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The Clinical Characteristics of Major Depression as Indices of the Familial Risk to Illness

Published online by Cambridge University Press:  02 January 2018

Kenneth S. Kendler ,
Michael C. Neale ,
Ronald C. Kessler ,
Andrew C. Heath  and
Lindon J. Eaves
Kenneth S. Kendler*
Affiliation:
Department of Psychiatry and Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA
Michael C. Neale
Affiliation:
Department of Psychiatry and Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA
Ronald C. Kessler
Affiliation:
Department of Human Genetics, Medical College of Virginia, and Department of Psychiatry, Washington University School of Medicine, St Louis, MO
Andrew C. Heath
Affiliation:
Department of Human Genetics, Medical College of Virginia
Lindon J. Eaves
Affiliation:
Institute for Social Research, University of Michigan, Ann Arbor, MI
*
Dr K. S. Kendler, Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
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Extract

Background

From both a clinical and an aetiological perspective, major depression (MD) is probably a heterogeneous condition. We attempt to relate these two domains.

Method

We examined which of an extensive series of clinical characteristics in 646 female twins from a population-based register with a lifetime diagnosis of MD predicts the risk for MD in co-twins. MD was defined by DSM–III–R criteria.

Results

Four variables uniquely predicted an increased risk for MD in the co-twin: number of episodes, degree of impairment and co-morbidity with panic disorder or bulimia. One variable uniquely predicted decreased risk: co-morbidity with phobia. Variables that did not uniquely predict risk of MD in the co-twin included age at onset, number and kind of depressive symptoms, treatment seeking, duration of the longest episode and co-morbidity with generalised anxiety disorder and alcohol dependence.

Conclusions

Our results suggest that the clinical features of MD can be meaningfully related to the familial vulnerability to illness, particularly with respect to recurrence, impairment and patterns of co-morbidity.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue 1 , July 1994 , pp. 66 - 72
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Bebbington, P., Katz, R., McGuffin, P., et al (1989) The risk of minor depression before age 65: results from a community survey. Psychological Medicine, 19, 393–400.Google Scholar
Bland, R. C., Newman, S. C. & Orn, H. (1986) Recurrent and nonrecurrent depression: a family study. Archives of General Psychiatry, 43, 1085–1089.Google Scholar
Breslau, N. & Davis, G. C. (1985) DSM–III generalized anxiety disorder: An empirical investigation of more stringent criteria. Psychiatry Research, 14, 231–238.Google Scholar
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression: A Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar
Cadoret, R. J., Woolson, R. & Winokur, G. (1977) The relationship of age of onset in unipolar affective disorder to risk of alcoholism and depression in parents. Journal of Psychiatric Research, 13, 137–142.Google Scholar
Cohen, J. (1960) A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.Google Scholar
DeFries, J. C. & Fulker, D. W. (1988) Multiple regression analysis of twin data: etiology of deviant scores versus individual differences. Acta Geneticae Medicae et Gemellologiae, 37, 205–216.CrossRefGoogle ScholarPubMed
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Gershon, E. S., Baron, M. & Leckman, J. F. (1975) Genetic models of the transmission of affective disorders. Journal of Psychiatric Research, 12, 301–317.CrossRefGoogle Scholar
Gershon, E. S., Weissman, M. M., Guroff, J. J., et al (1986) Validation of criteria for major depression through controlled family study. Journal of Affective Disorders, 11, 125–131.Google Scholar
Grove, W. M., Andreasen, N. C., Winokur, G., et al (1987) Primary and secondary affective disorders: unipolar patients compared on familial aggregation. Comprehensive Psychiatry, 28, 113–126.Google Scholar
Hopkinson, G. (1964) A genetic study of affective illness in patients over 50. British Journal of Psychiatry, 110, 244–254.Google Scholar
Kendler, K. S., Maclean, C. J., Neale, M. C., et al (1991) The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry, 148, 1627–1637.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1992a) A population based twin study of major depression in women: the impact of varying definitions of illness. Archives of General Psychiatry, 49, 257–266.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1992b) Generalized anxiety disorder in women: a population based twin study. Archives of General Psychiatry, 49, 267–272.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., et al (1993) Major depression and phobias: the genetic and environmental sources of comorbidity. Psychological Medicine, 23, 361–371.Google Scholar
Kessler, R. C., Price, R. H. & Wortman, C. B. (1985) Social factors in psychopathology. Annual Review of Psychology, 36, 531–572.Google Scholar
Kish, L. & Frankel, M. R. (1974) Inferences from complex samples. Journal of the Royal Statistical Society, Series B, 36, 1–37.Google Scholar
Klein, D. N. (1990) Symptom criteria and family history in major depression. American Journal of Psychiatry, 147, 850–854.Google Scholar
Kupfer, D. J., Frank, E., Carpenter, L. L. & Neiswanger, K. (1989) Family history in recurrent depression. Journal of Affective Disorders, 17, 113–119.CrossRefGoogle ScholarPubMed
Leckman, J. F., Merikangas, K. R., Pauls, D. L., et al (1983a) Anxiety disorders and depression: Contradictions between family study data and DSM–III conventions. American Journal of Psychiatry, 140, 880–882.Google Scholar
Leckman, J. F., Weissman, M. M., Merkangas, K. R., et al (1983b) Panic disorder and major depression: increased risk of depression, alcoholism, panic, and phobic disorders in families of depressed probands with panic disorder. Archives of General Psychiatry, 40, 1055–1060.Google Scholar
Leckman, J. F., Caruso, K. A., Prusoff, B. A., et al (1984) Appetite disturbance and excessive guilt in major depression: use of family study data to define depressive subtypes. Archives of General Psychiatry, 41, 839–844.Google Scholar
Lin, N., Dean, A. & Ensel, W. (1986) Social Support, Life Events, and Depression. New York: Academic Press.Google Scholar
Mazure, C. & Gershon, E. S. (1979) Blindness and reliability in lifetime psychiatric diagnosis. Archives of General Psychiatry, 36, 521–525.Google Scholar
McGuffin, P., Katz, R. & Bebbington, P. (1987) Hazard, heredity and depression: a family study. Journal of Psychiatric Research, 21, 365–375.Google Scholar
Mendlewicz, J. & Baron, M. (1981) Morbidity risks in subtypes of unipolar depressive illness: differences between early and late onset forms. British Journal of Psychiatry, 139, 463–466.Google Scholar
Parker, G. (1979) Parental characteristics in relation to depressive disorders. British Journal of Psychiatry, 134, 138–147.Google Scholar
Perris, C. (1966) A study of bipolar (manic-depressive) and unipolar recurrent depressive psychoses. Acta Psychiatrica Scandinavica, 42 (suppl. 194), 1–188.Google Scholar
Riskind, J. H., Beck, A. T., Berchick, R. J., et al (1987) Reliability of DSM–III diagnoses for major depression and generalised anxiety disorder using the Structured Clinical Interview for DSM–III. Archives of General Psychiatry, 44, 817–820.Google Scholar
Robins, E. & Guze, S. B. (1970) Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.Google Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949–958.Google Scholar
Rorsman, B., Grasbeck, A., Hagnell, O., et al (1990) A prospective study of first-incidence depression: the Lundby study, 1957–1972. British Journal of Psychiatry, 156, 336–342.CrossRefGoogle Scholar
SAS Institute (1985) SAS User's Guide: Statistics, Version 5. Cary, NC: SAS Institute, Inc.Google Scholar
Leckman, J. F., (1986) SUGI Supplemental Library User's Guide, Version 5 Edition. Cary, NC: SAS Institute, Inc.Google Scholar
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1987) Structured Clinical Interview for DSM–III–R. New York: Biometrics Research Dept, New York State Psychiatric Institute.Google Scholar
Stancer, H. C., Persad, E., Wagener, D. K., et al (1987) Evidence for homogeneity of major depression and bipolar affective disorder. Journal of Psychiatric Research, 21, 37–53.Google Scholar
Tennant, C. (1988) Parental loss in childhood: its effect in adult life. Archives of General Psychiatry, 45, 1045–1050.Google Scholar
Tsuang, M. T. & Faraone, S. V. (1990) The Genetics of Mood Disorders. Baltimore: The Johns Hopkins University Press.Google Scholar
Weissman, M. M., Merikangas, K. R., Wickramaratne, P., et al (1986) Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry, 43, 430–434.Google Scholar
Weissman, M. M., & Myers, J. K. (1978) Affective disorders in a US urban community: The use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry, 35, 1304–1311.Google Scholar
Winokur, G. (1973) The types of affective disorders. Journal of Nervous and Mental Disease, 156, 82–96.Google Scholar
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