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May 1986

Understanding the Clinical Heterogeneity of Major Depression Using Family Data

Author Affiliations

From the Departments of Psychiatry (Drs Weissman, Merikangas, Wickramaratne, Kidd, Prusoff, and Leckman), Epidemiology (Drs Weissman and Merikangas), and Human Genetics (Drs Kidd and Pauls), and the Child Study Center (Drs Leckman and Pauls), Yale University School of Medicine, New Haven, Conn. Dr Wickramaratne is a fellow of the MacArthur Foundation.

Arch Gen Psychiatry. 1986;43(5):430-434. doi:10.1001/archpsyc.1986.01800050028003

• For major depression, putative subgroups have been defined by age at onset, clinical severity, symptom patterns, or the presence of other disorders (comorbidity), yet the high degree of overlap in clinical presentation makes it difficult to determine which combination of criteria for defining subgroups best predicts familial aggregation. In dealing with this overlap, we found that only early age at onset, or major depression with an anxiety disorder or secondary alcoholism, were independently related to increased risk of major depression in relatives. Once the effects of these proband factors had been taken into account, endogenous, delusional, melancholic, or autonomous symptom patterns, recurrent depression, history of hospitalization, and suicidal ideation or attempts in probands were not associated with increased risk of major depression in relatives.

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