Table Of ContentBIOLOGY OF
DEPRESSIVE DISORDERS
Part A
A Systems Perspective
THE DEPRESSIVE ILLNESS SERIES
Series Editor: J. John Mann, M.D.
Laboratories of Neuropharmacology
Department of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Volume 1 PHENOMENOLOGY OF DEPRESSIVE ILLNESS
Edited by J. John Mann, M. D.
Volume 2 MODELS OF DEPRESSIVE DISORDERS
Psychological, Biological, and Genetic Perspectives
Edited by J. John Mann, M. D.
Volume 3 BIOLOGY OF DEPRESSIVE DISORDERS
Part A: A Systems Perspective
Edited by J. John Mann, M.D.,
and David J. Kupfer, M. D.
Volume 4 BIOLOGY OF DEPRESSIVE DISORDERS
Part B: Subtypes of Depression and Comorbid Disorders
Edited by J. John Mann, M. D.,
and David J. Kupfer, M. D.
BIOLOGY OF
DEPRESSIVE DISORDERS
Part A
A Systems Perspective
Edited by
J. John Mann, M.D.
and
David j. Kupfer, M.D.
University of Pittsburgh
Pittsburgh, Pennsylvania
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging in Publication Data
Biology of depressive disorders / edited by J. John Mann and David J. Kupfer.
p. cm.-(The Depressive illness series; v. 3-4)
lncludes bibliographical references and index.
Contents: Pt. A. A systems perspective-pt. B. Subtypes of depression and
comorbid disorders.
ISBN 978-1-4757-9500-4 ISBN 978-1-4757-9498-4 (eBook)
DOI 10.1007/978-1-4757-9498-4
1. Depression, Mental-Physiological aspects. 1. Mann, J. John (Joseph John)
Il. Kupfer, David J. date. III. Series IDNLM: 1. Depressive Disorder-diagnosis.
2. Diagnosis, Differentia!. 3. Psychology, Clinica!. W1 DE467p v. 3-4 / WM
171 B61531993J
RC537.B49951993
616.85 '27-dc20
DNLM/DLC 92-48362
for Library of Congress CIP
ISBN 978-1-4757-9500-4
© 1993 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1993
Softcover reprint of the hardcover 1s t edition 1993
AH rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
CONTRIBUTORS
Wade H. Berrettini • Department of Psychiatry and Human Behav
ior, Jefferson Medical College, Philadelphia, Pennsylvania 19107
Daniel}. Buysse • Department of Psychiatry, University of Pittsburgh
School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh,
Pennsylvania 15213
Sanjay Oube • Mood Disorders Module, Western Psychiatric Insti
tute and Clinic, Pittsburgh, Pennsylvania 15213
Fred Crossmar • Section on Clinical Pharmacology, Experimental
Therapeutic Branch, National Institute of Mental Health, Bethesda,
Maryland 20892
Roger F. Haskett • Department of Psychiatry, University of Pittsburgh
School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh,
Pennsylvania 15213-2593
William Hendrickse • Veterans Affairs Medical Center and Depart
ment of Psychiatry, University of Texas Southwestern Medical School,
Dallas, Texas 75216
Gerald L. Kramer • Veterans Affairs Medical Center and Department
of Psychiatry, University of Texas Southwestern Medical School, Dallas,
Texas 75216
David}. Kupfer • Department of Psychiatry, University of Pittsburgh
School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh,
Pennsylvania 15213
v
vi CONTRIBUTORS
Kevin Malone • Laboratories of Neuropharmacology, Western Psy
chiatric Institute and Clinic, Department of Psychiatry, University of
Pittsburgh, Pittsburgh, Pennsylvania 15213
}. john Mann • Laboratories of Neuropharmacology, Western Psychi
atric Institute and Clinic, Department of Psychiatry, University of Pitts
burgh, Pittsburgh, Pennsylvania 15213
Timothy H. Monk • Human Chronobiology Program, University of
Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,
Pittsburgh, Pennsylvania 15213
Frederick Petty • Veterans Affairs Medical Center and Department of
Psychiatry, University of Texas Southwestern Medical School, Dallas,
Texas 75216
William Z. Potter • Section on Clinical Pharmacology, Experimental
Therapeutic Branch, National Institute of Mental Health, Bethesda,
Maryland 20892
lsak Prohovnik • Departments of Biological Psychiatry and Brain Im
aging, New York State Psychiatric Institute and Department of Psychia
try, Columbia University, New York, New York 10032
Matthew V. Rudorfer • Section on Clinical Pharmacology, Experimen
tal Therapeutic Branch, National Institute of Mental Health, Bethesda,
Maryland 20892
Harold A Sackeim • Departments of Biological Psychiatry and Brain
Imaging, New York State Psychiatric Institute and Department of Psy
chiatry, Columbia University, New York, New York 10032
Andrew Winokur • Department of Psychiatry, University of Pennsyl
vania, Philadelphia, Pennsylvania 19104
PREFACE
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. It is essential to
distinguish features related to a constitutional predisposition to affec
tive disorders from the pathophysiologic changes associated with af
fective disorders and from the secondary effects of treatment and illness.
This ambitious approach has required the contributors to be forthcom
ing about areas where knowledge is lacking as well as introducing
the reader systematically to currently available information. These vol
umes should therefore be of value to researchers, psychiatrists in train-
vii
viii PREFACE
ing, and clinical practitioners who share a common interest in the scien
tific basis of psychiatry.
J. John Mann, M.D.
David J. Kupfer, M.D.
Pittsburgh, Pennsylvania
ACKNOWLEDGMENTS
This volume was made possible by the support of our wives and chil
dren, who permitted us the time to work on it. Ms. Jean Williams
assisted in the preparation of the manuscript and the organization of the
project. Our editor at Plenum Press, Norma Fox, showed great patience
and was a valuable source of encouragement throughout the process of
completing this volume. The contributing authors to this volume are
really the reason for its value and quality, and to them go our thanks and
acknowledgment.
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