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Biomedical subjects

K R Merikangas

Publications and source records attributed to K R Merikangas.

At least 109 records · Page 6Linked to original sources

Subtypes of depression. Family study perspective.

To address the validity of subtype distinctions within a large family study of major depression, probands (N = 133) were classified into several non-mutually exclusive subcategories, including endogenous (n = 89), melancholic (n = 61), autonomous (n = 50), and delusional (n = 21). Age-corrected lifetime rates of depression and subtypes among first-degree relatives were then compared by the proband's depression subtype. Rates of major depression were highest for the relatives of probands with the autonomous and delusional subtypes, and while lower for the relatives of endogenous and melancholic probands, these rates were still higher than for the relatives of the remaining depressed probands or the relatives of normal controls. The depressed relatives of depressed probands with the endogenous, melancholic, autonomous, or delusional subtypes were more likely to have one of these subtypes than the depressed relatives of either the remaining depressed probands or the normal controls.

Adult↗

Appetite disturbance and excessive guilt in major depression. Use of family study data to define depressive subtypes.

A post hoc analysis of the relationship between depression in first-degree family members (N = 810) and specific patterns of "endogenous" symptoms in 133 probands with nonbipolar major depression revealed that concomitant appetite disturbance and excessive guilt in the depressed probands was associated with increased rates of major depression among family members. The depressed, interviewed relatives of depressed probands with appetite disturbance and excessive guilt were found to be at a 2.5 greater risk for this same subtype compared with the depressed, interviewed relatives of the remaining depressed probands. These findings suggest that this subtype of depression may "breed true" within these families.

Adult↗

Depression and anxiety disorders in parents and children. Results from the Yale family study.

The children (aged 6 to 17 years) of probands with primary major depression, with and without various anxiety disorders, were compared with the children of a matched normal control group. The results from the study of these young children parallel our previous findings among the adult first-degree relatives of these probands. Depression in the proband increased the risk of depression in the children. Depression plus panic disorder or agoraphobia in the proband conferred an additional risk of depression and of an anxiety disorder in the children. Panic disorder in the parents conferred more than a threefold increased risk of separation anxiety in the children. Other factors that increased the risk to children were degree of familial loading for psychiatric illness, parental assortative mating, and parental recurrent depression. The findings suggest a relationship between depression and some of the anxiety disorders, and between adult panic disorder and agoraphobia and transmission of anxiety disorders to children.

Adolescent↗

Onset of major depression in early adulthood. Increased familial loading and specificity.

In a family study of 133 probands with major depression and 82 normal control subjects, and 1,518 of their first-degree relatives, we found a substantial inverse relationship between the age of onset of major depression in the probands and the risk of major depression in their relatives. The relatives of probands whose onset of major depression occurred when they were younger than 20 years of age had the highest risk of major depression, compared with the relatives of probands who had later ages of onset or with the relatives of normal subjects. Probands with an age of onset of 40 years or more had familial loading that was only slightly higher than the families of normal control subjects. Our statistical methods enabled us to examine the relationship of the ages of onset in the probands and their relatives while accounting for possible confounding factors. More studies will be needed to sort out secular changes in the rates of the occurrence of major depression among young persons (cohort effect) from the high familial loading of major depression that has its onset in childhood and adolescence, and to determine whether the specificity of transmission of early-onset depression is the result of a single homogeneous disorder.

Adolescent↗

Divorce and assortative mating among depressed patients.

Fifty-six married depressed patients were studied together with their spouses an average of 2 years after their discharge from the hospital. Thirty of the patients had psychiatrically ill spouses and 26 had psychiatrically well spouses. On follow-up the group as a whole had a divorce rate nine times the expected rate for the population. Couples in which both members were ill had a significantly higher divorce rate than couples in which only one member was affected. The authors suggest that the psychiatric status of the spouse of a depressed patient may be a significant factor in marital maladjustment and divorce.

Adaptation, Psychological↗

Is delusional depression related to bipolar disorder?

In a family study of major depression, the prevalence of bipolar illness was nearly six times as high among the relatives of delusionally depressed probands as among the relatives of nondelusionally depressed probands or of controls.

Bipolar Disorder↗

Assortative mating, social adjustment, and course of illness in primary affective disorder.

Fifty-six married inpatients with primary affective disorders and their spouses participated in a 12- to 36-month follow-up study in which the relationship of assortative mating to social adjustment and course of illness was examined. At follow-up, the patients who were concordant with their spouses for psychiatric illness had poorer social adjustment than the group of patients with well spouses. This finding was confirmed by both relatives' ratings and clinicians' ratings of the patients' social adjustment. Measures of relapse since the target hospitalization and self-rated symptoms at the time of follow-up were not different for the two groups. The divorce rate, however, was significantly greater for the couples who were concordant for psychiatric illness when compared with the discordant couples.

Adult↗

Panic disorder and major depression. Increased risk of depression, alcoholism, panic, and phobic disorders in families of depressed probands with panic disorder.

In a large, case-control family study of depression, 77 (58%) of 133 depressed probands displayed anxiety symptoms that met DSM-III criteria for agoraphobia, panic disorder, or generalized anxiety disorder. In two thirds of these 77 cases, these symptoms were associated with depressive episodes. In a previous study, the lifetime rate of major depression and anxiety disorders among first-degree family members of probands with major depression plus an anxiety disorder was found to be significantly increased regardless of when the anxiety symptoms occurred. In this study we analyzed our data according to the specific anxiety disorders observed. Major depression plus panic disorder in probands was associated with a marked increase in risk in relatives for a number of psychiatric disorders; relatives were more than twice as likely to have major depression, panic disorder, phobia, and/or alcoholism than the relatives of probands with major depression without any anxiety disorder. These results indicate that the relationship between major depression and anxiety disorders requires further study.

Adolescent↗

Anxiety disorders and depression: contradictions between family study data and DSM-III conventions.

The authors report data from a case-control family study of lifetime psychiatric diagnoses among the relatives of individuals with major depression. Specifically, they address the relationship between anxiety disorders and major depression. The findings indicate that relatives of individuals with major depression plus an anxiety disorder are at greater risk for major depression, as well as anxiety disorders; than are the relatives of individuals with major depression without an anxiety disorder. This increased risk appears to be present whether or not the anxiety disorder occurs solely in association with episodes of major depression or is temporally separate. The nosological implications of these findings are discussed.

Adolescent↗

Assortative mating for psychiatric disorders and psychological traits.

This article reviews the literature on assortative mating for psychological traits and psychiatric illness. Assortative mating appears to exist for personality traits, but to a lesser degree than that observed for physical traits, sociodemographic traits, intelligence, and attitudes and values. Concordance between spouses for psychiatric illness has also been consistently reported in numerous studies. This article examines alternative explanations for such observed concordance and discusses the effects of assortative mating on population genetics and the social environment.

Attitude↗

Assortative mating among in-patients with primary affective disorder.

Assortative mating among 56 married in-patients with primary affective disorders and their spouses was studied by determining the prevalence of psychiatric illness among the spouses by means of direct interviews and standardized diagnostic criteria. A high degree of assortative mating among both male and female patients was observed for total psychiatric illness, broad spectrum affective illness and major depression. A significantly higher prevalence of psychiatric and affective illness was found among the first-degree relatives of the ill spouses when compared with the first-degree relatives of the well spouses. There was a high degree of diagnostic concordance between the patients and spouses for both affective illness and alcoholism, with a higher degree of assortative mating among bipolar patients than among unipolar patients. The finding in this study of an increased prevalence of psychiatric disorder in the first-degree relatives of the ill spouses would support the hypothesis that there is a tendency for individuals with a predisposition to psychiatric illness to marry, rather than the existence of a marital interaction which causes an increased concordance for psychiatric illness.

Adolescent↗