Familial Depression -- Researchers Look at the Genetic Links between Family Members And Depression Peoria Journal Star - October 02, 2002 Speaking by telephone, through his new, artificial voice box, Dr. Ted Reich isn't the easiest person to understand. He had surgery to remove his larynx a few months ago. But two points come through perfectly clear. The first: "Severe depression is a crippling disease
, it's good for no one and for nothing." The second: "The problem with the drugs used to treat it is they're only 60 percent effective." [Fred A. Baughman Jr., MD:
Dr. Reich, a professor of psychiatry and genetics [Fred A. Baughman Jr., MD:
at Washington University in St. Louis, is among the early researchers to seriously look into the biochemistry of mental illness [Fred A. Baughman Jr., MD:
, work that helped refine the development of anti-depressants and anti-psychotic medications, and, more importantly, raised new questions about why psychiatric illnesses seemed to run in some families and not in others. [Fred A. Baughman Jr., MD:
His passion [Fred A. Baughman Jr., MD:
for finding better drugs to treat depression, and possibly prevent it, filters through the telephone line, despite the static in his voice. When he got interested in the links between genetics and mental disorders more than 30 years ago [Fred A. Baughman Jr., MD:
, psychiatry was still following Freud's footsteps, blaming mental illness on overbearing mothers and a dysfunctional family life. "Of course, there's been a revolution in thinking since then," he says. "Culture is still important, environment is still important, but biology is just as important [Fred A. Baughman Jr., MD:
. It's not an either-or question, we're trying to figure it all out." With assistance from the blueprint laid out in the Human Genome Project, Dr. Reich could help re-revolutionize the revolution. He is the leader, and Washington University is the only U.S. site, of a large-scale depression research study of families where at least two siblings have suffered from severe depression. By conducting detailed histories, interviews and DNA analysis of members of about 500 families in the United States and Europe, Dr. Reich and his team of geneticists hope to find the specific genes that increase - or decrease - the likelihood of depression [Fred A. Baughman Jr., MD: this is an
. Exactly how is clinical depression, or a susceptibility to it, inherited, like brown eyes, red hair, or big feet? It's a million- dollar question in psychiatry, with the possibility of billion- dollar answers. "We know there's a link, but we haven't done the mapping studies yet to find out which genes are involved," Dr. Reich says [Fred A. Baughman Jr., MD:
. Funded by British pharmaceutical giant, GlaxoSmithKline, the results would be used by the company's research and development to develop new medications. Scientists, and pharmaceutical companies with an eye on profits, have studied, researched and debated the connection between biology and mental illness for more than 20 years. But none of the work has led to comprehensive, conclusive answers. The problem is depression is a very complicated disease "and human behavior is just so darn complex" says Dr. Peter Alahi, co- director of the Anxiety and Mood Disorder Clinic at the University of Illinois College of Medicine at Peoria. "No two depressions are the same." [Fred A. Baughman Jr., MD:
Finding a pure sample, that is, families where siblings have been diagnosed with the same form of depression, has been one of the challenges of study. [Fred A. Baughman Jr., MD:
The study focuses strictly on families with a history of major clinical depression [Fred A. Baughman Jr., MD:
, sometimes referred to as unipolar depression [Fred A. Baughman Jr., MD:
. But the larger the family, the larger the likelihood of family members with other types of depression, such as schizophrenia or manic-depressive disorder. Additionally, many people with clinical depression have never been diagnosed or treated. About 500 families, including about 95 in the United States are currently enrolled in the study. Unlike clinical research trials, participants are not asked to take medications. [Fred A. Baughman Jr., MD:
The biggest risk of participating in a study like this is the fear of telling or learning family secrets, Dr. Reich says. But the project is set up to maintain strict confidentiality and anonymity. Records are kept under lock and key, all data is handled anonymously. Even family members aren't told what another family member said. The project also has a certificate of confidentiality, issued by the federal government, which prevents information from being subpoenaed. "We'd destroy the data before we'd give it out," Dr. Reich says. (C) 2002 Peoria Journal Star |
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