A Controlled Family History Study of Childhood-Onset Depressive Disorder

doi:10.1001/archpsyc.1997.01830190033004

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Vol. 54 No. 7, July 1997

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A Controlled Family History Study of Childhood-Onset Depressive Disorder

Maria Kovacs, PhD; Bernie Devlin, PhD; Myrna Pollock, MSW; Cheryl Richards, MBA; Protap Mukerji, MS

Arch Gen Psychiatry. 1997;54(7):613-623.

Abstract

Background
We studied the family psychiatric history of 125 youths withchildhood-onset depressive disorder (a portion of whom developedbipolar disorder) and 55 psychiatric controls with nonaffectivedisorder.

Methods
Probands were classified according to prospectively observedclinical course in childhood. Family psychiatric history wasdetermined by interviewers blind to probands' diagnoses, withmothers typically informing about themselves and about remainingfirst- and all second-degree adult relatives.

Results
Families of affectively ill juveniles had 5-fold greater oddsof lifetime depressive disorder and 2-fold greater odds of recurrentunipolar depressive disorder than did families of psychiatriccontrols. The higher risk of depression was most evident infirst-degree and female relatives. Mothers of affectively illyouths were younger at onset of depression than were mothersof controls. Alcoholism and substance use disorders were moreprevalent in relatives of affectively ill probands than in controlsand cosegregated with familial depression. However, other covariateswere more important at predicting patterns of familial depression.Familial illness patterns also varied somewhat with probandcharacteristics.

Conclusions
Child probands with affective disorder identify families enrichedwith affective disorder (even compared with families of psychiatriccontrols), suggesting that juvenile- and adult-onset forms ofthis condition share the same diathesis. Rates of affectiveillness in the families of depressed youngsters also are notablyhigher than population-based estimates. The findings thereforeindicate that very-early-onset affective disorder is familialand that pedigrees ascertained through affectively ill childrenare good candidates for family and genetic studies.

Author Affiliations

From the Department of Psychiatry, University of Pittsburgh School of Medicine, and Western Psychiatric Institute and Clinic (Drs Kovacs and Devlin, Mss Pollock, and Richards, and Mr Mukerji); and Carnegie Mellon University (Dr Devlin), Pittsburgh, Pa.

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