Looking forward in geriatric anxiety and depression: implications of basic science for the future

Howard K Gershenfeld; Robert A Philibert; Gary W Boehm

doi:10.1097/00019442-200512000-00002

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Looking forward in geriatric anxiety and depression: implications of basic science for the future

Journal article

Peer reviewed

Looking forward in geriatric anxiety and depression: implications of basic science for the future

Howard K Gershenfeld, Robert A Philibert and Gary W Boehm

The American journal of geriatric psychiatry, Vol.13(12), pp.1027-1040

12/2005

DOI: 10.1097/00019442-200512000-00002

PMID: 16319295

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Abstract

Major depression and anxiety are common psychiatric illnesses whose etiology remains incompletely understood. This review highlights progress in understanding the etiology of these illnesses through genetic strategies and looks forward to their impact on geriatric psychiatry. We briefly address three broad domains of progress, namely 1) genetic approaches to etiology, including linkage and association studies, pharmacogenetics ("personalized medicine"), and gene x environment interactions; 2) mechanisms of thyroid and testosterone action via nuclear receptors, given these hormones' status as possible augmenters of antidepressants; and 3) the role of the neuroimmune system as a contributor to the stress response. Genetic strategies offer one path for converting correlational findings into causal pathways while complementing studies of a gene's function at the molecular, cellular, network, and whole-organismal levels. Neuroendocrine supplementation (thyroid and testosterone) has a long history and tradition. A molecular understanding of nuclear receptor pathways and their coactivators, the mediator complex proteins, provides a rationale for improved targeting of hormonal action in a tissue-selective manner, yielding drugs with improved safety and efficacy. Neural-immune interactions in psychiatric illness remain tantalizing topics. Research suggests that cytokine pathways may contribute to the maintenance or susceptibility to stress, anxiety, and depressive disorders. The reciprocal and recursive interactions among basic science, drug discovery, and clinical science will continue to provide hopeful themes for improving the lives of patients with treatment-refractive psychiatric illness.

United States

Genetic Predisposition to Disease

Epidermal Growth Factor - genetics

Depressive Disorder, Major - metabolism

Humans

Genotype

Geriatric Psychiatry - trends

Forecasting

Testosterone - metabolism

Anxiety - genetics

Serotonin Plasma Membrane Transport Proteins - genetics

Depressive Disorder, Major - genetics

Nerve Net

Aged

Thyroid Gland - metabolism

Anxiety - metabolism

Genetic Linkage

Details

Title: Subtitle: Looking forward in geriatric anxiety and depression: implications of basic science for the future
Creators: Howard K Gershenfeld - Departments of Psychiatry and Integrative Biology, University of Texas Southwestern Medical Center/ NC6.530, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA. Howard.Gershenfeld@UTSouthwestern.edu
Robert A Philibert
Gary W Boehm
Resource Type: Journal article
Publication Details: The American journal of geriatric psychiatry, Vol.13(12), pp.1027-1040
DOI: 10.1097/00019442-200512000-00002
PMID: 16319295
NLM abbreviation: Am J Geriatr Psychiatry
ISSN: 1064-7481
eISSN: 1545-7214
Publisher: England
Grant note: K08 MH 06471 / NIMH NIH HHS R01 MH 67211 / NIMH NIH HHS DA 015789-01 / NIDA NIH HHS R21 MH 067070-01A1 / NIMH NIH HHS
Language: English
Date published: 12/2005
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Psychiatry; Iowa Neuroscience Institute
Record Identifier: 9984003447902771

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