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This Month in Archives of General Psychiatry
September 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(9):995. doi:10.1001/archpsyc.64.9.995

Using functional magnetic response imaging, Achim et alArticle demonstrated patterns of both normal and abnormal modulation of hippocampal activation during memory encoding in first-episode psychosis as a function of semantic relatedness of the stimulus pairs. In contrast, patients with first-episode psychosis showed an intact modulation of hippocampal activation during successful memory encoding, an observation that argues against a general inability to recruit this brain region.

Lin et alArticle applied statistical and functional analyses to study the role of tryptophan hydroxylase 2 (TPH2) in the etiology of bipolar disorder (BPD). The functional polymorphisms that exhibit significant association with BPD represent the potential susceptibility loci. Further analysis demonstrated that interaction between 2 TPH genes confers risk for BPD.

Major depressive disorder is associated with increased mortality and decreased heart rate variability (HRV) in patients with acute coronary syndrome. Glassman et alArticle examined the effect of sertraline on HRV and found that both drug and mood improvement increased some HRV indexes. However, improvement was very limited and in 258 patients with post–acute coronary syndrome depression, most HRV indexes decreased in the 16 weeks following their coronary event.

Moreno et alArticle report that between 1994 and 1995 and 2002 and 2003, the number of visits by youth that included a bipolar diagnosis increased approximately 40-fold in office-based medical practice. During 1999 to 2003, mood stabilizers were prescribed in 60.3% of youth visits and in 64.1% of adult visits with a bipolar diagnosis. Comparable percentages were 47.7% and 33.7% for antipsychotics and 34.0% and 46.5% for antidepressants.

Yehuda et alArticle measured basal plasma cortisol release over the diurnal cycle and chronobiological parameters in persons without current or lifetime posttraumatic stress disorder (PTSD) who were either born to Holocaust survivors with or without PTSD or parents unexposed to the Holocaust. Lower cortisol levels associated with parental, but particularly maternal, PTSD support the possibility that cortisol alterations are passed to offspring via early glucocorticoid programming.

The findings of a controlled comparison of family-based treatment and individual supportive psychotherapy for adolescents with bulimia nervosa are reported by le Grange et alArticle. Family-based treatment was statistically and clinically superior to supportive psychotherapy in terms of binge and purge abstinence at posttreatment and at 6-month follow-up.

Keel et alArticle examined clinical features and test meal responses in purging disorder. Participants with purging disorder demonstrated significantly greater postprandial cholecystokinin release compared with participants with bulimia nervosa and greater postprandial fullness and gastrointestinal distress compared with participants with bulimia nervosa and controls. Findings support consideration of purging disorder in the classification of eating disorders.

A pharmacogenetics study by Ray and HutchisonArticle examined the effects of naltrexone on alcohol sensitivity and the moderating role of the A118G single nucleotide polymorphism of the μ-opioid receptor gene (OPRM1). Naltrexone dampened alcohol-induced reward and the effects were stronger among carriers of the G allele on feelings of “high.” These findings suggest that lower relapse rates among individuals with the G allele after naltrexone treatment may be due to a more pronounced naltrexone-induced reduction in alcohol reward.

Hutchison et alArticle report that analyses ranging from basic biological approaches to clinical outcome data provide evidence that 2 single nucleotide polymorphisms (rs6122429 and rs2236196) in CHRNA4 are functional at a biological level and are associated with nicotine-dependence phenotypes.

Growing up in a single-parent home has been linked to adverse outcomes later in life. Using data from a longitudinal birth cohort, Fergusson et alArticle have shown that the associations between exposure to single parenthood and later outcomes, including mental health, achievement, and criminal behavior, could largely be explained by factors related to family background, family functioning, and personal factors associated with exposure to single parenthood rather than the direct effects of single parenthood per se.