Wickramaratne P J, Weissman M M
New York State Psychiatric Institute, New York, New York 10032, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Sep;37(9):933-42. doi: 10.1097/00004583-199809000-00013.
To determine the differential effects of parental major depression (MDD) on psychopathology of childhood, adolescent, and early-adult onset in offspring.
One hundred eighty-two offspring from 91 families in which one or more parents or neither parent had MDD were followed for more than 10 years and blindly reassessed by means of a structured diagnostic instrument.
Parental MDD is associated with increased risk in offspring of childhood-onset MDD (eightfold), anxiety disorder (threefold), conduct disorder (fivefold), and early-adult-onset MDD (fivefold) but not adolescent-onset MDD, where there is a marked increase in risk, particularly in girls, regardless of parental diagnosis. These findings were not explained by parental comorbidity, but the association with MDD was explained by parental age at onset of MDD--there was a 13-fold increase in childhood-onset MDD and a 7-fold increase in adult-onset MDD in offspring of parents with MDD of early (before age 30 years) onset.
Childhood- and early-adult-onset MDD may be etiologically homogeneous and familial subtypes. The reason for the high incidence of adolescent-onset MDD, particularly in girls, regardless of parental diagnosis, needs to be determined. The childhood offspring of depressed parents are a potential target for evaluation, especially when the parent had an early-onset depression.
确定父母重度抑郁症（MDD）对后代儿童期、青少年期和成年早期发病的精神病理学的不同影响。
对来自91个家庭的182名后代进行了10多年的随访，这些家庭中一方或多方父母患有或均未患有MDD，并通过结构化诊断工具进行盲法重新评估。
父母患MDD与后代儿童期发病的MDD（8倍）、焦虑症（3倍）、品行障碍（5倍）和成年早期发病的MDD（5倍）风险增加相关，但与青少年期发病的MDD无关，无论父母诊断如何，青少年期发病的MDD风险均显著增加，尤其是女孩。这些发现不能用父母的共病来解释，但与MDD的关联可以用父母MDD发病时的年龄来解释——父母在早年（30岁之前）发病的后代中，儿童期发病的MDD增加了13倍，成年期发病的MDD增加了7倍。
儿童期和成年早期发病的MDD可能在病因上是同质的家族亚型。青少年期发病的MDD，尤其是女孩，无论父母诊断如何，其高发病率的原因有待确定。抑郁父母的儿童后代是评估的潜在目标，尤其是当父母患有早发性抑郁症时。
