Psychiatric disorders in the relatives of probands with prepubertal-onset or adolescent-onset major depression

Objective: To determine whether the familial risk of major depressive disor der (MDD) varies with either onset, recurrence, or continuity of MDD in adu lthood in prepubertal- compared with adolescent-onset probands. Method: Sev enty-six prepubertal-onset MDD, 59 adolescent-onset MDD, and 78 never psych iatrically ill probands were assessed as children or adolescents and were e valuated 10 to 15 years later as adults, by an independent team that was bl ind to the initial diagnoses. At followup, psychiatric disorders among 731 of their first-degree relatives were assessed using direct interviews and f amily history methods by investigators who were blind to the clinical statu s of the probands. Results: Both prepubertal- and adolescent-onset MDD were significantly associated with a family history of MDD. The familial rates of MDD and other psychopathology did not vary between the 2 groups. For pre pubertal-onset MDD, family history was significantly associated with recurr ence and nonsignificantly associated (trend) with continuity into adulthood . In contrast, there was no association between a family history of MDD and either recurrence or continuity into adulthood of adolescent-onset MDD. Co nclusions: Prepubertal- and adolescent-onset MDD are both associated with a family history of MDD, but only in prepubertal-onset MDD is familial loadi ng associated with recurrence and continuity of MDD into adulthood.