Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2025-01-03T14:23:32.655Z Has data issue: false hasContentIssue false
  • English
  • Français

Developmental psychobiology of cyclic affective illness: Implications for early therapeutic intervention

Published online by Cambridge University Press:  04 March 2009

Robert M. Post ,
Susan R. B. Weiss ,
Gabriel S. Leverich ,
Mark S. George ,
Mark Frye  and
Terence A. Ketter
Robert M. Post*
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
Susan R. B. Weiss
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
Gabriel S. Leverich
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
Mark S. George
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
Mark Frye
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
Terence A. Ketter
Affiliation:
Biological Psychiatry Branch, National Institute of Mental Health
*
Robert M. Post, M.D., Chief, Biological Psychiatry Branch, NIMH, Bldg. 10, Room 3N212, 10 Center Drive MSC 1272, Bethesda, MD 20892-1272.
Get access Rights & Permissions [Opens in a new window]

Abstract

The recurrent affective disorders are discussed from the perspective of accumulating inherited and experiential effects on gene expression. Stress and episodes of affective illness are viewed as leaving biochemical and microstructural residues in the central nervous system (CNS) in relation to their patterning, severity, and recurrence. Comorbid factors such as substance abuse and developmental disturbances may also interact with these illness-related variables. In addition to the primary pathological processes, secondary adaptive changes can also be induced, which, in concert with pharmacological interventions, may be sufficient to counter episode occurrences and illness progression. We postulate that the balance of primary pathological and secondary adaptive changes at multiple levels of CNS regulation accounts for recurrence and cyclicity in the affective disorders. The importance of early, effective, long-term interventions in the recurrent affective disorders and the therapeutic potential of several new treatment modalities including repeated transcranial magnetic stimulation (rTMS) are discussed.

Type
Articles
Information
Development and Psychopathology , Volume 8 , Issue 1: Special Issue: Regulatory Process , Winter 1996 , pp. 273 - 305
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Austin, M. P., Dougall, N., Ross, M., Murray, C., O'Carroll, R. E., Moffoot, A., Ebmeier, K. P., & Goodwin, G. M. (1992). Single photon emission tomography with 99mTc-exametazime in major depression and the pattern of brain activity underlying the psychotic/neurotic continuum. Journal of the Affective Disorders, 26, 31–43.CrossRefGoogle ScholarPubMed
Bauer, M. S., Calabrese, J., Dunner, D. L., Post, R. M., Whybrow, P. C., Gyulai, L., Younkin, S., Bynum, D., Lavori, P., & Price, R. A. (1994). Multi-site data reanalysis: Rapid cycling as a modifier for bipolar disorder in DSM-IV. American Journal of Psychiatry, 151, 506–515.Google Scholar
Bauer, M. S., & Whybrow, P. C. (1990). Rapid cycling bipolar affective disorder, II: Treatment of refractory rapid cycling with high-dose levothyroxine: A preliminary study. Archives of General Psychiatry, 47, 435–440.CrossRefGoogle ScholarPubMed
Baumgartner, A., Bauer, M., & Hellweg, R. (1994). Treatment of Intractable Non-Rapid Cycling Bipolar Affective Disorder with high-dose thyroxine: An open clinical trial. Neuropsychopharmacology, 10, 183–189.CrossRefGoogle ScholarPubMed
Baxter, L. R. Jr., Phelps, M. E., Mazziotta, J. C., Schwartz, J. M., Gerner, R. H., Selin, C. E., & Sumida, R. M. (1985). Cerebral metabolic rates for glucose in mood disorders: Studies with positron emission tomography and fluorodeoxyglucose F 18. Archives of General Psychiatry, 42, 441–447.CrossRefGoogle ScholarPubMed
Baxter, L. R. Jr., Schwartz, J. M., Phelps, M. E., Mazziotta, J. C., Guze, B. H., Selin, C. E., Gerner, R. H., & Sumida, R. M. (1989). Reduction of prefrontal cortex glucose metabolism common to three types of depression. Archives of General Psychiatry, 46, 243–250.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., Scott, L. C., Frackowiak, R. S. J., & Dolan, R. J. (1992). The anatomy of melancholia — focal abnormalities of cerebral blood flow in major depression. Psychological Medicine, 22, 607–615.CrossRefGoogle ScholarPubMed
Beninger, R. J., & Hahn, B. L. (1983). Pimozide blocks establishment but not expression of amphetamine-produced environment-specific conditioning. Science, 220, 1304–1306.CrossRefGoogle Scholar
Beninger, R. J., & Herz, R. S. (1986). Pimozide blocks establishment but not expression of cocaineproduced environment-specific conditioning. Life Sciences, 38, 1425–1431.CrossRefGoogle Scholar
Bertagnoli, M. W., & Borchardt, C. M. (1990). A review of ECT for children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 302–307.CrossRefGoogle ScholarPubMed
Breier, A., Kelsoe, J. R., Kirwin, P. D., Beller, S. A., Wolkowitz, O. M., & Pickar, D. (1988). Early parental loss and the development of adult psychopathology. Archives of General Psychiatry, 45, 987–993.CrossRefGoogle ScholarPubMed
Brent, D. A., Perper, J. A., Moritz, G., Baugher, M., Schweers, J., & Roth, C. (1994). Suicide in affectively ill adolescents: A case-control study. Journal of Affective Disorders, 31, 193–202.CrossRefGoogle ScholarPubMed
Brown, G. W., Bifulco, A., Harris, T., & Bridge, L. (1986). Life stress, chronic subclinical symptoms and vulnerability to clinical depression. Journal of Affective Disorders, 11, 1–19.CrossRefGoogle ScholarPubMed
Calabrese, J. R., & Delucchi, G. A. (1989). Phenomenology of rapid cycling manic depression and its treatment with valproate. Journal of Clinical Psychiatry, 50, 30–34.Google ScholarPubMed
Calabrese, J. R., Markovitz, P. J., Kimmel, S. E., & Wagner, S. C. (1992). Spectrum of efficacy of valproate in 78 rapid-cycling bipolar patients. Journal of Clinical Psychopharmacology, 12, 53S–56S.CrossRefGoogle ScholarPubMed
Calabrese, J. R., Woyshville, M. J., Kimmel, S. E., & Rapport, D. J. (1993). Predictors of valproate response in bipolar rapid cycling. Journal of Clinical Psychopharmacology, 13, 280–283.CrossRefGoogle ScholarPubMed
Cicchetti, D. (in press). Child maltreatment: Implications for developmental theory. Human Development.Google Scholar
Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 541–565.CrossRefGoogle ScholarPubMed
Cicchetti, D., & Tucker, D. (Eds.). (1994a). Neural plasticity, sensitive periods, and psychopathology. Development and Psychopathology, 6(4), 531–814.Google Scholar
Cicchetti, D., & Tucker, D. (1994b). Development and self-regulatory structures of the mind. Development and Psychopathology, 6, 533–549.CrossRefGoogle Scholar
Clark, M., Massenburg, G. S., Weiss, S. R. B., & Post, R. M. (1994a). Analysis of the hippocampal GABAA receptor system in kindled rats by autoradiographic and in situ hybridization techniques: Contingent tolerance to carbamazepine. Molecular Brain Research, 26, 309–319.CrossRefGoogle ScholarPubMed
Clark, M., Post, R. M., Weiss, S. R. B., Cain, C. J., & Nakajima, T. (1991). Regional expression of c-fos mRNA in rat brain during the evolution of amygdala-kindled seizures. Molecular Brain Research, 11, 55–64.CrossRefGoogle ScholarPubMed
Clark, M., Smith, M., Weiss, S. R. B., & Post, R. M. (1994b). Modulation of hippocampal glucocorticoid and mineralocorticoid receptor mRNA expression by amygdaloid kindling. Neuroendocrinology, 59, 451–456.CrossRefGoogle ScholarPubMed
Cohen, B. M., & Baldessarini, R. J. (1985). Tolerance to therapeutic effects of antidepressants. American Journal of Psychiatry, 142, 489–490.Google ScholarPubMed
Cohen, R. M., Gross, M., Nordahl, T. E., Semple, W. E., Oren, D. A., & Rosenthal, N. (1992). Preliminary data on the metabolic brain pattern of patients with winter seasonal affective disorder. Archives of General Psychiatry, 49, 545–552.CrossRefGoogle ScholarPubMed
Denicoff, K. D., Smith-Jackson, E. E., Disney, E. R., Leverich, G. S., & Post, R. M. (1994). Outcome in bipolar patients randomized to lithium or carbamazepine prophylaxis and crossed over in year two. Abstracts of the First International Conference on Bipolar Disorder. (Abstract)Google Scholar
Denicoff, K. D., Smith-Jackson, E. E., Disney, E. R., Suddath, R. L., Leverich, G. S., & Post, R. M. (1995). A continuous measure of manic and depressive mood in a treatment trial using the prospective life chart methodology (LCM-P): Preliminary evidence of reliability and validity. Manuscript submitted for publication.Google Scholar
DHEW, Welfare Medical Practice Project. (1979). A state-of-the-science report for the Office of the Assistant Secretary for the U.S. Department of Health, Education, and Welfare. Baltimore, MD: Policy Research.Google Scholar
Dolan, R. J., Bench, C. J., Brown, R. G., Scott, L. C., & Frackowiak, R. S. (1994). Neuropsychological dysfunction in depression: The relationship of regional cerebral blood flow. Psychological Medicine. 24, 849–857.CrossRefGoogle ScholarPubMed
Dolan, R. J., Bench, C. J., Brown, R. G., Scott, L. C., Friston, K. J., & Frackowiak, R. S. (1992). Regional cerebral blood flow abnormalities in depressed patients with cognitive impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 768–773.CrossRefGoogle ScholarPubMed
Dratman, M. B. (1993). Cerebral versus peripheral regulation and utilization of thyroid hormones. In Joffe, R. T. & Levitt, A. J. (Eds.), The thyroid axis and psychiatric illness (pp. 3–94). Washington, DC: APA Press.Google Scholar
Drevets, W. C., Videen, T. O., Price, J. L., Preskorn, S. H., Carmichael, S. T., & Raichie, M. E. (1992). A functional anatomical study of unipolar depression. Journal of Neuroscience, 12, 3628–3641.CrossRefGoogle ScholarPubMed
Dudek, S. M., & Bear, M. F. (1992). Homosynaptic long-term depression in area CA1 of hippocampus and effects of N-methyl-D-aspartate receptor blockade. Proceedings of the National Academy of Sciences of the United States of America, 89, 4363–4367.CrossRefGoogle ScholarPubMed
Dunner, D. L., & Fieve, R. R. (1974). Clinical factors in lithium carbonate prophylaxis failure. Archives of General Psychiatry, 30, 229–233.CrossRefGoogle ScholarPubMed
Efron, R. (1956). The effect of olfactory stimuli in arresting uncinate fits. Brain, 79, 267–281.CrossRefGoogle ScholarPubMed
Fink, M. (1984). Theories of the antidepressant efficacy of convulsive therapy (ECT). In Post, R. M. & Ballenger, J. C. (Eds.), Neurobiology of mood disorders (pp. 721–730). Baltimore, MD: Williams and Wilkins.Google Scholar
Fleming, A. S., Suh, E. J., Korsmit, M., & Rusak, B. (1994). Activation of fos-like immunoreactivity in the medial preoptic area and limbic structures by maternal and social interactions in rats. Behavioral Neuroscience, 108, 724–734.CrossRefGoogle ScholarPubMed
Fleming, A. S., & Walsh, C. (1994). Neuropsychology of maternal behavior in the rat: C-fos expression during mother-litter interactions. Psychoneuroendocrinology, 19, 429–443.CrossRefGoogle ScholarPubMed
Frankenburg, F. R., Tohen, M., Cohen, B. M., & Lipinski, J. F. Jr. (1988). Long-term response to carbamazepine: A retrospective study. Journal of Clinical Psychopharmacology, 8, 130–132.CrossRefGoogle ScholarPubMed
Freeman, W. J. (1991). The physiology of perception. Scientific American, 264, 78–85.CrossRefGoogle ScholarPubMed
Geinisman, Y., de Toledo-Morrell, L., & Morrell, F. (1990). The brain's record of experience: Kindlinginduced enlargement of the active zone in hippocampal perforated synapses. Brain Research, 513, 175–179.CrossRefGoogle ScholarPubMed
George, M. S., Jones, M., Post, R. M., Putnam, F., Mikalauskas, K., & Leverich, G. S. (in press). The longitudinal course of affective illness: A mathematical model involving chaos theory. Psychiatry Research.Google Scholar
George, M. S., Ketter, T. A., Gill, D. S., Marangell, L. B., Pazzaglia, P. J., & Post, R. M. (1993). Blunted CBF with emotion recognition in depression. American Psychiatric Association New Research Program and Abstracts (Abstract No. 114).Google Scholar
George, M. S., Ketter, T. A., Parekh, P. I., Rosinky, N., Ring, H., Casey, B. J., Trimble, M. R., Horwitz, B., Herscovitch, P., & Post, R. M. (1994). Regional brain activity when selecting a response despite interference: An H215O PET study of the Stroop and an emotional Stroop. Human Brain Mapping, 1, 194–209.CrossRefGoogle Scholar
George, M. S., Ketter, T. A., & Post, R. M. (1993). SPECT and PET imaging in mood disorders. Journal of Clinical Psychiatry, 54, 6–13.Google ScholarPubMed
George, M. S., Wassermann, E. M., Williams, W. A., Callahan, A., Ketter, T. A., Basser, P., Hallett, M., & Post, R. M. (1995). Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. NeuroReport, 6, 1853–1856.CrossRefGoogle ScholarPubMed
Glazer, H. I., & Weiss, J. M. (1976). Long-term interference effect: An alterative to ‘learned helplessness’. Journal of Experimental Psychology (Animal Behavior Processes), 2, 202–213.CrossRefGoogle Scholar
Gloor, P., Olivier, A., Quesney, L. F., Andermann, F., & Horowitz, S. (1982). The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Annuals of Neurology, 12, 129–144.CrossRefGoogle ScholarPubMed
Goddard, G. V., McIntyre, D. C., & Leech, C. K. (1969). A permanent change in brain function resuiting from daily electrical stimulation. Experimental Neurology, 25, 295–330.CrossRefGoogle Scholar
Goyer, P. F., Schulz, P. M., Semple, W. E., Gross, M., Nordahl, T. E., King, A. C., Wehr, T. A., & Cohen, R. M. (1992). Cerebral glucose metabolism in patients with summer seasonal affective disorder. Neuropsychopharmacology, 7, 233–240.Google ScholarPubMed
Granger, R., & Lynch, G. (1991). Higher olfactory processes: Perceptual learning and memory. Current Opinion in Neurobiology and Neurosurgery, 1, 209–214.CrossRefGoogle ScholarPubMed
Halgren, E., Walter, R. D., Cherlow, D. G., & Crandall, P. H. (1978). Mental phenomena evoked by electrical stimulation of the human hippocampal formation and amygdala. Brain, 101, 83–117.CrossRefGoogle ScholarPubMed
Hoschl, C. (1991). Do calcium antagonists have a place in the treatment of mood disorders? Drugs, 42, 721–729.CrossRefGoogle ScholarPubMed
Hough, C. J., Irwin, R. P., Gao, X.-M., Rogawski, M. A., Chuang, D.-M., & Post, R. M. (in press). Carbamazepine inhibition of NMDA-evoked calcium influx in rat cerebellar granule cells. Journal of Pharmacology and Experimental Therapeutics.Google Scholar
Hovorka, J., Langmeier, M., & Mares, P. (1989). Are there morphological changes in presynaptic terminals of kindled rats. Neuroscience Letters, 107, 179–183.CrossRefGoogle ScholarPubMed
Hubel, D. H., & Wiesel, T. N. (1979). Brain mechanisms of vision. Scientific American, 241, 150–162.CrossRefGoogle ScholarPubMed
Insel, T. R., & Shapiro, L. E. (1992). Oxytocin receptor distribution reflects social organization in monogamous and polygamous voles. Proceedings of the National Academy of Sciences of the United States of America, 89, 5981–5985.CrossRefGoogle ScholarPubMed
Kalynchuk, L. E., Kim, C. K., Pinel, J. P. J., & Kippin, T. E. (1994). Effect of an ascending dose regimen on the development of tolerance to the anticonvulsant effect of diazepam. Behavioral Neuroscience, 108, 213–216.CrossRefGoogle Scholar
Kanaya, T., & Yonekawa, M. (1990). Regional cerebral blood flow in depression. Japanese Journal of Psychiatry and Neurology, 44, 571–576.Google ScholarPubMed
Keck, P. E. Jr., McElroy, S. L., Vuckovic, A., & Friedman, L. M. (1992). Combined valproate and carbamazepine treatment of bipolar disorder. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 319–322.Google ScholarPubMed
Keller, M. B., Lavori, P. W., Kane, J. M., Gelenberg, A. J., Rosenbaum, J. F., Walzer, E. A., & Baker, L. A. (1992). Subsyndromal symptoms in bipolar disorder. A comparison of standard and low serum levels of lithium. Archives of General Psychiatry, 49, 371–376.CrossRefGoogle ScholarPubMed
Ketter, T. A., Andreason, P. J., George, M. S., Lee, C., Gill, D. S., Parekh, P. I., Willis, M. W., Herscovitch, P., & Post, R. M. (in press). Anterior paralimbic mediation of procaine-induced emotional and psychosensory experiences. Archives of General Psychiatry.Google Scholar
Ketter, T. A., Andreason, P. J., George, M. S., Pazzaglia, P. J., Marangell, L. B., & Post, R. M. (1993). Blunted cerebral blood flow response to procaine in mood disorders. American Psychiatric Association New Research Program and Abstracts (Abstract No. NR297).Google Scholar
Ketter, T. A., George, M. S., Andreason, P. J., Horwitz, B., Parekh, P. J., Pazzaglia, P. J., Marangell, L. B., Callahan, A. M., Cohen, R. M., Herscovitch, P., & Post, R. M. (1994a). Depression and frontal regional cerebral metabolic rates of glucose correlate inversely. American Psychiatric Association New Research Program and Abstracts (Abstract No. NR443).Google Scholar
Ketter, T. A., George, M. S., Andreason, P. J., Parekh, P., Pazzaglia, P. J., Marangell, L. B., Callahan, A. M., Cohen, R. M., Herscovitch, P., & Post, R. M. (1994b). Regional cerebral metabolic rates of glucose in unipolar versus bipolar depression. American Psychiatric Association New Research Program and Abstracts (Abstract No. NR444).Google Scholar
Ketter, T. A., Pazzaglia, P. J., George, M. S., Marangell, L. B., Callahan, A. M., Kimbrell, T., Frye, M. A., Parekh, P., Andreason, P. J., Herscovitch, P., & Post, R. M. (1994c). Baseline cerebral hypometabolism may predict response to nimodipine in mood disorders. American College of Neuropsychopharmacology Abstracts (Abstract No. 149).Google Scholar
Ketter, T. A., Pazzaglia, P. J., & Post, R. M. (1992). Synergy of carbamazepine and valproic acid in affective illness: Case report and review of literature. Journal of Clinical Psychopharmacology, 12, 276–281.Google Scholar
Kovacs, G. L., & de Wied, D. (1994). Peptidergic modulation of learning and memory processes. Pharmacology Review, 46, 269–291.Google ScholarPubMed
Kraepelin, E. (1921). Manic-depressive insanity and paranoia (Robertson, G. M., Ed.; Barclay, R. M., Trans.). Edinburgh: E. S. Livingstone.CrossRefGoogle Scholar
Kramlinger, K. G., & Post, R. M. (in press). Ultrarapid and ultradian cycling in bipolar affective illness. British Journal of Psychiatry.Google Scholar
Kuhn, C. M., & Schanberg, S. M. (1991). Stimulation in infancy and brain development. In Carroll, B. J. & Barrett, J. E. (Eds.), Psychopathology and the brain (pp. 71–101). New York: Raven Press.Google Scholar
Kumar, A., Mozley, D., Dunham, C., Velchik, M., Reilley, J., Gottlieb, G., & Alavi, A. (1991). Semiquantitative [123I]IMP SPECT studies in late onset depression before and after treatment. International Journal of Geriatric Psychiatry, 6, 775–777.CrossRefGoogle Scholar
Kumar, R., Sukumar, S., & Barbacid, M. (1990). Activation of ras oncogenes preceding the onset of neoplasia. Science, 248, 1101–1104.CrossRefGoogle ScholarPubMed
LeDoux, J. E. (1992). Emotion and the amygdala. In Aggleton, J. P. (Ed.), The amygdala: Neurobiological aspects of emotion, memory, and mental dysfunction (pp. 339–351). New York: Wiley-Liss.Google Scholar
Maier, S. F., & Jackson, R. L. (1977). The nature of the initial coping response and the learned helplessness effects. Animal Learning and Behavior, 5, 404–414.CrossRefGoogle Scholar
Maj, M., Pirozzi, R., & Kemali, D. (1989). Long-term outcome of lithium prophylaxis in patients initially classified as complete responders. Psychopharmacology (Berlin), 98, 535–538.CrossRefGoogle ScholarPubMed
McDermut, W., Pazzaglia, P. J., Huggins, T., Mikalauskas, K., Leverich, G. S., Ketter, T. A., Bartko, J., & Post, R. M. (1995). Use of single case analyses in off-on-off-on trials in affective illness: A demonstration of the efficacy of nimodipine. Depression, 2, 259–271.CrossRefGoogle Scholar
McElroy, S. L., Keck, P. E., Pope, H. G., & Hudson, J. I. (1992). Valproate in the treatment of bipolar disorder: Literature review and clinical guidelines. Journal of Clinical Psychopharmacology, 12, 42S–52S.CrossRefGoogle ScholarPubMed
Meaney, M. J., Aitken, D. H., Van Berkel, C., Bhatnagar, S., & Sapolsky, R. M. (1988). Effect of neonatal handling on age-related impairments associated with the hippocampus. Science, 239, 766–768.CrossRefGoogle ScholarPubMed
Mishkin, M., & Appenzeller, T. (1987). The anatomy of memory. Scientific American, 256, 80–89.CrossRefGoogle ScholarPubMed
Mulkey, R. M., Endo, S., Shenolikar, S., & Malenka, R. C. (1994). Involvement of a calcineurin/inhibitor-1 phosphatase cascade in hippocampal longterm depression. Nature, 369, 486–488.CrossRefGoogle ScholarPubMed
O'Connell, R. A., Van Heertum, R. L., Billick, S. B., Holt, A. R., Gonzalez, A., Notardonato, H., Luck, D., & King, L. N. (1989). Single photon emission computed tomography (SPECT) with [123I]IMP in the differential diagnosis of psychiatric disorders. Journal of Neuropsychiatry and Clinical Neuroscience, 1, 145–153.Google ScholarPubMed
O'Connell, R. A., Van Heertum, R. L., Luck, D., Yudd, A. P., Cueva, J. E., Billick, S. B., Cordon, D. J., Gersh, R. J., & Masdeu, J. C. (1995). Singlephoton emission computed tomography of the brain in acute mania and schizophrenia. Journal of Neuroimaging, 5, 101–104.CrossRefGoogle ScholarPubMed
Okuma, T. (1993). Effects of carbamazepine and lithium on affective disorders. Neuropsychobiology, 27, 138–145.CrossRefGoogle ScholarPubMed
Pascual-Leone, A., Gomez-Tortosa, E., Grafman, J., Alway, P., Nichelli, P., & Hallett, M. (1994). Induction of visual extinction by rapid-rate transcranial magnetic stimulation of perietal lobe. Neurology, 44, 494–498.CrossRefGoogle Scholar
Pascual-Leone, A., Valls-Sole, J., Brasil-Neto, J. P., Cammarota, A., Grafman, J., & Hallett, M. (1994). Akinesia in parkinson's disease. II: Effects of subthreshold repetitive transcranial motor cortex stimulation. Neurology, 44, 892–898.CrossRefGoogle ScholarPubMed
Paykel, E. S., Emms, E. M., Fletcher, J., & Rassaby, E. S. (1980). Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 339–346.CrossRefGoogle ScholarPubMed
Pazzaglia, R. J., Post, R. M., Ketter, T. A., George, M. S., & Marangell, L. B. (1993). Preliminary controlled trial of nimodipine in ultra-rapid cycling affective dysregulation. Psychiatry Research, 49, 257–272.CrossRefGoogle ScholarPubMed
Pihoker, C., Owens, M. T., Kuhn, C. M., Schanberg, S. M., & Nemeroff, C. B. (1993). Maternal separation in neonatal rats elicits activation of the hypothalamic pituitary-adrenocortical axis: A putative role for corticotropin-releasing factor. Psychoneuroendocrinology, 18, 485–493.CrossRefGoogle Scholar
Pinel, J. P. J. (1983). Effects of diazepam and diphenylhydantoin on elicited and spontaneous seizures in kindled rats: A double dissociation. Pharmacology Biochemistry and Behavior, 18, 61–63.CrossRefGoogle ScholarPubMed
Plotsky, P. M., & Meaney, M. J. (1993). Early, postnatal experience alters hypothalamic corticotropinreleasing factor (CRF) mRNA, median eminence CRF content and stress-induced release in adult rats. Brain Research Molecular Brain Research, 18, 195–200.CrossRefGoogle ScholarPubMed
Post, R. M. (1990a). Alternatives to lithium for bipolar affective illness. In Tasman, A., Goldfinger, S. M., & Kaufmann, C. A. (Eds.), Review of psychiatry (Vol. 9, pp. 170–202). Washington, DC: APA Press.Google Scholar
Post, R. M. (1990b). Anticonvulsants for the lithiumresistant bipolar patient. In Amsterdam, J. (Ed.), Pharmacology of depression: Application for the outpatient practitioner (pp. 129–158). New York: Marcel Dekker.Google Scholar
Post, R. M. (1990c). Prophylaxis of bipolar affective disorders. International Review of Psychiatry, 2, 277–320.CrossRefGoogle Scholar
Post, R. M. (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry, 149, 999–1010.Google ScholarPubMed
Post, R. M., Altshuler, L. L., Ketter, T. A., Denicoff, K., & Weiss, S. R. B. (1991). Antiepileptic drugs in affective illness: Clinical and theoretical implications. In Smith, D. B., Treiman, D. M., & Trimble, M. R. (Eds.), Advances in neurology. Neurobehavioral problems in epilepsy (Vol. 55, pp. 239–277). New York: Raven Press.Google Scholar
Post, R. M., Ballenger, J. C., Rey, A. C., & Bunney, W. E. Jr. (1981). Slow and rapid onset of manic episodes: Implications for underlying biology. Psychiatry Research, 4, 229–237.CrossRefGoogle ScholarPubMed
Post, R. M., Delisi, L. E., Holcomb, H. H., Uhde, T. W., Cohen, R., & Buchsbaum, M. S. (1987). Glucose utilization in the temporal cortex of affectively ill patients: Positron emission tomography. Biological Psychiatry, 22, 46–54.CrossRefGoogle ScholarPubMed
Post, R. M., Ketter, T. A., Denicoff, K., Leverich, G. S., & Mikalauskas, K. (1993). Assessment of anticonvulsant drugs in patients with bipolar affective illness. In Hindmarch, I. & Stonier, P. D. (Eds.), Human psychopharmacology: Methods and measures (pp. 211–245). Chichester, England: John Wiley & Sons.Google Scholar
Post, R. M., Kramlinger, K. G., Altshuler, L. L., Ketter, T. A., & Denicoff, K. (1990). Treatment of rapid cycling bipolar illness. Psychopharmacology Bulletin, 26, 37–47.Google ScholarPubMed
Post, R. M., Leverich, G. S., Altshuler, L., & Mikalauskas, K. (1992). Lithium discontinuationinduced refractoriness: Preliminary observations. American Journal of Psychiatry, 149, 1727–1729.Google Scholar
Post, R. M., Leverich, G. S., Pazzaglia, P. J., Mikalauskas, K., & Denicoff, K. (1993). Lithium tolerance and discontinuation as pathways to refractoriness. In Birch, N. J., Padgham, C., & Hughes, M. S. (Eds.), Lithium in medicine and biology (pp. 71–84). Lancashire, UK: Marius Press.Google Scholar
Post, R. M., Leverich, G. S., Rosoff, A. S., & Altshuler, L. L. (1990). Carbamazepine prophylaxis in fractory affective disorders: A focus on long-term follow-up. Journal of Clinical Psychopharmacology, 10, 318–327.Google Scholar
Post, R. M., Putnam, F., Uhde, T. W., & Weiss, S. R. B. (1986). ECT as an anticonvulsant: Implications for its mechanism of action in affective illness. In Malitz, S. & Sackheim, H. A. (Eds.), Electroconvulsive therapy: Clinical and basic research issues. Annuals of the New York Academy of Sciences (Vol. 462, pp. 376–388). New York: New York Academy of Sciences.Google Scholar
Post, R. M., Rubinow, D. R., & Ballenger, J. C. (1986). Conditioning and sensitization in the longitudinal course of affective illness. British Journal of Psychiatry, 149, 191–201.CrossRefGoogle ScholarPubMed
Post, R. M., & Weiss, S. R. B. (1992). Endogenous biochemical abnormalities in affective illness: Therapeutic vs. pathogenic. Biology Psychiatry, 32, 469–484.CrossRefGoogle Scholar
Post, R. M., & Weiss, S. R. B. (1995a). The neurobiology of treatment-resistant mood disorders. In Bloom, F. E. & Kupfer, D. J. (Eds.), Psychopharmacology: The fourth generation of progress (pp. 1155–1170). New York: Raven Press.Google Scholar
Post, R. M., & Weiss, S. R. B. (1995b). How affective episodes drive illness cyclicity: A speculative model based on oscillatory patterns observed in amygdalakindled seizures. Manuscript submitted for publication.Google Scholar
Post, R. M., Weiss, S. R. B., Chuang, D., & Ketter, T. A. (1994). Mechanisms of action of carbamazepine in seizure and affective disorders. In Joffe, R. T. & Calabrese, J. R. (Eds.), Anticonvulsants in mood disorders (pp. 43–92). New York: Marcel Dekker.Google Scholar
Post, R. M., Weiss, S. R. B., & Leverich, G. S. (1994). Recurrent affective disorder: Roots in developmental neurobiology and illness progression based on changes in gene expression. Development and Psychopathology, 6, 781–813.CrossRefGoogle Scholar
Post, R. M., Weiss, S. R. B., Rosen, J., Smith, M., Thomas, N., & Pert, A. (1995). Co-morbidity of cocaine abuse and affective disorders. Unpublished manuscript.Google Scholar
Post, R. M., Weiss, S. R. B., & Smith, M. (1995). Sensitization and kindling: Implications for the evolving neural substrates of Post-Tramatic Stress Disorder. In Friedman, M. J., Charney, D. S., & Deutch, A. Y. (Eds.), Neurobiology and clinical consequences of stress: From normal adaptation to PTSD (pp. 203–224). Philadelphia: Lippincott-Raven.Google Scholar
Racine, R. J. (1972a). Modification of seizure activity by electrical stimulation: I. After-discharge threshold. Electroencephalography and Clinical Neurophysiology, 32, 269–279.CrossRefGoogle ScholarPubMed
Racine, R. J. (1972b). Modification of seizure activity by electrical stimulation: II. Motor seizure. Electroencephalography and Clinical Neurophysiology, 32, 281–294.CrossRefGoogle ScholarPubMed
Rao, U., Ryan, N. D., Birmaher, B., Dahl, R. E., Williamson, D. E., Kaufman, J., Rao, R., & Nelson, B. (1995). Unipolar depression in adolescents: Clinical outcome in adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 566–578.CrossRefGoogle ScholarPubMed
Rasmussen, H. (1989). The cycling of calcium as an intracellular messenger. Scientific American, 261, 66–73.CrossRefGoogle ScholarPubMed
Rawlings, S. R., Hoyland, J., & Mason, W. T. (1991). Calcium homeostasis in bovine somatotrophs: Calcium oscillations and calcium regulation by growth hormone-releasing hormone and somatostatin. Cell Calcium, 12, 403–414.CrossRefGoogle ScholarPubMed
Rolls, E. T. (1992). Neurophysiology and functions of the primate amygdala. In Aggletone, J. P. (Ed.), The amygdala: Neurobiological aspects of emotion, memory, and mental dysfunction (pp. 143–165). New York: Wiley-Liss.Google Scholar
Rosen, J. B., Cain, C. J., Weiss, S. R. B., & Post, R. M. (1992). Alterations in mRNA of enkephalin, dynorphin and thyrotropin releasing hormone during amygdala kindling: An in situ hybridization study. Molecular Brain Research, 15, 247–255.CrossRefGoogle ScholarPubMed
Rosen, J. B., Weiss, S. R., & Post, R. M. (1994). Contingent tolerance to carbamazepine: Alterations in TRH mRNA and TRH receptor binding in limbic structures. Brain Research, 651, 252–260.CrossRefGoogle ScholarPubMed
Rosenzweig, M. R., Bennett, E. L., & Diamond, M. C. (1972). Brain changes in response to experience. Scientific American, 226, 22–29.CrossRefGoogle Scholar
Ryan, N. D. (1993). Pharmacological treatment of child and adolescent major depression. Encephale, 19, 67–70.Google ScholarPubMed
Sakai, S., Baba, H., Sato, M., & Wada, J. A. (1991). Effect on DN-1417 on photosensitivity and cortically kindled seizure in Senegalese baboons, papio papio. Epilepsia, 32, 16–21.CrossRefGoogle ScholarPubMed
Sato, M., & Morimoto, K. (1983). Anti-epileptic effects of TRH-T and DN–1417. Kurume Medical Journal, 30, S57–S64.CrossRefGoogle ScholarPubMed
Sato, M., Ogawa, N., & Okamoto, M. (1986). Amygdaloid kindling and thyrotropin-releasing hormone. In Wada, J. A. (Ed.), Kindling (Vol. 3, pp. 319–331). New York: Raven Press.Google Scholar
Schlegel, S., Aldenhoff, J. B., Eissner, D., Lindner, P., & Nickel, O. (1989). Regional cerebral blood flow in depression: Associations with psychopathology. Journal of the Affective Disorders, 17, 211–218.CrossRefGoogle ScholarPubMed
Shatz, C. J. (1994). Role for spontaneous neural activity in the patterning of connections between retina and Ign during visual system development. International Journal of Developmental Neuroscience, 12, 531–546.CrossRefGoogle Scholar
Smith, M. A., Makino, S., Altemus, M., Michelson, D., Hong, S. W., Kvetnansky, R., & Post, R. M. (in press). Stress and antidepressant differentially regulate neurotrophin-3 mRNA expression in the locus ceruleus. Proceedings of the National Academy of Sciences U.S.A.Google Scholar
Sperk, G., Marksteiner, J., Gruber, B., Bellman, R., Mahata, M., & Ortler, M. (1992). Functional changes in neuropeptide Y- and somatostatincontaining neurons induced by limbic seizures in the rat. Neuroscience, 50, 831–846.CrossRefGoogle ScholarPubMed
Squillace, K., Post, R. M., Savard, R., & Ervin, M. (1984). Life charting of the longitudinal course of recurrent affective illness. In Post, R. M. & Ballenger, J. C. (Eds.), Neurobiology of mood disorders (pp. 38–59). Baltimore: Williams and Wilkins.Google Scholar
Suppes, T., Baldessarini, R. T., Faedda, G. T., & Tohen, M. (1991). Risk of recurrence following discontinuation of lithium treatment in bipolar disorder. Archives of General Psychiatry, 48, 1082–1088.CrossRefGoogle ScholarPubMed
Sutula, T. P. (1991). Reactive changes in epilepsy: Cell death and axon sprouting induced by kindling. Epilepsy Research, 10, 62–70.CrossRefGoogle ScholarPubMed
Sutula, T. P., Golarai, G., & Cavazos, J. (1992). Assessing the functional significance of mossy fiber sprouting. Epilepsy Research Supplement, 7, 251–259.Google ScholarPubMed
Wallace, C. S., Hawrylak, N., & Greenough, W. T. (1991). Studies of synaptic structural modifications after long-term potentiation-and kindling: Context for a molecular morphology. In Baudry, M. & Davis, J. L. (Eds.), Long-term potentiation: A debate of current issues (pp. 189–232). Cambridge, MA: MIT Press.Google Scholar
Wallace, C. S., Kilman, V. L., Withers, G. S., & Greenough, W. T. (1992). Increases in dendritic length in occipital cortex after 4 days of differential housing in weanling rats. Behavioral and Neural Biology, 58, 64–68.CrossRefGoogle ScholarPubMed
Wasserman, E. M., George, M. S., Williams, W., Post, R. M., & Hallett, M. (1995). Motor performance in depression improves following repetitive transcranial magnetic stimulation (rTMS) of prefrontal cortex. Submitted for presentation at the American Neurological Association Meeting. (Abstract)Google Scholar
Weiss, J. M., & Glazer, H. I. (1975). Effects of acute exposure to stressors on subsequent avoidanceescape behavior. Psychosomatic Medicine, 37, 499–521.CrossRefGoogle ScholarPubMed
Weiss, S. R. B., Clark, M., Rosen, J. B., Smith, M. A., & Post, R. M. (1995). Contingent tolerance to the anticonvulsant effects of carbamazepine: Relationship to loss of endogenous adaptive mechanisms. Brain Research Reviews, 20, 305–322.CrossRefGoogle Scholar
Weiss, S. R. B., Haas, K., & Post, R. M. (1991). Contingent tolerance to carbamazepine is associated with lowering of amygdala-kindled seizure thresholds. Experimental Neurology, 114, 300–306.CrossRefGoogle ScholarPubMed
Weiss, S. R. B., Heynen, T., Noguera, C. C., Li, X., & Post, R. M. (1994). Oscillating patterns of anticonvulsant responsivity: Putative model of affective illness cyclicity. American College of Neuropsychopharmacology Abstracts (Abstract No. 210).Google Scholar
Weiss, S. R. B., Li, X. L., Rosen, J. B., Li, H., Heynan, T., & Post, R. M. (in press). Quenching: Inhibition of development and expression of amygdala kindled seizures with low frequency stimulation. NeuroReport.Google Scholar
Weiss, S. R. B., & Post, R. M. (1990). Contingent tolerance to the anticonvulsant effects of carbamazepine: Implications for neurology and psychiatry. In Canger, R., Sacchetti, E., Perini, G. I., & Canevini, M. P. (Eds.), Carbamazepine: A bridge between epilepsy and psychiatric disorders (pp. 7–32). Origgio, Italy: Ciba-Geigy Edizioni.Google Scholar
Weiss, S. R. B., & Post, R. M. (1991). Development and reversal of conditioned inefficacy and tolerance to the anticonvulsant effects of carbamazepine. Epilepsia, 32, 140–145.CrossRefGoogle Scholar
Weiss, S. R. B., Post, R. M., Costello, M., Nutt, D. J., & Tandeciarz, S. (1990). Carbamazepine retards the development of cocaine-kindled seizures but not sensitization to cocaine-induced hyperactivity. Neuropsychopharmacology, 3, 273–281.Google Scholar
Winokur, G., & Kadrmas, A. (1989). A polyepisodic course in bipolar illness: Possible clinical relationship. Comprehensive Psychiatry, 30, 121–127.CrossRefGoogle Scholar
Yazici, K. M., Kapucu, O., Erbas, B., Varoglu, E., Gulec, C., & Bekdik, C. F. (1992). Assessment of changes in regional cerebral blood flow in patients with major depression using the 99m-HMPAO single photon emission tomography method. European Journal of Nuclear Medicine, 19, 1038–1043.CrossRefGoogle Scholar
Zhang, L. X., Wu, M., & Han, J. S. (1992). Suppression of audiogenic epileptic seizures by intracerebral injection of a CCK gene vector. Neuroreport, 3, 700–702.Google ScholarPubMed