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 ......
This Month in Archives of General Psychiatry |

This Month in Archives of General Psychiatry FREE

Arch Gen Psychiatry. 2000;57(12):1097. doi:10.1001/archpsyc.57.12.1097.
Text Size: A A A
Published online

Human behavior arises from both genotype and experience. A measurable portion of the variance in behavior is hereditary, and such inheritance is ultimately attributable to functional variants of genes programming brain development and function. The sequence of the human genome is revealing a complex pattern of gene sequence variation. Cravchik and GoldmanArticle analyze the sequence diversity in human neurotransmitter receptor and transporter genes, and propose that it might represent an example of "neurochemical individuality."

Driessen et alArticle aim to answer the question of whether traumatized patients with borderline personality disorders (BPD) show trauma-related brain abnormalities or neuropsychological deficits. They found that patients with BPD have smaller volumes of the hippocampus and the amygdala than healthy controls but no neuropsychological deficits when the results were contolled for levels of depression. Volumes of the hippocampus were negatively correlated with early traumatization when all subjects were considered. The hypothesis of trauma-induced volume reductions of the brain in BPD can only be partly supported by this study.

Schizophrenia is associated with deficits in the ability to perform tasks that require transient information storage. Javitt et alArticle used electrophysiological and behavioral measures to evaluate whether such deficits reflect impaired ability to form precise memory traces, or impaired ability to maintain such traces once they are formed. Patients showed impaired ability to process information in both an attention-dependent visual paradigm and an attention-independent auditory paradigm, but no deficit in information retention. Similar effects are observed following administration of ketamine in normal volunteersArticle, suggesting that N-methyl-D-aspartate receptor dysfunction may play a prominent role in the disorder.

Deficient functioning of N-methyl-D-aspartate receptors (NMDARs) has been implicated in the impairment of short-duration, transient memory in schizophrenia. Umbricht et alArticle used electrophysiological and behavioral measures to investigate the effects of the NMDAR antagonist ketamine in healthy volunteers in 2 tasks that require transient information storage at the preattentive, sensory, and attention-dependent levels, respectively. They demonstrate that ketamine administration induced patterns of abnormalities similar to those observed in schizophreniaArticle. Thus, NMDAR-related dysfunction may underlie deficits in the formation and utilization of transient memory traces at different levels of information processing in schizophrenia.

Individuals with schizophrenia show severe deficits in the ability to perform simple sensory tasks, such as the ability to match 2 tones following brief delay. Rabinowicz et alArticle evaluated the relative contributions of auditory vs prefrontal dysfunction in producing this deficit. Auditory cortical lesions are known to increase tone-matching thresholds whether or not distracting tones are present, whereas prefrontal lesions affect performance only in the presence of same-modality (auditory) distractors. Patients showed increased thresholds but no increased distractability, suggesting that deficits are due to sensory imprecision and cannot be attributed to prefrontal dysfunction.

Major depression is more common in women, with these gender differences appearing at puberty. Young et alArticle examined reproductive hormones in depressed premenopausal women and matched controls and found lower mean estradiol levels in the follicular phase. These data complement other findings of a beneficial effect of estrogen on mood.

A commentary by Halbreich is included.Article

Hallucinations and delusions, 2 hallmarks of psychosis, occur commonly in patients with Alzheimer disease and have been associated with a more rapid cognitive decline. Farber et alArticle report that, as compared with nonpsychotic subjects, psychotic subjects have a greater density of neocortical neurofibrillary tangles, one of the major neuropathological hallmarks of Alzheimer disease. A similar increase was not found for senile plaques, another neuropathological hallmark of Alzheimer disease, or for neurofibrillary tangles in non-neocortical brain regions. These findings suggest that the mechanism(s) underlying psychosis may be associated with disease specific processes involved in the production of neocortical neurofibrillary tangles.

Although several models of schizophrenia hypothesize that the exacerbation of psychotic symptoms involves the interaction of psychobiological vulnerability and environmental stressors, little research has examined this issue directly. Rosenfarb et alArticle studied whether the combination of neurocognitive deficits and interpersonal criticism would predict the emergence of unusual thinking during stressful family transactions. A model that included the joint interaction of patients' working-memory deficits and interpersonal criticism from relatives best accounted for patients' unusual thinking. The data provide empirical support for a specific form of vulnerability-stress interaction in schizophrenia.





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.