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Übersichtsarbeit

Genetik depressiver Störungen

Published Online:January 23, 2008https://doi.org/10.1024/1422-4917.36.1.27

Abstract

Zusammenfassung: Depressive Störungen gehören weltweit zu den häufigsten psychiatrischen Erkrankungen, die die psychische und psychosoziale Entwicklung der Erkrankten nachhaltig beeinflussen. Meist beginnen die Erkrankungen im Kindes- und Jugendalter. Anhand der Symptomatik, des Verlaufs und der Ursachen werden unipolare Depressionen von bipolaren Störungen, die durch depressive und manische Erkrankungsphasen gekennzeichnet sind, unterschieden. Für die Entstehung dieser Erkrankungen spielen genetische Faktoren eine entscheidende Rolle. Familien- und Zwillingsstudien konnten das erhöhte Erkrankungsrisiko von Kindern in betroffenen Familien und die hohe Heritabilität, insbesondere von bipolaren Störungen, eindrücklich nachweisen. Die Suche nach prädisponierenden Krankheitsgenen mittels Kopplungs- und Assoziationsanalysen konnte in den vergangenen Jahren beachtliche Fortschritte erzielen. Insbesondere das s-Allel des Serotonintransportergens wurde wiederholt als Risikofaktor bestätigt. Meta-Analysen deuten allerdings auf relativ begrenzte Effekte einzelner Gene hin. Neben genetischen Komponenten sind Umweltfaktoren maßgeblich an der Krankheitsgenese beteiligt: Bei unipolaren Depressionen wird die Erkrankungswahrscheinlichkeit bei entsprechender genetischer Disposition wesentlich durch protektive oder pathogene Umweltfaktoren im Sinne einer engen Gen-Umwelt-Interaktion moduliert.


The genetics of depressive disorders

Summary: Among the most common severe psychiatric disorders worldwide, depressive disorders are a leading cause of morbidity, the onset usually occurring during childhood or adolescence. Symptomatology, prevalence, outcome and treatment differentiate depressive disorder nosologically as being either unipolar depression or bipolar disorder, which is characterized by one or more episodes of mania with or without episodes of depression. Genetic factors decisively influence the susceptibility to depressive disorders. Family studies and twin studies have been essential in defining the magnitude of familial risk and liability to heritability, particularly in the case of bipolar disorder. In recent years, linkage and association studies have made great strides towards identifying candidate genes. Particularly the s-allele of the serotonin transporter has been repeatedly confirmed to be a risk factor. Meta-analyses suggest, however, that the genetic contributions of the ascertained loci are relatively small. Along with genetic factors, environmental factors are heavily involved. Gene-environment action plays a pivotal role, particularly in unipolar depression. The genetic disposition seems to be modulated by a protective or pathogenic environment. Early-onset disorders must be further investigated in future as studies to date are somewhat limited.

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