Roots of Juvenile-Onset and Adult-Onset Depression May Differ
Originally published by Reuters Health, April 10, 2002
NEW YORK (Reuters Health) — Indications are that juvenile-onset and adult-onset major depressive disorder (MDD) may be etiologically distinct, according to researchers in the UK, US, and New Zealand.
In fact, Dr. Sara R. Jaffee of King's College, London, told Reuters Health that "people who first become depressed in young adulthood don't seem to grow up in the same family environments or to have the same kinds of behavioral and emotional problems that characterize people who first become depressed as children."
Dr. Jaffee and colleagues examined MDD diagnoses in a cohort of 1,037 children who had been enrolled at birth, 980 of whom were followed for 26 years. The findings are published in the March issue of the Archives of General Psychiatry.
Overall, 21 of the participants were diagnosed as having MDD in childhood, but not in adulthood, 34 had such a diagnosis in childhood and had a recurrence in adulthood and 314 were diagnosed as having MDD in adulthood. Those remaining were deemed "never-depressed."
Compared with the adult-onset group, say the researchers, the juvenile-onset groups had more "perinatal insults and motor skill deficits, caretaker instability, criminality, and psychopathology in their family-of-origin, and behavioral and socioemotional problems."
On the other hand, apart from elevated childhood sexual abuse, "the adult-onset group's risk profile was similar to that of the never-depressed group."
Commenting on the findings, Dr. Jaffee observed that "targeting early childhood risk factors has been shown to prevent childhood depression, and that's extremely important because child-onset depression is highly recurrent over time."
However, such an approach "is less likely to help individuals who will first become depressed as adults. Preventing adult-onset depression is more likely to involve targeting the kinds of risk factors that emerge in adolescence." Among these, she added, are negative life events such as school failure.
In an accompanying editorial, Dr. Myrna M. Weissman, of Columbia University, New York, points to limitations in the study, but concludes that the authors deserve congratulation for "producing many useful findings."
