We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Psychiatry |

Highlights FREE

JAMA Psychiatry. 2013;70(11):1121-1123. doi:10.1001/jamapsychiatry.2013.2015.
Text Size: A A A
Published online


Carrión and colleagues found that functional impairments, reduced neurocognitive performance, and nonpositive attenuated symptoms at baseline were associated with an increased risk of poor long-term functioning in a prospective, naturalistic, longitudinal follow-up study of individuals at clinical high risk for developing psychosis. Poor functional outcomes were not entirely dependent on emerging psychosis, further highlighting the need for intervention at this early stage of development for those who do and do not convert to a full-blown psychotic disorder.

Fornito and colleagues used resting-state functional magnetic resonance imaging to demonstrate that both patients with first-episode psychosis and their unaffected relatives show a common dysregulation of corticostriatal systems, characterized by hypoconnectivity of dorsal and hyperconnectivity of ventral frontostriatal circuits.

Jarrett and colleagues examined the efficacy of continuation phase therapy across 8 months in comparison with pharmacotherapy with fluoxetine or pill placebo in 241 patients with recurrent major depressive disorder at higher risk for relapse/recurrence. Results indicated that both continuation phase therapy and fluoxetine reduced the risk of relapse across 8 months of treatment. There were, however, no significant differences in relapse/recurrence rates across 24 months after treatments were stopped.

Beardslee and colleagues report the 33-month follow-up of a randomized prevention trial of 316 offspring of depressed parents. Youth (aged 13-17 years) had a prior depressive episode, current subsyndromal symptoms, or both. Adolescents in the cognitive-behavioral prevention program had significantly fewer onsets of depressive episodes compared with usual care. When parents were not depressed at baseline, cognitive-behavioral prevention was superior to usual care (number needed to treat = 6). The baseline parental depression effect varied across sites.

A longitudinal cohort of patients with unipolar major depressive episodes (MDEs) was studied by Judd and colleagues. Anger/irritability in 54.5% of participants with a unipolar MDE at study intake was significantly associated with increased depressive severity, longer index MDEs, poor impulse control, greater psychosocial impairment, and more severe long-term course of illness. The presence of irritability/anger during MDEs is a robust clinical marker of a more severe complex depressive illness.

Related Editorial, Related Article

Heller and colleagues examined relationships between changes in circuits involved in regulating negative emotion and depressive symptoms over a 6-month antidepressant trial. Slope trajectories were calculated for rate of change in depression severity as well as rate of change in neural activity. Patients showing the fastest decrease in depression severity also showed the fastest increase in prefrontal cortex activity when regulating negative emotion.

Related Editorial, Related Article

Simpson and colleagues compared the effects of augmenting serotonin reuptake inhibitors with risperidone, cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP), or pill placebo in 100 adults with obsessive-compulsive disorder (OCD). Those receiving EX/RP had significantly greater reduction in OCD severity and significantly higher response rates, indicating that patients with OCD taking serotonin reuptake inhibitors with ongoing symptoms should be offered EX/RP before antipsychotics.

Related Editorial

Pietrzak and colleagues examined in vivo norepinephrine transporter availability in the locus coeruleus in adults with posttraumatic stress disorder (PTSD). Results revealed that adults with PTSD had significantly lower norepinephrine transporter availability compared with healthy adults (41% lower) and trauma-exposed adults without PTSD (31% lower). Norepinephrine transporter availability in the locus coeruleus was independently positively associated with severity of anxious arousal (ie, hypervigilance) in adults with PTSD.

The study by Reichborn-Kjennerud and colleagues explore the structure of etiological factors underlying the symptoms of DSM-IV borderline personality disorder. Results indicate that most of the genetic effects on the individual criteria derive from one highly heritable general factor, while the environmental influences were mostly criterion specific.

Hall and colleagues examined the large-scale brain networks underlying the cognitive and behavioral symptoms of fragile X syndrome, the most common known inherited cause of intellectual disability. Five large-scale networks were identified in which patients with fragile X showed significantly decreased functional connectivity compared with matched controls.

Ludvigsson and colleagues examined the risk of autism among some 43 000 individuals undergoing investigation for celiac disease. Autism was markedly increased among individuals with normal small intestinal mucosa but positive celiac disease serologic test results, while no association was seen with celiac disease with villous atrophy.

D’Onofrio and colleagues examined the association between early gestational age and numerous indices of mortality and morbidity in a population-based cohort study in Sweden. The analyses, which compared differentially exposed siblings, suggest that the mechanisms responsible for the relations between preterm birth and mortality and morbidity are outcome specific.

Wallace and colleagues demonstrate a novel moderator approach using data from a randomized clinical trial comparing pharmacotherapy and psychotherapy as treatments for depression. Eight individual moderators were optimally combined to create a single moderator with a much stronger effect size than any of the individual moderators examined. Unlike when multiple individual moderators are identified, a single optimally combined moderator can provide practitioners with a clear and consistent algorithm for making treatment decisions.





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.