High Familial Risk Increases Likelihood of Depression Onset in Adolescence

The likelihood of developing first-onset depression is over 8 times greater in adolescents with high familial risk for depression compared with adolescents with low familial risk, according to a study published in Journal of Affective Disorders.

The investigators of this study examined how familial risk for depression, along with other forms of parental psychopathy and early or recent life stress, affect the onset of adolescent major depressive disorder.

The study included 325 adolescents, aged 12 to 15 years, with high familial risk (n=166) or low familial risk (n=159) for depression. Participants were followed over a 5-year period in which lifetime psychiatric conditions were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia – Present and Lifetime Version, administered to both adolescents and their parents, and were reevaluated annually to diagnose new-onset disorders and persistence of existing conditions. Participants further completed the Stressful Life Events Schedule and Childhood Trauma Questionnaire, self-reporting measures of mood, anxiety, stress, and substance use. Survival analyses were used to determine the cumulative probability of depression onset, while path analyses assessed contributions of direct and indirect factors to depression onset.

Among 325 participants, 23 (13.8%) high-risk adolescents developed major depressive disorder compared with 3 (1.89%) low-risk adolescents; Cox proportional hazards showed the likelihood of high-risk adolescents developing depression was 8.24 times greater than low-risk adolescents. In path analyses, presence of maternal behavioral disorders and recent stressful life events directly predicted first onset of major depressive disorder in high-risk adolescents; childhood trauma also predicted depression onset through indirect effects on recent life stress. Socioeconomic status was the only demographic factor associated with cumulative probability of developing depression, with lower status corresponding to higher risk.

Limitations to the study included screening eligible adolescents who only had a commercially available phone number, excluding low-risk youth with a history of anxiety, and the relatively low number of major depressive disorder diagnoses, which may be due to the longitudinal study design. Only one measure of recent life stress and childhood trauma was used, and results were susceptible to bias from self-report.

The researchers of the study concluded that risk for first-onset depression is increased in adolescents with high familial risk for depression. Independent of familial risk, recent life stress and maternal behavioral psychopathy were the most important factors predicting depression onset in adolescents.

This study was sponsored by the National Institute on Alcohol Abuse and Alcoholism.

Reference
Elsayed NM, Fields KM, Olvera RL, Williamson DE. The role of familial risk, parental psychopathology, and stress for first-onset depression during adolescence [published online April 22nd, 2019]. J Affect Disord. doi: 10.1016/j.jad.2019.04.084