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In This Issue of JAMA Psychiatry
January 2018


JAMA Psychiatry. 2018;75(1):1. doi:10.1001/jamapsychiatry.2017.1494


Drug development in psychotic disorders is hampered by a lack of functional target-engagement biomarkers. Javitt and colleagues evaluated ketamine-evoked changes in functional magnetic resonance imaging blood oxygen level–dependent response, glutamate proton magnetic spectroscopy, and task-based functional magnetic resonance imaging in brain glutamate in 65 healthy volunteers across 3 sites and found a highly significant increase in functional magnetic resonance imaging blood oxygen level–dependent response that was consistent across sites. In an Invited Commentary, Kraguljac and Lahti discuss the implications of these findings for new drug development efforts.

Invited Commentary

Continuing Medical Education

It is not known whether adverse childhood experiences are associated with worse mental health in the next generation. Santavirta and colleagues compared the risk of psychiatric hospitalization in cousins whose parents were vs were not evacuated from Finland to Sweden during World War II (N=93 391) and found that female offspring of mothers evacuated during childhood had a significantly elevated risk of psychiatric hospitalization, but female offspring of evacuated fathers and male offspring did not. In an Editorial, Betancourt et al discuss the implications for intergenerational effects of war trauma.


The incidence of psychotic disorders varies considerably across gradients of age, sex, race/ethnicity, and urban birth. Jongsma and colleagues estimated the treated incidence of psychotic disorders in 17 catchment areas from 6 countries. The overall crude incidence of psychotic disorders was 21.4 per 100 000 person-years, which varied 8-fold between catchment areas after standardization for age, sex, and racial/ethnic minority status. In an Editorial, Susser and Martínez-Alés discusses the social determinants of psychosis.


The association of obsessive-compulsive disorder and academic performance has not been objectively quantified. Pérez-Vigil and colleagues studied more than 2 million individuals from the Swedish National Patient Register and found that people diagnosed with obsessive-compulsive disorder were significantly less likely to pass all courses in compulsory education, finish secondary education, start and finish a university degree, and finish postgraduate education. These findings indicate that obsessive-compulsive disorder is associated with a pervasive and profound decrease in educational attainment.

Author Audio Interview

Collaborative care for depression and anxiety is superior to routine primary care but has not been paired with computer technology. Rollman and colleagues conducted a randomized clinical trial with 704 patients comparing computerized cognitive behavioral therapy, computerized cognitive behavioral therapy and an internet support group, and usual care; they found that patients in the first 2 arms experienced similar improvements in quality of life and mood and anxiety symptoms. These results indicate that addition of an internet support group provides no additional benefit vs computerized cognitive behavioral therapy.