Recent Advances in Depression Research: From Stress to Molecular Biology and Brain Imaging

This article will heuristically overview some of the more recent conceptualizations of the pathogenesisand pathophysiology of major depression as well as the functional changes in the central nervoussystem accompanying its successful pharmacotherapy. The neuropharmacology of affective disordersis a rapidly advancing field of scientific interest with significant complexity and numerous apparentlycontradictory findings. Within the space limitations of this article, some of the relevant newerconceptualizations of the pathophysiology and treatment of affective disorders will be summarized.Major concepts to be presented include the following: (1) the pathogenesis of affective illness may beconceptualized as an interaction between early and current life stressors and genetic vulnerability; (2)affective illness has been increasingly conceptualized as a potentially chronic progressive illnessrather than an intermittent illness with full recovery between episodes; (3) affective illness, includingits various stages, may be readily documented and monitored through changes in functional brain imaging;and (4) due to advances in molecular biology technology, there has been increasing evidencedocumenting changes in genetic activity involved in the pathogenesis of affective disorders from environmentalstressors and/or from inherited genetic alterations and of the reversal of these changesaccompanying successful pharmacotherapy.