A Case-Control Family History Study of Depression in Adolescents

doi:10.1097/00004583-199512000-00010

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 34, Issue 12, December 1995, Pages 1596-1607

https://doi.org/10.1097/00004583-199512000-00010 Get rights and content

ABSTRACT

Objective

To examine whether depression aggregates in the families of depressed adolescents and to determine whether clinical features and/or comorbid syndromes in the depressed adolescents change the risk of psychopathology in relatives.

Method

Lifetime prevalence rates of psychopathology in the first-degree (n = 228) and second-degree (n = 736) relatives of 76 adolescents with major depressive disorder (MDD) and the first-degree (n = 107) and second-degree (n = 323) relatives of 34 normal control adolescents were assessed by the Family History-Research Diagnostic Criteria (FH-RDC) method using the parent/guardian as the family informant.

Results

Compared with the first-degree relatives of normal controls, the relatives of depressed adolescents had significantly higher lifetime rates of MDD (25% versus 13%) and “any” of the FH-RDC psychiatric disorders (53% versus 36%). The second-degree relatives of adolescents with MDD had significantly higher lifetime rates of FH-RDC “other” psychiatric disorder (12% versus 7%) and “any” of the FH-RDC psychiatric disorders (22% versus 15%) but not MDD (5% versus 6%) compared with the relatives of normal controls. The first-degree relatives of depressed adolescents who were also suicidal had increased lifetime rates of suicidal behavior which significantly cosegregated with MDD. Comorbid conduct disorder in the depressed adolescent was associated with increased rates of antisocial personality disorder in the first-degree relatives and also tended to cosegregate with MDD.

Conclusions

The current study provides further evidence for the familial aggregation of depression in adolescent-onset MDD. This study also suggests that the familial aggregation of nonaffective psychiatric disorders depends on the clinical features and comorbid syndromes present in the depressed adolescent proband.

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Contributions from resting state functional connectivity and familial risk to early adolescent-onset MDD: Results from the Adolescent Brain Cognitive Development study
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Family history of Major Depressive Disorder (MDD) is a robust predictor of MDD onset, especially in early adolescence. We examined the relationships between familial risk for depression and alterations to resting state functional connectivity (rsFC) within the default mode network (wDMN) and between the DMN and the left/right hippocampus (DMN-LHIPP/DMN-RHIPP) to the risk for early adolescent MDD onset.
We examined 9403 youth aged nine to eleven from the Adolescent Brain Cognitive Development study. Depressive symptoms were measured with the parent-reported Child Behavior Checklist. Both youth and their parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia, which provided MDD diagnoses. A family history screen was administered to determine familial risk for depression. Youth underwent a resting state functional magnetic resonance imaging scan, providing us with rsFC data.
Negative wDMN rsFC was associated with child-reported current depression, both child- and parent-reported past depression, and parent-reported current depressive symptoms. No difference was found in wDMN, DMN-LHIPP or DMN-RHIPP rsFC in children with or without familial risk for depression. Familial risk for depression interacted with wDMN rsFC in association with child-reported past MDD diagnosis and parent-reported current depressive symptoms.
Information such as length of depressive episodes and age of onset of depression was not collected.
Altered wDMN rsFC in youth at familial risk for depression may be associated with increased risk for MDD onset in adolescence, but longitudinal studies are needed to test this hypothesis.
The neural basis of hot and cold cognition in depressed patients, unaffected relatives, and low-risk healthy controls: An fMRI investigation
2020, Journal of Affective Disorders
Modern cognitive neuropsychological models of depression posit that negatively biased emotional (“hot”) processing confers risk for depression, while preserved executive function (“cold”) cognition promotes resilience.
We compared neural responses during hot and cold cognitive tasks in 99 individuals: those at familial risk for depression (N = 30 unaffected first-degree relatives of depressed individuals) and those currently experiencing a major depressive episode (N = 39 unmedicated depressed patients) with low-risk healthy controls (N = 30). Primary analyses assessed neural activation on two functional magnetic resonance imaging tasks previously associated with depression: dorsolateral prefrontal cortex (DLPFC) responsivity during the n-back working memory task; and amygdala and subgenual anterior cingulate cortex (sgACC) responsivity during incidental emotional face processing.
Depressed patients exhibited significantly attenuated working memory-related DLPFC activation, compared to low-risk controls and unaffected relatives; unaffected relatives did not differ from low-risk controls. We did not observe a complementary pattern during emotion processing. However, we found preliminary support that greater DLPFC activation was associated with lower amygdala response during emotion processing.
These findings require confirmation in a longitudinal study to observe each individual's risk of developing depression; without this, we cannot identify the true risk level of the first-degree relative or low-risk control group.
These findings have implications for understanding the neural mechanisms of risk and resilience in depression: they are consistent with the suggestion that preserved executive function might confer resilience to developing depression in first-degree relatives of depressed patients.
A cross-lagged panel analysis of children's sleep, attention, and mood in a prenatally stressed cohort: The QF2011 Queensland flood study
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Citation Excerpt :
The association between current maternal mood and risk for poor child outcomes is a well-documented phenomenon (Goodman et al., 2011). This link may also be explained by some combination of the following hypotheses: current maternal mood is related to their children's propensity to develop mental health problems via genetically inherited vulnerability (Kovacs et al., 1997; Williamson et al., 1995), or via sub-optimal parenting behaviors such as inconsistent parenting (Patterson et al., 1992) or reduced maternal sensitivity (Goodman and Gotlib, 1999). The current results showed that children's scores for sleep, attention, and anxious/depressed problems at 2½ years were correlated with their scores on these scales at 4 years of age (stability effects).
It is well recognized that childhood sleep, attention and mood problems increase risk for multiple adverse outcomes across the life-span; therefore, understanding factors, such as prenatal maternal stress, that underlie these types of childhood problems is critical for developing interventions that may optimize longer-term functioning. Our goal was to determine the association between disaster-related stress in pregnancy and young children's sleep, attention, and anxious/depressed symptoms.
Soon after a major flood in Australia in 2011, we assessed various aspects of disaster-related prenatal maternal stress (PNMS) in women who had been pregnant at the time. Mothers rated several domains of their children's development with the Child Behavior Checklist (CBCL) at ages 2½ (n = 134) and 4 years (n = 118).
The primary finding was that more severe objective flood-related hardship in pregnancy predicted higher sleep problem scores at 2½ years, and that a negative maternal cognitive appraisal of the flood predicted lower attention problem scores at 2½ years. A cross-lagged panel analysis examined the association between children's sleep, attention, and anxious/depressed symptoms within and across ages. Results showed that these problems were likely to co-occur at each age, and that they were stable from 2½ to 4 years. Additionally, anxious/depressed scores at age 2½ predicted sleep problem scores at 4 years, all else being equal.
Limitations of the study include a relatively small sample size and the children's outcome data relied on maternal report using the CBCL, rather than independent observation of the children's functioning, which may have introduced reporter bias.
These findings highlight the importance of early intervention for these childhood problems to optimize long-term mental health, particularly under conditions of prenatal stress.
The role of familial risk, parental psychopathology, and stress for first-onset depression during adolescence
2019, Journal of Affective Disorders
Adolescence represents a critical developmental period during which the initial onset of depression emerges. Family risk for depression is a salient risk factor for the initial onset of Major Depressive Disorder (MDD). We examined the effects of familial risk, stress, and behavior on the risk of developing first-onset depression.
Adolescents aged 12 to 15 with high (n = 166) or low (n = 159) familial risk for depression were assessed annually for up to five years. Stress was assessed using the Stressful Life Events Schedule and Childhood Trauma Questionnaire. The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version was administered to the adolescents and their parents to assess lifetime psychiatric conditions and diagnose MDD onset. Survival and path analyses were used in tandem to determine the risk for first-onset depression as well as the contributions of additional direct and indirect pathways to onset.
High-risk adolescents were eight times more likely to develop first-onset depression compared with low-risk adolescents. The path analyses revealed that the presence of maternal behavioral disorders and increased recent life stress directly predicted an initial onset of MDD in high-risk adolescents.
The small samples used in this study limit the generalizability of these findings.
Adolescents at high familial risk for depression had an increased risk for the emergence of first-onset depression during adolescence. Stress and maternal behavioral psychopathology directly contributed to depression onset independently of familial risk, while childhood trauma exerted an indirect effect on first-onset MDD through recent stress.
Genetic and environmental effects on the development of depressive symptoms from adolescence to adulthood in a nationally representative sample
2019, Journal of Affective Disorders
Previous research has shown substantial heritability for depressive symptoms, yet, there are few genetically-informed studies which focused on developmental changes. The current study sought to model prototypical developmental trajectories of depressive symptoms from adolescence to adulthood and to elucidate genetic and environmental contributions to these changes.
The Add Health data set, a nationally representative sample of adolescents, was used. For the genetically-informed analyses, a subsample of N = 531 same-sex monozygotic and dizygotic male and female twin pairs was selected. Longitudinal development was modeled separately for two waves in early adolescence and for four waves from middle adolescence to young adulthood using a latent growth model (LGM). Both models were extended to twin models to estimate the effects of heritability and the environment.
The rates of depressive symptoms peaked in mid-adolescence and then sharply declined as individuals moved from adolescence to young adulthood, leveling off in the twenties. The effects of the shared environment were substantial among early adolescents, but negligible for middle-to-late adolescents. An opposite pattern was found for heritability. The largest proportion of developmental changes was driven by nonshared environmental effects.
The study only used same-sex twins as there exist mixed findings regarding the possibility of qualitative or quantitative genetic effects.
The salience of unique experiences and, to a lesser extent, heritable factors in affecting developmental changes in depressive symptoms underscore the need for targeting environments that place individuals with genetic predisposition at double the risk for the development of depression.
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Dr. Joaquim (Kim) Puig-Antich was responsible for the design and implementation of this study prior to his sudden death in December 1989. This paper is dedicated to his memory.

The authors are indebted to Dr. David A. Brent for his valuable feedback on earlier drafts of this paper.

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ARTICLESA Case-Control Family History Study of Depression in Adolescents

ABSTRACT

Objective

Method

Results

Conclusions

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Psychiatr Res

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

The family history method using diagnostic criteria

Arch Gen Psychiatry

The family history approach to diagnosis: how useful is it?

Arch Gen Psychiatry

Familial risk factors for adolescent suicide: a case-control study

Acta Psychiatr Scand

Age and depression

J Affect Disord

The assessment of affective disorders in children and adolescents by semi-structured interview: test-retest reliability

Arch Gen Psychiatry

A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia

Arch Gen Psychiatry

Preliminary data on DSM-III associated features of major depressive disorders in children and adolescents

Am J Psychiatry

The inheritance of affective disorders: a review of data and hypotheses

Behav Genet

A family study of schizoaffective, bipolar I, bipolar II, unipolar and normal control probands

Arch Gen Psychiatry

Situational depression: validity of the concept

Br J Psychiatry

Four-Factor Index of Social Position

Nonparametric estimation from incomplete observations

J Am Stat Assoc

A population-based twin study of major depression in women. The impact of varying definitions

Arch Gen Psychiatry

ARTICLES
A Case-Control Family History Study of Depression in Adolescents