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This Month in Archives of General Psychiatry
May 2001

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2001;58(5):423. doi:10.1001/archpsyc.58.5.423

In the largest Tourette syndrome (TS) imaging study to date, Peterson et alArticle report that subjects with TS have larger dorsal prefrontal but smaller parieto-occipital and inferior occipital volumes. Volumes in the TS group were inversely associated with age, and orbitofrontal, midtemporal, and parieto-occipital volumes were positively associated with the severity of tic symptoms.

A commentary by Giedd is included. Article

Infectious diseases and other conditions associated with increased production of inflammatory cytokines are often associated with mood and cognitive disturbances. Reichenberg et alArticle report that low-dose endotoxemia, a well-established model of experimental host defense activation, induces a transient increase in anxiety and depressed mood in healthy volunteers, although subjects did not perceive subjective symptoms of illness. Moreover, verbal and nonverbal memory functions were compromised. These effects of endotoxin were significantly correlated with the secretion of cytokines, in particular tumor necrosis factor α, and interleukin 6. These findings suggest that cytokines are important mediators of emotional and cognitive changes in infectious, autoimmune, and neurodegenerative diseases.

A community-based longitudinal study by Johnson et alArticle investigated the role of maladaptive parental behavior in the association between parent and offspring psychopathology. Maladaptive parenting mediated the association between parent and offspring psychiatric symptoms. Most of the youths who experienced highly maladaptive parenting developed psychiatric disorders during adolescence or adulthood, whether or not their parents had psychiatric disorders.

The aging of the brain was studied by Bartzokis et alArticle in normal men using magnetic resonance imaging methods that measure gray and white matter components of the brain. In the brain regions most developed in humans, the white matter volume continues to increase until the late 40s and then declines. This suggests that from a biological perspective the societal concept of a stable/unchanging "adult" brain may not be valid.

Impaired working memory in schizophrenia may be mediated by altered connections of the dorsal prefrontal cortex with the thalamus and/or other cortical regions. Cortical pyramidal neurons located in deep layer 3 are critical nodes in these circuits. Because the size of a neuron's cell body is positively correlated with the extent of both its inputs and projections, Pierri et alArticle estimated the volume of deep layer 3 pyramidal neurons in subjects with schizophrenia and matched controls. Somal volumes were smaller in schizophrenia, suggesting that abnormalities in the connectivity of these neurons may contribute to working memory dysfunction in schizophrenia.

The impact of torture on the distribution of psychiatric disorders among refugees is unknown. Van Ommeren et alArticle studied a large community sample of tortured and nontortured Bhutanese refugees living in United Nations refugee camps in Nepal. Refugees who reported torture had higher lifetime and 12-month rates of psychiatric disorder. Men were more likely to report torture, but tortured women were more likely to report certain disorders.

A commentary by North is included. Article

In a controlled study of sertraline and placebo in patients with chronic posttraumatic stress disorder (PTSD), Davidson et alArticle found that sertraline produced a significantly greater improvement on all main measures of PTSD. Moreover, sertraline was effective for treating intrustive, avoidant, numbing, and hyperarousal symptoms, as well as social and occupational function. The drug was well-tolerated.

Classen et alArticle report on a randomized clinical trial for women with metastatic breast cancer comparing a year-long supportive-expressive group against a control condition. Participants in the treatment condition showed a significantly greater decline in traumatic stress symptoms and in mood disturbance.

Tracking a large cohort of heroin users over 30 years, Hser et alArticle confirm that heroin addiction is a chronic relapsing condition that has severe personal and social consequences. Half of the sample had died during the course of the study. Many of those still living continued to use heroin and had significant health, mental health, and legal problems.