ARTICLES
Family Discord, Parental Depression, and Psychopathology in Offspring: 20-Year Follow-up

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ABSTRACT

Objective

To determine the independent effects of parental depression and family discord on offspring psychopathology among children at high and low risk of depression.

Method

Family discord factors were assessed when subjects were approximately 17 years old, and offspring diagnoses were assessed about 20 years later. Parental and offspring psychopathology was assessed by interviewers blind to parents' clinical status. The following dimensions of family discord were assessed: poor marital adjustment, parent child discord, low family cohesion, affectionless control, and parental divorce.

Results

Most family discord factors were associated with parental depression. Among children of depressed parents, none of the measures of family discord had a statistically significant association with offspring major depressive disorder or anxiety disorders. Among children of nondepressed parents, parental affectionless control was associated with an almost fivefold increased risk of major depressive disorder (odds ratio [OR] = 4.8; p ≤ .05) and with more than a 14-fold increased risk of substance use disorders (OR = 14.3; p ≤ .01).

Conclusions

Parental depression is associated with family discord and is a consistent risk factor for offspring major depressive disorder and anxiety disorders, as shown over a 20-year follow-up of offspring of depressed and nondepressed parents. Family discord factors may be a risk factor for major depressive disorder and substance use disorders in offspring of nondepressed parents.

Section snippets

METHOD

Parents and their children participated in a 20-year follow-up study of offspring of depressed (high-risk families) and nondepressed (low-risk families) probands. The study design and sample assessments have been described in detail elsewhere (Weissman et al., 1987, Weissman et al., 1997, Weissman et al., 2005, Weissman et al). The depressed parents had moderate to severe MDD that resulted in impairment and were receiving treatment at the Yale University Depression Research Unit. The control

Family Discord in Offspring by Parental Depression Status

Of the 182 offspring, 86 were men and 96 were women. The mean age at time 20 was 34.1 years (SD = 5.6). Because family risk factors were measured at baseline (wave 1) and there was no change in parental depression status since the last wave, the distribution of family discord in offspring according to parental depression status has not changed since the 10-year follow-up (Nomura et al., 2002). Briefly, children of depressed parents were more likely to be exposed to poor marital adjustment (OR =

DISCUSSION

Our findings at the 20-year follow-up are consistent with the overall pattern found at the 2- and 10-year follow-ups (i.e., family discord factors were associated with offspring MDD only in children of nondepressed parents). Over the 20-year follow-up, two trends are noteworthy. First, the impact of family risk factors, even in children of nondepressed parents, has diminished over time (Table 4). Second, the impact of parental affectionless control on offspring psychopathology has persisted

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    This study was supported by RO1 MH 036197 from the National Institute of Mental Health (Myrna Weissman, PI).

    Disclosure: Dr. Weissman has received investigator initiated grants from Eli Lilly and Glaxo and has been on the scientific advisory board of Eli Lilly. The other authors have no financial relationships to disclose.

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