THE EFFECT OF A HISTORY OF CONDUCT DISORDER IN ADULT MAJOR DEPRESSION

This paper examines the impact of a history of conduct disorder on maj or depression in adulthood, including its symptomatology, comorbidity and response to tricyclic antidepressants. 103 subjects with DSM-III-R major depression were assessed for DSM-III-R axis I and II comorbidit y, severity of depression, social functioning, general psychiatric sym ptomatology, early familial environment and family psychiatric history . 18 patients (17%) had a history of conduct disorder, 32 (31%) were s ubthreshold, and 53 (51%) had no childhood symptoms of conduct disorde r. Depressed adults with a history of conduct disorder had significant ly higher lifetime alcohol and drug dependence and virtually all (17/1 8, 94%) met criteria for a personality disorder. Despite this, the cur rent episode of depression did not differ in severity, symptoms or res ponse to treatment except that those with a history of conduct disorde r were more likely to be agitated when depressed. The authors conclude that a history of conduct disorder in depressed patients predicts the presence of adult personality disorders and psychoactive substance de pendence. In most other ways, depressed subjects with a history of con duct disorder were similar to other subjects.