Skip to main content Accessibility help
×
Home
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 3
  • Print publication year: 2003
  • Online publication date: August 2009

20 - Psychosocial Stressors as Predisposing Factors to Affective Illness and PTSD: Potential Neurobiological Mechanisms and Theoretical Implications

Summary

SENSITIZATION IN THE AFFECTIVE DISORDERS

Stressor and Episode Sensitization in the Unmedicated State

At the beginning of the twentieth century, Kraepelin (1921) laid out the fundamentals of the sensitization hypothesis of affective disorders:

the attacks begin not infrequently after the illness or death of near relatives … we must regard all alleged injuries as possibly sparks for the discharge of individual attacks, but the real cause of the malady must be sought in permanent internal changes, which at least very often, perhaps always, are innate … in spite of the removal of the discharging cause, the attack follows its independent development. But, finally, the appearance of wholly similar attacks on wholly dissimilar occasions or quite without external occasion shows that even there where there has been external influence, it must not be regarded as a necessary presupposition for the appearance of the attack.

(pp. 180–181)

In this terse and insightful paragraph, he outlines four different components of the sensitization hypothesis: (1) initial episodes of affective illness are often precipitated by psychosocial stressors; (2) as recurrences emerge, later episodes do not require the same psychosocial precipitation, but may occur more spontaneously; (3) episodes tend to occur with a characteristic similarity; and (4) innate neurobiological mechanisms mediate these vulnerabilities and recurrences, and presumably these could occur both on an inherited and an experiential basis.

Other aspects of this sensitization hypothesis are outlined in additional passages from his work.

Abou-Saleh, M. T. & Coppen, A. (1986). Who responds to prophylactic lithium? Journal of Affective Disorders 10, 115–125
Ahrens, B., Muller-Oerlinghausen, B., Schou, M., Wolf, T., Alda, M., Grof, E., Grof, P., Lenz, G., Simhandl, C., & Thau, K. (1995). Excess cardiovascular and suicide mortality of affective disorders may be reduced by lithium prophylaxis. Journal of Affective Disorders, 33, 67–75
Altshuler, L. L., Bartzokis, G., Grieder, T., Curran, J., Jimenez, T., Leight, K., Wilkins, J., Gerner, R., & Mintz, J. (2000). An MRI study of temporal lobe structures in men with bipolar disorder or schizophrenia. Biological Psychiatry, 48, 147–162
Ambelas, A. (1979). Psychologically stressful events in the precipitation of manic episodes. British Journal of Psychiatry, 135, 15–21
Ambelas, A. (1987). Life events and mania. A special relationship? British Journal of Psychiatry, 150, 235–240
Angst, J. (1966). Atiologie und Nosologie endogener depressiver Psychosen. Berlin: Springer Verlag
Angst, J. (1978). The course of affective disorders. II. Typology of bipolar manic-depressive illness. Archiv Fur Psychiatrie und Nervenkrankheiten, 226, 65–74
Angst, J. & Sellaro, R. (2000). Historical perspectives and natural history of bipolar disorder. Biological Psychiatry, 48, 445–457
Angst, J., Felder, W., Frey, R., & Stassen, H. H. (1978). The course of affective disorders. I. Change of diagnosis of monopolar, unipolar, and bipolar illness. Archiv Fur Psychiatrie und Nervenkrankheiten, 226, 57–64
Angst, J. & Weiss, p. (1967). Periodicity of depressive psychoses. In H. Brill, J. O. Cole, p. Deniker, et al. (Eds.), Proceedings of the Fifth International Medical Foundation; International Congress Series (pp. 702–710). Amsterdam: Excerpta Medica
Anisman, H., Zaharia, M. D., Meaney, M. J., & Merali, Z. (1998). Do early-life events permanently alter behavioral and hormonal responses to stressors? International Journal of Developmental Neuroscience, 16, 149–164
Antelman, S. M., Eichler, A. J., Black, C. A., & Kocan, D. (1980) Interchangeability of stress and amphetamine in sensitization. Science, 207, 329–331
Astrup, C., Fossum, A., & Holmboe, R. (1959). A follow-up study of 270 patients with acute affective psychoses. Acta Psychiatrica Scandinavica, 34, 7–62
Ayuso, G. J., Fuentenebro, D. D., Mendez, B. R., & Marteo, M. I. (1981). [Analysis of precipitating factors in a sample of patients hospitalized for endogenous depression] Analyse des Facteurs declencheurs sur un echantillon de patients hospitalises pour depression endogene. Annales Medico-Psychologiques, 139, 759–769
Baldessarini, R. J., Tondo, L., & Hennen, J. (1999). Effects of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders. Journal of Clinical Psychiatry, 60 Supplement 2, 77–84
Banki, C. M., Bissette, G., Arato, M., & Nemeroff, C. B. (1988). Elevation of immunoreactive CSF TRH in depressed patients. American Journal of Psychiatry, 145, 1526–1531
Barrett, G. L. (2000). The p75 neurotrophin receptor and neuronal apoptosis. Progress in Neurobiology, 61, 205–229
Bauer, M. (1994). Refractoriness induced by lithium discontinuation despite adequate serum lithium levels [letter]. American Journal of Psychiatry, 151, 1522
Beaulieu, S., Rousse, I., Gratton, A., Barden, N., & Rochford, J. (1994). Behavioral and endocrine impact of impaired type II glucocorticoid receptor function in a transgenic mouse model. Annals of the New York Academy of Sciences, 746, 388–391
Berghofer, A. & Muller-Oerlinghausen, B. (1996). No loss of efficacy after discontinuation and reinstitution of long-term lithium treatment? In V. S. Gallicchio & N. J. Birch (Eds.), Lithium: biochemical and clinical advances (pp. 39–46). Cheshire: Weidner Publishing
Bratfos, O. & Haug, J. O. (1968). The course of manic-depressive psychosis: Follow-up investigation of 215 patients. Acta Psychiatrica Scandinavica, 44, 89–112
Breier, A., Kelsoe, J. R. Jr., Kirwin, p. D., Beller, S. A., Wolkowitz, O. M., & Pickar, D. (1988) Early parental loss and development of adult psychopathology. Archives of General Psychiatry, 45, 987–993
Bremner, J. D. (2001). Hypotheses and controversies related to effects of stress on the hippocampus: an argument for stress-induced damage to the hippocampus in patients with posttraumatic stress disorder. Hippocampus, 11, 75–81
Bremner, J. D., Randall, P., Scott, T. M., Bronen, R. A., Seibyl, J. P., Southwick, S. M., Delaney, R. C., McCarthy, G., Charney, D. S., & Innis, R. B. (1995). MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. American Journal of Psychiatry, 152, 973–981
Bremner, J. D., Randall, P., Vermetten, E., Staib, L., Bronen, R. A., Mazure, C., Capelli, S., McCarthy, G., Innis, R. B., & Charney, D. S. (1997). Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse – a preliminary report. Biological Psychiatry, 41, 23–32
Brown, G. W. & Harris, T. O. Social origins of depression. London: Tavistock Press, 1978
Cassano, G. B., Akiskal, H. S., Musetti, L., Perugi, G., Soriani, A., & Mignani, V. (1989). Psychopathology, temperament, and past course in primary major depressions. 2. Toward a redefinition of bipolarity with a new semistructured interview for depression. Psychopathology, 22, 278–288
Castine, M. R., Meador-Woodruff, J. H., & Dalack, G. W. (1998). The role of life events in onset and recurrent episodes of schizophrenia and schizoaffective disorder. Journal of Psychiatric Research, 32, 283–288
Chen, R. W. & Chuang, D. M. (1999). Long term lithium treatment suppresses p53 and Bax expression but increases Bcl-2 expression. A prominent role in neuroprotection against excitotoxicity. Journal of Biological Chemistry, 274, 6039–6042
Chen, G., Zeng, W. Z., Yuan, p. X., Huang, L. D., Jiang, Y. M., Zhao, Z. H., & Manji, H. K. (1999). The mood-stabilizing agents lithium and valproate robustly increase the levels of the neuroprotective protein bcl-2 in the CNS. Journal of Neurochemistry, 72, 879–882
Chuang, D. M., Chen, R. W., Chalecka-Franaszek, E., Ren, M., Hashimoto, R., Senatorov, V., Kanai, H., Hough, C., Hiroi, T., & Leeds, P. (2002). Neuroprotective effects of lithium in cultured cells and animal models of diseases. Bipolar Disorders, 4, 129–136
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2000). The efficacy of toddler-parent psychotherapy for fostering cognitive development in offspring of depressed mothers. Journal of Abnormal Child Psychopathology, 28, 135–148
Coppen, A., Standish-Barry, H., Bailey, J., Houston, G., Silcocks, P., & Hermon, C. (1991). Does lithium reduce the mortality of recurrent mood disorders? Journal of Affective Disorders, 23, 1–7
Coryell, W., Endicott, J., & Keller, M. (1992). Rapidly cycling affective disorder. Demographics, diagnosis, family history, and course. Archives of General Psychiatry, 49, 126–131
Coryell, W., Solomon, D., Leon, A. C., Akiskal, H. S., Keller, M. B., Scheftner, W. A., & Mueller, T. (1998). Lithium discontinuation and subsequent effectiveness. American Journal of Psychiatry, 155, 895–898
Denicoff, K. D., Smith-Jackson, E. E., Disney, E. R., Ali, S. O., Leverich, G. S., & Post, R. M. (1997). Comparative prophylactic efficacy of lithium, carbamazepine, and the combination in bipolar disorder. Journal of Clinical Psychiatry, 58, 470–478
Dolan, R. J., Calloway, S. P., Fonagy, P., De Souza, F. V., & Wakeling, A. (1985). Life events, depression and hypothalamic-pituitary-adrenal axis function. British Journal of Psychiatry, 147, 429–433
Drevets, W. C., Ongur, D., & Price, J. L. (1998). Neuroimaging abnormalities in the subgenual prefrontal cortex: implications for the pathophysiology of familial mood disorders. Molecular Psychiatry, 3, 220–221
Duman, R. S. (1998). Novel therapeutic approaches beyond the serotonin receptor. Biological Psychiatry, 44, 324–335
Dunn, R. T., Frye, M. S., Kimbrell, T. A., Denicoff, K. D., Leverich, G. S., & Post, R. M. (1998). The efficacy and use of anticonvulsants in mood disorders. Clinical Neuropharmacology, 21, 215–235
Egeland, J. A., Hostetter, A. M., Pauls, D. L., & Sussex, J. N. (2000). Prodromal symptoms before onset of manic-depressive disorder suggested by first hospital admission histories. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1245–1252
Ezquiaga, E., Ayuso, G. J., & Garcia, L. A. (1987). Psychosocial factors and episode number in depression. Journal of Affective Disorders, 12, 135–138
Francis, D. D., Caldji, C., Champagne, F., Plotsky, p. M., & Meaney, M. J. (1999). The role of corticotropin-releasing factor – norepinephrine systems in mediating the effects of early experience on the development of behavioral and endocrine responses to stress. Biological Psychiatry, 46, 1153–1166
Gelenberg, A. J., Kane, J. M., Keller, M. B., Lavori, P., Rosenbaum, J. F., Cole, K., & Lavelle, J. (1989). Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder. New England Journal of Medicine, 321, 1489–1493
Ghaziuddin, M., Ghaziuddin, N., & Stein, G. S. (1990). Life events and the recurrence of depression. Canadian Journal of Psychiatry, 35, 239–242
Glassner, B., Haldipur, C. V., & Dessauersmith, J. (1979). Role loss and working-class manic depression. Journal of Nervous and Mental Disease, 167, 530–541
Goddard, G. V., McIntyre, D. C., & Leech, C. K. (1969). A permanent change in brain function resulting from daily electrical stimulation. Experimental Neurology, 25, 295–330
Goldberg, J. F., Harrow, M., & Leon, A. C. (1996). Lithium treatment of bipolar affective disorders under naturalistic follow UP conditions. Psychopharmacology Bulletin, 32, 47–54
Gould, E. & Tanapat, P. (1999). Stress and hippocampal neurogenesis. Biological Psychiatry, 46, 1472–1479
Grof, P., Angst, J., & Haines (1974). The clinical course of depression: Practical issues. In J. Angst (Ed.), Classification and prediction of outcome of depression/Symposium Schloss Reinhartshausen/Rhein, September 23–26, l973 (pp. 141–148). Stuttgart: F.K. Schattauer Verlag
Gurvits, T. V., Shenton, M. E., Hokama, H., Ohta, H., Lasko, N. B., Gilbertson, M. W., Orr, S. P., Kikinis, R., Jolesz, F. A., McCarley, R. W., & Pitman, R. K. (1996). Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder. Biological Psychiatry, 40, 1091–1099
Hammen, C. & Gitlin, M. (1997). Stress reactivity in bipolar patients and its relation to prior history of disorder. American Journal of Psychiatry, 154, 856–857
Huot, R. L., Thrivikraman, K. V., Meaney, M. J., & Plotsky, p. M. (2001). Development of adult ethanol preference and anxiety as a consequence of neonatal maternal separation in Long Evans rats and reversal with antidepressant treatment. Psychopharmacology (Berl), 158, 366–373
Kalivas, p. W. & Duffy, P. (1989). Similar effects of daily cocaine and stress on mesocorticolimbic dopamine neurotransmission in the rat. Biological Psychiatry, 25, 913–928
Kendler, K. S., Kessler, R. C., Neale, M. C., Heath, A. C., & Eaves, L. J. (1993). The prediction of major depression in women: toward an integrated etiologic model. American Journal of Psychiatry, 150, 1139–1148
Kessing, L. V., Andersen, p. K., Mortensen, p. B., & Bolwig, T. G. (1998). Recurrence in affective disorder. I. Case register study. British Journal of Psychiatry, 172, 23–28
Ketter, T. A., George, M. S., Kimbrell, T. A., Benson, B. E., & Post, R. M. (1997). Functional brain imaging in mood and anxiety disorders. Current Review of Mood and Anxiety Disorders, 1, 95–112
Knable, M. B., Torrey, E. F., Webster, M. J., & Bartko, J. O. (2001). Multivariate analysis of prefrontal cortical data from the Stanley Foundation Neuropathology Consortium. Brain Research Bulletin, 55, 651–659
Korte, M., Kang, H., Bonhoeffer, T., & Schuman, E. (1998). A role for BDNF in the late-phase of hippocampal long-term potentiation. Neuropharmacology, 37, 553–559
Koukopoulos, A., Reginaldi, D., Minnai, G., Serra, G., Pani, L., & Johnson, F. N. (1995). The long term prophylaxis of affective disorders. Advances in Biochemical Psychopharmacology, 49, 127–147
Kraepelin, E. (1921). Manic-depressive insanity and paranoia. Edinburgh: E.S. Livingstone
Kubek, M. J., Liang, D., Byrd, K. E., & Domb, A. J. (1998). Prolonged seizure suppression by a single implantable polymeric-TRH microdisk preparation. Brain Research, 809, 189–197
Ladd, C. O., Huot, R. L., Thrivikraman, K. V., Nemeroff, C. B., Meaney, M. J., & Plotsky, p. M. (2000). Long-term behavioral and neuroendocrine adaptations to adverse early experience. Progress in Brain Research, 122, 81–103
Leverich, G. S., Altshuler, L. L., McElroy, S. L., Keck, p. E., Jr., Suppes, T., Denicoff, K. D., Nolen, W. A., Rush, A. J., Kupka, R., Frye, M. A., Autio, K. A., & Post, R. M. (2000). Prevalence of Axis II comorbidity in bipolar disorder: relationship to mood state and course of illness. Presented at the Second European Stanley Foundation Conference on Bipolar Disorder, Amsterdam, The Netherlands, September 21–22
Leverich, G. S., McElroy, S. L., Suppes, T., Keck, p. E., Jr., Denicoff, K. D., Nolen, W. A., Altshuler, L. L., Rush, A. J., Kupka, R., Frye, M., Autio, K., & Post, R. M. (2002). Early physical and sexual abuse associated with an adverse course of bipolar illness. Biological Psychiatry, 51, 288-297
Leverich, G. S., Nolen, W. A., Rush, A. J., McElroy, S. L., Keck, p. E., Denicoff, K. D., Suppes, T., Altshuler, L. L., Kupka, R., Kramlinger, K. G., & Post, R. M. (2001). The Stanley Foundation Bipolar Treatment Outcome Network. I. Longitudinal methodology. Journal of Affective Disorders, 67, 33–44
Levine, S., Huchton, D. M., Wiener, S. G., & Rosenfeld, P. (1991). Time course of the effect of maternal deprivation on the hypothalamic-pituitary-adrenal axis in the infant rat. Developmental Psychobiology, 24, 547–558
Lish, J. D., Dime-Meenan, S., Whybrow, p. C., Price, R. A., & Hirschfeld, R. M. (1994). The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. Journal of Affective Disorders, 31, 281–294
Liu, D., Diorio, J., Tannenbaum, B., Caldji, C., Francis, D., Freedman, A., Sharma, S., Pearson, D., Plotsky, p. M., & Meaney, M. J. (1997). Maternal care, hippocampal glucocorticoid receptors, and hypothalamic-pituitary-adrenal responses to stress. Science, 277, 1659–1662
Loosen, p. T. (1985). The TRH-induced TSH response in psychiatric patients: a possible neuroendocrine marker. Psychoneuroendocrinology, 10, 237–260
Lundqvist, G. (1945). Prognosis and course in manic-depressive psychosis. Acta Psychiatrica Neurologica, 35, 1–96
Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: a critical evaluation and guidelines for future work. Child Development, 71, 543–562
Maj, M., Pirozzi, R., & Magliano, L. (1995). Nonresponse to reinstituted lithium prophylaxis in previously responsive bipolar patients: prevalence and predictors. American Journal of Psychiatry, 152, 1810–1811
Maj, M., Pirozzi, R., Magliano, L., & Bartoli, L. (1998). Long-term outcome of lithium prophylaxis in bipolar disorder: a 5-year prospective study of 402 patients at a lithium clinic. American Journal of Psychiatry, 155, 30–35
Maj, M., Veltro, F., Pirozzi, R., Lobrace, S., & Magliano, L. (1992). Pattern of recurrence of illness after recovery from an episode of major depression: a prospective study. American Journal of Psychiatry, 149, 785–800
Malzberg, B. (1929). A statistical study of the factor of age in manic-depressive psychoses. Psychiatric Quarterly, 3, 590–604
Matussek, p. Halbach, A., & Troger, U. (1965). Endogene depression. Munchen: Urban and Schwarzenberg
McElroy, S. L., Altshuler, L., Suppes, T., Keck, p. E., Frye, M. A., Denicoff, K. D., Nolen, W. A., Kupka, R., Leverich, G. S., Rochussen, J., Rush, A. J., & Post, R. M. (2001). Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. American Journal of Psychiatry, 158, 420–426
Meaney, M. J. (1999). Early environmental experience and lifelong changes in behavior and in gene expression (abstract). Presented at the 38th Annual American College of Neuropsychopharmacology Meeting, Acapulco, Mexico, December 12–16
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
Meaney, M. J., Brake, W., & Gratton, A. (2002). Environmental regulation of the development of mesolimbic dopamine systems: a neurobiological mechanism for vulnerability to drug abuse? Psychoneuroendocrinology, 27, 127–138
Moore, G. J., Bebchuk, J. M., Wilds, I. B., Chen, G., & Manji, H. K. (2000a). Lithium-induced increase in human brain grey matter. Lancet, 356, 1241–1242
Moore, G. J., Bebchuk, J. M., Hasanat, K., Chen, G., Seraji-Bozorgzad, N., Wilds, I. B., Faulk, M. W., Koch, S., Glitz, D. A., Jolkovsky, L., & Manji, H. K. (2000b). Lithium increases N-acetyl-aspartate in the human brain: in vivo evidence in support of bcl-2's neurotrophic effects? Biological Psychiatry, 48, 1–8
Nierenberg, A. A., Pingol, M. G., Baer, H. J., Alpert, J. E., Pava, J., Tedlow, J. R., & Fava, M. (1998). Negative life events initiate first but not recurrent depressive episodes. APA New Research Program and Abstracts, Abstract NR, 236, 132
Nissenbaum, H., Quinn, N. P., Brown, R. G., Toone, B., Gotham, A. M., & Marsden, C. D. (1987). Mood swings associated with the “on-off” phenomenon in Parkinson's disease. Psychological Medicine, 17, 899–904
Nonaka, S. & Chuang, D. M. (1998). Neuroprotective effects of chronic lithium on focal cerebral ischemia in rats. Neuroreport, 9, 2081–2084
Nonaka, S., Katsube, N., & Chuang, D. M. (1998). Lithium protects rat cerebellar granule cells against apoptosis induced by anticonvulsants, phenytoin and carbamazepine. Journal of Pharmacology and Experimental Therapeutics, 286, 539–547
O'Connell, R. A., Mayo, J. A., Flatow, L., Cuthbertson, B., & O'Brien, B. E. (1991). Outcome of bipolar disorder on long-term treatment with lithium. British Journal of Psychiatry, 159, 123–129
Okuma, T. & Shimoyama, N. (1972). Course of endogenous manic-depressive psychosis, precipitating factors and premorbid personality – a statistical study. Folia Psychiatrica et Neurologica Japonica, 26, 19–33
Paskind, H. A. (1930). Manic-depressive psychosis in a private practice. Archives of Neurological Psychiatry, 23, 699–794
Pazzaglia, p. J. & Post, R. M. (1992). Contingent tolerance and reresponse to carbamazepine: a case study in a patient with trigeminal neuralgia and bipolar disorder. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 76–81
Pearlson, G. D., Barta, p. E., Powers, R. E., Menon, R. R., Richards, S. S., Aylward, E. H., Federman, E. B., Chase, G. A., Petty, R. G., & Tien, A. Y. (1997). [Ziskind-Somerfeld Research Award 1996]. Medial and superior temporal gyral volumes and cerebral asymmetry in schizophrenia versus bipolar disorder. Biological Psychiatry, 41, 1–14
Pepin, M. C., Pothier, F., & Barden, N. (1992). Impaired type II glucocorticoid-receptor function in mice bearing antisense RNA transgene. Nature, 355, 725–728
Perris, C. (1968). The course of depressive psychoses. Acta Psychiatrica Scandinavica, 44, 238–248
Perris, H. (1984). Life events and depression. Part 2. Results in diagnostic subgroups, and in relation to the recurrence of depression. Journal of Affective Disorders, 7, 25–36
Plotsky, p. M. (1997). Long-term consequences of adverse early experience: A rodent model (abstract). Biological Psychiatry, 41, 77S
Pollock, H. M. (1931). Recurrence of attacks in manic-depressive psychoses. American Journal of Psychiatry, 11, 567–573
Poort, R. (1945). Catamnestic investigations on manic-depressive psychoses with special reference to the prognosis. Acta Psychiatrica et Neurologica Scandinavica, 20, 59–74
Post, R. M., Denicoff, K. D., Frye, M. A., Dunn, R. T., Leverich, G. S., Osuch, E., & Speer, A. (1998a). A history of the use of anticonvulsants as mood stabilizers in the last two decades of the 20th century. Neuropsychobiology, 38, 152–166
Post, R. M., Frye, M. A., Denicoff, K. D., Leverich, G. S., Kimbrell, T. A., & Dunn, R. T. (1998b). Beyond lithium in the treatment of bipolar illness. Neuropsychopharmacology, 19, 206–219
Post, R. M., Denicoff, K., Frye, M., Leverich, G. S., Cora-Locatelli, G., & Kimbrell, T. A. (1999). Long-term outcome of anticonvulsants in affective disorders. In J. F. Goldberg & M. Harrow (Eds.), Bipolar disorders: clinical course and outcome (pp. 85–114). Washington, D.C.: American Psychiatric Press
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 I. Hindmarch & p. D. Stonier (Eds.), Human psychopharmacology: methods and measures (pp. 211–245). Chichester: Wiley
Post, R. M., Ketter, T. A., Denicoff, K., Pazzaglia, p. J., Leverich, G. S., Marangell, L. B., Callahan, A. M., George, M. S., & Frye, M. A. (1996). The place of anticonvulsant therapy in bipolar illness. Psychopharmacology (Berl.), 128, 115–129
Post, R. M., Ketter, T. A., Speer, A. M., Leverich, G. S., & Weiss, S. R. (2000). Predictive validity of the sensitization and kindling hypotheses. In J. C. Soares & S. Gershon (Eds.), Bipolar disorders: basic mechanisms and therapeutic implications (pp. 387–432). New York: Marcel Dekker
Post, R. M., Kramlinger, K. G., Altshuler, L. L., Ketter, T., & Denicoff, K. (1990). Treatment of rapid cycling bipolar illness. Psychopharmacology Bulletin, 26, 37–47
Post, R. M., Leverich, G. S., Altshuler, L., & Mikalauskas, K. (1992). Lithium-discontinuation-induced refractoriness: preliminary observations. American Journal of Psychiatry, 149, 1727–1729
Post, R. M., Leverich, G. S., Pazzaglia, p. J., Mikalauskas, K., & Denicoff, K. (1993). Lithium tolerance and discontinuation as pathways to refractoriness. In N. J. Birch, C. Padgham, & M. S. Hughes (Eds.), Lithium in medicine and biology (1st ed., pp. 71–84). Lancashire, UK: Marius Press
Post, R. M., Leverich, G. S., Rosoff, A. S., & Altshuler, L. L. (1990). Carbamazepine prophylaxis in refractory affective disorders: a focus on long-term follow-up. Journal of Clinical Psychopharmacology, 10, 318–327
Post, R. M. & Silberstein, S. D. (1994). Shared mechanisms in affective illness, epilepsy, and migraine. Neurology, 44, S37–S47
Post, R. M. & Weiss, S. R. (1992). Ziskind-Somerfeld Research Award 1992. Endogenous biochemical abnormalities in affective illness: therapeutic versus pathogenic. Biological Psychiatry, 32, 469–484
Post, R. M. & Weiss, S. R. B. (1996). A speculative model of affective illness cyclicity based on patterns of drug tolerance observed in amygdala-kindled seizures. Molecular Neurobiology, 13, 33–60
Prien, R. F., Caffey, E. M. J., & Klett, C. J. (1974). Factors associated with treatment success in lithium carbonate prophylaxis. Report of the Veterans Administration and National Institute of Mental Health collaborative study group. Archives of General Psychiatry, 31, 189–192
Racine, R. J. (1972a). Modification of seizure activity by electrical stimulation. I. After-discharge threshold. Electroencephalography and Clinical Neurophysiology, 32, 269–279
Racine, R. J. (1972b). Modification of seizure activity by electrical stimulation. II. Motor seizure. Electroencephalography and Clinical Neurophysiology, 32, 281–294
Rajkowska, G., Miguel-Hidalgo, J. J., Wei, J., Dilley, G., Pittman, S. D., Meltzer, H. Y., Overholser, J. C., Roth, B. L., & Stockmeier, C. A. (1999). Morphometric evidence for neuronal and glial prefrontal cell pathology in major depression. Biological Psychiatry, 45, 1085–1098
Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Journal of the American Medical Association, 264, 2511–2518
Rennie, T. (1942). Prognosis in manic-depressive psychoses. American Journal of Psychiatry, 98, 801–814
Roy-Byrne, P., Post, R. M., Uhde, T. W., Porcu, T., & Davis, D. (1985). The longitudinal course of recurrent affective illness: life chart data from research patients at the NIMH. Acta Psychiatrica Scandinavica, Suppl, 71, 1–34
Rush, A. J., Giles, D. E., Schlesser, M. A., Fulton, C. L., Weissenburger, J., & Burns, C. A. (1986). The inventory for depressive symptomatology (IDS): Preliminary findings. Psychiatry Research, 18, 65–87
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B., & Trivedi, M. H. (1996). The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychological Medicine, 26, 477–486
Sarantidis, D. & Waters, B. (1981). Predictors of lithium prophylaxis effectiveness. Progress in Neuropsychopharmacology, 5, 507–510
Smith, M. A., Makino, S., Altemus, M., Michelson, D., Hong, S. K., Kvetnansky, R., & Post, R. M. (1995). Stress and antidepressants differentially regulate neurotrophin 3 mRNA expression in the locus coeruleus. Proceedings of the National Academy of Sciences of the United States of America, 92, 8788–8792
Soares, J. C. & Mann, J. J. (1997). The anatomy of mood disorders – review of structural neuroimaging studies. Biological Psychiatry, 41, 86–106
Starkman, M. N. (1993). The HPA axis and psychopathology: Cushing's syndrome. Psychiatric Annals, 23, 691–701
Steen, R. B. (1933). Prognosis in manic-depressive psychoses. Psychiatric Quarterly, 7, 419–429
Stenstedt, A. (1952). A study in manic-depressive psychosis. Acta Psychiatrica et Neurologica Scandinavica, Supp, 79, 1–111
Strakowski, S. M., Del Bello, M. P., Sax, K. W., Zimmerman, M. E., Shear, p. K., Hawkins, J. M., & Larson, E. R. (1999). Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. Archives of General Psychiatry, 56, 254–260
Suppes, T., Leverich, G. S., Keck, p. E. Jr., Nolen, W., Denicoff, K. D., Altshuler, L. L., McElroy, S. L., Rush, A. J., Kupka, R., Frye, M. A., Bickel, M., & Post, R. M. (2001). The Stanley Foundation Bipolar Treatment Outcome Network: II. Demographics and illness characteristics of the first 261 patients. Journal of Affective Disorders, 67, 45–59
Swann, A. C., Bowden, C. L., Calabrese, J. R., Dilsaver, S. C., & Morris, D. D. (1999). Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. American Journal of Psychiatry, 156, 1264–1266
Swendsen, J., Hammen, C., Heller, T., & Gitlin, M. (1995). Correlates of stress reactivity in patients with bipolar disorder. American Journal of Psychiatry, 152, 795–797
Swift, J. M. (1907). The prognosis of recurrent insanity of the manic-depressive type. American Journal of Insanity, 64, 311–326
Taschev, T. (1974). The course and prognosis of depression on the basis of 652 patients decreased. In F. K. Schattauer (Ed.), Symposia Medica Hoest: Classification and prediction of outcome of depression (8th ed., pp. 156–172). New York: Schattauer
Tondo, L., Baldessarini, R. J., Floris, G., & Rudas, N. (1997). Effectiveness of restarting lithium treatment after its discontinuation in bipolar I and bipolar II disorders. American Journal of Psychiatry, 154, 548–550
Tondo, L., Baldessarini, R. J., Hennen, J., Floris, G., Silvetti, F., & Tohen, M. (1998). Lithium treatment and risk of suicidal behavior in bipolar disorder patients. Journal of Clinical Psychiatry, 59, 405–414
Wan, R. Q., Noguera, E. C., & Weiss, S. R. (1998). Anticonvulsant effects of intra-hippocampal injection of TRH in amygdala kindled rats. Neuroreport, 9, 677–682
Wei, H., Qin, Z., Senatorov, V. V., Wei, W., Wang, Y., Qian, Y., & Chuang, D. (2001). Lithium suppresses excitotoxicity-induced striatal lesions in a rat model of Huntington's disease. Neuroscience, 106, 603–612
Weiss, S. R., 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, Brain Research Reviews, 20, 305–325
Weiss, S. R. & Post, R. M. (1994). Caveats in the use of the kindling model of affective disorders. Toxicology and Industrial Health, 10, 421–447
Xing, G. Q., Russell, S., Hough, C., O'Grady, J., Zhang, L., Yang, S., Zhang, L. X., & Post, R. M. (2002). Decreased prefrontal CaMKII α mRNA in bipolar illness. NeuroReport, 13, 501–505
Xing, G. Q., Smith, M. A., Levine, S., Yang, S. T., Post, R. M., & Zhang, L. X. (1998). Suppression of CaMKII and nitric oxide synthase by maternal deprivation in the brain of rat pups (abstract). Society for Neuroscience Abstracts, 24 [176.9], 452
Zhang, L. X., Levine, S., Dent, G., Zhan, Y., Xing, G., Okimoto, D., Kathleen, G. M., Post, R. M., & Smith, M. A. (2002). Maternal deprivation increases cell death in the infant rat brain. Developmental Brain Research, 133, 1–11
Zhang, L. X., Xing, G. Q., Levine, S., Post, R. M., & Smith, M. A. (1998). Effects of maternal deprivation on neurotrophic factors and apoptosis-related genes in rat pups (abstract). Society for Neuroscience Abstracts, 24 [176.8], 451
Zis, A. P., Grof, P., & Webster, M. (1980). Prediction of relapse in recurrent affective disorder. Psychopharmacology Bulletin, 16, 47–49