Consequences of deterministic and random dynamics for the course of affective disorders

Background: Uni- and bipolar affective disorders tend to be recurrent and progressive. Illness patterns can evolve from isolated episodes to more rapid rhythmic, and "chaotic" mood patterns. Nonlinear deterministic dynamics are currently proposed to explain this progression. However, most natural systems are nonlinear and noisy, and cooperative behavior of possible clinical relevance can result. Methods: The latter issue has been studied with a mathematical model for progression of disease patterns in affective disorders. Results: Deterministic dynamics can reproduce a progression from stable, to periodic, to chaotic patterns. Noise increases the spectrum of dynamic behaviors, enhances the responsiveness to weak activations, and facilitates the occurrence of aperiodic patterns. Conclusions: Noise might amplify subclinical vulnerabilities into disease onset and could induce transitions Co rapid-changing dysrhythmic mood patterns. We suggest that noise-mediated cooperative behavior, including stochastic resonance, should be considered in appropriate models for affective illness. (C) 1999 Society of Biological Psychiatry.