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This Month in Archives of General Psychiatry
November 2007

This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2007;64(11):1227. doi:10.1001/archpsyc.64.11.1227

By combining event-related potentials and functional magnetic resonance imaging, Haenschel et al70033 determined the contribution of early visual deficits to working memory dysfunction in 17 adolescents with schizophrenia and 17 healthy controls. Compared with controls, patients showed reduced P1 amplitude, no P1 working memory load modulation, and reduced activation in early visual areas during working memory encoding.

Greenwood et al70035 provide an in-depth analysis of the heritability and covariation of some of the most compelling endophenotypes for schizophrenia via a requisite family study approach. They report that many of these endophenotypes are heritable and some appear to be influenced by common genetic mechanisms, suggesting that future genetic analysis should focus on these endophenotypes as well as the schizophrenia diagnosis itself.

Alden et al70036 estimated the lifetime prevalence of arrests for sex offenses among men with psychotic disorders. Psychotic disorders comorbid with personality disorders and substance use disorders were associated with an increased risk of sex offending with and without physical aggression.

Second-generation antipsychotics are widely prescribed for psychosis, aggression, and agitation in Alzheimer disease. As part of the Clinical Antipsychotic Trial of Intervention Effectiveness–Alzheimer Disease (CATIE-AD) trial, Rosenheck et al70037 conducted a cost-benefit analysis comparing olanzapine, quetiapine fumarate, or risperidone and placebo, which was taken to represent a “watchful waiting” strategy. There were no differences between treatments on a measure of quality-adjusted life-years or on other measures of functioning, but total health costs were significantly lower for placebo, by $50 to $100 per month.

Ashtari et al70045 examined the left inferior longitudinal fasciculus using diffusion tensor imaging and tractography in adolescents with schizophrenia. The results provide strong evidence for lower white matter integrity in the inferior longitudinal fasciculus, particularly for patients with a history of visual hallucinations.

Peterson et al70029 report enlargement of the hippocampus and amygdala in 154 children and adults with Tourette syndrome compared with 128 controls. Enlargement was localized to the anterior and medial borders of the hippocampus and over the lateral, cortical, and centromedian nuclei of the amygdala. The degree of enlargement in both structures correlated with fewer tic symptoms, suggesting that the enlargement subserves an activity-dependent, neuroplastic response that modulates the severity of tic-related symptoms.

D’Onofrio et al70039 tested the widely held hypothesis that prenatal alcohol exposure causes an increased risk for externalizing problems in offspring by comparing siblings differentially exposed to prenatal alcohol. The analysis of a large, nationally representative sample of children in the United States suggests that prenatal alcohol exposure has a specific environmentally mediated influence on childhood conduct problems in offspring but not on their attention and impulsivity problems.

Using a large representative population sample, Côté et al70034 found that children of low-educated mothers were less likely than children of educated mothers to receive nonmaternal care services. Those who did, however, had lower risk of physical aggression problems during early childhood. The protective role of nonmaternal care services was greater if initiated before age 9 months.

In 4865 members of male-male and female-female pairs from Virginia, Kendler et al70043 examine lifetime symptoms of abuse of and dependence on cannabis, cocaine, alcohol, caffeine, and nicotine. Dependence on these substances is best explained by 2 correlated genetic factors, one predisposing largely to illicit drug dependence and the other primarily to licit drug dependence.

King-Hele et al70041 investigated risk of sudden infant death syndrome among Danish infants whose parents were admitted for psychiatric treatment. Risks were more than double with exposure to maternal or paternal admission; they were especially high if both parents were admitted or if the mother was diagnosed as having an alcohol- or drug-related disorder. Risk linked with maternal schizophrenia was no higher than that with other illnesses resulting in admission and was lower than previously reported.