What Comes Before New-Onset Major Depressive Disorder in Kids, Teens?

Early-onset major depressive disorder (MDD) is common in individuals with a family risk of depression. So what signs or symptoms might precede that initial onset of MDD during adolescence among a high-risk group of children with depressed parents?

A new article published online by JAMA Psychiatry by Frances Rice, Ph.D., of Cardiff University, Wales, and coauthors examined data from a study that began with 337 families where a parent (315 mothers and 22 fathers) had at least two episodes of MDD and among whom there was a biologically related child from 9 to 17 years of age living with them.

The authors simultaneously examined the contributions of familial and social risk factors and specific clinical symptoms to the first onset of adolescent MDD. Analyses suggest irritability and fear/anxiety were clinical antecedents associated with new-onset adolescent MDD. Family/genetic and social risk factors also influenced the risk for new-onset MDD, according to the results. The study results suggest that there are multiple routes to the first onset of MDD.

The study cannot establish causality.

“Primary depression prevention or early intervention strategies may need to not only target clinical features in the high-risk child and the parent but also incorporate public health and community strategies to help overcome social risks, most notably poverty and psychosocial adversity,” the study concludes.

(JAMA Psychiatry. Published online December 7, 2016. doi:10.1001/ jamapsychiatry.2016.3140;