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This Month in Archives of General Psychiatry
May 2010

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2010;67(5):437. doi:10.1001/archgenpsychiatry.2010.49

Cohort studies have identified an association between cannabis use and psychosis-related outcomes, but concerns remain about unmeasured confounding variables. Based on an Australian birth cohort, McGrath et al examined 228 pairs of siblings from within a birth cohort of 3801 young adults. They confirmed that the early use of cannabis was associated with psychotic symptoms and disorder. The use of sibling pairs reduces the likelihood that unmeasured confounding explains these findings.

Using immunocytochemistry and microscopic imaging, Soetanto et al measured microtubule-associated protein 2–labeled dendrites and synaptopodin-labeled spines in the CA3 region of the postmortem hippocampus from older adult participants in the Religious Orders Study longitudinal study of aging and mental functioning. Analogous to the regressive neuronal changes reported in animal models of chronic stress, they found that anxiety and depression were associated with decreased densities of dendrites and spines.

Goldstein et al report findings from the New England Family Study's High-Risk Study that investigated offspring from their mother's pregnancy to their adulthood. Transmission of psychoses in parents (schizophrenia and affective psychoses) to their offspring and the specificity of transmission across psychosis subtypes were studied. Having a parent with psychosis significantly increased the risk for psychosis 6- to 14-fold among offspring and demonstrated specificity for the transmission of schizophrenia and affective psychoses within families.

Sacher et al applied positron emission tomography to compare monoamine oxidase A (MAO-A) binding between women who were recently post partum (day 4 to 6) and women not recently post partum. They found a 43% elevation in MAO-A binding in affect-modulating brain regions in women who were recently post partum. Elevated MAO-A binding in early post partum can be interpreted as a marker of a monoamine-lowering process contributing to the sadness of postpartum blues.

Davidson et al examined the association of the 2 cardinal depression symptoms—anhedonia and depressed mood—and 1-year cardiac events and death in a cohort of 453 patients with acute coronary syndrome. Patients with anhedonia, but not depressed mood, had increased independent risk of having another cardiac event or death in the year following their first cardiac event, even when additionally controlling for major depressive diagnosis or depressive symptom severity.

Byers et al determined nationally representative estimates of age-specific 12-month prevalence rates of DSM-IV mood, anxiety, and comorbid mood-anxiety disorders in a national probability sample of older adults. They found that prevalence rates of mood and anxiety disorders in late life declined with age, rates of anxiety disorders were as high or even higher than mood disorders, coexistence of these disorders was common, and women had the highest rates across age strata.

Schneeweiss et al compared the risk of suicide and suicide attempts across antidepressant agents in an adult population with recorded diagnoses of depression. Health care claims data were used to identify the study population and outcomes. There were no meaningful differences in event rates among selective serotonin reuptake inhibitors or across classes of antidepressants. This finding supports the Food and Drug Administration's decision to treat all antidepressants alike in its safety advisory.

Daily left prefrontal transcranial magnetic stimulation to treat depression in the acute phase has aroused considerable interest and some skepticism. George et al report the results of a large National Institutes of Health–sponsored multisite trial using a new active sham, which created a true double-blind study. Daily transcranial magnetic stimulation monotherapy for 3 to 5 weeks in a treatment-resistant group was well tolerated and produced clinically meaningful antidepressant effects significantly greater than sham (14% remission rate active, 5% sham, 30% open-label follow-up).

Priebe et al assessed mental disorders in war-affected community samples (N = 3313) in Bosnia-Herzegovina, Croatia, Kosovo, Macedonia, and Serbia. On average, 8 years after the war, prevalence rates were high (overall, 44.8%) and varied significantly across countries. More exposure to potentially traumatic war events was linked to higher rates of anxiety and mood disorders, but not substance use disorders.

D’Onofrio et al investigated the association between maternal smoking during pregnancy (SDP) and offspring criminal conviction in a population-based study of individuals born in Sweden from 1983 through 1989. Although maternal SDP was associated with increased risk for antisocial problems when comparing unrelated individuals, siblings who were differentially exposed to SDP had the same rates of violent and nonviolent convictions. The results suggest that family background factors are responsible for the association between SDP and criminal convictions, not the specific exposure to SDP.