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Family
history predicts presence and course of
Psychiatric Disorders
Newswise — A family history of depression,
anxiety, alcohol dependence or drug
dependence is associated with the presence
of each condition and also may predict its
course and prognosis, according to a report
in the July issue of Archives of General
Psychiatry, one of the JAMA/Archives
journals.
Family history of a psychiatric condition is
generally known to increase an individual’s
risk of developing that condition, according
to background information in the article.
“However, there is a need to go further and
test whether family history is also
associated with clinical features of the
disorder thought to represent a continuum of
seriousness among individuals who meet
criteria for diagnosis,” the authors write.
Barry J. Milne, Ph.D., of University of
Auckland, New Zealand, and colleagues
studied 981 residents of Dunedin, New
Zealand, born in 1972 or 1973.
Participants were enrolled in the Dunedin
Study at age 3 and followed up through age
32. Between 2003 and 2005, family history
data were collected about each individual’s
biological parents, grandparents and
siblings older than 10 years.
Four psychiatric disorders were studied:
major depressive episode, anxiety disorder,
alcohol dependence and drug dependence.
“In general, we found that associations
showed a consistent direction of effect
across all four disorders: (1) family
history was associated with the presence vs.
absence of disorder for all four disorder
types; (2) family history was associated
with a recurrent course for all four
disorders (but not significantly for women
with depression); (3) family history was
associated with worse impairment for all
four disorders (but not significantly for
depression and drug dependence); and (4)
family history was associated with greater
service use for all four disorders (but not
significantly for anxiety disorders),” the
authors write.
The results suggest implications for
researchers who wish to study genetic forms
of a disorder and also for clinicians
treating psychiatric conditions, the authors
note.
From a public health perspective, family
history may be useful for determining which
patients will have the poorest prognosis,”
they conclude.
“For example, among those with depression,
anxiety disorder, alcohol dependence and
drug dependence, a family history screen may
help determine whose illness will recur,
whose illness will cause the greatest
impairment and who will be the most likely
to use treatment resources.
"Thus,
family history may identify a subgroup in
need of primary or early intervention, and
for whom treatments appropriate for
recurrent, highly disabling disorder may be
needed.”
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