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This Month in Archives of General Psychiatry
March 2010

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2010;67(3):217. doi:10.1001/archgenpsychiatry.2010.4

The relationship between overweight, obesity, and depression was longitudinally and bidirectionally confirmed by the systematic review and meta-analysis performed by Luppino et al. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. Overweight increased the risk of depression and depression was found to be predictive of developing obesity.

Using the D2/D3 receptor positron emission tomography radioligand raclopride labeled with carbon 11 and a dopamine depletion paradigm, Kegeles et al localized dopaminergic hyperfunction within the striatum to the head of the caudate, a subregion with significant connectivity to the dorsolateral prefrontal cortex. This localization provides new information on the pathophysiology of the illness and on the site of therapeutic effect of antipsychotic medications.

Ruhrmann et al investigated the validity of the ultra-high-risk criteria and the basic symptom approach for prediction of psychosis in a prospective European multicenter study in 245 persons at risk. During the 18-month follow-up, 19% converted to psychosis. Based on clinical and demographic variables, a Cox regression model with excellent prognostic accuracy emerged.

Gottesman et al used a Danish register cohort of 2.7 million persons to determine the risks of severe mental disorders in offspring of parents with a diagnosis of schizophrenia or bipolar disorder. Schizophrenia risk was 27% when both parents had been diagnosed with schizophrenia, increasing to 39% with the inclusion of specific spectrum disorders, contrasted with a 7% risk when only 1 parent was affected. Comparable risks for bipolar disorder were 25%, 36%, and 4%.

Epigenetic alterations at the BDNF gene in the Wernicke area of suicide completers were found by Keller et al. The BDNF gene was found frequently hypermethylated in this brain area of suicide subjects as compared with controls, irrespective of global methylation levels, indicating that a gene-specific increase in DNA methylation could contribute to downregulation of BDNF expression in suicide victims.

Major depressive disorder has been associated with reduced hippocampal volume; the nature of this relation, however, is not clear. Chen et al used voxel-based morphometry and manual tracing to examine hippocampal volume in healthy never-depressed girls at high or low familial risk for the development of depression. Compared with low-risk girls, daughters of mothers with recurrent depression had smaller hippocampal volume, suggesting that neuroanatomical anomalies precede and may influence the development of depression.

Sheline et al found in late-life depression (n = 217) that both comprehensive neuropsychological function and brain white matter lesion severity prospectively predicted change in depression scores during 12 weeks of antidepressant treatment. Baseline neuropsychological function differentiated remitters from nonremitters and predicted time to remission. Predictor variables all correlated highly with vascular risk factor severity.

Blanco et al compared phenelzine, cognitive behavior treatment, their combination, and pill placebo as treatments for individuals with social anxiety disorder. They found a specific order of effect on dimensional measures as well as rates of response and remission, with the largest improvement for the combined treatment group, followed by the monotherapies, and the least reduction in the placebo group.

Wang et al studied the hippocampal subfields in veterans with combat-related posttraumatic stress disorder (PTSD) using high-resolution magnetic resonance imaging. They found smaller cornu ammonis 3 and dentate gyrus subfields in PTSD whereas other subfields were spared. The findings indicate a selective vulnerability of cornu ammonis 3 in PTSD, a region known for adult neurogenesis.

Using data from more than 900 community-based older persons from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, Boyle et al show that purpose in life is associated with a substantially reduced risk of developing Alzheimer disease and its precursor, mild cognitive impairment. Further, purpose in life is associated with a slower rate of cognitive decline among older persons initially free of cognitive impairment.