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Genetics of Bipolar Disorder

Susanne Bengesser and Eva Reininghaus

The high hereditary factor of Bipolar Disorder has been proven by many twin-, adoption- and family-studies already decades ago. Concordance rates between monozygotic twins are even as high as 40-70%. Children of two affected parents have a lifetime-risk of 50-65% to fall ill with Bipolar Disorder, while children with one affected parent show a risk of 25% to get Bipolar Disorder. Therefore psychiatric genetics is highly important to detect the genetic blueprint of Bipolar Disorder to invent prevention strategies, as well as individualized pharmacotherapy and new medication targets. Interestingly top susceptibility genes belong to the ion channel group, growth hormones, clock genes, neurotransmitter systems, Lithium sensitive pathway and other important groups. A detailed and exciting description is given by the authors within this book. Furthermore basic principles of genetics, gene-environment-interactions and genetic overlaps between psychiatric diseases are described to picture the whole painting of Genetics of Bipolar Disorder.


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1. Introduction


Many psychiatric diseases run within families and kinship. A high hereditary factor of mental disease was proven early through numerous family, twin and adoption studies. Important mental diseases such as Schizophrenia, Depression, Addiction, Autism, and Chorea Huntington have a strong genetic predisposition. With the exception of Chorea Huntington, those mental diseases do not show monogenetic pathogenesis, but a polygenetic inheritance. An orchestra of mul- tiple, potentially interacting genes with small effects and incomplete penetrance lead to predisposition. Numerous possible susceptibility genes for psychiatric diseases are still unidentified and it is not exactly known how they interact to lead to illness. Although molecular psychiatry is still in its infancy it is possible that in the future psychiatric genetics might help to draw exact lines between psychiatric diagnoses, which may lead to restructuring of nosology [Burmeister et al. 2008]. Furthermore, molecular genetics give insight in pathogenetic mechanisms, which will help to find targets for development of new medication and laboratory markers. Additionally, the knowledge of inheritance could lead to potent preven- tion strategies. However, one has to illuminate the gene-environment-inter- actions to detect plans against disease onset. Though molecular psychiatry still has to overcome initial difficulties, it is an attempt to review the genetics of bipo- lar affective disorder [Craddock et al. 2005]. 1.1 Bipolar Affective Disorder 1.1.1 History and Symptomatology of Bipolar Disorder Over centuries psychiatric terminology was confusing. Among the first to pro- vide potential concepts were Araeteus from Cappadocia (50-130 A.D.), Jean Pierre Falret (1794-1870) and Jules Baillarges (1809...

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