Magazine article The Saturday Evening Post

Update on Bipolar Illness

Magazine article The Saturday Evening Post

Update on Bipolar Illness

Article excerpt

Q. Could you tell us about the research you've done on the familial and hereditary aspects of bipolar illness.?

A. We have been identifying families with multiple cases of bipolar disorder for the last eight years or so here at the Indiana University Medical Center. We are studying these families carefully and taking blood samples for analysis of DNA. We've looked at the DNA in the laboratory in conjunction with other centers at Washington University in St. Louis, Johns Hopkins, and the National Institute of Mental Health intramural program. We are currently preparing our results for publication from the first series that we have done with that collaboration. It does show that a number of genes are possibly inked to bipolar illness, not just one. We are pursuing the possible areas with additional studies now.

Q. Is it too soon to start thinking about genetic testing for bipolar illness?

A. Yes. The work needs to be replicated. We need to understand if a gene is there, exactly what the gene is, and exactly where it is. We should understand that we are dealing with vulnerability genes. It is not the same situation as it is with Huntington's disease, for instance, where you have a single gene that will determine whether somebody gets the illness. Here you have a situation where the presence of a particular gene probably increases the risk, but it is not an absolute positive or negative.

Q. And more than one chromosome might be involved?

A. That's the way it looks. Looking at the studies that exist thus far, I would say the best evidence exists for a gene on chromosome 18, but there is also evidence for a gene on chromosome 21. There may be one on 11, one on the X chromosome, and possibly one on the other end of chromosome 18. We have been looking at the long arm of that chromosome, but there may be one on the short arm as well.

Q. How many families have you studied in your research at Indiana University?

A. We have screened out 1,500 patients with bipolar I disorder. Of those, we have identified about 50 that meet our criteria for having multiple cases closely related to each other and a family size that is large enough to study with persons within the family available for study. We are pursuing a number of the families you have helped us identify with the first survey you published and are interested in seeing something like it appear again.

Q. Do early identification and treatment make a big difference in the course of the illness?

A. We suspect that they really do make a big difference, because people can devastate their lives in so many ways with untreated mania and depression that might be prevented. There is also increasing evidence that early treatment may actually alter the course later.

Q. Do you have useful information that might help our readers identify, some of the symptoms in their teenagers or young people as they begin to occur in manic-depression?

A. If you or a member of your family have severe or persistent depression or an elevated mood, it's something that should be evaluated by a professional. We advise, particularly people who come from families in which there are multiple cases of depression or manic-depressive illness, that they are wise to be aware of the symptoms and signs that may indicate it's appropriate to seek professional help. The National Institute of Mental Health has publications that are helpful for people in identifying the signs and symptoms. Most university medical centers can help provide information as well. We can help provide information to people in this area about appropriate treatment possibilities. If you are looking at a change in somebody's mood that goes on for several weeks and seems to be interfering in their functioning, then it's reasonable to get a professional evaluation.

Q. In the third or fourth generation of a family affected with bipolar disease, does it become less intense or is it more likely to get worse? …

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