Multiple genes and environmental factors, especially childhood adversity, play a role in the genesis of vulnerabilities for depression and anxiety.

In the Zurich Study of young adults, childhood adversity and childhood problems were assessed in retrospect. A factor analysis revealed two factors 1) ‘family problems’ and 2) ‘behavioural problems’. Major depressive episodes (MDE) were defined by DSM-III-R criteria and generalised anxiety disorder (GAD) by DSM-III criteria (duration one month). An anxious personality in childhood or adolescence was defined subjectively as having been more anxious than peers with a negative impact on development. Chronicity was defined by a daily or at least weekly occurrence of the syndrome during the previous twelve months; six interviews were carried out from age 20/21 to 40/41. We compared 87 chronic and 105 non-chronic MDE cases and 62 chronic and 43 non-chronic GAD cases.

Higher family problem scores, earlier onset and chronicity, and an anxious personality in childhood or adolescence were all associated with each other; with a few exceptions this was true for both MDE and GAD.

As hypothesised childhood adversity was a risk factor for the earlier onset and chronicity of MDE and GAD.