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A Ray of Light

J. Raymond DePaulo, M.D.Dr. DePaulo

Ray DePaulo co-directs the Mood Disorders Center; he also heads Hopkins’ psychiatry department, so you’d expect executive skills as well as a clinician’s eye—the ability to size up illness, chart a therapeutic course.

But several decades of medical students and patients know there’s more.

When he’s on rounds, it’s not the same physician who addresses a depressed, tearful elderly woman, a film editor numbed by his new bipolar diagnosis, a young mother with a ladder of cuts up her arm. Of course, different illnesses and life histories demand some adapting, and DePaulo does that well. His empathy enfolds patients.

That same concern drives DePaulo’s research. He began, in the early 1980s, by defining lithium’s use as a therapy for bipolar disorder. But like many, he saw that the real hope for that illness lay in isolating its genes.

Thus began a hunt for bipolar genes that continues today. DePaulo and Hopkins colleagues were quick to see possibilities in linkage analysis—a statistical approach that tells the likelihood that a trait is linked to a specific stretch of chromosome.

In 1985, he became a leader of a dogged amalgam of the country’s best psychiatric geneticists, the NIMH Genetics Initiative Bipolar Group, in a series of ever-better linkage studies that’s continued for 20 years. Surprisingly, in several dozen national studies, no master bipolar gene has surfaced. The groundwork, however, has produced a handful of suspects.

The Next Phase, then, turns on a new idea: that BP stems from the way a number of genes—some probably benign enough on their own—interact with each other and with environmental triggers. A new approach of tighter, “boutique” studies, as DePaulo calls them, aimed to flush out those genes from small, less diverse family groups, has already begun at Hopkins.

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