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This Month in Archives of General Psychiatry
January 2001

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2001;58(1):12. doi:10.1001/archpsyc.58.1.12

In a family study of a large community sample, Klein et alArticle report that the first-degree relatives of adolescents with major depressive disorder (MDD) had elevated rates of MDD and dysthymic disorder, but not of most nonaffective disorders. In contrast, relatives of adolescents with anxiety, substance use, and disruptive behavior disorders tended to have elevated rates of those disorders, but not MDD. These findings indicate that adolescent MDD runs in families, and that there is considerable specificity in the familial transmission of adolescent psychopathology.

A commentary by Harrington is included.Article

Heaton et alArticle longitudinally administered a comprehensive neuropsychological test battery to schizophrenic outpatients and normal controls, and found no evidence of progression of deficits in the entire schizophrenia group or in subgroups defined by baseline level of impairment, duration of follow-up, duration of illness, current age or age at illness onset, change in clinical symptoms, or incident tardive dyskinesia.

In a controlled twin study in monozygotic and dizygotic twins discordant for schizophrenia, Baaré et alArticle tried to disentangle effects of risk for schizophrenia and the effects of the illness itself on brain morphology as measured with 3-dimensional magnetic resonance imaging. The results indicate that increased genetic risk to develop schizophrenia is related to reduced brain growth early in life. The manifestation of the disorder, however, seem to be related to neurodegenerative processes that are most likely nongenetic in origin.

In a large epidemiological study, Wahlbeck et alArticle discovered that people who developed schizophrenia had mothers with a lower late-pregnancy body mass index, were small at birth, and remained lean during primary school when compared with people who did not develop schizophrenia. The study shows that indicators of intrauterine and childhood undernutrition are associated with an increased lifetime risk of schizophrenia.

From a community sample, Young et alArticle interviewed adults with probable major depression, dysthymia, generalized anxiety, or panic disorder. Although most people with a disorder saw some health care provider, fewer than one third received potentially effective psychotherapy or medication.

Children with velocardiofacial syndrome due to a deletion on chromosome 22q11.2 are at increased risk for developing schizophrenia and cognitive impairment. Eliez et alArticle show that parental origin of the deleted chromosome 22 influences development of cerebral gray matter, with a selective decrease only in subjects with a maternally derived deletion. This finding suggest that a potentially imprinted gene involved in cerebral gray matter development and maturation is encoded in the deleted region. Therefore, parental origin of the deletion could be the first predictive factor of brain development and neurobehavioral outcome in children with velocardiofacial syndrome.

Light therapy combats winter depression, but the effect of its timing has been controversial. Terman et alArticle measured phase shifts of the circadian melatonin rhythm after treatment. The antidepressant response to morning light was markedly enhanced with phase advances of 1.5 hours or more, which occurred with light (30 minutes at 10 000 lux) about 8.5 hours after melatonin onset or 2.5 hours after the midpoint of sleep when patients were depressed. Remission rate fell by half under evening and later morning light. It is suggested that treatment be scheduled in circadian time rather than clock time.

One night of sleep deprivation transiently cures half of all depressed patients. Orth et alArticle report that major depression is associated with a unique thyroid disorder: the gland is resistant to thyrotropin, the pituitary hormone that regulates thyroid secretion. While their thyroid hormone levels are normal, sleep deprivation responders have increased serum concentrations of normal thyrotropin, and nonresponders have normal concentrations of superactive thyrotropin.

In a representative sample of the Dutch population, Sandfort et alArticle show that in homosexual men, rates of mood and anxiety disorders are substantially higher than in heterosexual men. In homosexual women the prevalence of substance use disorders in particular is higher than in heterosexual women.