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Indian Journal of Psychiatry
Medknow Publications
Publication Date
  • Original Article
  • Medicine


Indian J. Psychiat. (1980), 22, 39—50 A FAMILY A N D GENETIC STUDY OF PRIMARY AFFECTIVE DISORDERS GURMEET SIxXGH*, M.B.B.S., M.R.C. Psych., D.P...M. (Lond.), Dip. Psych. (McGill), Dip. Am. Board Psych. & Neurology. M. L. AGARWAL1, M..B.B.S., M.D. T h e unitary concept of manic-depres- sive psychoses as originally proposed by Kraeplin (1921) has been questioned by recent investigators such as Leonhard (1965) and Perris (1966), who have presented clinical and genetic evidence to suggest that it is a heterogenous group consisting of two distinct types—(a) the unipolar which is characterised by recurrent episodes of depression only, and (b) the bipolar in which both manic and depressive episodes occur. Among the unipolar g roup , Wood- ruff et al. (1971) and Winokur et al. (1971, 1975) claim to have further distingushed two subtypes based on observed differences in family history between patients develop- ing their first illness before the age of 40 yrs.—the depressive spectrum disease; and after the age of 40 yrs.—the pure depressive disease. Evidence for a genetic contribution to the etiology of pr imary affective disorders comes from both twin and family studies and has been summarised by Slater and Gowie (1971), and Gershon et al . (1975a). The work of Leonhard (1966), Angst (1966), and Perris (1966) have all provided data supporting the division into the unipolar and bipolar groups—each with its distinct genetic mechanism. Winokur and Tana (1969), on the basis of (a) the occurence of bipolar illness in successive generations, (b) a preponderance of female affected relatives of bipolar probands, and (c) the rarity of father to son transmission, have suggested the possibility of a single domi- nant gene located on the X chromosome in the bipolar group. However, other workers are not in agreement with this (Gershon e t a l . , 1975b and Smeraldi et al., 1977) although confirming the importance of gene- tic factors, suggest that bipolar and unipo

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