Psychiatric News February 4, 2005
Volume 40 Number 3
© 2005 American Psychiatric Association
p. 38
Familial Psychiatric Risk May Extend to Third Generation
Joan Arehart-Treichel
Having both a grandparent and a parent with major depression seems to
raise a child's chance of developing a psychiatric disorder. The first signs
of illness, however, may be anxiety, not depression.
Depression can run in the family, numerous studies have shown. None of
these studies, however, has gone beyond two generations, and only a few have
had a longitudinal design.
Now a three-generation longitudinal investigation also implies that
depression can run in the family.
The investigation was headed by Myrna Weissman, Ph.D., a professor of
epidemiology in psychiatry at Columbia University. Study results are reported
in the January Archives of General Psychiatry.
In 1982 Weissman and her colleagues selected 47 persons—some of whom
had experienced a major depression and others who had not—for a study,
then followed the psychiatric fates of those subjects' 86 offspring as they
grew older. Then, as the offspring grew up and had 161 children of their own,
Weissman and her team tracked their psychiatric outcomes as well. By 2002, the
161 grandchildren were, on average, 12 years of
age.
The researchers then divided these 161 youngsters into four
groups—those with at least one grandparent and at least one parent who
had experienced a major depression (71); those with at least one grandparent
who had experienced a major depression but with no parent who had (30); those
with no grandparent who had experienced a major depression, but with at least
one parent who had experienced one (25); and those who had neither a
grandparent nor a parent who had experienced a major depression (35).
Grandchildren with at least one grandparent and at least one parent who had
experienced a major depression had the highest rate of psychopathology, with
59 percent having at least one psychiatric disorder.
In contrast, grandchildren with at least one grandparent—but no
parent—who had experienced a major depression had the lowest rate of
psychopathology, with 13 percent having at least one psychiatric disorder.
The other two groups fell between those two. Psychiatric disorders were
identified in 20 percent of grandchildren who had no grandparent who had
experienced a major depression, but at least one parent who had. And 29
percent of grandchildren with neither a grandparent nor a parent who had
experienced a major depression had at least one psychiatric disorder.
Moreover, when the scientists compared grandchildren who had a grandparent
with a history of major depression and a parent with a history of
severe major depression with grandchildren who had a grandparent with
a history of major depression and a parent with less-debilitating
major depression, 68 percent of the former had at least one psychiatric
disorder, whereas only 31 percent of the latter did, a highly significant
difference.
These results have clinical implications, the researchers said in their
study report: "Obtaining family history of depression and its severity
and impairment in previous generations should help to identify persons at high
risk for psychopathology at a young age."
Another noteworthy finding from the study was that anxiety disorders, not
depressive disorders, were the principal psychiatric disturbance experienced
by grandchildren who had at least one grandparent and parent with a history of
depression. Other studies have shown that anxiety disorders in childhood often
precede depression in adolescence and young adulthood. Thus anxiety in these
grandchildren may herald later risk for depression, Weissman and her
colleagues wrote, and treatment of such anxiety might protect them from the
later development of depression.
In fact, as Weissman told Psychiatric News, they are considering
conducting a study to see whether treating anxiety in children from families
at high risk of depression might prevent the onset of major depression
later.
"Nothing in these findings was surprising," Neal Ryan, M.D., a
professor of child psychiatry at the University of Pittsburgh, said in an
interview. "I think they extend what we have seen so far...[But] this is
a uniquely valuable study because of the very long period of follow-up of
these families, which now extends into the third generation.... [Also] the
earlier findings of this series of studies has very well withstood the test of
time."
The study was funded by the National Institute of Mental Health.
An abstract of "Families at High and Low Risk for
Depression" is posted online at
<http://archpsyc.ama-assn.org/cgi/content/abstract/62/1/29>.
Arch Gen Psychiatry 2005 62 29[Abstract/Free Full Text]
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