Predicting the 2(1)/(2)-year outcome of dysthymic disorder: The roles of childhood adversity and family history of psychopathology

Follow-up studies of dysthymic disorder (DD) indicate that demographic and clinical variables are not strong predictors of its outcome. The present st udy extended this literature by examining the relationship between the earl y home environment and family history of psychopathology and outcome in DD. Eighty-six outpatients with DD were followed up over a 30-month period usi ng structured clinical interviews. A number of measures of childhood advers ity and familial psychopathology assessed at baseline predicted outcome, ev en after controlling for baseline severity and clinical variables. The best predictors included a history of sexual abuse, quality of the patient's re lationship with both parents, and higher familial loadings for drug abuse a nd Cluster A personality disorders. These findings indicated that childhood adversity and familial psychopathology have greater predictive utility for DD than for demographic and clinical variables.