The Identification and Validation of Distinct Depressive Syndromes in a Population-Based Sample of Female Twins

doi:10.1001/archpsyc.1996.01830050025004

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Vol. 53 No. 5, May 1996

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The Identification and Validation of Distinct Depressive Syndromes in a Population-Based Sample of Female Twins

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

Arch Gen Psychiatry. 1996;53(5):391-399.

Abstract

Background
Depression, a clinically heterogeneous syndrome, may also beetiologically heterogeneous. Using a prospective, epidemiologic,and genetically informative sample of adult female twins, weidentify and validate a typology of depressive syndromes.

Methods
Latent class analysis was applied to 14 disaggregated DSM-III-Rsymptoms for major depression reported over the last year bymembers of 1029 female-female twin pairs.

Results
Seven classes were identified, of which 3 represented clinicallysignificant depressive syndromes: (1) mild typical depression,(2) atypical depression, and (3) severe typical depression.Severe typical depression was characterized by comorbid anxietyand panic, long episodes, impairment, and help seeking. Atypicaldepression was similar in severity to mild typical depression,but was characterized by increased eating, hypersomnia, frequent,relatively short episodes, and a proclivity to obesity. Individualswith recurrent episodes tended to have the same syndrome oneach occasion. The members of twin pairs concordant for depressionhad the same depressive syndrome more often than expected bychance and this resemblance was greater in monozygotic thanin dizygotic pairs.

Conclusion
In an epidemiologic sample of female twins, depression is notetiologically homogeneous, but is instead made up of severalsyndromes that are at least partially distinct from a clinical,longitudinal, and familial/genetic perspective.

Author Affiliations

From the Departments of Psychiatry (Drs Kendler, Neale, and Eaves and Ms Walters) and Human Genetics (Drs Kendler and Eaves), Medical College of Virginia/Virginia Commonwealth University, Richmond; the Institute for Social Research, University of Michigan, Ann Arbor (Dr Kessler); and the Department of Psychiatry, Washington University School of Medicine, St Louis, Mo (Dr Heath).

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