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Published Online: 1 January 2010

Genetics, PTSD Research Featured in AACAP Posters

Abstract

Research presented as posters at the recent AACAP annual meeting discusses MRIs that may suggest early brain changes in autistic children and shows that poor families hesitate to follow up on mental health care referrals, among other topics.
Here is a not-so-random sampling of posters from the recent annual meeting of the American Academy of Child and Adolescent Psychiatry:
•. 
A study of 705 mother-child pairs in Australia found that children of mothers who have posttraumatic stress disorder (PTSD) are at increased risk for major depression by age 15—but only male children, said researchers from Emory University, UCLA, and Australia's University of Queensland.
Also, serotonin transporter polymorphisms did not affect the positive association between maternal PTSD status and children's depression at age 15, but did so at age 20, except among children with the l/l allele.
The processes producing this effect are unknown, but may be social or biological, possibly through HPA-axis dysregulation, said the researchers.
Prior investigation by the same group suggested that mothers with PTSD who also were exposed to trauma as children tended to produce offspring who showed a hyperreactive cortisol response to stress. “Hyper-responsiveness to stress can in turn place the offspring at risk for future episodes of major depression,” they said.
Source: Sarah Brand, Emory University, [email protected]
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Inner-city minority families have low rates of mental health service utilization, variously attributed to practical or intangible barriers. To better understand these problems, Johns Hopkins researchers surveyed parents of children referred from a pediatric primary care clinic to a community-based mental health center in Baltimore.
Intangible barriers (like the acceptability of mental health care, perceptions of stigma, or mistrust of mental health providers) were more significant than tangible ones (such as inconvenience involved in making visits) in explaining who attends a mental health evaluation, said the researchers. Also, parents who were most distressed by their child's emotions or behavior tended to overcome barriers and bring their child in for evaluation.
If pediatricians can better assess barriers likely to keep patients from following up on mental health referrals, they may be able to improve parents' readiness to follow through, said the researchers.
Source: Justine Larson, Division of Child and Adolescent Psychiatry, Johns Hopkins University, [email protected]
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Brown University researchers interviewed 16 psychiatric geneticists at six institutions around the United States and found broad agreement that the most important discoveries in psychiatric genetics so far are the heritability or familiality of psychiatric disorders and the fact that psychiatric genetics has moved away from a Mendelian model toward a polygenic one in which multiple genes exert small effects that add up to symptoms and disorders.
Tests for treatment response to psychiatric drugs will be the first genetic tools available, said the scientists surveyed. The behavioral geneticists among the survey respondents emphasized the mutual influences of environment and gene expression on each other.
Finally, survey participants viewed the future of psychiatry from two different perspectives. Researchers without M.D. degrees generally believed that genetic markers will eventually explain and define mental disorders. All the clinical researchers said that they expect continued collaboration but no merger with neurology.
The authors next hope to survey clinicians to assess their views on genetics and their readiness to cope with advances in the field.
Source: Jeffery Hunt, M.D., Brown University Warren Alpert School of Medicine
•. 
Magnetic resonance imaging (MRI) of the brain is not used to diagnose autism spectrum disorders, but a retrospective study of 244 subjects of other research reveals some incidental findings that suggest new avenues of autism research, according to University of Connecticut medical student Emily Allen.
Allen and two colleagues reviewed the MRIs of 44 subjects with autism spectrum disorders (ASDs), 120 with other neuropsychiatric disorders, and 80 healthy controls. Differences between the ASD group and the healthy controls appeared as an enlarged cisterna magna (p=.082) and as a partially empty sella (p=.041).
An empty sella is filled with cerebrospinal fluid and may be due to various pathological processes, including hormonal deficiencies, which were absent in this sample. The cisterna magna develops at eight weeks postovulation, so the data in ASD subjects “suggest that atypical brain development may be present during the fetal period and may begin as early as the second month of fetal life,” they said.
Source: Emily Allen, [email protected]

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Go to Psychiatric News
Psychiatric News
Pages: 17 - 20

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Published online: 1 January 2010
Published in print: January 1, 2010

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