Depressive Illness Series – serie

This volume is the third in a series on depressive illness. The first volume, entitled Phenomenology of Depressive Illness, is devoted to a de­ scription of depressive illness from a variety of perspectives that include those of the patient, the clinician, and the psychiatric researcher. It de­ scribes the major subtypes of depressive illness and places them in the context of the life cycle. The second volume in this series is entitled Models of Depres­ sive Disorders: Psychological, Biological, and Genetic Perspectives. This volume describes several major models of depressive disorders, in­ cluding genetic, cognitive, interpersonal, intrapsychic, and neurobio­ logical models. The third and fourth volumes deal with the biology of affective disorders in detail. These volumes are distinguished by a triaxial ap­ proach. In Volume III the biology of affective disorders is described from the perspective of individual transmitter systems and neurophysi­ ologic and biologic processes. In Volume IV the biology of depression is addressed from the vantage point of symptom components of de­ pression, and similarities and differences in the biology of depression are described compared to other psychiatric disorders with clinically overlapping features such as anxiety disorders or eating disorders. The effects on biology of comorbid conditions such as anxiety, personal­ ity disorders, alcoholism, and eating disorders are reviewed. These ap­ proaches incorporate issues of state versus trait.

This volume is the fourth in a series on depressive illness. The first volume, entitled Phenomenology of Depressive Illness, is devoted to a de- scription of depressive illness from a variety of perspectives that include that of the patient, the clinician, and the psychiatric researcher. It de- scribes the major subtypes of depressive illness and places them in the context of the life cycle. The second volume in this series is entitled Models of Depres- sive Disorders: Psychological, Biological, and Genetic Perspectives. This volume describes several major models of depressive disorders, in- cluding genetic, cognitive, interpersonal, intrapsychic, and neurobio- logical models. The third and fourth volumes deal with the biology of affective disorders in detail. These volumes are distinguished by a triaxial ap- proach. In Volume III the biology of affective disorders is described from the perspective of individual transmitter systems and neurophysio- logic and biologic processes.In Volume IV the biology of depression is addressed from the vantage point of symptom components of de- pression, and similarities and differences in the biology of depression are described compared to other psychiatric disorders with clini- cally overlapping features such as anxiety disorders or eating disor- ders. The effects on biology of comorbid conditions such as anxiety, personality disorders, alcoholism, and eating disorders are reviewed.

This volume is the second in a series on depressive illness. The first volume, entitled Phenomenology of Depressive Illness, is de­ voted to a description of depressive illness from many vantage points including that of the patient as well as the psychiatrist. Epidemiological, nosological, and developmental aspects are included together with specific descriptions of major subtypes of depressive illness. It is only after an illness is fully described that an attempt should be made to generate models with ex­ planatory and predictive properties. This second volume is that next step. The major models of depressive illness are described. The limited progress that has been made in integrating these models is discussed, but with further knowledge, this will change. Each model has different advantages and may apply more directly to different subtypes of depressive illness. Such refinements also await the results of future studies. However, the heuristic and clinical usefulness of the models described is considerable and will inform the reader about the current state of knowledge regarding the etiology and pathogenesis of de­ pressive illness and directions of future research. J. John Mann, M.D. New York vii ACKNOWLEDGMENTS This volume would not have been possible without the support of my wife and children who permitted me the time to work on it. Ms. Renee Azima-Heller assisted greatly in the organi­ zation of the material for the book. A career scientist award from the Irma T. HirschI Trust provided support for this work.

In Volume IV the biology of depression is addressed from the vantage point of symptom components of de­ pression, and similarities and differences in the biology of depression are described compared to other psychiatric disorders with clinically overlapping features such as anxiety disorders or eating disorders.