other stressors on multiple variables indicating pathologic conditions. Results indicate that uncomplicated bereavement and uncomplicated other-loss reactions are similar on almost all indicators and are similarly different from complicated episodes. The authors suggest extending the bereavement exclusion to other stressors in DSM-V.

Scherk et alArticle conducted a meta-analysis of randomized controlled trials on the efficacy of second-generation antipsychotics (SGAs) in the treatment of acute mania. Twenty-four studies with 6187 patients were included. The SGAs were more efficacious than placebo and of similar efficacy as mood stabilizers. Data suggest that combining SGAs and mood stabilizers is the most efficacious treatment of acute mania.

Analyzing a nationally distributed sample, Feinberg et alArticle found that genotype interacted with both parental negativity and low warmth, predicting overall antisocial behavior but not depression. Genetic influence was greater for adolescent antisocial behavior when parenting was more negative or less warm. This study demonstrates that a continuous measure of parenting in the normative range moderates the influence of genotype on antisocial behavior.

To determine the effects of the publicity concerning the potential for increased suicidality with selective serotonin reuptake inhibitor use in children and adolescents, Nemeroff et alArticle analyzed the Verispan retail pharmacy prescription database, which captures nearly one half of all prescriptions in the United States. The number of children and teenagers who were prescribed antidepressants decreased after the Food and Drug Administration Public Health Advisory meetings. Moreover, psychiatrists are now prescribing a higher percentage and generalists a lower percentage of antidepressants to individuals 18 years and younger.

Using a 30-year prospective study, Odgers et alArticle assessed whether youth with childhood-onset life-course-persistent antisocial behavior become adult men with poor physical health. Health outcomes included injury, sexually transmitted diseases, cardiovascular risk, immune function, and dental disease, suggesting the health costs of childhood-onset conduct disorder are considerable.

Neighbors et alArticle examined the 12-month mental health service use in a national probability sample of African American and Caribbean black adults 18 years and older. Respondents who met criteria for a 12-month DSM-IV disorder reported greater use of services compared with those without a disorder. However, mental health service sectors were generally underused by both African American and Caribbean black individuals.

In a large population-based study of hospitalized persons aged 18 to 44 years, Westover et alArticle found an association between amphetamine abuse and hemorrhagic stroke, as well as between cocaine abuse and both ischemic and hemorrhagic stroke, in a multivariate logistic regression model. Amphetamine abuse has increased more than other drugs of abuse from 2000 to 2003 and was associated with a higher risk of in-hospital death from hemorrhagic stroke.