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Family history of depression is associated with younger age of onset in patients with recurrent depression

Published online by Cambridge University Press:  13 February 2008

F. Tozzi ,
I. Prokopenko ,
J. D. Perry ,
J. L. Kennedy ,
A. D. McCarthy ,
F. Holsboer ,
W. Berrettini ,
L. T. Middleton ,
H. D. Chilcoat  and
P. Muglia
F. Tozzi
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Verona, Italy
I. Prokopenko
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Verona, Italy
J. D. Perry
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Greenford, UK
J. L. Kennedy
Affiliation:
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Canada
A. D. McCarthy
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Greenford, UK
F. Holsboer
Affiliation:
Max-Planck-Institut für Psychiatrie, Munich, Germany
W. Berrettini
Affiliation:
Center for Neurobiology and Behavior, University of Pennsylvania School of Medicine, USA
L. T. Middleton
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Greenford, UK
H. D. Chilcoat
Affiliation:
Worldwide Epidemiology, GlaxoSmithKline R&D, Research Triangle Park, NC, USA The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
P. Muglia*
Affiliation:
Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Verona, Italy Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Canada
*
*Address for correspondence: P. Muglia, M.D., Medical Genetics, Clinical Pharmacology and Discovery Medicine, GlaxoSmithKline R&D, Via A. Fleming, 4, 37135 Verona, Italy. (Email: [email protected])
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Abstract

Background

Genetic epidemiology data suggest that younger age of onset is associated with family history (FH) of depression. The present study tested whether the presence of FH for depression or anxiety in first-degree relatives determines younger age of onset for depression.

Method

A sample of 1022 cases with recurrent major depressive disorder (MDD) was recruited at the Max Planck Institute and at two affiliated hospitals. Patients were assessed using the Schedules for Clinical Assessment in Neuropsychiatry and questionnaires including demographics, medical history, questions on the use of alcohol and tobacco, personality traits and life events. Survival analysis and the Cox proportional hazard model were used to determine whether FH of depression signals earlier age of onset of depression.

Results

Patients who reported positive FH had a significantly earlier age of onset than patients who did not report FH of depression (log-rank=48, df=1, p<0.0001). The magnitude of association of FH varies by age of onset, with the largest estimate for MDD onset before age 20 years (hazard ratio=2.2, p=0.0009), whereas FH is not associated with MDD for onset after age 50 years (hazard ratio=0.89, p=0.5). The presence of feelings of guilt, anxiety symptoms and functional impairment due to depressive symptoms appear to characterize individuals with positive FH of depression.

Conclusions

FH of depression contributes to the onset of depression at a younger age and may affect the clinical features of the illness.

Keywords

Age of onsetdepressionfamily historymood disorderspsychiatry
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 5 , May 2008 , pp. 641 - 649
Copyright
Copyright © Cambridge University Press 2008

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