HealthDay News — Irritability and fear and/or anxiety are significant clinical antecedents of new adolescent-onset major depressive disorder (MDD) in individuals at familial risk, according to a study published online Dec. 7 in JAMA Psychiatry.

Frances Rice, PhD, from Cardiff University in the United Kingdom, and colleagues conducted a 4-year longitudinal study to examine the developmental pathways that lead to first-episode adolescent-onset MDD among offspring of depressed parents. Participants included 337 families with an index parent who had experienced at least 2 episodes of MDD and who had a biologically-related child aged 9 to 17 years living with the index parent.

The researchers found that at follow-up, the offspring had a mean of 1.85 Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) symptoms of MDD. Twenty adolescents had new-onset MDD (mean age at onset, 14.4 years). Significant independent clinical antecedents of new adolescent-onset MDD included irritability and fear and/or anxiety, but not disruptive behavior and low mood. Similar results were seen for the DSM-IV symptom count at follow-up. All measured familial/genetic and social risk indicators influenced the risk of new-onset MDD directly, rather than through dimensional clinical antecedents.

“There are multiple pathways to first-onset adolescent depression in individuals at familial risk,” the authors wrote. “Irritability and fear/anxiety may be additional clinical phenomena to be included as targets in primary preventive interventions focusing on the child.”

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  1. Hammerton G, Rice F, Sellers R, et al. Antecedents of New-Onset Major Depressive Disorder in Children and Adolescents at High Familial RiskJAMA Psychiatry. 2016 Dec 7; doi:10.1001/jamapsychiatry.2016.3140.
  2. Glowinski AL, Rosen MS. Prevention Targets for Child and Adolescent DepressionJAMA Psychiatry. 2016 December 7; doi:10.1001/jamapsychiatry.2016.3160.