Differences in early childhood risk factors for juvenile-onset and adult-onset depression.

Published

Journal Article

BACKGROUND:Family and twin studies suggest that juvenile-onset major depressive disorder (MDD) may be etiologically distinct from adult-onset MDD. This study is the first to distinguish prospectively between juvenile- and adult-onset cases of MDD in a representative birth cohort followed up from childhood into adulthood. METHOD:The study followed a representative birth cohort prospectively from birth to age 26 years. Early childhood risk factors covered the period from birth to age 9 years. Diagnoses of MDD were made according to DSM criteria at 3 points prior to adulthood (ages 11, 13, and 15 years) and 3 points during adulthood (ages 18, 21, and 26 years). Four groups were defined as (1) individuals first diagnosed as having MDD in childhood, but not in adulthood (n = 21); (2) individuals first diagnosed as having MDD in adulthood (n = 314); (3) individuals first diagnosed in childhood whose depression recurred in adulthood by age 26 years (n = 34); and (4) never-depressed individuals (n = 629). RESULTS:The 2 juvenile-onset groups had similar high-risk profiles on the childhood measures. Compared with the adult-depressed group, the juvenile-onset groups experienced more perinatal insults and motor skill deficits, caretaker instability, criminality, and psychopathology in their family-of-origin, and behavioral and socioemotional problems. The adult-onset group's risk profile was similar to that of the never-depressed group with the exception of elevated childhood sexual abuse. CONCLUSIONS:Heterogeneity within groups of psychiatric patients poses problems for theory, research, and treatment. The present study illustrates that the distinction between juvenile vs adult-onset MDD is important for understanding heterogeneity within depression.

Full Text

Duke Authors

Cited Authors

  • Jaffee, SR; Moffitt, TE; Caspi, A; Fombonne, E; Poulton, R; Martin, J

Published Date

  • March 2002

Published In

Volume / Issue

  • 59 / 3

Start / End Page

  • 215 - 222

PubMed ID

  • 11879158

Pubmed Central ID

  • 11879158

Electronic International Standard Serial Number (EISSN)

  • 1538-3636

International Standard Serial Number (ISSN)

  • 0003-990X

Digital Object Identifier (DOI)

  • 10.1001/archpsyc.59.3.215

Language

  • eng