FAMILIAL DEPRESSION VERSUS DEPRESSION IDENTIFIED IN A CONTROL-GROUP -ARE THEY THE SAME

Subjects who meet the criteria for an affective syndrome possibly are aetiologically heterogeneous. An approach to this possibility involves examining affectively ill subjects obtained by different methods of a scertainment, This study compares depressed and manic subjects who are related to affectively ill probands with affectively ill subjects who were obtained from a study of a control population, and, therefore, w ere less likely to be familial. The subjects were identified in a larg e collaborative study of depression where both family members as well as controls were personally interviewed and followed up for 6 years af ter admission to the study, Data were obtained on subtypes of affectiv e disorder using the Research Diagnostic Criteria and information was gathered about psychiatric hospitalizations, suicide attempts, alcohol ism and psychological functioning prior to admission. Similar assessme nts were made for the comparison groups for the 6 year period between intake and follow-up. Relatives of bipolar I/schizoaffective manic pro bands were more likely to show mania than affectively ill controls or relatives of unipolar/schizoaffective depressed probands, Affectively ill controls were less likely to be hospitalized and less likely to su ffer from an incapacitating depression, They were also likely to have functioned in a more healthy fashion than the affectively ill relative s of the bipolars and unipolars, in the 5 years before admission to th e study, In the 6 year follow-up, both the subjects themselves and rat ers assessed the depressed controls as functioning better than the aff ectively ill relatives of the probands, Further, assessment of global adjustment during the 6 year period was worse for the relatives of aff ectively ill probands than for the depressed controls. Length of major depression was longer in relatives of bipolar and unipolar probands t han in controls, Though all of the subjects in this study met research criteria for an affective illness, there were marked differences in t he qualitative aspects of these illnesses with the relatives of affect ively ill probands, who functioned less well and had longer and more s evere episodes and more hospitalizations.