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Hi K--Curious about your thoughts on the article below from the Washington Post.--Lorraine A Unified Field Theory of Mental Disorders Washington Post, Tuesday, February 18, 2003; Page HE03 Depression, which often runs in the family, appears to have a bigger and more tightknit clan than previously thought. A study in this month's issue of the Archives of General Psychiatry argues that a common genetic root may link depression with 14 distinct psychiatric and physical disorders. The list includes such to-be-expected relations as dysthymia (low-grade chronic depression), generalized anxiety disorder and obsessive-compulsive disorder, but also more surprising relatives including bulimia, cataplexy (a brief loss of posture or motor control preceded by a burst of strong emotion), fibromyalgia, migraine headaches and irritable bowel syndrome (IBS). The list also includes attention-deficit hyperactivity disorder (ADHD) and premenstrual dysphoric disorder, though for technical reasons they cannot be linked as conclusively as the others. Study co-author Harrison Pope labels this cluster of illnesses "affective spectrum disorder," or ASD. Pope and James Hudson, both of Harvard-affiliated McLean Hospital in Belmont, Mass., compared 64 depressed hospital patients and their families with a control group of 58 non-depressed patients and their families. Members of the former group, they found, were 21/2 times more likely than members of the latter to have at least one of the disorders in the cluster. Their conclusion: Your chances of being, say, bulimic are more than doubled if anyone in your immediate family is, say, depressed. Ditto your chances of having post-traumatic stress disorder if a close relative has IBS. And all disorders in the cluster, including depression, "spring from the same root," says Pope. While the researchers chose to start the web of connections with depression, this was only because more studies about depression's linkages to other conditions were available. They could just as well have started their research with IBS, Pope says.The findings are based on a statistical analysis of more than 450 diagnostic interviews conducted in Austria in collaboration with Innsbruck University. The study took nearly four years to complete. Pope and Hudson first proposed ASD in 1990, but they trace their idea back several more years. While measuring the effectiveness of antidepressants for treating bulimia nervosa, they observed that many of the women participating in that study also suffered from depression, obsessive-compulsive disorder and other ailments. The study returned the expected results: Antidepressants do aid in treating bulimia. Then came the unexpected."The striking thing was," recalls Hudson, "a young woman comes in with bulimia, depression, panic disorder, etc., and [with antidepressants] everything got better." The researchers suspected some unseen link among the conditions. They began sifting through studies, isolating disorders that responded positively to at least three types of antidepressants. What started as a group of eight disorders grew to 14, all of which have been shown to have a genetic element."What's surprising to us," says Hudson, "is that [while] mood and anxiety disorders were expected to go together, we had no idea that migraines and IBS could go with that. [But] we found that they fit our criteria."Nailing the genetic culprit responsible for ASD won't happen soon. "We don't have a good clue what the gene might be," Pope says. "What tends to intrigue people," Pope continues, "is that mood and anxiety disorders can be grouped with physical problems. But is there enough evidence to change the paradigm [that separates the two in clinical practice]?"If the answer is yes, says Hudson, "psychiatrists will have to learn how to look at the body." -- Matt McMillen � 2003 The Washington Post Company
 
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