The Lifetime History of Major Depression in Women: Reliability of Diagnosis and Heritability

doi:10.1001/archpsyc.1993.01820230054003

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Vol. 50 No. 11, November 1993

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The Lifetime History of Major Depression in Women

Reliability of Diagnosis and Heritability

Kenneth S. Kendler, MD; Michael C. Neale, PhD; Ronald C. Kessler, PhD; Andrew C. Heath, DPhil; Lindon J. Eaves, PhD, DSc

Arch Gen Psychiatry. 1993;50(11):863-870.

Abstract

Background
In epidemiologie samples, the assessment of lifetime history(LTH) of major depression (MD) is not highly reliable. In femaletwins, we previously found that LTH of MD, as assessed at asingle personal interview, was moderately heritable (approximately40%). In that analysis, errors of measurement could not be discriminatedfrom true environmental effects.

Methods
In 1721 female twins from a populationbased register, includingboth members of 742 pairs, LTH of MD, covering approximatelythe same time period, was obtained twice, once by self-administeredquestionnaire and once at personal interview.

Results
Reliability of LTH of MD was modest (x= + .34, tetrachoric r=+ .56) and was predicted by the number of depressive symptoms,treatment seeking, number of episodes, and degree of impairment.Deriving an "index of caseness" from these predictors, the estimatedheritability of LTH of MD was greater for more restrictive definitions.Incorporating error of measurement into a structural equationmodel including both occasions of measurement, the estimatedheritability of the liability to LTH of MD increased substantially(approximately 70%). More than half of what was considered environmentaleffects when LTH of MD was analyzed on the basis of one assessmentappeared, when two assessments were used, to reflect measurementerror.

Conclusions
Major depression, as assessed over the lifetime, may be a ratherhighly heritable disorder of moderate reliability rather thana moderately heritable disorder of high reliability.

Footnotes

From the Departments of Psychiatry (Drs Kendler, Neale, andEaves) and Human Genetics (Drs Kendler and Eaves), Medical Collegeof Virginia/Virginia Commonwealth University, Richmond; theInstitute for Social Research, Universiiy of Michigan, Ann Arbor(Dr Kessler); and the Department of Psychiatry, Washington (JniversiiySchool of Medicine, St Louis, Mo (Dr Heath).

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