In This Issue

Attention deficit hyperactivity disorder (ADHD) is associated with diminished cortical thinning during adolescence. Many children who do not meet full diagnostic criteria for ADHD nevertheless have some hyperactive and impulsive symptoms. Shaw et al. (CME, p. 143) report that cortical thinning during late childhood and adolescence was fastest in youth with no hyperactive/impulsive symptoms, and the rate slowed progressively with increasing symptom levels (figure). The areas affected were predominantly prefrontal regions. In an editorial (p. 111), Klein suggests that these data provide further evidence that ADHD symptoms, even at levels below full diagnostic criteria, are associated with abnormalities in brain development.

The interplay between schizophrenia and substance use disorders was revealed by patients' electronic self-reports four times a day. Swendsen et al. (CME, p. 202) supplied patients with personal digital assistants, which prompted them to record symptoms, stress, and substance use. The pattern of alcohol use suggested self-medication, often following but not preceding symptom increases. Use of cannabis or other illicit substances had a bidirectional pattern: following negative states but also preceding increases in psychotic symptoms. In their editorial, Csernansky and Smith (p. 120) welcome ambulatory monitoring as a way for patients to reveal their experiences.