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Biomedical subjects

K R Merikangas

Publications and source records attributed to K R Merikangas.

At least 91 records · Page 5Linked to original sources
PubMed1988

Migraine and depression: association and familial transmission.

We have studied the association between migraine and major depression in a group of 133 probands with major depression, a group of 82 normal community controls and 400 interviewed first-degree relatives of the probands and controls. There was a significant association between depression and migraine among both the probands and the relatives. We also found that concomitant symptoms of anxiety were prominent among the depressed persons with migraine. Both depression and migraine were strongly familial but their association did not appear to be highly transmissible. Rather, our data suggested that depression may either be a sequela of migraine or the diathesis which results in both migraine and depression.

Adolescent↗
PubMed1988

Assortative mating and affective disorders: psychopathology in offspring.

Familial aggregation has been frequently observed among probands with depression, anxiety disorders, and alcoholism (Gershon et al. 1976; Goodwin et al. 1973; Crowe et al. 1983). Because of the familial nature of these disorders, offspring of such probands have been identified to be at high risk for developing these illnesses themselves (Tarter 1983). Information regarding such risk has come from several sources: retrospective studies of patients with psychiatric disorders; studies of children whose parents are being treated for these disorders; and longitudinal follow-up studies of children with symptoms of the disorder.

Adolescent↗
PubMed1988

Delusional depression and bipolar spectrum: evidence for a possible association from a family study of children.

Recent pedigree studies demonstrating a possible linkage of bipolar disorder to markers on different chromosomes have included family members with major depression and cyclothymia as affected. There is general agreement that cyclothymia is related to bipolar disorder and that major depression is heterogenous. It is unclear which subtype of major depression is related to bipolar disorder. Data suggesting a relationship between delusional subtype of major depression and bipolar spectrum are presented. The data derive from a direct-interview study of 220 offspring (ages 6 to 23 years) of probands with either delusional or nondelusional major depression and normal controls. The children of delusional as contrasted with nondelusional probands had nearly a threefold increase in cyclothymia, were more often described by health professionals as hyperactive, and had increased school and social impairments. These findings in children replicate earlier findings in adults on the possible relationship between delusional depression and bipolar disorder and its spectrum. The findings must be considered tentative, however, because of the small sample of children in the subgroups of interest.

Adolescent↗
PubMed1987

Assessing psychiatric disorders in children. Discrepancies between mothers' and children's reports.

Results were compared from independent interviews using the Schedule for Affective Disorders and Schizophrenia for School-aged Children-Epidemiologic Version and DSM-III with 220 subjects (ages 6 to 23 years) and their parent informants. In agreement with results from studies using a variety of structured diagnostic interviews or symptom scales, considerable discrepancies were found between parents' and children's reports on the degree and nature of the child's psychopathology. The children reported more illness about themselves than their parents reported about them. The parents' reports were primarily a subset of the children's reports. Various factors that might affect agreement, including demography, parental clinical status, severity of illness, and treatment, were also explored. The findings that parents under-report psychiatric disorders in their children are comparable with those reported in studies of adults when family informants are used to obtain diagnostic information. Until these parent-child discrepancies can be resolved by longitudinal, family, and other research, diagnostic assessment of children should include direct interviews with them. An independent assessment of the child's diagnosis based on information from multiple informants, including the child, may be the best estimate.

Adolescent↗
PubMed1987

Children of depressed parents. Increased psychopathology and early onset of major depression.

Data on the psychiatric diagnosis, overall functioning, and treatment of 220 6- to 23-year-old subjects who were at high or low risk for major depression are presented. The subjects' diagnoses were made by a child psychiatrist based on best-estimate evaluation of diagnostic information derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Epidemiologic Version) with the subjects and separately with their mothers about their children. The major findings were an increased overall prevalence of major depression and substance abuse, psychiatric treatment, poor social functioning, and school problems in the children of depressed proband parents compared with children of normal proband parents. Overall prepubertal depression was uncommon and the sex ratios were equal. After 12 years of age, there was an increasing preponderance of female subjects in the group with major depression. The mean age at onset of major depression was similar for male and female subjects. However, it was significantly earlier in the children of depressed probands (mean age at onset, 12 to 13 years) compared with the children of normal probands (mean age at onset, 16 to 17 years). Symptom profiles and additional types of diagnoses in the depressed children from either proband parent group did not differ. These children are being followed up longitudinally to determine the prognostic significance, persistence, recurrence, and recall of their symptoms. Several research and clinical strategies are suggested by these data.

Adolescent↗
PubMed1987

Parent and child reports of depressive symptoms in children at low and high risk of depression.

The K-SADS-E psychiatric interview was administered to children and parents (N = 220) from families containing proband parents who had previously been depressed or who were normal. Agreement between parents and their children about depressive symptoms in the children was significant but low. Boy's reports agreed more highly with their parents' reports about them than did girls' reports. Overall, the children reported more depressive symptoms than their parents reported about them and the overall pattern suggests that parents are relatively insensitive to their children's depressive symptomatology, but their reports show high specificity. The implications of these findings for research and clinical work are discussed.

Adolescent↗
PubMed1986

Depressed parents and their children. General health, social, and psychiatric problems.

Two hundred twenty children (aged 6 to 23 years) from families with either depressed or normal (nonpsychiatrically ill) parents of comparable sociodemographic backgrounds were studied. The children from families in which at least one parent had experienced a major depression were reported to have had more adverse perinatal events; were later in achieving some developmental landmarks; had more convulsions, head injuries, operations, and psychiatric disorders (particularly major depression); and made more suicide attempts. Overall, there were no significant differences in IQ between children in both groups. Mothers in families with a depressed parent reported more medical problems during pregnancy and labor, and the children were reported to have experienced more distress at birth. Since major depression is a highly prevalent disorder in women of childbearing ages, these findings have direct clinical implications for pediatricians. Their specificity for major depression, as contrasted with other psychiatric disorders or chronic illnesses in the parents, requires further study.

Adolescent↗
PubMed1986

Understanding the clinical heterogeneity of major depression using family data.

For major depression, putative subgroups have been defined by age at onset, clinical severity, symptom patterns, or the presence of other disorders (comorbidity), yet the high degree of overlap in clinical presentation makes it difficult to determine which combination of criteria for defining subgroups best predicts familial aggregation. In dealing with this overlap, we found that only early age at onset, or major depression with an anxiety disorder or secondary alcoholism, were independently related to increased risk of major depression in relatives. Once the effects of these proband factors had been taken into account, endogenous, delusional, melancholic, or autonomous symptom patterns, recurrent depression, history of hospitalization, and suicidal ideation or attempts in probands were not associated with increased risk of major depression in relatives.

Adolescent↗
PubMed1986

Family-genetic studies of psychiatric disorders. Developing technologies.

During the past decade new concepts and technologies have improved the conduct of family-genetic studies in psychiatry. We compiled and critically evaluated these advances, including study design, pedigree collection, diagnostic procedures in adults and children, and epidemiologic and genetic approaches to data analysis. These approaches have improved the collection of accurate information on the nature and patterns of psychiatric illness in families. The data generated from well-designed and well-conducted family studies are useful for the identification of homogeneous subgroups of psychiatric disorders, for understanding the spectrum of psychiatric disorders, for examining the associations between psychiatric disorders, and for studying the continuity between adult and childhood manifestations of psychiatric disorders. Findings from these studies also may enhance our capacity to identify the mode of transmission of the psychiatric disorders and to select potentially informative families for future genetic linkage studies using the new recombinant DNA techniques. The adaptation of these methods to routine clinical practice and new directions in the application of family-genetic studies employing more refined assessments and analytic methods are also discussed.

Data Collection↗
PubMed1986

The use of survival time models with nonproportional hazard functions to investigate age of onset in family studies.

The use of survival time models with non-proportional hazard functions is introduced as a method of studying age of onset effects in family studies. Statistical methods for investigating non-proportionality of the hazard function are described, and the application of these methods is illustrated using data from a family study of depression to investigate transmission of age of onset between probands and their first degree relatives. The method is broadly applicable and useful for many chronic diseases where transmission of a disorder in families varies by age of onset of the disorder. It may also be used to investigate the effect of other proband factors such as sex on the age of onset of disease in relatives.

Adolescent↗
PubMed1986

The epidemiology of anxiety and panic disorders: an update.

Epidemiologic data on the prevalence rates for various DSM-III categories of anxiety disorders, including panic disorder, agoraphobia, and generalized anxiety disorder, are now available from several community studies of adults. High degrees of co-morbidity have been found, especially among the anxiety disorders and between anxiety and affective disorders. Risk factors for anxiety disorders include young age, female gender, and familial history. The results of twin studies suggest that genetic factors are involved in the etiology of the anxiety disorders, particularly for panic disorder and agoraphobia. Implications for case finding and family psychiatry are discussed.

Adolescent↗
PubMed1985

Familial transmission of depression and alcoholism.

The familial transmission of major depression and alcoholism among probands who had depression and alcoholism was examined. Our findings indicated that depressives without alcoholism did not transmit alcoholism, and probands with depression and alcoholism tended to transmit both depression and alcoholism. This confirms the observation that depression and alcoholism are not manifestations of the same underlying disorder. An increased risk of anxiety disorders in the relatives of probands with alcoholism, which could specifically be attributed to the presence of alcoholism in addition to an anxiety disorder in the proband, was also observed. This suggested that the alcoholism in these probands may result from self-medication of anxiety symptoms. The results of this study underscore the importance of examining combinations of diagnoses in patients in decreasing the heterogeneity of diagnostic categories.

Adult↗
PubMed1985

Marital adjustment in major depression.

The association between depression and marital adjustment is examined in 45 married inpatients with major depression as compared to 45 normal controls from the same community. The marriages of the depressed couples were significantly worse in all areas of functioning than were those of the normals. Two risk factors which distinguished the families of origin of the depressed and normal couples were history of divorce and/or separation in parents and death in the family. In addition, twice as many of the children of the depressives had serious medical or psychiatric illness compared to those of the normals.

Adaptation, Psychological↗
PubMed1985

Genetic factors in the sex ratio of major depression.

A twofold increase in the prevalence of depression among women has been consistently observed. Several possible explanations, including methodological, endocrine, psychosocial, and genetic factors, have been proposed for the increased rates of depression among women. This paper describes the analysis of data from a family-genetic study of depressed probands to examine whether genetic factors can explain the preponderance of depressed females. Our data indicate that the excess of females with major depression cannot be attributed to increased genetic loading for depression in women. Other factors which may explain increased rates of major depression in women are discussed.

Alcoholism↗
PubMed1985

Blood choline and response to clonazepam and haloperidol in Tourette's syndrome.

This paper reports the results of a single blind clinical study of drug treatment response of 20 patients with Tourette's syndrome to haloperidol and clonazepam. Because patients with Tourette's syndrome have been reported to have increased red blood cell choline levels, choline levels were examined in relation to treatment response. Differential drug treatment response was found among patients with high versus low red blood cell-to-plasma choline ratios. Patients with high red blood cell-to-plasma choline ratios responded better to clonazepam than to haloperidol. This suggests that there may be two distinct subtypes of patients with Tourette's syndrome.

Adolescent↗
PubMed1985

Depressives with secondary alcoholism: psychiatric disorders in offspring.

The risk of psychiatric illness among the offspring of probands with major depression and secondary alcoholism was examined. The offspring aged 6-17 (N = 107) and 18 + (N = 171) of probands with major depression (114 with depression only and 19 with secondary alcoholism) were compared with the offspring aged 6-17 (N = 87) and 18 + (N = 103) of controls (N = 82). Offspring of probands with secondary alcoholism had a threefold greater risk of alcoholism and a fivefold greater risk of antisocial personality-conduct disorder compared with offspring of probands with depression only, and a threefold greater risk of alcoholism and a 20-fold greater risk of antisocial personality-conduct disorder compared with offspring of controls. Familial aggregation of alcoholism was observed only among probands with secondary alcoholism. The presence of secondary alcoholism in depressed probands did not convey additional increase in risk of either major depression or anxiety disorders to offspring beyond that observed among offspring of probands with depression only. This suggests that depression and alcoholism are not alternate forms of expression of the same underlying illness. Assortative mating for alcoholism among parents was related to increased risk of both alcoholism and antisocial personality-conduct disorder but not of major depression among offspring. A linear effect on rates of these disorders according to the number of parents with alcoholism was observed.

Adolescent↗