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This Month in Archives of General Psychiatry
July 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(7):766. doi:10.1001/archpsyc.64.7.766

To evaluate the basis for progressive cortical gray matter loss in patients with childhood-onset schizophrenia, Gogtay et alArticle mapped cortical gray matter thickness in 52 healthy siblings of patients with childhood-onset schizophrenia, aged 8 through 28 years. These younger siblings showed gray matter deficits in the prefrontal and temporal cortices, which disappeared by age 20 years. The process of deficit reduction correlated with overall functioning at the last scan. Gray matter loss appears to be a familial/trait marker.

In a clinical effectiveness trial of outpatients with nonpsychotic major depressive disorder who received citalopram, Hu et alArticle found a significant association between lesser adverse effect burden and the high-expression gain-of-function allele of the serotonin transporter gene (5-HTTLPR). No significant association was seen with symptomatic outcome. Taken together, the results suggest that increased serotonin transporter levels in the brain and other tissues may lead to fewer adverse effects for antidepressant medications that target the transporter.

Cameron et alArticle used positron-emission tomography and the benzodiazepine receptor ligand flumazenil tagged with carbon 11 to compare the pattern of brain benzodiazepine binding in panic disorder with unaffected individuals. Significant decreases were observed bilaterally in the insular cortices. No other abnormality was seen. Since the insular cortex is involved in visceral-somatic functioning, reduced benzodiazepine (and thus γ-aminobutyric acid) activity is consistent with the physical symptoms prominent in panic disorder.

Wilson et alArticle found that a brief test of odor identification predicted cognitive decline and incident mild cognitive impairment in elderly people without evidence of cognitive impairment at study entry. The results suggest that olfactory dysfunction may be useful in identifying persons at risk for Alzheimer disease before cognitive systems are manifestly impaired.

Lee et alArticle conducted a cross-sectional analysis of salivary cortisol and cognitive function in 967 randomly selected, community-dwelling adults aged 50 to 70 years. Elevated cortisol was associated with decreased performance in multiple cognitive domains. These results are consistent with the hypothesis that hypothalamic-pituitary-adrenal axis dysregulation, possibly a result of exposure to psychosocial hazards in the environment, may be a risk factor for poorer cognitive performance in older persons.

D'Onofrio et alArticle used the Children of Twins Study to explore the extent to which genetic and environmental processes account for the intergenerational transmission of conduct problems. The results suggest that most of the intergenerational transmission for male offspring was due to environmental factors specifically related to parental conduct problems, consistent with a causal relation. In contrast, the intergenerational transmission of conduct problems for female offspring was due to a common genetic liability.

Hasin et alArticle present the epidemiology of DSM-IV alcohol abuse and dependence in the United States. Current prevalence of alcohol abuse and dependence was 4.7% and 3.8%, respectively. Significant disability and comorbidity were particularly associated with alcohol dependence. Only 24.1% of those with alcohol dependence were ever treated.

Sareen et alArticle used a population-based sample of active military personnel to demonstrate a strong relationship between combat and witnessing atrocities and emotional problems. Approximately 30% of the sample had one of the following: (1) met criteria for a common mental disorder, (2) perceived a need for treatment, or (3) used mental health services. The majority of individuals with an emotional problem did not receive mental health treatment.

Using a prospective, longitudinal design, Landa et alArticle examined patterns of social, communication, and play development in children with early and later diagnosis of autism spectrum disorders. The early-diagnosis group differed from all other groups in all areas by 14 months of age; the later-diagnosis group did not differ from nonautism groups until 24 months of age. Examination of growth trajectories suggests that autism may involve developmental arrest, slowing, or even regression.