The Origins of Depression: Current Concepts and Approaches: Report of the Dahlem Workshop on The Origins of Depression: Current Concepts and Approaches Berlin 1982, Oct.31 – Nov. 5

470 Pages·1983·8.795 MB·English

by  J. Angst (auth.), J. Angst (eds.)

Dahlem Workshop Reports
Life Sciences Research Report 26
The Origins of Depression:
Current Concepts and Approaches
The goal of this Dahlem Workshop is:
to review current concepts and integrate approaches
to the origins of depression
Life Sciences Research Reports
Editor: Silke Bernhard
Held and published on behalf of the
Stifterverband fUr die Deutsche Wissenschaft
Sponsored by:
Breuninger Stiftung GmbH
Senat der Stadt Berlin
The Origins of Depression:
Current Concepts and
Approaches
J. Angst, Editor
Report of the Dahlem Workshop on
The Origins of Depression:
Current Concepts and Approaches
Berlin 1982, Oct. 31 - Nov. 5
Rapporteurs:
S. A Checkley . H. Katschnig . W. Z. Potter' M. L. Reite
AJ. Rush
Program Advisory Committee:
J. Angst, Chairperson' A Carlsson· B. J. Carroll
H. Helmchen . A. Herz . G. L. Klerman . W. T. McKinney
Springer-Verlag
Berlin Heidelberg New York Tokyo 1983
Copy Editors: M. A. Cervantes-Waldmann, M. Grunwald, K McWhirter
Photographs: E. P.Thonke
With 4 photographs, 12 figures, and 27 tables
ISBN-13: 978-3-642-69131-7 e-ISBN-13: 978-3-642-69129-4
DO I: 10.1007/ 978-3-642-69129-4
CIP-Kurztitelaufnahme der Deutschen Bibliothek:
The origins of depression: current concepts and approaches: report of the Dahlem
Workshop on the Origins of Depression, Bertin, 1982, Oct. 31 - Nov. 51 J. Angst, ed.
Rapporteurs: S. A. Checkley ...
[Dahlem Konferenzen. Held and pub!, on behalf of the Stifterverb. fur d. Dt. Wiss.
Sponsored by: Breuninger-Stiftung GmbH; Senat d. Stadt Berlin]. - Berlin; Heidelberg;
New York; Tokyo: Springer, 1983
(Life sciences research report; 26)
(Dahlem Workshop reports)
NE: Angst, Jules [Hrsg.]; Checkley, Stuart A. [Mitverf.]; Workshop on the Origins of
Depression <1982, Berlin, West>; Dahlem Konferenzen; 1. GT
This work is subject to copyright. All rights are reserved, whether the whole or part of
the material is concerned, specifically those of translation, reprinting, re-use of
illustrations, broadcasting, reproduction by photocopying machine or similar means,
and storage in data banks. Under § 54 of the German Copyright Law, where copies
are made for other than private use, a fee is payable to "Verwertungsgesellschaft
Wort", Munchen.
© Dr. S. Bernhard, Dahlem Konferenzen, Berlin 1983
Softcover reprint of the hardcover 18t edition 1983
The use of registered names, trademarks, etc. in this publication does not imply,
even in the absence of a specific statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general use.
2131/3014-543210
TABLE OF CONTENTS
The Dahlem Konferenzen
S. Bernhard IX
Introduction
J. Angst
The Scope of Depression
G.L. Klerman 5
The Epidemiology of Bipolar and Nonbipolar Depression:
Rates and Risks
M.M. Weissman and J.H. Boyd 27
Depression and Affective Disorder in Later Life
M. Roth 39
Gender and Depression
P.J. Clayton 77
Recent Life Events and Depression
E.S. Paykel 91
Vulnerability to Depression: The Lack of Social Support Does
Not Cause Depression
A.S. Henderson 107
Stress, Conflict, and Depression
R.J. Katz 121
Separation Models and Depression
G. W. Kraemer, M.H. Ebert, and W. T. McKinney 133
Learned Helplessness - An Animal Model Revisited
D. Hellhammer 147
vi Table of Contents
Neurobiologic Dimensions of Depression and Mania
B.J. Carroll 163
Current Status of Genetic Research in Affective Disorders
E.S. Gershon, J.I. Nurnberger, Jr., N.S. Nadi, W.H. Berrittini,
and L.R. Goldin 187
Neuroendocrine Function in Depression
R. T. Rubin and R.E. Poland 205
Opioid Systems and the Regulation of Mood:
Possible Significance in Depression?
A. Herz and H.M. Emrich 221
Neurophysiologic Studies of Depression:
State of the Art
D.J. Kupfer and C.F. Reynolds 235
Chronobiology of Depression
D. von Zerssen 253
New Research Techniques for Studying the Functional Anatomy
of Depression
M.S. Buchsbaum and H.H. Holcomb 273
Depression and Altered Neurotransmission - States, Traits,
and Interactions
H. Agren 297
Pharmacological Models of Depression
R.D. Porsolt 313
Heuristically Important Mood-altering Drugs
P.1. McGrath and D.F. Klein 331
Mode of Action of Antidepressant Drugs - Primary Effects
A. Delini-Stula 351
Table of Contents VB
Mode of Action of Antidepressant Agents and ECT -
Adaptive Changes After Subchronic Treatment
T.H. Svensson 367
Risk Factors
Group Report
H. Katschnig, Rapporteur
I. Angst, P.J. Clayton, E.S. Gershon, M. Hautzinger, H. Helmchen,
A.S. Henderson, G.L. Klerman, H.-I. Moller, E.S. Paykel, M. Roth,
M.M. Weissman 385
Animal Models
Group Report
M.L. Reite, Rapporteur
T.F. Anders, W. Greil, D. Hellhammer, F.A. Henn, R.I. Katz,
I.e. Kaufman, G. W. Kraemer, M. Linden, M.T. McGuire,
W. T. McKinney, G. Nissen, R.D. Porsolt 405
Functional Indices of Biological Disturbance
Group Report
S.A. Checkley and A.I. Rush, Rapporteurs
H. Beckmann, M.S. Buchsbaum, B.J. Carroll, 1.F. Greden, H. Heimann,
F. Holsboer, D.J. Kupfer, N. Matussek, 1.A.A. Risberg, R. T. Rubin,
T. Wehr, D. von Zerssen 425
N eurotransmission
Group Report
w.z. Potter, Rapporteur
H. Agren, A. Carlsson, R. W. Cowdry, A. Delini-Stula, H.M. Emrich,
A. Herz, W. Kehr, D.F. Klein, I. Maj, T.H. Svensson 447
List of Participants 458
Subject Index 463
Author Index 472
THE DAHLEM KONFERENZEN
S. Bernhard
Dahlem Konferenzen
Wallotstra8e 19
1000 Berlin 33, F. R. Germany
FOUNDATION
Dahlem Konferenzen was founded in 1974 and is supported by the Stifterverband fUr
die Deutsche Wissenschaft*, in cooperation with the Deutsche Forschungsgemein
schaft** and the Senat of the City of Berlin.
OBJECTIVES
The task of Dahlem Konferenzen is:
to promote the interdisciplinary exchange of scientific information and ideas,
to stimulate international cooperation in research, and
to develop and test different models conducive to more effective scientific meetings.
AIM
Each Dahlem Workshop is designed to provide a survey of the present state of the art
of the topic at hand as seen by the various disciplines concerned, to review n.ew concepts
and techniques, and to recommend directions for future research.
TOPICS
The workshop topics should be:
of contemporary international interest,
timely,
interdisciplinary in nature, and
problem-oriented.
* The Donors Association for the Promotion of Sciences and Humanities
** German Science Foundation
x The Dahlem Konferenzen
PROCEDURE
Dahlem Konferenzen approaches internationally recognized scientists to suggest topics
fulfilling these criteria and to propose members for a Program Advisory Committee
which is responsible for the workshop's scientific program. Once a year, the topic sug
gestions are submitted to a scientific board for approval.
P ARTICIP ANTS
The number of participants is limited to 48 for each workshop. They are selected exclu
sively by a Program Advisory Committee. Selection is based on international scientific
reputation alone and is independent of national considerations, although a balance be
tween Europeans and Americans is desirable. Exception is made for younger German
scientists for whom 10% of the places are reserved.
THE DAHLEM WORKSHOP MODEL
A special workshop model has been developed by Dahlem Konferenzen, the Dahlem
Workshop Model. The main work of the workshop is done in four small, inter
disciplinary discussion groups, each with 12 members. Lectures are not given.
Some participants are asked to write background papers providing a review of the field
rather than a report on individual work. These are circulated to all participants 4 weeks
before the meeting with the request that the papers be read and questions on them for
mulated before the workshop, thus providing the basis for discussions.
During the workshop, each group prepares a report reflecting the essential points of its
discussions, including suggestions for future research needs. These reports are distribut
ed to all participants at the end of the workshop and are discussed in plenum.
PUBLICATION
The Dahlem Workshop Reports contain:
the Chairperson's introduction,
the Background Papers, and
the Group Reports.
The Dahlem Workshop Reports are available in two series:
I) Life Sciences Research Reports (LS) and
2) Physical, Chemical, and Earth Sciences Research Reports (PC).
The Origins of Depression: Current Concepts and Approaches, ed. 1. Angst, pp. 1-3
Dahlem Konferenzen 1983. Berlin, Heidelberg, New York, Tokyo: Springer-Verlag.
INTRODUCTION
J. Angst
Psychiatrische Universitatsklinik
8029 Zurich 8, Switzerland
This report reviews comprehensively our knowledge of the origins of depres
sion. It presents a highly critical assessment of methodology and findings, re
sulting in the refutation of many prevailing beliefs and well-known hypoth
eses. The result is not destructive, but does away with commonly held as
sumptions and remnants of outdated scientific theories. Thus a more solid ba
sis for new research has been founded.
In this volume the term "depression" denotes a clinical syndrome or state and
does not refer to normal mood or depression as a symptom within other psy
chiatric syndromes. Depression as a disorder occurs in all cultures and has a
high lifetime prevalence of at least several percent, usually with a preponder
ance of females. Linked with tremendous suffering, social impairment, and
suicide, depression is a major problem of psychiatry. Since the introduction of
tricyclic compounds and MAO inhibitors in 1958, much research has been ini
tiated. Considering the wide variety of approaches with conflicting concepts
and models, this Dahlem Workshop concentrating solely on discussion pro
vided a unique opportunity to obtain some overview of the state of the art in
this field and the future perspectives.
An initial hope had been to base the discussion on causal models already
developed, but a certain lack of conceptualization and models proved to be
still present. The even higher goal, to arrive at integrated interdisciplinary
causal models based on dynamic functional systems instead of thinking in
simple, linear causal relationships, was approached in a few aspects only.
Nevertheless, the workshop turned out to be extremely fruitful.