HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gershenfeld, H. K. Articles by Boehm, G. W. Search for Related Content PubMed PubMed Citation Articles by Gershenfeld, H. K. Articles by Boehm, G. W.

Looking Forward in Geriatric Anxiety and Depression

Implications of Basic Science for the Future

Received December 31, 2004; accepted February 18, 2005. From the Depts. of Psychiatry and Integrative Biology, University of Texas Southwestern Medical Center, Dallas, TX (HKG), the Dept. of Psychiatry and Neuroscience, University of Iowa, Iowa City, IA (RAP), and the Dept. of Psychology, Texas Christian University, Fort Worth, TX (GWB). Send correspondence and reprint requests to Howard Gershenfeld, M.D., Ph.D., UT Southwestern / NC6.530, 5323 Harry Hines Blvd., Dallas, TX 75390-9070. e-mail: Howard.Gershenfeld{at}UT Southwestern.edu
© 2005 American Association for Geriatric Psychiatry

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.

Key Words: Depression • Anxiety • Basic Research • Genetics

This article has been cited by other articles:

				E. J. Lenze and B. H. Mulsant Biomarkers in Geriatric Psychiatry Am J Geriatr Psychiatry, October 1, 2007; 15(10): 827 - 831. [Full Text] [PDF]

				D. J. Smith Basic Brain Research Shows Its Age Am J Geriatr Psychiatry, December 1, 2005; 13(12): 1025 - 1026. [Full Text] [PDF]