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American Journal of Psychiatry

Volume 163, Issue 2

February 2006

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In This Issue

February 2006

Page:A38
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.A38

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Editorials

February 2006

Bipolar Disorder Treatment: An Evidence-Based Reality Check

J. Raymond DePaulo, M.D.

Pages:175–176
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.175

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February 2006

What Is Bipolar Disorder?

Alan C. Swann, M.D.

Pages:177–179
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.177

First Page
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February 2006

Pathological Gambling: Focusing on the Addiction, Not the Activity

Carol A. Tamminga, M.D., and
Eric J. Nestler, M.D., PH.D.

Pages:180–181
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.180

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February 2006

Psychotherapy in the Journal: What’s Missing?

Glen O. Gabbard, M.D., and
Robert Freedman, M.D.

Pages:182–184
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.182

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Editor's Note

February 2006

New Submission Requirement

Page:184
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.184

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Reviews and Overviews

February 2006

Why Olanzapine Beats Risperidone, Risperidone Beats Quetiapine, and Quetiapine Beats Olanzapine: An Exploratory Analysis of Head-to-Head Comparison Studies of Second-Generation Antipsychotics

Stephan Heres, M.D.,
John Davis, M.D.,
Katja Maino, M.D.,
Elisabeth Jetzinger, M.D.,
Werner Kissling, M.D., and
Stefan Leucht, M.D.

Pages:185–194
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.185

Abstract
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OBJECTIVE: In many parts of the world, second-generation antipsychotics have largely replaced typical antipsychotics as the treatment of choice for schizophrenia. Consequently, trials comparing two drugs of this class—so-called head-to-head studies—are ...

Introspections

February 2006

Piano Sonata in A Major

Richard G. Druss, M.D., New York, N.Y.

Pages:195–197
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.195

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Treatment in Psychiatry

February 2006

New-Onset Bipolar Disorder in Late Life: A Case of Mistaken Identity

David B. Arciniegas, M.D.

Pages:198–203
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.198

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Clinical Case Conference

February 2006

Myocarditis During Clozapine Treatment

David B. Merrill, M.D.,
Susanne E. Ahmari, M.D., Ph.D.,
Jean-Marie E. Bradford, M.D., and
Jeffrey A. Lieberman, M.D.

Pages:204–208
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.204

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Images in Psychiatry

February 2006

Victor Kandinsky, M.D., 1849–1889

Vladimir Lerner, M.D., Ph.D., and
Eliezer Witztum, M.D.

Page:209
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.209

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Article

February 2006

Treatment-Resistant Bipolar Depression: A STEP-BD Equipoise Randomized Effectiveness Trial of Antidepressant Augmentation With Lamotrigine, Inositol, or Risperidone

Andrew A. Nierenberg, M.D.,
Michael J. Ostacher, M.D., M.P.H.,
Joseph R. Calabrese, M.D.,
Terence A. Ketter, M.D.,
Lauren B. Marangell, M.D.,
David J. Miklowitz, Ph.D.,
Sachiko Miyahara, M.S.,
Mark S. Bauer, M.D.,
Michael E. Thase, M.D.,
Stephen R. Wisniewski, Ph.D., and
Gary S. Sachs, M.D.

STEP-BD Investigators

Pages:210–216
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.210

Abstract
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OBJECTIVE: Clinicians have few evidence-based options for the management of treatment-resistant bipolar depression. This study represents the first randomized trial of competing options for treatment-resistant bipolar depression and assesses the ...

February 2006

Predictors of Recurrence in Bipolar Disorder: Primary Outcomes From the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)

Roy H. Perlis, M.D.,
Michael J. Ostacher, M.D., M.P.H.,
Jayendra K. Patel, M.D.,
Lauren B. Marangell, M.D.,
Hongwei Zhang, M.D., M.S.,
Stephen R. Wisniewski, Ph.D.,
Terence A. Ketter, M.D.,
David J. Miklowitz, Ph.D.,
Michael W. Otto, Ph.D.,
Laszlo Gyulai, M.D.,
Noreen A. Reilly-Harrington, Ph.D.,
Andrew A. Nierenberg, M.D.,
Gary S. Sachs, M.D., and
Michael E. Thase, M.D.

Pages:217–224
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.217

Abstract
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OBJECTIVE: Little is known about clinical features associated with the risk of recurrence in patients with bipolar disorder receiving treatment according to contemporary practice guidelines. The authors looked for the features associated with risk of ...

February 2006

Clinical Features of Bipolar Depression Versus Major Depressive Disorder in Large Multicenter Trials

Roy H. Perlis, M.D.,
Eileen Brown, Ph.D.,
Robert W. Baker, M.D., and
Andrew A. Nierenberg, M.D.

Pages:225–231
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.225

Abstract
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OBJECTIVE: Failure to recognize bipolar disorder in patients who experience a major depressive episode may lead to inappropriate treatment and poorer outcomes. Clinical features that could distinguish bipolar from unipolar depression would facilitate more ...

February 2006

Risk of Switch in Mood Polarity to Hypomania or Mania in Patients With Bipolar Depression During Acute and Continuation Trials of Venlafaxine, Sertraline, and Bupropion as Adjuncts to Mood Stabilizers

Gabriele S. Leverich, M.S.W., L.C.S.W.-C.,
Lori L. Altshuler, M.D.,
Mark A. Frye, M.D.,
Trisha Suppes, M.D., Ph.D.,
Susan L. McElroy, M.D.,
Paul E. Keck, M.D.,
Ralph W. Kupka, M.D., Ph.D.,
Kirk D. Denicoff, M.D.,
Willem A. Nolen, M.D., Ph.D.,
Heinz Grunze, M.D.,
Maria I. Martinez, M.A., and
Robert M. Post, M.D.

Pages:232–239
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.232

Abstract
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OBJECTIVE: The authors examined the comparative risks of switches in mood polarity into hypomania or mania during acute and continuation trials of adjunctive antidepressant treatment of bipolar depression. METHOD: One hundred fifty-nine patients with ...

February 2006

Clinical Correlates and Familial Aggregation of Age at Onset in Bipolar Disorder

Ping-I Lin, M.D., Ph.D.,
Melvin G. McInnis, M.D.,
James B. Potash, M.D., M.P.H.,
Virginia Willour, Ph.D.,
Dean F. MacKinnon, M.D.,
J. Raymond DePaulo, M.D., and
Peter P. Zandi, Ph.D.

Pages:240–246
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.240

Abstract
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OBJECTIVE: To assess whether age at onset variation reflects underlying genetic heterogeneity in bipolar disorder, the authors examined the clinical and familial characteristics of age at onset in bipolar disorder subjects from families with multiple ...

February 2006

Randomized, Placebo-Controlled Trial of Olanzapine as Maintenance Therapy in Patients With Bipolar I Disorder Responding to Acute Treatment With Olanzapine

Mauricio Tohen, M.D., Dr.P.H.,
Joseph R. Calabrese, M.D.,
Gary S. Sachs, M.D.,
Michael D. Banov, M.D.,
Holland C. Detke, Ph.D.,
Richard Risser, M.S.,
Robert W. Baker, M.D.,
James C.-Y. Chou, M.D., and
Charles L. Bowden, M.D.

Pages:247–256
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.247

Abstract
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OBJECTIVE: In a placebo-controlled, double-blind study, the authors investigated the efficacy and safety of olanzapine as monotherapy in relapse prevention in bipolar I disorder. METHOD: Patients achieving symptomatic remission from a manic or mixed ...

February 2006

Risk and Resilience Markers in Bipolar Disorder: Brain Responses to Emotional Challenge in Bipolar Patients and Their Healthy Siblings

Stephanie Krüger, M.D.,
Martin Alda, M.D., F.R.C.P.C.,
L. Trevor Young, M.D., Ph.D., F.R.C.P.C.,
Kim Goldapple, B.S.,
Saghar Parikh, M.D., F.R.C.P.C., and
Helen S. Mayberg, M.D.

Pages:257–264
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.257

Abstract
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OBJECTIVE: The authors previously identified depression-specific differences in brain responses to an emotional challenge in patients with bipolar and unipolar mood disorder. In this study, potential markers of bipolar risk and resilience were examined in ...

February 2006

Laboratory-Observed Behavioral Disinhibition in the Young Offspring of Parents With Bipolar Disorder: A High-Risk Pilot Study

Dina R. Hirshfeld-Becker, Ph.D.,
Joseph Biederman, M.D.,
Aude Henin, Ph.D.,
Stephen V. Faraone, Ph.D.,
Gabrielle A. Cayton, B.S., and
Jerrold F. Rosenbaum, M.D.

Pages:265–271
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.265

Abstract
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OBJECTIVE: This study tested whether behavioral disinhibition is more prevalent among offspring of parents with bipolar disorder than among offspring of parents without bipolar disorder. METHOD: The authors conducted a secondary analysis of data from a ...

February 2006

Linear Relationship of Valproate Serum Concentration to Response and Optimal Serum Levels for Acute Mania

Michael H. Allen, M.D.,
Robert M. Hirschfeld, M.D.,
Patricia J. Wozniak, Ph.D.,
Jeffrey D. Baker, Ph.D., and
Charles L. Bowden, M.D.

Pages:272–275
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.272

Abstract
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OBJECTIVE: Several studies have shown that achieving adequate serum valproate levels is critical to rapid stabilization of acute mania, but estimates of the target therapeutic level have been imprecise. A post hoc analysis of pooled intent-to-treat data ...

February 2006

Basal Ganglia Shape Alterations in Bipolar Disorder

Jaeuk Hwang, M.D.,
In Kyoon Lyoo, M.D., Ph.D.,
Stephen R. Dager, M.D.,
Seth D. Friedman, Ph.D.,
Jung Su Oh, M.S.,
Jun Young Lee, M.D.,
Seog Ju Kim, M.D.,
David L. Dunner, M.D., and
Perry F. Renshaw, M.D., Ph.D.

Pages:276–285
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.276

Abstract
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OBJECTIVE: Shape differences in the caudate heads and putamen were compared between drug-naive and drug-treated patients with bipolar disorder and healthy comparison subjects by using spherical harmonic (SPHARM) techniques. On the basis of previous ...

February 2006

Neurocognitive Function in Unmedicated Manic and Medicated Euthymic Pediatric Bipolar Patients

Mani N. Pavuluri, M.D., Ph.D., F.R.A.N.Z.C.P.,
Lindsay S. Schenkel, M.A.,
Subhash Aryal, M.S.,
Erin M. Harral, B.A.,
S. Kristian Hill, Ph.D.,
Ellen S. Herbener, Ph.D., and
John A. Sweeney, Ph.D.

Pages:286–293
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.286

Abstract
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OBJECTIVE: A systematic evaluation of neuropsychological functioning in individuals with pediatric bipolar disorder is necessary to clarify the types of cognitive deficits that are associated with acutely ill and euthymic phases of the disorder and the ...

February 2006

Autistic Social Impairment in the Siblings of Children With Pervasive Developmental Disorders

John N. Constantino, M.D.,
Clara Lajonchere, Ph.D.,
Marin Lutz, B.A.,
Teddi Gray,
Anna Abbacchi, M.S.,
Kathleen McKenna,
Deepti Singh, B.A., and
Richard D. Todd, Ph.D., M.D.

Pages:294–296
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.294

Abstract
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OBJECTIVE: Sibling recurrence risk in autism has been estimated to be approximately 10%. This study investigated subsyndromal autistic impairments among siblings of probands with pervasive developmental disorders. METHOD: The authors used the Social ...

February 2006

Natural Recovery and Treatment-Seeking in Pathological Gambling: Results of Two U.S. National Surveys

Wendy S. Slutske, Ph.D.

Pages:297–302
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.297

Abstract
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OBJECTIVE: Pathological gambling is described in DSM-IV as a chronic and persisting disorder, but recent community-based longitudinal studies that have highlighted the transitory nature of gambling-related problems have called into question whether this ...

February 2006

Multicenter Investigation of the Opioid Antagonist Nalmefene in the Treatment of Pathological Gambling

Jon E. Grant, J.D., M.D.,
Marc N. Potenza, M.D., Ph.D.,
Eric Hollander, M.D.,
Renee Cunningham-Williams, Ph.D., M.P.E., L.C.S.W.,
Tommi Nurminen, M.Sc.,
Gerard Smits, Ph.D., and
Antero Kallio, M.D., Ph.D.

Pages:303–312
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.303

Abstract
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OBJECTIVE: Pathological gambling is a disabling disorder experienced by approximately 1%–2% of adults and for which there are few empirically validated treatments. The authors examined the efficacy and tolerability of the opioid antagonist nalmefene in ...

Brief Report

February 2006

Lower Switch Rate in Depressed Patients With Bipolar II Than Bipolar I Disorder Treated Adjunctively With Second-Generation Antidepressants

Lori L. Altshuler, M.D.,
Trisha Suppes, M.D., Ph.D.,
David O. Black, Ph.D.,
Willem A. Nolen, M.D.,
Gabriele Leverich, M.S.W.,
Paul E. Keck, M.D.,
Mark A. Frye, M.D.,
Ralph Kupka, M.D.,
Susan L. McElroy, M.D.,
Heinz Grunze, M.D., Ph.D.,
Christina M.R. Kitchen, Ph.D., and
Robert Post, M.D.

Pages:313–315
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.313

Abstract
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OBJECTIVES: The authors compared the switch rate into hypomania/mania in depressed patients treated with second-generation antidepressants who had either bipolar I or bipolar II disorder. METHOD: In a 10-week trial, 184 outpatients with bipolar depression ...

February 2006

Differences in Brain Chemistry in Children and Adolescents With Attention Deficit Hyperactivity Disorder With and Without Comorbid Bipolar Disorder: A Proton Magnetic Resonance Spectroscopy Study

Constance M. Moore, Ph.D.,
Joseph Biederman, M.D.,
Janet Wozniak, M.D.,
Eric Mick, Sc.D.,
Megan Aleardi, B.A.,
Megan Wardrop, B.A.,
Meghan Dougherty, B.S.,
Terri Harpold, M.D.,
Paul Hammerness, M.D.,
Edin Randall, B.A., and
Perry F. Renshaw, M.D., Ph.D.

Pages:316–318
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.316

Abstract
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OBJECTIVE: The authors’ goal was to investigate phosphatidylinositol and glutamatergic metabolism in the anterior cingulate cortex of children and adolescents with attention deficit hyperactivity disorder (ADHD) alone, children with ADHD plus bipolar ...

February 2006

Comorbidity in Bipolar Disorder Among the Elderly: Results From an Epidemiological Community Sample

Benjamin I. Goldstein, M.D., Ph.D.,
Nathan Herrmann, M.D., F.R.C.P.C., and
Kenneth I. Shulman, M.D., F.R.C.P.C.

Pages:319–321
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.319

Abstract
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OBJECTIVE: This study sought to determine psychiatric comorbidity among elderly individuals with bipolar disorder. METHOD: An epidemiological community survey identified 84 elderly (ages ≥65) respondents with bipolar disorder, 1,327 younger adults with ...

February 2006

Evidence of White Matter Pathology in Bipolar Disorder Adolescents Experiencing Their First Episode of Mania: A Diffusion Tensor Imaging Study

Caleb M. Adler, M.D.,
John Adams, B.A.,
Melissa P. DelBello, M.D.,
Scott K. Holland, Ph.D.,
Vince Schmithorst, Ph.D.,
Ari Levine, B.S.,
Kelly Jarvis, B.S.E., and
Stephen M. Strakowski, M.D.

Pages:322–324
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.322

Abstract
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OBJECTIVE: Previous diffusion tensor imaging findings have supported suggestions that bipolar disorder is characterized by subtle white matter changes. The chronic nature of the study population, however, has limited interpretation of these findings. In ...

Letter to the Editor

February 2006

QTc Prolongation and Torsades de Pointes in an Elderly Woman Taking Fluoxetine

INGEBORG WILTING, Pharm.D.,
O.M. SMALS, M.D.,
N.J. HOLWERDA, M.D., Tilburg, the Netherlands,
R.H. MEYBOOM, M.D., Ph.D.,
M.L. De BRUIN, Pharm.D., Ph.D., and
T.C.G. EGBERTS, Pharm.D., Ph.D., Utrecht, the Netherlands

Page:325
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.325

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February 2006

Pisa Syndrome in a Patient in a Wheelchair Taking Valproic Acid

MONIQUE YOHANAN, M.D.,
JASDEEP S. AULAKH, M.D.,
JOANNE WEITH, R.N., and
JAMES W. HAWKINS, M.D., Palo Alto, Calif.

Pages:325-a–326
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.325-a

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February 2006

Comorbidity of Anxiety With Eating Disorders and OCD

NATHALIE GODART, M.D., Ph.D.,
SYLVIE BERTHOZ, Ph.D.,
FABIENNE PERDEREAU, M.D., M.S., and
PHILIPPE JEAMMET, M.D., Ph.D., Paris, France

Page:326
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.326

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February 2006

NADIA MICALI, M.D., M.R.C.Psych., and
ISOBEL HEYMAN, M.B.B.S., Ph.D., M.R.C.Psych., London, U.K.

Pages:326-a–327
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.326-a

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February 2006

PER SÖDERSTEN, Ph.D., and
CECILIA BERGH, Ph.D., Stockholm, Sweden

Page:327
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.327

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February 2006

Dr. Kaye and Colleagues Reply

WALTER H. KAYE, M.D.,
CYNTHIA BULIK, Ph.D.,
LAURA THORNTON, Ph.D., and
KATHERINE PLOTNICOV, Ph.D., PRICE FOUNDATION COLLABORATIVE INVESTIGATORS Pittsburgh, Pa.

Pages:327-a–329
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.327-a

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February 2006

Suicide Risk in Placebo-Controlled Trials of Bipolar Disorder

ROBERT D. GOLDNEY, M.D., Adelaide, South Australia, Australia

Page:329
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.329

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February 2006

JITSCHAK G. STOROSUM, M.D., Ph.D.,
TAMAR WOHLFARTH, Ph.D.,
CHRISTIEN C. GISPEN-de WIED, M.D., Ph.D.,
DON H. LINSZEN, M.D., Ph.D.,
BETHOLD P.R. GERSONS, M.D., Ph.D.,
BARBARA J. van ZWIETEN, Ph.D., and
WIM van den BRINK, M.D., Ph.D., Amsterdam, the Netherlands

Pages:329-a–329
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.329-a

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February 2006

New Mnemonic for Depressive Symptoms

PRAVEEN F. ABRAHAM, D.O., and
EDWIN R. SHIRLEY, Ph.D., Cleveland, Ohio

Pages:329-b–330
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.329-b

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Correction

February 2006

Page:330
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.330

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Book Forum

February 2006

The American Psychiatric Publishing Textbook of Suicide Assessment and Management

HERBERT HENDIN, M.D., New York, N.Y.

Page:331
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.331

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February 2006

Late-Life Depression

NORMAN B. LEVY, M.D., Brooklyn, N.Y.

Page:332
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.332

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February 2006

Autism Spectrum Disorders: A Research Review for Practitioners

ELISSA P. BENEDEK, M.D., Ann Arbor, Mich.

Pages:332-a–333
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.332-a

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February 2006

Freud’s Requiem: Mourning, Memory, and the Invisible History of a Summer Walk

PAUL ROAZEN, Ph.D., Cambridge, Mass.

Pages:333–334
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.333

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February 2006

Playing Sick? Untangling the Web of Munchausen Syndrome, Munchausen by Proxy, Malingering, and Factitious Disorder

JAMES S. EATON, M.D., Washington, D.C.

Pages:334–335
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.334

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Books Received

February 2006

Page:336
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.336

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APA Official Actions

February 2006

APA Council Reports

Pages:337–352
Published Online:1 February 2006

https://doi.org/10.1176/appi.ajp.163.2.337

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