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  Vol. 63 No. 11, November 2006 TABLE OF CONTENTS
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This Month in Archives of General Psychiatry

Arch Gen Psychiatry. 2006;63:1176.

Yeap et al (SEE ARTICLE) demonstrate the potential of the P1 component of the visual evoked potential (VEP) as an endophenotypic marker for schizophrenia. Substantially reduced P1 amplitude was demonstrated in clinically unaffected first-degree relatives of patients with schizophrenia, compared with age-matched controls. A series of later divergent VEP componentry hints at compensatory mechanisms at play in the relatives.

Reilly et al (SEE ARTICLE) used a translational task to demonstrate that treatment-naive patients with first-episode schizophrenia were impaired in their ability to maintain spatial location information in working memory. After 6 weeks of risperidone treatment, this impairment worsened to a level that was sustained through 1 year. Treatment-related changes in modulatory functions of prefrontal D1 receptor systems may account for risperidone's apparent adverse effect.

Kennedy et al (SEE ARTICLE) examine the function of the endogenous opioid system, involved in the regulation of stress emotional responses, in healthy women and in women diagnosed as having major depressive disorder (MDD). They found evidence of overactivation of µ-opioid receptor–mediated neurotransmission in MDD, paralleling plasma levels of stress hormones. Overactivation of this system in the rostral anterior cingulate in women with MDD during a sadness induction challenge was further associated with poor response to a 10-week course of a serotonin-selective antidepressant treatment.

Meyer et al (SEE ARTICLE) measured an index of monoamine oxidase A (MAO-A) density in the brain of depressed and healthy individuals using carbon 11–labeled harmine positron emission tomography. In depressed individuals, MAO-A density was elevated by 34%, providing evidence that greater MAO-A density is an important monoamine-lowering process in depression.

Taylor et al (SEE ARTICLE) performed a meta-analysis of placebo-controlled randomized trials of selective serotonin reuptake inhibitors for the treatment of unipolar depression. They saw improvement in depression symptoms by the end of the first week of treatment. Benefits continued to accumulate at a decreasing rate for at least 6 weeks.

Remijnse et al (SEE ARTICLE) used a reversal learning task in a sample of unmedicated patients with obsessive-compulsive disorder (OCD) and in a group of healthy controls during functional magnetic resonance imaging. Subjects with OCD showed impaired task performance accompanied by reduced activity in the orbitofrontal cortex, the caudate nucleus, and the dorsal prefrontal cortex. These findings provide further evidence for the involvement of both ventral and dorsal prefrontal striatal loops in the pathophysiologic nature of OCD.

Using data from a longitudinal study of a randomly selected sample assessed at age 6 years and followed up to age 17 years, Breslau et al (SEE ARTICLE) found that IQ greater than 115 at age 6 years predicted decreased risk for exposure to traumatic events and decreased probability of posttraumatic stress disorder following exposure. The conditional probability of posttraumatic stress disorder was increased for youth with anxiety disorders and a high level of behavior problems at age 6 years.

Essex et al (SEE ARTICLE) generated testable models of how early risk factors work together over time to predict the severity and directionality (externalizing vs internalizing) of childhood mental health symptoms in third grade. Family socioeconomic status defined different pathways to symptom severity, and for all children, social and academic impairment during the school transition was an important mediator. There were 2 pathways to later symptom directionality, one beginning with child sex and the other with early child temperament.

Heim et al (SEE ARTICLE) examined associations between chronic fatigue syndrome (CFS) and childhood trauma in cases and controls identified from the general population in Wichita, Kan. Childhood trauma was associated with a 3- to 8-fold risk for CFS across different trauma types. The association demonstrated a graded response. Risk of CFS conveyed by childhood trauma increased with the presence of psychopathology.

Kato et al (SEE ARTICLE) investigated whether information collected in 1972 and 1973 in a population-based sample of Swedish twins could predict chronic fatigue–like illness assessed 25 years later. They found that reports of elevated stress and the personality trait of emotional instability were significant prospective risk factors for chronic fatigue–like illness.

When investigating a proposed association between anabolic androgenic steroids (AAS) and criminality, Klötz et al (SEE ARTICLE) found that use of AAS is often connected to an antisocial lifestyle involving various types of criminality, some of which require preparation and planning. One tentative explanation for this is that some of the effects of AAS, such as increased muscularity and aggressiveness, are advantageous to certain individuals involved in criminality.

Foster et al (SEE ARTICLE) examined the cost-effectiveness of the Fast Track intervention, a multiyear, multicomponent program designed to reduce violence among at-risk children. Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay. Subsequent analysis showed that the intervention likely was cost-effective for those most at risk, however, on 2 or 3 behavioral outcomes. This finding has important policy implications since such children are likely to generate higher costs for society over their lifetimes.







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