American Journal of Psychiatry

H Schrader, G Bovim, and T Sand

doi: N/Apmid: N/A

Hill, JC; Schoener, EP

doi: N/Apmid: 8780416

OBJECTIVE: This study was undertaken to assess whether the diagnosis of attention deficit hyperactivity disorder (ADHD) is retained from childhood into adulthood. METHOD: A search of the literature yielded nine prospective studies in which cohorts of children with the disorder were formed and then reexamined 4-16 years later to determine the level of retained ADHD. The resulting data were subjected to nonlinear regression analysis to ascertain the relationship with chronological age. RESULTS: The data followed an exponential decline over time to a high degree of accuracy. CONCLUSIONS: The rate of ADHD in a given age group appears to decline by 50% approximately every 5 years. If a prevalence of ADHD in childhood of 4% is assumed and the exponential decline extrapolated, the estimated rate of

J Paris and H Zweig-Frank

doi: N/Apmid: N/A

Lewine, RR; Walker, EF; Shurett, R; Caudle, J; Haden, C

doi: N/Apmid: 8780422

OBJECTIVE: The view of schizophrenic men as having poorer premorbid development, earlier age at onset, and worse outcome than schizophrenic women predicts greater neuropsychological impairment in the former than the latter. The authors examined in detail neuropsychological functioning in a large group of schizophrenic patients and a healthy comparison group. METHOD: Neuropsychological functioning in 132 male and 63 female patients with schizophrenia or schizoaffective disorder was extensively studied and compared with that of 99 (40 male, 59 female) healthy individuals. RESULTS: As expected, the schizophrenic patients as a group were pervasively and significantly more impaired than the comparison group. Within schizophrenia, in contrast to the prediction, women performed significantly more poorly than men in verbal memory, spatial memory, and visual processing. Female schizophrenic patients also had significantly poorer right than left hemisphere performance, whereas male schizophrenic patients had identical scores for right and left hemisphere impairment. CONCLUSIONS: The findings are consistent with the hypothesis that schizophrenia among women may be partially understood as a right hemisphere dysfunction. Sampling, diagnostic, and epidemiologic factors may have affected the

S Bolton and JG Gunderson

doi: N/Apmid: N/A

Gorwood, P; Leboyer, M; Falissard, B; Jay, M; Rouillon, F; Feingold, J

doi: N/Apmid: 8780421

OBJECTIVE: Anticipation, recently found in several neuropsychiatric disorders, is an inheritance pattern within a pedigree in which disease severity increases or age at onset decreases in successive generations. Demonstration of genetic anticipation in schizophrenia could be of heuristic value, since unstable trinucleotide repeat DNA is known to be the biological basis of anticipation. However, to overcome one of the major ascertainment biases that might mimic anticipation--namely, the fact that patients in different generations are not interviewed at the same age, resulting in a greater chance of finding a later age at onset in the older generation--a new method of investigating anticipation was used. METHOD: The study subjects were 97 systematically ascertained schizophrenic patients belonging to 24 families with at least two generations affected who were identified during a 1-year prevalence study in a limited geographical area of Reunion Island (Indian Ocean). A method of calculating expected age at onset according to age at interview was used in the analyses. RESULTS: In the younger generation of patients, the observed age at onset (21.80 years) was earlier than the expected age at onset (24.95 years), demonstrating anticipation, even when five additional biases that can mimic this genetic effect-- the proband effect, the presence of an affected father or mother, the bilineality of the illness, the fertility effect, and the cohort effect- -were taken into account. CONCLUSIONS: Evidence for anticipation was demonstrated in this group of schizophrenic patients. This may help the search for pathological genes implicated in the

Greenwald, BS; Kramer-Ginsberg, E; Krishnan, RR; Ashtari, M; Aupperle, PM; Patel, M

doi: N/Apmid: 8780429

OBJECTIVE: The authors rated periventricular and subcortical signal hyperintensities on magnetic resonance imaging (MRI) scans in elderly patients with depression and in normal subjects with similar demographic features to examine whether such changes discriminate patients with depression from normal subjects and whether they are associated with any clinical variables. METHOD: Two established hyperintensity rating systems were used to compare the MRI brain scans of 48 elderly patients with depression diagnosed according to DSM-III-R with the scans of 39 normal elderly subjects. RESULTS: Elderly depressed patients manifested significantly more severe hyperintensity ratings in the subcortical gray matter than age-matched comparison subjects. Significant differences were not identified between patients with similar current ages and cerebrovascular disease risk who had early-onset or late-onset depression. CONCLUSIONS: These findings support those of neuroimaging studies implicating the basal ganglia in depression and geriatric depression. The data suggest that the relationship observed in some reports between late-onset depression and MRI hyperintensities is most likely a function of

SC Miller

doi: N/Apmid: N/A

HB Simpson and MR Liebowitz

doi: N/Apmid: N/A

Rutherford, MJ; Cacciola, JS; Alterman, AI; McKay, JR

doi: N/Apmid: 8780424

OBJECTIVE: The authors studied methadone maintenance patients to determine the degree of their impairment in object relations and reality testing and the relationship of such impairment to comorbid axis I and axis II disorders. It was expected that deficits in object relations and, to a lesser degree, reality testing would be exhibited by the group as a whole and that they would be related to the presence of comorbid disorders. METHOD: The self-report Bell Object Relations Reality Testing Inventory was administered to 240 methadone maintenance patients. The subjects were first divided into groups on the basis of number of comorbid axis I disorders and then on the basis of number of comorbid axis II disorders. Finally, the subjects were placed into one of four groups on the basis of the combined presence or absence of axis I and axis II disorders. RESULTS: The methadone patients exhibited some specific impairments in object relations, but not in reality testing. Bell inventory scores did not significantly differ according to the number of comorbid axis I disorders, but they did significantly differ according to number of axis II disorders diagnosed. The scores were poorest for those with axis II disorders only, while subjects with only axis I disorders had scores similar to those with neither axis I nor II disorders. CONCLUSIONS: Comorbid axis II disorders, more than axis I disorders, may be associated with problems in object