Grandparents, parents, and grandchildren at high risk for depression: A three-generation study

Objective: High-risk studies of psychiatric disorders in parents and offspr ing that include 3 generations are uncommon. Multigenerational studies can be clinically useful as they can provide information for risk prediction fr om one generation to another for the development of empirically based inter ventions. Using a high-risk design, this study examines the association of grandparent major depressive disorder (MDD) and parent MDD with psychopatho logy in grandchildren. Method: Using Cox proportional hazards in a sample o f 90 grandchildren at high and low risk for depression by Virtue of their g randparents' and parents' depression status, the authors examined the risk for offspring depression and anxiety. Results: Grandparent and parent MDD w ere associated with grandchild anxiety (relative risk [RR] = 5.51 and RR = 3.09, respectively). Grandchildren with both a depressed parent and grandpa rent had the highest risk for anxiety. Parental MDD is associated with an i ncreased risk for grandchild disruptive disorder (RR = 10.77). Forty-nine p ercent of the grandchildren in families in which both the parent and grandp arent were depressed had some form of psychopathology. The grandchildren fr om those families were the most impaired. Conclusions: Prepubertal-onset an xiety disorder is a risk factor for the later development of clinically sig nificant recurrent MDD across several generations of families at high risk for depression. Parental impaired functioning increases the risk for disrup tive disorders. Children in families with multiple generations of depressio n are at particularly high risk for some form of psychopathology.