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The British Journal of Psychiatry (2003) 182: 518-524
© 2003 The Royal College of Psychiatrists

Morphology of the anterior cingulate cortex in young men at ultra-high risk of developing a psychotic illness

MURAT YÜCEL, PhD

Department of Psychiatry and ORYGEN Research Centre, University of Melbourne, and Mental Health Research Institute, Parkville, Victoria

STEPHEN J. WOOD, PhD

Department of Psychiatry, University of Melbourne, and Brain Research Institute,Victoria

LISA J. PHILLIPS, MPsych(Clin)

ORYGEN Research Centre, PACE Clinic and Department of Psychiatry, University of Melbourne

GEOFFREY W. STUART, PhD

Department of Psychiatry, University of Melbourne, and Mental Health Research Institute, Parkville, Victoria

DEIDRE J. SMITH, GradDipAdolPsych and ALISON YUNG, FRANZCP

ORYGEN Research Centre, PACE Clinic and Department of Psychiatry, University of Melbourne

DENNIS VELAKOULIS, FRANZCP

Department of Psychiatry, University of Melbourne, and Mental Health Research Institute, Parkville, Victoria

PATRICK D. McGORRY, FRANZCP

ORYGEN Research Centre, PACE Clinic and Department of Psychiatry, University of Melbourne

CHRISTOS PANTELIS, MRCPsych, FRANZCP

Department of Psychiatry and Centre for Neuroscience, University of Melbourne, and Mental Health Research Institute, Parkville, Victoria, Australia

Correspondence: Dr Murat Yücel, Cognitive Neuropsychiatry Unit, c/o Mental Health Research Institute, 155 Oak Street (Locked Bag 11), Parkville, Victoria, Australia 3052. Tel: 3 9388 1633; fax: 3 9387 5061; e-mail: murat.yucel{at}wh.org.au

Declaration of interest P.D.M.'s group is receiving support from Janssen—Cilag for an intervention study in the ultra-high-risk group. Funding detailed in Acknowledgements.

Background The anterior cingulate cortex (ACC) is consistently implicated in the pathophysiology of schizophrenia, and our own work has identified morphological anomalies in the ACC of people witht his disorder.

Aims To examine whether ACC morphological anomalies are present in a group at ultra-high risk of psychosis and whether such anomalies can be used to predict the subsequent development of a psychotic illness.

Method Magnetic resonance imaging of 75 healthy volunteers and 63 people at ultra-high risk of developing a psychotic disorder (all right-handed males) was used to examine ACC sulcal and gyral features.

Results Compared with the controls, significantly fewer people in the ultra-high risk group had a well-developed left paracingulate sulcus and significantly more had an interrupted left cingulate sulcus. There was no difference between those who did (n=21) and did not (n=42) subsequently develop a psychotic illness.

Conclusions Although ACC anomalies are present in young people considered to be at ultra-high risk of psychosis, they do not identify individuals who subsequently make the transition to psychosis.

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