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In This Issue of JAMA Psychiatry
November 2017


JAMA Psychiatry. 2017;74(11):1085. doi:10.1001/jamapsychiatry.2016.2546

Suicides have increased in the United States, but trends among sociodemographic and clinical groups have not been characterized. Using nationally representative survey data, Olfson and colleagues found that the percentage of adults making a recent suicide attempt increased from 0.62% in 2004/2005 to 0.79% in 2012/2013. The increase in risk was significantly larger among younger adults and among adults with no more than a high school education. In an Editorial, Caine discusses implications for suicide research.


One in 3 children experience bullying. In this population-based cohort study, Singham and colleagues analyzed data from 11 108 twins with a mean age of 11.3 years who were followed up for approximately 5 years. Bullying was associated with increased mental health problems concurrently and at the 2-year follow-up. However, at the 5-year follow-up, there was a significant decline of the association of bullying with mental health problems, with the exception of paranoid thoughts and cognitive disorganization. In an Editorial, Silberg and Kendler discuss the subtlety in differentiating causality from association between bullying and mental health.


There is clinical overlap between autism spectrum disorder and attention-deficit/hyperactivity disorder, but the underlying brain mechanisms remain unknown. Aoki and colleagues analyzed diffusion tensor imaging data from children with either disorder and healthy children and found a significant influence of autism diagnosis on measures of white matter integrity in the corpus callosum. They also found a significant association between autism symptom severity and the same measures in widespread brain regions including the corpus callosum across all individuals, regardless of diagnosis. In an Editorial, Ameis discusses implications for research on neurodevelopmental disorders.


Between 20% and 40% of patients with depression do not adhere to their antidepressant treatment. To compare the effect of the Treatment Initiation and Participation Program vs primary care clinician visits, Sirey and colleagues conducted a randomized clinical trial that enrolled 231 primary care patients prescribed antidepressant medication for depression. Patients enrolled in the Treatment Initiation and Participation Program were 5 times more likely to be adherent at 6 weeks and also showed an earlier reduction in depressive symptoms.

Continuing Medical Education

Psychotic experiences are linked with increased risk of suicidal thoughts and behaviors, but their association across the lifespan and with mental disorders is unknown. Using World Mental Health Survey data from 33 370 adult respondents across 19 countries, Bromet and colleagues found the prevalence of suicidal thoughts and behaviors was significantly higher among individuals with psychotic experiences in a dose-responsive manner after adjusting for antecedent or intervening mental disorders. Results highlight the importance of including information about psychotic experiences in suicide assessments.