DEVELOPMENTAL PRECURSORS OF AFFECTIVE-ILLNESS IN A GENERAL-POPULATIONBIRTH COHORT

Background: Recent evidence suggests that neurodevelopmental impairmen t may be a risk factor for later affective disorder. Methods: Associat ions between childhood developmental characteristics and affective dis order were examined in a prospectively studied national British birth cohort of 5362 individuals born between March 3 and March 9, 1946. Men tal state examinations by trained interviewers performed at ages 36 an d 43 years identified 270 case subjects with adult affective disorder (AD). Teachers' questionnaires completed at age 13 and 15 years identi fied 195 case subjects who had shown evidence of childhood affective d isturbance (CAD). Results: Female gender and low educational test scor es at ages 8, 11, and 15 years were a risk factor for AD, CAD, and AD without CAD. In addition, attainment of motes milestones was later in the CAD group (odds ratio [OR] = 1.2; 95% confidence interval [CI], 1. 1-1.3), followed by, and independent of, greater risk for speech defec ts between the ages of 6 and 15 years (OR = 2.0; 95% CI, 1.3-3.0), dec reased psychomotor alertness on medical examination between ages 4 and 11 years [OR = 4.6; 95% CI, 2.2-9.7), and an excess of twitching and grimacing motor behaviors in adolescence (OR = 3.9; 95% CI, 2.5-6.1). Persistent CAD was strongly associated with persistent AD (OR = 7.8; 9 5% CI, 2.6-23.2). Conclusion: The findings give credence to the sugges tion that affective disorder, especially its early-onset form, is prec eded by impaired neurodevelopment.