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Clinical Antecedents of Adolescent-Onset MDD Identified

Clinical Antecedents of Adolescent-Onset MDD Identified
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MONDAY, Dec. 12, 2016 (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, Ph.D., from Cardiff University in the United Kingdom, and colleagues conducted a four-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 two 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 write. “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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