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Am J Psychiatry 2005;162:A56-A56. doi:10.1176/appi.ajp.162.3.A56

Disrupted coordination among brain systems is a recent focus of schizophrenia research. Spatial aspects of this disconnection have been investigated, but dysfunctional coordination implies a temporal dimension as well. Symond et al. (p. 459) measured synchronization of brain activity in patients with a first episode of schizophrenia. Oscillations in a narrow gamma frequency band were measured in EEG tracings recorded as patients and healthy subjects distinguished target sounds from background tones. Compared to the healthy subjects, the patients showed lower magnitude and latency of synchrony in the gamma 1 phase, –150 to 150 msec after the target sounds. Their gamma 1 synchrony was lower in the front of the brain than in the back, while for the healthy subjects the pattern was just the opposite. This finding, in patients with recent-onset schizophrenia, replicates results for chronic schizophrenia, which suggests that this frontal deficit of gamma synchrony is a trait of the illness itself.

Healthy adults frequently are overly optimistic when judging whether unpleasant events are more or less likely to happen to them than to other people. This bias often stems from their perception that they have control over events. If shared by patients with schizophrenia, this optimistic bias could distort their judgments about research participation, medical treatments, and risky social situations. Prentice et al. (p. 507) asked stable patients with schizophrenia and healthy adults how likely they were, compared to other people, to experience 40 adverse events classified as controllable, uncontrollable, and neutral. Both groups indicated that they were less likely than others to experience all three types of events. The patients’ optimism, however, was less pronounced than that of the comparison subjects, especially for the controllable events. Hence, patients with schizophrenia may be more realistic than healthy people in assessing risk.

In 1999, an earthquake of magnitude 5.9 struck near Athens, Greece. The municipality at the epicenter, Ano Liosia, sustained extensive destruction, with 10 deaths. Dafni, 10 km away, was less damaged. At 3–4 months after the earthquake, Roussos et al. (p. 530) evaluated 1,937 children and adolescents in these areas. The median score for symptoms of posttraumatic stress disorder (PTSD) was significantly higher in Ano Liosia than in Dafni. Students in Ano Liosia reported more fears during the earthquake and greater family conflict and housing-related problems in the aftermath. These responses were associated with more severe PTSD symptoms. The rates of PTSD and clinical depression for both cities combined were 4.5% and 13.9%, respectively. Girls reported more severe symptoms than boys. There was a high correlation between PTSD and depression. Collecting such data is feasible and can help in planning resources and interventions for postdisaster mental health programs.

Sexual, physical, or emotional abuse during childhood can produce long-lasting impairment and distress. Treating chronic posttraumatic stress disorder (PTSD) may require time and a safe environment. Stalker et al. (p. 552) compared the outcomes of 119 adult patients in a 6-week inpatient program for trauma recovery with those of applicants on waiting lists. At discharge the patients had more improvement than the control subjects in all three measures—global symptoms, PTSD, and trauma-related belief distortions. At 3 months the treated patients had lost some of their gains, but at 1 year their scores had rebounded. Clinically significant change in the outcome measures at 1 year was found for 32%–45%. These proportions are substantial but confirm the tendency of chronic PTSD to resist change.

Tobacco’s habit-forming power apparently comes from nicotine. Where and how nicotine affects the brain have been difficult to pin down. To reduce methodologic sources of confusion, Zubieta et al. (p. 567) provided smokers with nicotine in the form of a standard cigarette, measured brain responses after overnight abstinence, and compared the effects to those produced by a denicotinized cigarette. Increases in blood flow after the first regular cigarette of the day occurred in the visual cortex and thalamus, regions with high concentrations of nicotinic receptors, and in the cerebellum. Decreases occurred in areas implicated in the reinforcing properties of abused drugs. Decreases in self-rated craving after the first regular cigarette correlated with decreased blood flow in the dorsal anterior cingulate, previously suggested as a mediator of craving and relapse, and the right hippocampus, which helps associate drugs with environmental cues. F1




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