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Familial depression versus depression identified in a control group: are they the same?

Published online by Cambridge University Press:  09 July 2009

G. Winokur ,
W. Coryell ,
J. Endicott ,
H. Akiskal ,
M. Keller ,
J. D. Maser  and
M. Warshaw
G. Winokur*
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
W. Coryell
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
J. Endicott
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
H. Akiskal
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
M. Keller
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
J. D. Maser
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
M. Warshaw
Affiliation:
National Institute of Mental Health Collaborative Program on the Psychobiology of Depression – Clinical Studies2, Iowa City, USA
*
1Address for correspondence: Dr George Winokur, University of Iowa Hospitals and Clinics, Department of Psychiatry Administration, 200 Hawkins Drive, 2887 JPP, Iowa city, IA 52242–1057, USA.
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Synopsis

Subjects who meet the criteria for an affective syndrome possibly are aetiologically heterogeneous. An approach to this possibility involves examining affectively ill subjects obtained by different methods of ascertainment. This study compares depressed and manic subjects who are related to affectively ill probands with affectively ill subjects who were obtained from a study of a control population, and, therefore, were less likely to be familial. The subjects were identified in a large collaborative study of depression where both family members as well as controls were personally interviewed and followed up for 6 years after admission to the study. Data were obtained on subtypes of affective disorder using the Research Diagnostic Criteria and information was gathered about psychiatric hospitalizations, suicide attempts, alcoholism and psychological functioning prior to admission. Similar assessments were made for the comparison groups for the 6 year period between intake and follow-up. Relatives of bipolar I/schizoaffective manic probands were more likely to show mania than affectively ill controls or relatives of unipolar/schizoaffective depressed probands. Affectively ill controls were less likely to be hospitalized and less likely to suffer from an incapacitating depression. They were also likely to have functioned in a more healthy fashion than the affectively ill relatives of the bipolars and unipolars, in the 5 years before admission to the study. In the 6 year follow-up, both the subjects themselves and raters assessed the depressed controls as functioning better than the affectively ill relatives of the probands. Further, assessment of global adjustment during the 6 year period was worse for the relatives of affectively ill probands than for the depressed controls. Length of major depression was longer in relatives of bipolar and unipolar probands than in controls. Though all of the subjects in this study met research criteria for an affective illness, there were marked differences in the qualitative aspects of these illnesses with the relatives of affectively ill probands, who functioned less well and had longer and more severe episodes and more hospitalizations.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 4 , July 1995 , pp. 797 - 806
Copyright
Copyright © Cambridge University Press 1995

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References

Andreasen, N., Endicott, J., Spitzer, R. & Winokur, G. (1977). The family history method using diagnostic criteria. Archives of General Psychiatry 34, 1229–1235.CrossRefGoogle ScholarPubMed
Andreasen, N., Rice, J., Endicott, J., Coryell, W., Grove, W. & Reich, T. (1987). Familial rates of affective disorders: a report from the National Institute of Mental Health Collaborative Study. Archives of General Psychiatry 44, 461–469 (correction 1988; 45, p. 776).CrossRefGoogle ScholarPubMed
Aronson, T. (1987). A follow-up of two panic disorder-agoraphobic study populations. Journal of Nervous and Mental Disease 175, 595–598.CrossRefGoogle ScholarPubMed
Åsberg, M., Krag-Sorensen, P., Mindham, R. & Tuck, J. (1973). International reliability and communicability of a rating scale for depression. Psychological Medicine 3, 458–465.CrossRefGoogle ScholarPubMed
Cassano, G., Akiskal, H., Perugi, G., Musetti, L. & Savino, M. (1992). The importance of measures of affective temperaments in genetic studies of mood disorders. Journal of Psychiatric Research 26, 257–268.CrossRefGoogle ScholarPubMed
Clayton, P., Halikas, J. & Maurice, W. (1972). The depression of widowhood. British Journal of Psychiatry 120, 71–77.CrossRefGoogle ScholarPubMed
Coryell, W., Winokur, G., Maser, J., Akiskal, H. & Keller, M. (1994). Recurrently situational (reactive) depression: a study of course, phenomenology and familial psychopathology. Journal of Affective Disorders 31, 203–210.CrossRefGoogle ScholarPubMed
Costello, C. (1990). The similarities and dissimilarities between community and clinic cases of depression. British Journal of Psychiatry 157, 812–821.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. (1978). A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, R., Fleiss, J. & Cohen, J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33, 766–771.CrossRefGoogle Scholar
Keller, M. & Shapiro, R. (1979). LIFE Base Schedule. Massachusetts General Hospital: Boston.Google Scholar
Kendler, K., Neale, M., Kessler, R., Heath, A. & Eaves, L. (1992). Familial influences on the clinical characteristics of major depression: a twin study. Acta Psychiatrica Scandinavica 86, 371–378.CrossRefGoogle ScholarPubMed
Kendler, K., Neale, M., Kessler, R., Heath, A. & Eaves, L. (1994). The clinical characteristics of major depression as indices of the familial risk to illness. British Journal of Psychiatry 165, 66–72.CrossRefGoogle ScholarPubMed
Lavori, P., Klerman, G., Keller, M., Reich, T., Rich, J. & Endicott, J. (1987). Age period cohort analysis of secular trends in onset of major depression: findings in siblings of patients with major affective disorder. Journal of Psychiatric Research 21, 23–35.CrossRefGoogle ScholarPubMed
Motulsky, A. (1978). Biased ascertainment and the natural history of diseases. New England Journal of Medicine 298, 1196–1197.CrossRefGoogle ScholarPubMed
Parker, G., Hadzi-Pavlovic, D., Hickie, I., Boyce, P., Mitchell, P., Wilhelm, K. & Brodaty, H. (1991). Distinguishing psychotic and non-psychotic melancholia. Journal of Affective Disorders 22, 135–148.CrossRefGoogle ScholarPubMed
Sashidharan, S., Surtees, P., Kreitman, N., Ingham, J. & Miller, P. (1990). Affective disorder among women in the general population and among those referred to psychiatrists, clinical features and demographic correlations. British Journal of Psychiatry 157, 828–834.CrossRefGoogle Scholar
Spitzer, R., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.CrossRefGoogle ScholarPubMed
Winokur, G. (1983). Controversies in depression, or do clinicians know something after all? In Treatment of Depression, Old Controversies and New Approaches (ed. Clayton, P. and Barrett, J.), pp. 155–166. Raven Press: New York.Google Scholar
Winokur, G. (1991). Mania and Depression. A Classification of Syndrome and Disease. The Johns Hopkins University Press: Baltimore.Google Scholar
Winokur, G. & Coryell, W. (1991). Familial alcoholism in primary unipolar major depressive disease. American Journal of Psychiatry 148, 184–188.Google Scholar
Winokur, G. & Crowe, R. (1983). Bipolar illness: the sex polarity effect in affectively ill family members. Archives of General Psychiatry 40, 54–55.CrossRefGoogle ScholarPubMed
Winokur, G., Tsuang, M. & Crow, R. (1982). The Iowa 500: affective disorder in relatives of manic and depressed patients. American Journal of Psychiatry 139, 209–212.Google ScholarPubMed