Journal Digest
Journal Digest
Psychiatric News
Volume 45 Number 19 page 27-27

Severe brain malformations, such as microcephaly, can result from prenatal exposure to alcohol, drugs, and some viruses. In many cases, the cause is genetic, but the responsible gene is unknown.

Now a gene called WDR62 has been identified as one of the culprits by Murat Gunel, M.D., co-director of Yale University's Program on Neurogenetics, and his colleagues. They found six mutations in WDR62 in 30 children with malformations of cortical development from 30 different families. The findings were published online August 22 in Nature.

Although its role has not been identified, WDR62 is known to be located on a band of brain tissue containing neural stem cells.

The scientists found the mutations with a new gene-scanning technology called whole-exome sequencing. Rather than scanning a person's entire genome for mutations, this technique focuses on the protein-coding bits of DNA, or exome, which makes up the genome.

The study was funded by the National Institutes of Health.

An abstract of "Whole-Exome Sequencing Identifies Recessive WDR62 Mutations in Severe Brain Malformations" is posted at <www.nature.com/nature/journal/vaop/ncurrent/abs/nature09327.html>.


If education can protect people against dementia, it seems logical that it would do so by decreasing neurodegeneration or vascular pathology in the brain. But that doesn't appear to be the case, a new study has found.

It was conducted by Hannah Keage, Ph.D., a Marie Curie fellow at the University of Cambridge in England, and colleagues. Results appeared in the August Brain.

The study was based on 872 deceased subjects, over half of whom had been diagnosed with dementia before they died. The scientists determined the number of years of formal education the subjects had and found that subjects who had been educated longer were less likely to be diagnosed with dementia than subjects who had been educated for a shorter time. This finding suggested that education can protect against dementia and did not surprise the scientists, as other studies have produced similar findings.

The scientists then examined the brains of the deceased subjects, but could find no relationship between the amount of education and the amount of neurodegeneration or vascular pathology in their brains.

Instead, the scientists speculated that education provides a brain reserve or buffer against dementia because even when subjects had comparable brain pathology, those with more education had received fewer diagnoses of dementia than those with less education.

Keage told Psychiatric News, "Those with high and low education had similar pathology, but those with [more] education were better able to cope with the cognitive consequences of this pathology and therefore could withstand a higher burden of pathology before being diagnosed with clinical dementia."

The study was funded by a European Union Marie Curie International Incoming Fellowship and the BUPA Foundation, a private health insurance company in the United Kingdom that gives research grants.

An abstract of "Education, the Brain, and Dementia: Neuroprotection or Compensation?" is posted at <http://brain.oxfordjournals.org/cgi/content/abstract/133/8/2210>.


Medical students can benefit from a short curriculum on psychotherapy taught by psychiatry residents, increasing the likelihood that they will refer patients for psychotherapy whatever specialty they pursue later, according to a report in the July-August Academic Psychiatry.

Psychiatry residents at Baylor College of Medicine, working closely with a faculty mentor, created a six-hour curriculum for medical students called "Therapy 101: An Introduction to Psychotherapy." The curriculum was taught by residents and used video clips from TV shows, role playing, and recordings of therapy sessions as teaching tools. The course was evaluated using a multiple-choice pre/postcourse test with questions on psychotherapy, written feedback, and perceived knowledge of psychotherapy.

The scores from the pre/postcourse test measuring the students' knowledge of psychotherapy did not change significantly, but students' self-rating of knowledge greatly increased after the series, and written feedback showed substantial enthusiasm for the course.

"By increasing the understanding of psychotherapy, the lecture series served the pathway's objective of expanding students' perceptions of physician roles in the community," wrote the authors of the report, Frieda Aboul-Fotouh, M.D., and Ali Abbas Asghar-Ali, M.D. "From the feedback, students had a clearer understanding of psychotherapy and the value of referring to psychotherapeutic treatment."

"Therapy 101: A Psychotherapy Curriculum for Medical Students" is posted at <http://ap.psychiatryonline.org/cgi/content/abstract/34/4/248>.


Not much has been known about the long-term course and impact of pediatric obsessive-compulsive disorder (OCD). Now, what may be the largest long-term study on the subject appears to provide some answers.

The study was headed by Nadia Micali, M.D., Ph.D., a child psychiatrist at the Institute of Psychiatry, King's College, London. Results were published in the August British Journal of Psychiatry.

Subjects were 142 children or adolescents with OCD; their average age was 14. They were recruited from a specialty OCD clinic at the Maudsley Hospital in London from 1996 to 2005 and followed up for five years on average. Fifty-nine percent of the subjects were found to be free of OCD at the end of follow-up.

The reasons why are not clear from the study since it did not track how many subjects had received treatment before or during the study. But "I think treatment certainly explains most of the success," Micali told Psychiatric News. "We have good treatments for OCD. We know that if carried out well, CBT can be very successful. It can also be augmented with SSRIs."

The researchers also found that subjects who had particularly severe OCD at baseline were more likely to still have it five years later.

Even though a majority of subjects—59 percent—were free of OCD at follow-up, a substantial number (40 percent) had another psychiatric disorder at this point. The most common diagnoses were generalized anxiety disorder (25 percent), a depressive disorder (16 percent), or a tic disorder (16 percent).

The study was funded by the South London and Maudsley NHS Foundation Trust.

An abstract of "Long-Term Outcomes of Obsessive-Compulsive Disorder: Follow-Up of 142 Children and Adolescents" is posted at <http://bjp.rcpsych.org/cgi/content/abstract/197/2/128>.


Worry about taking tests is common among college students, so what can students do to deal with such angst?

Two things, a study published in the September Behavior Research and Therapy suggested. It was conducted by Kate Wolitzky-Taylor, a doctoral student in psychology, and Michael Telch, Ph.D., a professor of psychology, at the University of Texas, Austin.

One is to employ a technique called worry exposure (WE), which consists of individuals visualizing themselves in test-taking situations until distress over them eases. The other is for the students to expose themselves to a pulsed audio-photic stimulation (APS) device to achieve relaxation. APS devices—about the size of an iPod—can be purchased on the Internet.

The study included 113 college students experiencing clinically significant test worry. They were randomized to four interventions: WE, APS, expressive writing about their test worries, or a wait-list control group. Subjects were instructed to practice their interventions three times a week for a month. Test worry and general anxiety were evaluated at baseline and after the interventions. Subjects in the WE and APS groups showed significantly greater improvement than did subjects in the other two groups.

The study was funded by the National Institute of Mental Health.

An abstract of "Efficacy of Self-Administered Treatments for Pathological Academic Worry: A Randomized Controlled Trial" can be accessed at <www.science-direct.com/science/journal/00057967> by clicking on the September issue.blacksquare

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