Recent advances in depression across the generations.

This Editorial presents recent research on the transmission of depression across three generations and discusses the implications for improving detection, treatment and prevention and for identifying important subgroups for biological studies. It reports a case-control study of three generations at high or low risk for major depression. The first two generations were followed longitudinally for 20 years and were assessed blind to the clinical status of the other generations. Depression is highly familial across three generations. Over 60% of grandchildren (average age 12 yrs.) with two generations affected with depression already have some psychopathology. Anxiety disorders are usually the first presentation before puberty with an increase in depression in adolescents, especially among girls. New opportunities for early detection and treatment exist. Families with three generations affected with depression present a potentially important group for biological, genetic and neuroimaging studies.