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This Month in Archives of General Psychiatry
October 2009

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2009;66(10):1043. doi:10.1001/archgenpsychiatry.2009.135

Donohoe et al (Article examined the effects on cognition of the NOS1 variant rs6490121, identified in a recent genome-wide association study as a potential schizophrenia risk variant. In large Irish samples, the risk genotype was found to be associated with clinically significant variation in both verbal IQ and working memory both in patients with schizophrenia and healthy participants. These findings were then replicated in large independent German samples of both patients and healthy participants.

Holliday et alArticle applied latent class analysis to identify clinically homogeneous subtypes in 1236 Han Chinese individuals with schizophrenia. Two of the 4 identified groups demonstrated familial aggregation and were used as alternative phenotypes in genome-wide linkage analyses. A deficit subtype characterized by severe negative symptoms and pronounced functional impairment showed genome-wide significant linkage to chromosome 1q23-25.

Perry et alArticle used a novel Behavioral Pattern Monitor to identify distinctive exploratory phenotypes in patients with bipolar mania and schizophrenia. Patients with bipolar mania demonstrated a unique pattern of increased activity and object exploration. In parallel tests in mice, pharmacological and genetic reductions in the dopamine transporter produced a similar behavioral pattern.

Simon et alArticle examined the long-term benefits and costs of 2 programs to improve depression treatment in primary care: a telephone care management program to improve antidepressant treatment and a telephone program including care management and cognitive behavioral psychotherapy. The care management program had greater costs than benefits, even if a day free of depression was valued at $20. In contrast, the program including psychotherapy had greater benefits than costs if a day free of depression was valued at $9 or more.

Sánchez-Villegas et alArticle found that a greater adherence to the Mediterranean dietary pattern significantly reduced the incidence of depression among 10 094 healthy middle-aged adults of the Spanish Seguimiento Universidad de Navarra cohort. Inverse dose-response relationships were found for fruits and nuts and legumes.

Shin et alArticle used positron emission tomography and a twin design to determine whether functional neuroimaging abnormalities in posttraumatic stress disorder (PTSD) are acquired characteristics or familial risk factors. Combat veterans with PTSD and their trauma-unexposed identical co-twins had greater metabolic activity in the dorsal anterior cingulate/midcingulate cortex than veterans without PTSD and their identical co-twins. Hypermetabolism in this region appears to represent a familial risk factor for developing PTSD after trauma exposure.

Oral naltrexone hydrochloride effectively antagonizes heroin, but its clinical utility is limited by patient noncompliance; sustained-release preparations may overcome this limitation. Hulse et alArticle showed that treatment with a long-acting sustained-release naltrexone implant improved clinical efficacy compared with oral naltrexone, with significantly more of the patients treated with oral naltrexone than the naltrexone implant returning to regular heroin use by 6 months.

Martell et alArticle report that an anticocaine vaccine produced high (≥43 μg/mL) IgG anticocaine antibody levels in 21 of 55 methadone-maintained, cocaine-dependent subjects completing a 24-week, randomized, double-blind trial. These 21 subjects had more cocaine-free urine samples than 47 subjects who took placebo or 34 subjects with low IgG anticocaine antibody levels who completed 24 weeks (45% vs 35%). The proportion of subjects having 50% reduction in cocaine use also was significantly greater in the subjects with a high IgG level than a low IgG level (0.53 vs 0.23).

Love et alArticle examined interindividual variations in the traits impulsiveness and deliberation and how they relate to the functional response of the endogenous opioid neurotransmitter system to an experimental stressor. Opioid receptor concentrations and measures of endogenous function as obtained with neuroimaging techniques predict a high proportion of the variability of personality traits deliberation and impulsiveness.

Bellgrove et alArticle examined whether a common haplotype of the dopamine transporter gene, a replicated risk factor for attention-deficit/hyperactivity disorder (ADHD), could predict patterns of attentional impairment in children with ADHD. DAT1 haplotype status strongly predicted impairments of spatial selective attention, with impairment being greatest in children with ADHD who were homozygous for the risk haplotype.