Affective Disorders
About one in every eight women can expect to develop clinical depression during
their lifetime, while prevalences in males are only slightly less. Schizophrenia
and bipolar illness each affects about one percent of the general population,
causing the loss of the ability to work, to have close relationships, and to have
a fulfilling life. Available treatments, though effective, are incomplete and
there is no cure for a considerable proportion of patients.
Incomplete Treatments
Pharmacological treatment is unsatisfactory in the sense that (1) a large proportion
of patients (35%-45%) exhibit a refractory clinical picture which is resistant to all
treatment modalities, and (2) treatment response cannot predicted for the individual
patient for any of the currently available antipsychotics and antidepressants. In
tandem with the benefits of pharmacological medications are significant risks
associated with their use ("unwanted side effects").
Etiology of Major Psychiatric Disorders
Evidence from twin, family and adoption studies suggests that there is a genetic
predisposition to major psychiatric disorders which varies across patients and may
"explain" some 25%-60% of causality. Genetic predisposition acts nonspecifically,
by elevating a subject's "vulnerability" (or "sensitivity") to environmental or
endogenous challenges. Vulnerability is neither necessary nor sufficient for the
development of psychiatric disorders.
Mechanisms that Support and Maintain Health
A subject's vulnerability is compensated by resilience factors. The term "resilience"
denotes all those endogenous mechanisms that support and maintain health. Strengthening
resilience combined with the early detection of impending mental health problems are a
much better strategy than passively waiting until clinical symptoms develop. In fact,
"vulnerable" subjects can significantly benefit from early interventions that
strengthen resilience and general health.
More to Explore
Stassen HH, Angst J, Hell D, Scharfetter C, Szegedi A: Is there a common resilience mechanism
underlying antidepressant drug response? Evidence from 2848 patients. J Clin Psychiatry
2007; 68(8): 1195-1205
Lötscher K, Stassen HH, Hell D, Bridler R: Community-based crisis home programme — cost-efficient
alternative to psychiatric hospitalization. Nervenarzt 2009; 80(7): 818-826
Stassen HH, Anghelescu IG, Angst J, Böker H, Lötscher K, Rujescu D, Szegedi A, Scharfetter C:
Predicting Response to Psychopharmacological Treatment. Survey of Recent Results.
Pharmacopsychiatry 2011; 44: 263-272
Mohr C, Braun S, Bridler R, Chmetz F, Delfino JP, Kluckner VJ, Lott P, Schrag Y, Seifritz E, Stassen HH:
Insufficient Coping Behavior under Chronic Stress and Vulnerability to Psychiatric Disorders.
Psychopathology 2014; 47: 235-243
