title: Early developmental characteristics and features of major depressive disorder among child psychiatric patients in Hungary.
abstract: OBJECTIVE
  We investigate the relations of early atypical characteristics (perinatal problems, developmental delay, and difficult temperament) and onset-age (as well as severity of) first major depressive disorder (MDD) and first internalizing disorder in a clinical sample of depressed children in Hungary.
  
  
  METHODS
  Participants were 371 children (ages 7-14) with MDD, and their biological mothers, recruited through multiple clinical sites. Diagnoses (via DSM-IV criteria) and onset dates of disorders were finalized "best estimate" psychiatrists, and based on multiple information sources. Mothers provided developmental data in a structured interview.
  
  
  RESULTS
  Difficult temperament predicted earlier onset of MDD and first internalizing disorder, but its effect was ameliorated if the family was intact during early childhood. Further, the importance of difficult temperament decreased as a function of time. Perinatal problems and developmental delay did not impact onset ages of disorders, and none of the early childhood characteristics associated with MDD episode severity.
  
  
  CONCLUSIONS
  Children with MDD may have added disadvantage of earlier onset if they had a difficult temperament in infancy. Because early temperament mirrors physiological reactivity and regulatory capacity, it can affect various areas of functioning related to psychopathology. Early caregiver stability may attenuate some adverse effects of difficult infant temperament.
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary. kapornai@gyip.szote.u-szeged.hu
authors.forename: Krisztina
authors.initials: K
authors.lastname: Kapornai
authors.forename: Amy L
authors.initials: AL
authors.lastname: Gentzler
authors.forename: Ping
authors.initials: P
authors.lastname: Tepper
authors.forename: Eniko
authors.initials: E
authors.lastname: Kiss
authors.forename: László
authors.initials: L
authors.lastname: Mayer
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Tamás
authors.forename: Maria
authors.initials: M
authors.lastname: Kovacs
authors.forename: Agnes
authors.initials: A
authors.lastname: Vetró
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D013694:Temperament