Dear colleagues,
I am delighted to introduce to you our first issue of 2015 focusing on characteristics and treatment options of psychotic disorders and research on non-invasive brain stimulation treatments.
In his 2013 Anna-Monika Award Lecture, Alan F. Schatzberg reviews the role of the hypothalamic-pituitary-adrenal (HPA) axis in the pathogenesis of psychotic major depression. He received the prize for his outstanding research into new therapy approaches, especially for the treatment of delusional depression. In this review Schatzberg discusses current results on clinical phenomenology, HPA axis acitivity and genetics as well as trials on the glucocorticoid receptor antagonist mifepristone. He concludes with an emphasis on a major role of HPA over-activity in the pathogenesis and on being a target of drug development.
In a 3-year follow-up study, van Tricht and colleagues investigated sensory gating deficits in subjects at ultra high risk for psychosis before and after transition to a first psychotic episode. P50, N100 (N1) and P200 (P2) sensory gating was established using a paired click paradigm. N1 difference scores contributed modestly to the prediction of a first psychotic episode. In addition, N1 and P2 sensory gating measures also showed alterations between the prodromal phase and the first psychosis, suggesting that these changes may relate to psychotic onset.
Schwarz and co-workers assessed whether serum molecules measured before treatment initiation were associated with subsequent weight gain following a 6-week treatment with antipsychotics in schizophrenia patients. Their results suggest that patients who experience antipsychotic-induced weight gain have specific molecular alterations already prior to treatment.
Using diffusion tensor imaging (DTI), Wigand and colleagues examined microstructural properties of the interhemispheric auditory pathway in chronic schizophrenia. Streamline tractography was applied to both patients with a history of auditory verbal hallucinations and those without. The authors found decreased fibre integrity at different parts of the tract in patients with lifetime auditory verbal hallucinations.
Fonseka and co-workers investigated whether variants in the genes encoding interleukin (IL)-1β, IL-2, and IL-6, and brain-derived neurotrophic factor (BDNF) Val66Met are associated with antipsychotic-induced weight gain in schizophrenia patients. Results suggest that SNPs across IL-1β and BDNF Val66Met may influence weight gain due to antipsychotic treatment.
Introducing our second topic, Prasser and colleagues tested the safety and therapeutic efficacy of bilateral theta-burst stimulation (TBS) as an add-on therapy to standard treatment of depression. The authors found a tendency towards a superior effect of bilateral TBS of the dorsolateral-prefrontal cortex (dlPFC) at the end of the follow-up period over transcranial magnetic stimulation sham.
In a brief report, Girardi and colleagues investigated the efficacy of add-on bilateral prefrontal high-frequency deep TMS (dTMS) compared to standard drug treatment in patients with comorbid dysthymic disorder (DD) and alcohol use disorder (AUD). Results show that craving scores and depressive symptoms dropped more in patients who had received high frequency bilateral dlPFC as compared to the standard treatment group and that dTMS was well tolerated as add-on therapy.
Yours sincerely,
Siegfried Kasper, MD
Chief Editor