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This Month in Archives of General Psychiatry
January 2004

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2004;61(1):12. doi:10.1001/archpsyc.61.1.12

Gogtay et al Article examinedthe diagnostic specificity of cortical gray matter (GM) loss by comparingpatients with prospective childhood-onset schizophrenia (COS), patients withatypical psychosis, and healthy patients. The COS group had greater totaland regional GM loss than both the atypical psychosis and control groups.Because patient groups had similar cognitive functioning, medications, andhospitalization, the striking GM loss appears intrinsic to early-onset schizophrenia.

Agerbo et al Article examinedthe long-term association between schizophrenia, marital status, and labormarket affiliation before and after the first inpatient episode using a population-basedcase-controlled design. Patients diverged from age-, sex-, and year-matchedcontrols up to 19 years before and 25 years after their first hospital admission.This pattern was especially pronounced for men and for individuals who hadmore than 1 hospital admission.

Goldapple et al Article examinedbrain changes associated with response to cognitive behavior therapy in asample of patients with unipolar depression using positron emission tomography.Treatment response resulted in unique metabolic changes in the dorsal cingulateand medial frontal cortex not seen with pharmacotherapy. Changes in the prefrontalcortex and hippocampus were also present but were the inverse of those seenwith medication. These specific brain changes may reflect a primary top-downmechanism of action for cognitive behavior therapy response within a moregeneral depression-remission circuit.

Major depression is a frequent psychiatric complication among patientswith traumatic brain injury. Jorge et al Article prospectivelyassessed the clinical, neuropsychological, and structural neuroimaging correlatesof major depression occurring after traumatic brain injury. Major depressivedisorder was associated with executive dysfunction, negative affect, aggression,and prominent anxiety symptoms. In addition, neuroimaging findings suggestthat prefrontal damage plays a significant role in the pathogenesis of thissyndrome.

Fann et al Article prospectivelyexamined the risk of psychiatric illness in the 3 years following traumaticbrain injury in a large staff-model health maintenance organization. Bothmoderate to severe and mild traumatic brain injury were associated with increasedrisk for subsequent psychiatric illness, especially in the first 6 to 12 monthsafter traumatic brain injury. Prior psychiatric illness significantly modifiedthe relationship between traumatic brain injury and subsequent psychiatricillness and was itself a significant predictor of subsequent psychiatric illness.

Freeman et al Article examinedassociations between depressed mood and hormonal changes in the transitionto menopause in a population-based cohort. The likelihood of depressive symptomsincreased in the menopausal transition as identified by menstrual bleedingpatterns and decreased following menopause. A significant inverse associationof subject aggregate profiles of follicle-stimulating hormone with depressivesymptoms provided strong corroborating evidence that the changing hormonalmilieu contributes to dysphoric mood in this transition period.

London et al Article assessedmood disturbances and regional cerebral glucose metabolism in newly abstinentmethamphetamine abusers and healthy control subjects during the performanceof a vigilance task. Methamphetamine abusers reported elevated depressionand anxiety and had altered metabolism in brain structures implicated in mooddisorders, suggesting that these regions are involved in affective dysregulationand may be an important target of intervention for methamphetamine dependence.

Canino et al Article examinedthe prevalence rates and relationship of DSM-IV diagnosesto global impairment, demographic correlates, and service use in a representativesample of children and adolescents aged 4 to 17 years in Puerto Rico. Although16.4% of the population had 1 or more of the DSM-IV disorders,rates were reduced to 6.9% when a measure of global impairment was added.Global impairment was more important in predicting service use than diagnosis.

Hampel et al Article investigatedthe diagnostic performance of 3 different tau phosphorylation epitopes (p-tau231, p-tau181, and p-tau199) in the cerebrospinalfluid of patients with primary dementia disorders and healthy patients. Appliedas single markers, p-tau231 and p-tau181reached specificitylevels greater than 75% between the Alzheimer disease (AD) group and the combinednon-AD group when sensitivity was set at 85% and higher. Discrimination betweenAD and dementia with Lewy bodies was maximized using p-tau181,whereas p-tau231 maximized group separation between AD and frontotemporaldementia.