Affective Disorders: An Overview of Current Concepts and Ongoing Research

Abstract

To the psychiatrist, affective disorders mean those illnesses whose primary manifestations involve major alterations in mood and subsequent or conconmitant alterations in thinking and behavior, such as those found in depression or mania. In this regard, it is interesting to note that in the past twenty years probably the greatest advances in understanding and treatment of psychiatric illnesses have been in the area of affective disorders. There are many examples of success. Lithium effectively treats most patients with manic-depressive disorders, diminishing the amplitude and frequency of their recurrent mood swings. Lithium may also be effective in the prevention of recurrent depressions. The tricyclic antidepressants markedly accelerate the rate of recovery in about 75% of patients with severe depressions. More is being learned about the appropriate use of the monoamine oxidase inhibitors which are also powerful antidepressants. There have been major advances in understanding the psychobiology of depression, and there seems to be on the horizon the possibility of a biochemical classification of depressions that would permit a more selective approach to the utilization of the tricyclic antidepressants. However, just as all good research answers many questions and generates an equal number of different questions, so too do we have a large number of questions at the frontier of our knowledge about the affective disorders which will be the subject of the next three chapters.