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This Week in Psychiatry – 3/7/11

March 7, 2011

Maternal History of Alzheimer’s Disease Could Determine Risk

The authors of a recent Neurology study examined whether cognitively healthy patients with a family history of Alzheimer’s disease would have less gray matter volume (GMV) and if those differences in GMV reflect family history. Subjects included 67 cognitively intact patients >60 years of age with 1 first-degree maternal relative with an onset of dementia between 60–80 years of age. Sixteen patients had a paternal history of Alzheimer’s disease, 8 had no paternal history, and 43 had no parental history at all. Subjects with a maternal history of Alzheimer’s disease had lower GMV in those brain regions most vulnerable to Alzheimer’s disease—the prefrontal cortices (Brodmann area 45, 46, and 47) and the precuneus. Subjects in the paternal history group did not have any GMV decreases.

Metacognitive Training for Cognitive Symptoms in Schizophrenia

Previous studies have validated the association of a jumping-to-conclusions bias with schizophrenia. A Behaviour Research and Therapy study assessed the effect of metacognitive training (MCT)—a group treatment—for jumping to conclusions and other schizophrenia- related cognitive biases. Subjects with subacute or remitted schizophrenia were randomized to MCT or treatment as usual. Delusion distress, and memory and social skills were significantly reduced in the MCT group compared to treatment as usual, and the incidence of jumping to conclusions decreased in the MCT group.

Patients Weigh In On Quality of PCP Care for Anxiety Disorders

Quality pharmacologic or psychosocial care for anxiety disorders is not common in primary care settings, according to a Journal of Clinical Psychiatry study. A sample of 1,004 patients with an anxiety disorder was surveyed. Of the initial sample, 576 patients (57.4%) had received an indicated anxiolytic during the previous 6 months. As for psychosocial treatment, only 213 patients (21.2%) received strong counseling, defined as including ≥3 elements of CBT, and 81 patients (8.1%) received both quality pharmacotherapy and psychotherapy. Receiving quality psychosocial treatment was the only positive predictor of patient satisfaction for anxiety disorder treatment in this survey.

This Week in Psychiatry is written by Lonnie Stoltzfoos

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