title: War exposure, 5-HTTLPR genotype and lifetime risk of depression.
abstract: BACKGROUND
  In 1962 approximately 1.5 million French people living in Algeria were repatriated to France in very poor and often life-threatening conditions. These people constitute a cohort for the study of the long-term impact of gene-environment interaction on depression.
  
  
  OBJECTIVE
  To examine the interaction between a highly stressful life event and subsequent depression, and its modulation by a length polymorphism of the serotonin transporter gene (5-HTTLPR).
  
  
  METHODS
  A community sample of people aged 65 years and over residing in the Montpellier region of the south of France was randomly recruited from electoral rolls. Genotyping was performed on 248 repatriated persons and 632 controls. Current and lifetime major and minor depressive disorders were assessed according to DSM-IV criteria.
  
  
  RESULTS
  A significant relationship was observed between exposure to repatriation and subsequent depression (P<0.002), but there was no significant effect of gene alone (P = 0.62). After controlling for age, gender, education, disability, recent life events and cognitive function, the gene-environment interaction (repatriation × 5-HTTLPR) was globally significant (P<0.002; OR = 3.21, 95% CI 2.48-5.12). Individuals carrying the two short (s) alleles of 5-HTTLPR were observed to be at higher risk (P<0.005; OR = 2.34, 95% CI 1.24-4.32), particularly when repatriation occurred before age 35 years (P<0.002; OR = 2.91, 95% CI 1.44-5.88), but this did not reach significance in those who were older at the time of the event (P = 0.067).
  
  
  CONCLUSIONS
  The association between depression and war repatriation was significantly modulated by 5-HTTLPR genotype but this appeared to occur only in people who were younger at the time of exposure.
authors: INSERM U1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, 34093 Montpellier cedex 5, France. sylvaine.artero@inserm.fr
authors: Sylvaine
authors: S
authors: Artero
authors: Jacques
authors: J
authors: Touchon
authors: Anne-Marie
authors: AM
authors: Dupuy
authors: Alain
authors: A
authors: Malafosse
authors: Karen
authors: K
authors: Ritchie
references: Mol Psychiatry. 2005 Feb;10(2):220-4
references: 15263905
references: Nat Neurosci. 2005 Jan;8(1):20-1
references: 15592465
references: Ann Intern Med. 2003 Sep 2;139(5 Pt 2):437-40
references: 12965972
references: JAMA. 2009 Nov 4;302(17):1859; author reply 1861-2
references: 19887662
references: Br J Psychiatry. 2004 Feb;184:147-52
references: 14754827
references: Biol Psychiatry. 2006 Feb 1;59(3):224-9
references: 16154545
references: Psychol Med. 1999 Sep;29(5):1055-67
references: 10576298
references: Lancet. 2002 Oct 5;360(9339):1056-62
references: 12383986
references: Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17316-21
references: 15563601
references: JAMA. 2001 Aug 1;286(5):546-54
references: 11476656
references: Int J Neuropsychopharmacol. 2006 Aug;9(4):443-9
references: 16212676
references: Am J Epidemiol. 1980 Jun;111(6):736-52
references: 7386449
references: Arch Gen Psychiatry. 2005 Feb;62(2):146-52
references: 15699291
references: Arch Gen Psychiatry. 2006 Sep;63(9):989-96
references: 16953001
references: Mol Psychiatry. 2010 Jan;15(1):18-22
references: 20029411
references: Eur J Epidemiol. 2005;20(1):103-11
references: 15756910
references: JAMA. 2009 Jun 17;301(23):2462-71
references: 19531786
references: Age Ageing. 1998 Nov;27(6):707-14
references: 10408665
references: Arch Gen Psychiatry. 2009 Nov;66(11):1201-9
references: 19884608
references: Soc Sci Med. 2009 Jul;69(2):246-57
references: 19539414
references: JAMA. 1963 Sep 21;185:914-9
references: 14044222
references: Neurobiol Aging. 2010 May;31(5):886-7
references: 18640745
references: Br J Psychiatry. 1973 Oct;123(575):467-70
references: 4748864
references: Mol Psychiatry. 2007 Aug;12(8):748-55
references: 17387319
references: Alcohol Clin Exp Res. 2005 Jan;29(1):8-16
references: 15654286
references: Biol Psychiatry. 2007 Sep 1;62(5):423-8
references: 17482146
references: J Clin Psychiatry. 2009 Sep;70(9):1281-8
references: 19573496
references: Presse Med. 2002 Nov 9;31(36):1696-9
references: 12467149
references: Science. 2003 Jul 18;301(5631):386-9
references: 12869766
references: Psychol Med. 1993 Aug;23(3):679-90
references: 8234575
references: Biol Psychiatry. 2006 Oct 1;60(7):671-6
references: 16934775
references: Am J Psychiatry. 2006 Sep;163(9):1588-93
references: 16946185
references: J Neurol Neurosurg Psychiatry. 2008 Sep;79(9):979-84
references: 18450788
references: Br J Psychiatry. 2006 Mar;188:210-5
references: 16507960
references: Psychopharmacol Bull. 1988;24(4):609-14
references: 3074322
references: Mol Psychiatry. 2004 Oct;9(10):908-15
references: 15241435
references: Arch Gen Psychiatry. 2005 May;62(5):529-35
references: 15867106