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Sources of contribution to the understanding of the etiology of mood disorders
511
AESTRACTS
associated abnormalities chemical with these disorders. This paper will summarize our studies of the effects of these drugs (which produce alterations of mood in man) on the metabolism of biogenic amines (particin norepinephrine ) , both ularly animals and in man. Correlative clinical neurochemical studies of patients with affective disorders will also be presented. The possibility that these neuropharmacological findings may provide clues to the etiology of the affective disorders will be discussed. Neurophysiology Significance for Psychosis
of Induced Convulsions: a Theory of Depressive
MAX FINK, M.D., New York Medical College, New York, N.Y. The alteration of cyclothymic disorders by induced convulsions, thymoleptics or lithium depend on the rapid development of changes in the central nervous system. Successful convulsive therapy requires repeated grand ma1 seizures. When convulsions are induced infrequently, when electrical currents are applied without inducing convulsions, or when convulsions fail to produce persistent changes in the CNS, the behavioral changes are minimal and do not materially affect the psychotic process, and the EEG changes, characteristic of the therapy process, are not elicited. Slow wave activity in the postconvulsive EEG may be modified by a variety of experimental drugs and
reduced by the administration of anticholinergic drugs. These observations have been interpreted as consistent with a cholinergic mechanism underlying the ECT process, and suggest that disordered metabolism of acetylcholine is a factor in the etiology of cyclothymic disorders. Sourcesof Contribution ing of the Etiology
to the Understandof Mood Disorders
MORRIS A. LIPTON, PH.D., ARTHUR J. PRANGE,JR., M.D.,
M.D., AND
IAN C. WILSON, M.B., D.P.M.,
University of North Chapel Hill, N.C.
The Carolina,
There is no known necessary or sufficient cause for either mania or depression. Even amine depletion, as from reserpine, is effective in causing depression in only a minority of cases. Findings in depression that may reflect contributions to cause are biochemical (amines, hormones, electro(muscle lytes ) , neurophysiological tone, sedation threshold, sleep), and whole-organismic (genes, experience, life situation). We shall examine each of these findings for its possible causal significance and shall indicate whether its acquisition is mainly the result of naturalistic observation or of active intervention. On balance, it appears that information of greater causal import has come from the latter technique. In particular, inferences from new treatments have told us most about what we may be treating.
SATURDAY MORNING, 9:00 a.m., February 14, 1970 Session III. Therapy in Mood Disorders Chairman: JOEL ELKES, M.D. Lithium Studies RONALD ,FIEVE, M.D.,
State Psychiatric York, N.Y. Lithium’s
New Institute,
well-established
York New thera-
peutic efficacy against certain affective disorders has moved research to examine more deeply other aspects of its use. Among these are its possible prophylactic properties in preventing
AESTRACTS
associated abnormalities chemical with these disorders. This paper will summarize our studies of the effects of these drugs (which produce alterations of mood in man) on the metabolism of biogenic amines (particin norepinephrine ) , both ularly animals and in man. Correlative clinical neurochemical studies of patients with affective disorders will also be presented. The possibility that these neuropharmacological findings may provide clues to the etiology of the affective disorders will be discussed. Neurophysiology Significance for Psychosis
of Induced Convulsions: a Theory of Depressive
MAX FINK, M.D., New York Medical College, New York, N.Y. The alteration of cyclothymic disorders by induced convulsions, thymoleptics or lithium depend on the rapid development of changes in the central nervous system. Successful convulsive therapy requires repeated grand ma1 seizures. When convulsions are induced infrequently, when electrical currents are applied without inducing convulsions, or when convulsions fail to produce persistent changes in the CNS, the behavioral changes are minimal and do not materially affect the psychotic process, and the EEG changes, characteristic of the therapy process, are not elicited. Slow wave activity in the postconvulsive EEG may be modified by a variety of experimental drugs and
reduced by the administration of anticholinergic drugs. These observations have been interpreted as consistent with a cholinergic mechanism underlying the ECT process, and suggest that disordered metabolism of acetylcholine is a factor in the etiology of cyclothymic disorders. Sourcesof Contribution ing of the Etiology
to the Understandof Mood Disorders
MORRIS A. LIPTON, PH.D., ARTHUR J. PRANGE,JR., M.D.,
M.D., AND
IAN C. WILSON, M.B., D.P.M.,
University of North Chapel Hill, N.C.
The Carolina,
There is no known necessary or sufficient cause for either mania or depression. Even amine depletion, as from reserpine, is effective in causing depression in only a minority of cases. Findings in depression that may reflect contributions to cause are biochemical (amines, hormones, electro(muscle lytes ) , neurophysiological tone, sedation threshold, sleep), and whole-organismic (genes, experience, life situation). We shall examine each of these findings for its possible causal significance and shall indicate whether its acquisition is mainly the result of naturalistic observation or of active intervention. On balance, it appears that information of greater causal import has come from the latter technique. In particular, inferences from new treatments have told us most about what we may be treating.
SATURDAY MORNING, 9:00 a.m., February 14, 1970 Session III. Therapy in Mood Disorders Chairman: JOEL ELKES, M.D. Lithium Studies RONALD ,FIEVE, M.D.,
State Psychiatric York, N.Y. Lithium’s
New Institute,
well-established
York New thera-
peutic efficacy against certain affective disorders has moved research to examine more deeply other aspects of its use. Among these are its possible prophylactic properties in preventing