Etiology of Depression: Genetic and Environmental Factors

摘要

Major depression is a common disorder, accounting for more disability than any other disorder worldwide. The rates of major depression in the United States rose markedly in the decade from 1991 to 2001, from 3.33% to 7.06%.1 This increase is of considerable consequence, besause depression is associated with significant morbidity, disability, increased medical comorbidities, and mortality.2 It is the most significant risk factor for suicide, a leading cause of death worldwide, especially in adolescents, young adults, and the elderly.Despite the prevalence and costly consequences of depression, there are still no validated, diagnostically useful biological tests to aid in the diagnosis of this disorder and very few that predict a response to established and effective treatments. Similarly, although some promising candidates are emerging, there are no biomark-ers, such as alteratiorhn gene expression or tumor marker, that are associated with improvement with anticfepressant or psychotherapeutic treatments.Of considerable concern is the recent realization, stemming from several large-scale treatment studies, that the efficacy and effectiveness of currently available antidepressants and psychotherapy are unacceptably low (eg, STAFTD).