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In This Issue of JAMA Psychiatry
March 2017

In This Issue

JAMA Psychiatry. 2017;74(3):205. doi:10.1001/jamapsychiatry.2016.2506


Research has shown that retrieval-extinction training may decrease craving and cue reactivity in humans addicted to heroin. Germeroth and colleagues randomized 88 volunteer nicotine smokers to either a smoking or a nonsmoking retrieval-extinction training. The mean craving response to familiar and novel smoking cues and the mean number of cigarettes smoked per day were lower in the smoking retrieval-extinction training group. This brief behavioral treatment has the potential to enhance smoking relapse prevention. In an editorial, Kamboj discusses the implications of this study.


Relapse to nicotine addiction during abstinence often occurs after reactivation of nicotine reward memories, but it is not clear whether interference with reconsolidation reduces nicotine craving. Xue and colleagues administered the β-adrenoceptor antagonist propranolol during reconsolidation after retrieval of nicotine-associated memories in rats and human smokers and found that propranolol inhibits conditioned place preference in rats and decreases nicotine preference in humans. These results suggest propranolol may be useful in reducing nicotine craving and relapse. In an editorial, Kamboj discusses the implications of this study.


Chronic depression is associated with higher morbidity and mortality than acute depression. Schramm and colleagues randomized 268 patients with chronic depression who were not taking antidepressants to either a specific therapy (Cognitive Behavioral Analysis System of Psychotherapy) or nonspecific supportive therapy. The disorder-specific psychotherapy was moderately more effective in reducing symptom severity, and patients were more likely to reach response and remission. Cuijpers and colleagues discuss the importance of researching treatments of chronic depression in an invited commentary.

Invited Commentary

Continuing Medical Education

Delirium is associated with cognitive decline in elderly individuals, but it is not known whether the delirium effect is related to that of dementia. Davis and colleagues examined mini-mental status examination scores during life and brain samples post mortem from 987 individuals (mean age 90 at death) and found that delirium and dementia pathology both affect cognitive decline with a multiplicative joint effect. These findings suggest that delirium and dementia pathology trigger independent cognitive decline. In an editorial, Fong and Inouye discuss implications for the field.


Schizophrenia is associated with an increased risk of type 2 diabetes mellitus, but it is not known whether this is owing to inherent risk or effects of chronic illness and long-term treatment. Pillinger and colleagues conducted a meta-analysis of 15 studies, and found that fasting plasma glucose, plasma glucose post–oral glucose tolerance test, fasting plasma insulin, and insulin resistance (but not Hg A1c levels) were significantly elevated in patients compared with control individuals. These findings suggest glucose homeostasis is altered from illness onset in schizophrenia.