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In This Issue of JAMA Psychiatry
June 2017

In This Issue

JAMA Psychiatry. 2017;74(6):549. doi:10.1001/jamapsychiatry.2016.2521


Suicide is a leading cause of death, but there are few suicide prevention efforts in emergency departments. Miller and colleagues studied treatment as usual, universal screening, and universal screening plus intervention in 8 emergency departments that had no psychiatric services. Among the 1376 participants, 21% made at least 1 suicide attempt for a total of 548 suicide attempts. Patients in the intervention phase had 30% fewer total suicide attempts than participants in the treatment-as-usual phase. In an editorial, Bridge and colleagues discuss the importance of this study.


Continuing Medical Education

Anxiety and depression in youths are prevalent but markedly undertreated. Weersing and colleagues conducted a 2-center randomized clinical trial of brief behavioral therapy versus assisted referral to care in 185 youths. Participants who received 8 to 12 weekly sessions of brief behavior therapy in pediatric clinics had higher rates of clinical improvement, greater reduction of symptoms, and better functioning. In an editorial, Walkup and colleagues review the value of behavioral therapies in pediatric primary care.


More states have passed medical marijuana laws as illicit cannabis use has become more common among US adults, but the relationship between these is not known. Hasin and colleagues examined change in marijuana use in states with and without medical marijuana laws between 1991 and 2013 and found that illicit cannabis use and cannabis use disorders increased significantly more in states that passed medical marijuana than in others. Thus, medical marijuana laws may have contributed to increased prevalence of illicit cannabis use. In an editorial, Compton and colleagues discuss the policy implications.


Maternal smoking during pregnancy has been linked to severe mental illness in offspring, but this could be owing to confounding influences shared by the 2. Quinn and colleagues analyzed population data from Sweden, examined cousins and siblings who were discordant on smoking during pregnancy, and showed that the association became nonsignificant when controlling for familial confounding. These results indicate that the observed association between maternal smoking and severe mental illness is not causal. In an editorial, Kendler reviews the methodological contribution of this study.


It is unknown whether the cognitive impairment seen across the psychotic disorder spectrum has shared neurobiological mechanisms. Sheffield and colleagues examined the relationship between cognitive ability and resting state brain network integrity in 201 healthy participants and a transdiagnostic sample of 375 patients with psychosis and showed that reduced cingulo-opercular and subcortical network efficiency underlie the general cognitive deficits observed across the psychosis spectrum. In an invited commentary, Palaniyappan and colleagues discuss the relationship between brain networks and cognition in psychotic disorders.

Invited Commentary