Psychological Medicine


Vulnerability to depression: what is the role of stress genes in gene × environment interaction?

W. El Hagea1a2 c1, J. F. Powella2 and S. A. Surguladzea2

a1 INSERM U930 ERL CNRS 3106, CHRU de Tours, Université François Rabelais, Tours, France

a2 Institute of Psychiatry, King's College London, UK

Vulnerability to depression has been linked to the interaction of genetic predisposition with stressful life events. This review considers the associations between serotonergic and hypothalamic–pituitary–adrenal (HPA) systems. We follow the standpoint of a previous Editorial Review (Bhagwagar & Cowen, Psychological Medicine 2008, 38, 307–313) and consider another possible mechanism of vulnerability to depressive disorder, that is we suggest that the gene×environment interaction involves complex participation of serotonergic genes modulating response to stress through the HPA system.

(Received May 20 2008)

(Revised December 12 2008)

(Accepted December 19 2008)

(Online publication February 12 2009)


c1 Address for correspondence: Dr W. El Hage, Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London SE5 8AF, UK. (Email: