The Dual Models of behavioral Sensitization and kindling in the Pathophysiology of Mood Disorders: On the Basis of Molecular Mechanisms

Chung, Young In; Kim, Sung Gon; Kim, Myung Jung

Abstract

Recurrent mood disorders show tendencies toward cycle acceleration over time-shorter and shorter well intervals belween successive episodes. On the other hand, clinical findings suggest that psychosocial stresses ore impl icated more prominently in early episodes of mood disorders, whereas less prominent stressors or conditioned behavioral factors are associated with the onset of later episodes. The dual models of behavioral sensitization and kindling may help to explain the pattern of apparent clinical course in th natural history of mood disorders and to link older psychoanclytic and neurobiologic concepts of illness evaluation. The unified approach suggests that psychosocial precipitants are involved in initial episodes, but later ones occur more autonomously : both the stresses and episodes themselves may leave behind changes in the individual's neurobiology by affecting gene expression. From the standpoint of treatment the dual models place a high premium on effective early pharmacologic interventions and their long term maintenance, and support the combination of psychotherapeutic and pharmacologic interventions, accepting the usefulness of psychodynamic or cognitive therapy.