The fusiform gyrus (FG) on the ventral surface of the temporal lobe
is critical for face recognition. Lee et al (SEE ARTICLE) used high spatial resolution magnetic resonance imaging
in patients with first-episode schizophrenia and normal controls. Bilaterally
smaller relative volumes of FG gray matter, smallest on the left, were present
in patients with schizophrenia when compared with healthy controls and patients
with affective psychosis (mainly mania). Smaller FG gray matter volume is
evident early in schizophrenia but not in affective psychosis and may contribute
to impaired facial recognition in schizophrenia.
Hyperintensities in deep white matter on magnetic resonance imaging
are increased in major depression. Thomas et al (SEE ARTICLE) hypothesized that these would more likely have an ischemic
basis in depressed subjects. In a cohort of 20 elderly subjects with a history
of major depression and 20 elderly controls, they first performed in vitro
postmortem imaging and then neuropathologically analyzed the lesions in the
same slices. Virtually all deep white matter hyperintensities in the depressed
group were ischemic, compared with less than one third in the control group.
Ischemic lesions were more likely to be found in dorsolateral prefrontal cortex
in depressed subjects. The findings support a vascular etiology in late-life
depression.
The association between alcoholism and major depression has been explained
as alcohol intoxication and withdrawal effects misdiagnosed as depressive
syndromes. Hasin and Grant (SEE ARTICLE) investigated former drinkers in a national survey, comparing the prevalence
of current major depression between those with and without a history of alcohol
dependence. Prior alcohol dependence increased the risk of current major depressive
disorder more than 4-fold in these former drinkers, a relationship not attenuated
by many control variables. Since intoxication/withdrawal could not account
for the association, better understanding of the relationship is needed.
Brent et al (SEE ARTICLE) showed that
early-onset suicidal behavior is transmitted in the families of mood-disordered
suicide attempters. The offspring of mood-disordered suicide attempters had
a suicide attempt rate that was 6 times higher than that of the offspring
of mood-disordered nonattempters. Familial transmission of suicidal behavior
in families with mood disorders almost always required transmission of a mood
disorder, and was also related to offspring impulsive aggression and the familial
transmission of sexual abuse. Early treatment of mood disorders and targeting
impulsive aggression and sexual trauma may prevent and treat suicidal behavior
in families with mood disorder.
Klin et al (SEE ARTICLE) used eye-tracking
technology to study visual fixations in cognitively able individuals with
autism when viewing dynamic social scenes. Coding was performed by dividing
viewed scenes into eye, mouth, body, and object regions. Relative to controls,
they focused twice as much time on the mouth region, and 2
times less
on the eye, body, and object regions. Increased focus on mouths predicted
improved social adjustment and less autistic social impairment, whereas more
time on objects predicted the opposite relationship. Focus on eyes was unrelated
to measures of social competence.
Rawson et al (SEE ARTICLE) compared
contingency management and cognitive-behavioral therapy for the treatment
of cocaine dependence. One hundred twenty cocaine-dependent methadone maintenance
patients were randomly assigned to 1 of 4 conditions: contingency management
(CM), cognitive-behavioral therapy (CBT), combined CM and CBT (CBT + CM),
or treatment as usual (ie, methadone maintenance treatment program only).
Participants assigned to the 2 groups featuring CM procedures produced significantly
superior in-treatment results from urinanalysis. Cocaine use was significantly
reduced from baseline levels for all 3 treatment conditions, but not for the
methadone maintenance–only group. The CBT participants showed a substantial
improvement, resulting in equivalent performance with the CM groups at 2 follow-up
points.
Lappalainen et al (SEE ARTICLE) studied
whether the functional Pro7Leu polymorphism in the
neuropeptide Y (NPY) gene predisposes to alcohol dependence in European American
populations. They found that the Pro7 allele was
present at a higher frequency among the 2 alcohol-dependent samples they studied
as compared with healthy controls. They then estimated the frequency of the Pro7 allele in other psychiatric diagnostic groups and
populations. The Pro7 allele frequency was lower
in groups with other psychiatric diagnoses, suggesting a degree of specificity
to alcohol dependence. The Pro7 allele was present
at a much lower frequency in almost all populations, including African American
and Asian populations. Thus, the Pro7 allele of the
NPY gene may be a risk factor for alcohol dependence among the European American
population.
Inhibition of emotional processing has been suggested as a mechanism
underlying some of the clinical features of depersonalization/derealization. Sierra et al (SEE ARTICLE) tested the prediction
that autonomic response to emotional stimuli would be reduced in patients
with depersonalization disorder. In comparison with healthy and clinical controls,
patients with depersonalization were found to have attenuated skin conductance
responses (SCR) to emotional pictures but their response to nonspecific elicitors
of SCR was similarly increased compared with that of patients with anxiety
disorders. This suggests the presence of a selective inhibition of emotional
processing in depersonalization.
Clues to the etiology of schizophrenia can be derived from studying
first-degree relatives of patients with the disorder. Seidman
et al (SEE ARTICLE) compared hippocampal volumes and verbal
declarationmemory fuctioning in nonpsychotic adult first-degree relatives,
their schizophrenic relatives, and healthy controls. Nonpsychotic relatives
and their ill relatives had significantly smaller left hippocampi compared
with controls. Verbal memory and left hippocampal volumes were significantly
and positively correlated. Hippocampal volumes did not differ between schizophrenic
patients and their nonpsychotic relatives. Results support the hypothesis
that a small left hippocampus and a verbal memory deficit are vulnerability
indicators for schizophrenia.
Using proton magnetic resonance spectroscopy, Epperson
et al (SEE ARTICLE) measured cortical GABA levels across the
menstrual cycle in women with premenstrual dysphoric disorder (PMDD) and healthy
menstruating controls. They found that cortical GABA levels fluctuate in the
menstrual cycle in a phase- and diagnosis-specific fashion. While cortical
GABA levels appeared to be modulated by the neurosteroid allopregnanolone
in the healthy control group, there was no significant relationship between
allopregnanolone and cortical GABA levels in those with PMDD. These findings
suggest that GABAergic dysregulation plays a role in the pathophysiology of
PMDD.
