title: First episode of depression in children at low and high familial risk for depression.
abstract: OBJECTIVE
  To examine the development of first-onset major depressive disorder (MDD) in children at high and low familial risk for depression in a prospective study.
  
  
  METHODS
  High-risk children (n = 76) who were free of any lifetime affective disorder and had at least one first-degree and one second-degree relative with a lifetime history of childhood-onset, recurrent, bipolar, or psychotic depression were included. Low-risk children (n = 63) were included if they were free of any lifetime psychiatric disorder and had no first-degree relatives and fewer than 20% of their second-degree relatives with a lifetime affective disorder. Children and their parents were assessed in a prospective design using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version (K-SADS-E). The average interval between follow-up interviews was 18 months, and the average follow-up period was 6 years.
  
  
  RESULTS
  High-risk children had approximately a threefold increased risk of developing first-onset MDD compared with low-risk children (odds ratio = 3.21). The average age of new-onset MDD was 14.0 +/- 2.9 years (range 9.5-19.5 years). Above and beyond the familial loading for MDD, mother's lifetime anxiety disorder (odds ratio = 2.84) and lifetime behavioral disorder (odds ratio = 3.25) in the child significantly added to the risk of developing a first-onset MDD.
  
  
  CONCLUSIONS
  Having high familial loading for affective disorders, a mother with and anxiety disorder, and a behavioral disorder in the child all significantly contributed to the risk of developing depression.
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. WilliamsonDE@upmc.edu
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Williamson
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: David A
authors.initials: DA
authors.lastname: Axelson
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk