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August 1987

A Potential Artifact in Determining Rates of Depression

Author Affiliations

Department of Mental Hygiene The Johns Hopkins University School of Hygiene and Public Health 615 N Wolfe St Baltimore, MD 21205

Arch Gen Psychiatry. 1987;44(8):759. doi:10.1001/archpsyc.1987.01800200087013

To the Editor.—  The data published by Klerman et al in the July 1985 Archives1 derive from the Psychobiology of Depression Clinical Study. They are of great epidemiologic interest, fitting well with other recent epidemiologic work on temporal variation in the affective illnesses.2The authors concluded that "some form of temporal effect is operating to increase rates of depression among relatives of affectively ill probands in recent decades." I wonder if they would comment on whether this might be partly an artifact of the Schedule for Affective Disorder and Schizophrenia—Research Diagnostic Criteria (SADS-RDC) method. Specifically, the SADS-RDC major depressive disorder case definition requires helpseeking for symptoms, medicine use to relieve symptoms, or a report of impaired functioning in connection with dysphoria.3 Could it be that SADS-RDC—diagnosed major depression occurs more frequently among the more recently born cohorts, and especially among women, because they are more likely to