Williams et al (SEE ARTICLE) report a haplotype of the gene encoding dystrobrevin binding protein (DTNBP1) associated with increased risk of schizophrenia and 2 haplotypes associated with reduced risk in more than 700 control subjects and subjects with schizophrenia from the United Kingdom. The authors were able to replicate these findings in independent samples from Ireland. The common protective haplotype was also associated with higher education achievement, suggesting that the effect of this haplotype may be mediated by an influence on intelligence.
To determine the magnitudes of the genetic and environmental contributions to hippocampal volume reduction in schizophrenia, van Erp et al (SEE ARTICLE) applied mixed-model regression, intraclass correlation, and variance components analyses to hippocampal volumes of twins with schizophrenia and matched healthy control twins, as measured from high-resolution magnetic resonance imaging results. Hippocampal volumes in the healthy twins appeared to be highly heritable (ie, h2 = 71%), whereas those in twins discordant for schizophrenia were also heritable (ie, h2 = 42%) but were subject to greater modulation by environmental factors compared with healthy twins.
In a longitudinal study of 50 087 male Swedish conscripts, Zammit et al (SEE ARTICLE) report that low IQ is associated with an increased risk of developing schizophrenia, other nonaffective psychotic disorders, and severe depression across a 27-year follow-up period. Risk of schizophrenia was spread across the whole IQ range. However, there was no association between IQ and risk of bipolar disorder, indicating possible differences in some areas of the neurodevelopmental etiology of these disorders.
Grant et al (SEE ARTICLE) found that the co-occurrence of DSM-IV alcohol and drug use disorders and personality disorders was pervasive in the US general population. Associations between these Axis I and Axis II disorders were overwhelmingly positive and significant, and the strength of these associations varied among men and women. The results highlight the need for further research on the underlying structures of these disorders and the treatment implications of these disorders when comorbid.
Tiemeier et al (SEE ARTICLE) investigated the relation between atherosclerosis and depression in a population-based study of 4019 elderly individuals. Atherosclerosis was assessed at 5 different locations. More severe extracoronary atherosclerosis was associated with a higher prevalence of depressive disorders; the prevalence increased by 30% per standard deviation of atherosclerosis measure. Further, they observed a strong relationship between severe coronary and aortic calcifications and depressive disorders. The findings are compatible with the vascular depression hypothesis.
Quality improvement programs for depression in primary care can improve patient outcomes up to 28 months, but are there long-term benefits for patients? In this issue, Wells et al (SEE ARTICLE) provide new evidence from the Partners in Care study that benefits for patients of short-term quality-improvement programs can last up to 5 years while reducing ethnic disparities in outcomes and improving the equity of care.
The report by Ormel et al (SEE ARTICLE) , based on NEMESIS data, strongly suggests that psychosocial disability after remission from a unipolar major depressive episode largely reflects the continuation of premorbid psychosocial disability. Disability that developed during the major depressive episode did not persist routinely beyond recovery except in a severe recurrent episode. The analysis also showed that within-subject premorbid-postmorbid comparisons are sensitive to state effects of prodromal and residual symptoms.
Trauma can precipitate posttraumatic stress disorder (PTSD), which has been linked to changes in the levels of the adrenal stress hormones cortisol and catecholamine. Young and Breslau (SEE ARTICLE) examine these hormone profiles in persons never exposed to trauma and persons exposed to trauma with and without PTSD in representative groups drawn from an ongoing epidemiological community sample. Posttraumatic stress disorder was associated with increased catecholamine excretion levels but normal cortisol excretion levels. The presence of lifetime comorbid depression resulted in increased cortisol excretion levels in the PTSD group.
Abram et al (SEE ARTICLE) assessed trauma and posttraumatic stress disorder (PTSD) in a sample of 1829 detained youth. Most detainees (92.5%) reported 1 or more traumatic experiences; 11.2% met criteria for PTSD in the past year. Witnessing violence was the most common precipitating trauma. Trauma and PTSD appear to be more prevalent among juvenile detainees than in community samples. Timely interventions may avert subsequent and often chronic social problems common among youth exposed to trauma.
McRae et al (SEE ARTICLE) examined quality of life in a double-blind sham-surgery controlled trial designed to determine the effectiveness of transplantation of human embryonic dopamine neurons into the brains of persons with advanced Parkinson disease. During the 1-year period of the trial, there were more differences and changes among perceived treatment groups than among the actual surgery groups in ratings by both patients and medical staff. Results indicate that the placebo effect was very strong in this study.
