Previous "top-down" and "bottom-up" depression studies, studying the offspring of depressed patients and the parents of depressed offspring, respectively, have had weaknesses in selection criteria and have failed to consider diagnostic comorbidities that might influence the results, says the German team. Therefore, Dr Roselind Lieb from the Max Planck Institute of Psychiatry in Munich, in collaboration with other German researchers, examined the associations between depressive disorders, their natural course, other psychopathology and parental major depression in a representative sample of adolescents and young adults.
A total of 2,427 adolescents and young adults, for whom diagnostic information about psychopathology in both parents was available, were followed for four years. Psychiatric morbidity among the study participants was assessed using the Munich-Composite International Diagnostic Interview and information on depression in parents was collected by history taking. For 51 per cent of the subjects studied, neither parent suffered from major depression. In about 34 per cent, one parent suffered from major depression and in 16 per cent both parents suffered from this condition. Those adolescents and young adults with one or two affected parents appeared to be at increased risk of depression. In terms of parental loading, having one or two affected parents carried an equal risk of depression for offspring.
Parental depression was also associated with an earlier onset and a more malignant course of depressive disorders in offspring. Furthermore, parental depression was linked with other psychopathologies in offspring, such as anxiety, substance abuse and bipolar disorder. Which parent suffered from depression did not appear to affect the results, however.
The researchers said their findings suggested that specific prevention and intervention efforts are needed for high-risk offspring. "The early detection of mental health problems in offspring of depressed parents seems to be crucial, as this would allow the treatment of early manifestations of mental problems before they cause clinical impairment," wrote the study authors in Archives of General Psychiatry. Reference: Lieb et al, Archives of General Psychiatry 2002;59:365-374
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