0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
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 ......
This Month in Archives of General Psychiatry |

This Month in Archives of General Psychiatry FREE

Arch Gen Psychiatry. 1998;55(11):962. doi:10.1001/archpsyc.55.11.962.
Text Size: A A A
Published online

Persons who abuse one illicit drug are also likely to abuse other drugs. This pattern is consistent with a trait that affects abuse of all drugs. Tsuang et alArticle, using a large sample of twin Vietnam-era veterans, found a single vulnerability factor that underlies the abuse of marijuana, sedatives, stimulants, heroin, and psychedelics. This vulnerability was influenced by genetic, family environmental, and nonfamily environmental factors.

Merikangas et alArticle conducted a controlled family study of probands with several different predominant drugs of abuse, including opioids, cocaine, cannabis, and/or alcohol. The results reveal an 8-fold increased risk of drug disorders among the relatives of probands with drug disorders across a wide range of specific drugs. There was also evidence for specificity of familial aggregation of the predominant drug of abuse.

Using data from the Collaborative Study on the Genetics of Alcoholism, Bierut et alArticle found that siblings of an alcohol-dependent subject are at an increased risk for alcohol dependence. Marijuana dependence, cocaine dependence, and habitual smoking cluster within families of alcoholics in a substance-specific fashion and are in part independent of alcohol dependence.

A Commentary by Goldman and Bergen on the genetics of substance abuse is included.Article

The serotonin autoreceptor 5-MTIB has been implicated in alcohol consumption and aggressive behavior in mice. Lappalainen et alArticle present evidence for linkage and association between a silent polymorphism within the HT1B gene and antisocial alcoholism in Finns and Southwestern American Indians. Linkage was also demonstrated for a genetic marker locus, D6S284, that is closely linked to HT1B. These findings suggest that a locus predisposition to antisocial alcoholism may be located near HTR1B at chromosome 6q13-15.

Leptin is a hormone that regulates fat metabolism and appetite, and its secretion is increased by various factors including glucocorticoids (GCs). Newcomer et alArticle report that stress-level doses of cortisol can significantly increase plasma leptin concentrations in healthy humans. Increases in leptin concentrations returned to baseline during 4 treatment days, suggesting tolerance to this effect in healthy subjects. The results indicate an important role for GCs in the acute regulation of human leptin secretion.

People with schizophrenia may show abnormal frontal lobe activity but it is unclear whether these observations depend on the task subjects are performing. Fletcher et alArticle explored memory-related brain activation, in controls and patients, using both easy and difficult memory tasks. Frontal activation was similar across groups during the easier tasks. When the task became more difficult and performance fell, abnormal frontal activation was observed in the patient group, suggesting that abnormal brain activity in schizophrenia may only be observed under certain conditions.

Selective serotonin reuptake inhibitors are increasingly being used as first-line agents to treat panic disorder. In this large, double-blind, placebo-controlled, flexible-dose study, Pollack et alArticle report that sertraline was significantly more effective than placebo in reducing panic attack frequency as well as other clinician and patient assessments of improvement.

Current nosological thinking that assumes a key pathogenic role of spontanous primary panic attack for onset of secondary agoraphobia has been challenged. Wittchen et alArticle demonstrate that in a community sample, even after adjusting for potential diagnostic bias, most subjects with agoraphobia had no prior history of panic. The findings suggest the existence of diverse pathogenic pathways for panic and agoraphobia.

In an overview of the evidence available on the treatment of depression with alternative or complementary therapies, Ernst et alArticle found rigorous scientific data to be extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (St John's wort) and, to a lesser extent, acupuncture and relaxation therapies.

Botanical medicines are increasingly encountered in psychiatric practice. Wong et alArticle assess the literature regarding herbs commonly available in North America (eg, St John's wort, Ginkgo, valerian, chamomile, and kava) for safety, adverse effects, drug interactions, and efficacy.

Figures

Tables

References

Correspondence

CME
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.
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.
Submit a Comment

Multimedia

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

Related Content

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