Genes and Depression

Manic-depressive illness, or psychosis, is one of the most common and clearly defined, yet one of the most baffling of emotional disorders. The victim may seem normal for months, then enter a period of mania in which, as one imaginative psychiatrist described it, he "comes in swinging from chandeliers that aren't there." Back to normal for a while, he may next become depressed, sometimes suicidally.

Psychiatrists have argued for generations about the cause of manic-depressive illness, although it is known to run in families. Is it "functional," meaning that it is acquired as the result of life experiences, or is it "organic," involving some abnormality in the body's biochemistry? Last week, at a conference in Copenhagen, a New York City team of researchers suggested that a tendency or predisposition to manic-depressive illness might be deeply rooted indeed: in the genes that determine heredity.

The suspected villain is the female or X chromosome, which carries hundreds of genetic instructions to offspring of both sexes. Three years ago, investigators at Barnes Hospital in St. Louis reported "presumptive evidence" that an anomalous gene on the X chromosome is associated with the emotional disorder. The new and more definite evidence comes from Dr. Ronald R. Fieve and colleagues at the Columbia-Presbyterian Medical Center.

The evidence is admittedly indirect.

The Columbia researchers studied 19 manic-depressive patients. In the families of seven there was red-green color blindness, which is known to result from a defective gene on the X chromosome. The other twelve families displayed the blood-group pattern known as Xga, also transmitted on the X chromosome. The Mendelian pattern of inheritance for both these traits is known. Manic-depressive illness is associated with them, says Fieve. So the disorder is probably--in some cases, at least --transmitted by a nearby defective gene.

Fieve does not claim that his hypothesis accounts for all manic-depressive illness, or that all people with the abnormal gene will develop the emotional disorder in severe form. But with the refinement of testing for abnormal genes, it may eventually be possible to detect early in life those individuals in greatest danger of developing the illness, and thus to treat them earlier and more effectively.

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