Genes, psychological adversity in childhood, and recent or ongoing psychological stress may combine to cause major depression, write Dr. Sanjay Mathew and colleagues from Mount Sinai School of Medicine in New York in a review published in CMAJ http://www.cmaj.ca/press/pg298.pdf.
"Major depressive disorder is thought to result from the complex interplay of multiple inherited factors and subsequent exposure to a wide range of environmental variables through life," write Dr. Mathew and coauthors.
The review provides a framework for this complex disease that requires a diverse approach in research, diagnosis and treatment. Current treatment options are limited by their delayed onset of action, lack of efficacy and adverse outcomes.
The authors conclude that "much needs to be explored in terms of how genes interact with other environmental variables to influence the risk of major depressive disorder."