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Specific Parental Depression Symptoms as Risk Markers for New-Onset Depression in High-Risk Offspring

J Clin Psychiatry 2013;74(9):925-931
10.4088/JCP.12m08152

Objective: To disaggregate the depression construct and investigate whether specific depression symptoms in parents with a history of recurrent depression are clinical risk markers for future depression in their high-risk offspring. Our hypothesis was that parental symptoms of the type that might impact offspring would most likely be of greatest importance.

Method: Data were drawn from a longitudinal high-risk family study. Families were mainly recruited from primary care and included 337 parent-child dyads. Parents had a history of recurrent DSM-IV unipolar depression and were aged 26–55 years. Their offspring (197 female and 140 male) were aged 9–17 years. Three assessments were conducted between April 2007 and April 2011. Ninety-one percent of families (n = 305) provided full interview data at baseline and at least 1 follow-up, of which 291 were included in the primary analysis. The main outcome measure was new-onset DSM-IV mood disorder in the offspring, which was assessed using the Child and Adolescent Psychiatric Assessment.

Results: Of the 9 DSM-IV depression symptoms, parental change in appetite or weight, specifically loss of appetite or weight, most strongly predicted new-onset mood disorder (odds ratio [OR] = 4.47; 95% CI, 2.04–9.79; P < .001) and future depression symptoms in the offspring (β = 0.12; B = 0.21; 95% CI, 0.00–0.42; P = .050). The cross-generational association was not accounted for by measures of parental depression severity (total depression symptom score, episode recurrence, age at onset, and past impairment or hospitalization) or other potential confounds (parent physical health, eating disorder, or medication).

Conclusions: Findings from this study suggest that loss of appetite or weight in parents with a history of recurrent depression is a marker of risk for depression in their offspring. The findings highlight the importance of examining depression heterogeneity. The biological and environmental mechanisms underlying this finding require investigation.

J Clin Psychiatry 2013;74(9):925–931

Submitted: September 6, 2012; accepted January 10, 2013 (doi:10.4088/JCP.12m08152).

Corresponding author: Stephan Collishaw, PhD, Child and Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neuroscience, Cardiff University School of Medicine, 4th Floor B-C Link Corridor, Heath Park, Cardiff CF14 4XN, United Kingdom (wpcsc5@cf.ac.uk).