Stress and the Brain: A Fresh Perspective

Extract

Stress, the Brain and Depression, by Herman M. van Praag, Ron de Kloet, and Jim van Os. (2004). Cambridge, UK: Cambridge University Press. 293 pp., $110.00, £65.00.

This book addresses one of the fundamental questions in the etiology of depression: Does stress cause depression? Although intuitively one may answer yes to this question, the book presents detailed psychological and neurobiological evidence to show the complexity of the issue. The book focuses on three major themes: (1) pathophysiology of stress in depression; (2) stress-inducible subtypes of depression; and (3) diagnosing depression to understand biological underpinnings of the condition. Although each of the three authors wrote individual chapters (with van Praag writing most chapters), the book is well organized and flows smoothly. The book is well written in an entertaining style, especially the chapters written by van Praag. For example, when discussing the problems with the current DSM-IV diagnostic system, van Praag states, “psychiatric diagnosing is locked up in a nosological straightjacket, and thus immobilized” (p. 8). It is this type of commentary, sprinkled throughout the book, that holds the reader's interest. In addition, the authors provide a fresh perspective on diagnostic issues in depression, stress/negative life events, and the neurobiology of depression. I expect the volume will stimulate research ideas. To get the most out of the book, it should be read in its entirety. Exceptions are the chapters reviewing the psychobiology of stress and depression, which provide very comprehensive summaries of the research literature, and may serve as a good reference. The initial chapters build the theoretical foundation for the presentation of the biological data, and the final chapters integrate the biological data with the initial hypotheses. The authors take issue with diagnostic trends in psychiatry, definitions of stress and life events, and to a lesser extent, neurobiological approaches to psychiatric research. The authors do not rehash old findings, but include the most recent literature. For example, when discussing corticotrophin releasing hormone (CRH) receptors, they present new findings supporting a possible parallel parasympathetic-related system in addition to the traditional sympathetic response. When the data presentation becomes complex, information is summarized in easy-to-read tables.