Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T06:55:32.040Z Has data issue: false hasContentIssue false

Developmental pathways in depression: Multiple meanings, antecedents, and endpoints

Published online by Cambridge University Press:  04 March 2009

Richard Harrington
Affiliation:
MRC Child Psychiatry Unit, London
Michael Rutter*
Affiliation:
MRC Child Psychiatry Unit, London
Eric Fombonne
Affiliation:
MRC Child Psychiatry Unit, London
*
Professor Michael Rutter, MRC Child Psychiatry Unit and the Social, Genetic, and Developmental Psychiatry Research Centre, the Institute of Psychiatry, de Crespigny Park, Denmark Hill, Camber-well, London SE5 8AF, England.

Abstract

This article presents an overview of work conducted at the Institute of Psychiatry over the past 30 years on childhood depression. The work began with the basic question of definition and measurement. Epidemiological studies showed that depressive symptoms were quite common in children and were a good, if nonspecific, indicator of psychological disturbance. Further work in both epidemiological and clinical samples provided some evidence for the validity of a depressive syndrome. However, this work also showed that these depressive syndromes represented a heterogeneous group of phenomena. The validity of major depressive disorder in children was therefore tested further in longitudinal and family-genetic studies. These studies supported the validity of the concept but confirmed that there was heterogeneity in respect to both developmental stage at the time of onset and comorbidity with conduct disorder. We concluded that there are probably several different kinds of depressive syndromes in children. Some are strongly linked with depressive disorders in adulthood, but others are probably better conceptualized as part of another psychopathological problem altogether.

Type
Articles
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders-DSM-IV (fourth edition). Washington, DC: Author.Google Scholar
Angold, A., Costello, E. J., Pickles, A., & Winder, F. (1987). The development of a questionnaire for use in epidemiological studies of depression in children and adolescents. London: Medical Research Council Child Psychiatry Unit.Google Scholar
Angold, A., & Costello, E. J. (1995). A test-retest reliability study of child-reported psychiatric symptoms and diagnoses using the Child and Adolescent Psychiatric Assessment (CAPA-C). Psychological Medicine, 25, 755762.CrossRefGoogle ScholarPubMed
Angold, A., Costello, E. J., Messer, S. C., Pickles, A., Winder, F., & Silver, D. (1995). The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237249.Google Scholar
Angold, A., Prendergast, M., Cox, A., Rutter, M., & Harrington, R. (1995). The Child and Adolescent Psychiatric Assessment (CAPA). Psychological Medicine, 25, 739753.CrossRefGoogle ScholarPubMed
Angold, A., & Rutter, M. (1992). Effects of age and pubertal status on depression in a large clinical sample. Development and Psychopathology, 4, 528.CrossRefGoogle Scholar
Brown, G. W., & Harris, T. (1978). Social Origins of Depression. London: Tavistock.Google ScholarPubMed
Champion, L. A., Goodall, G., & Rutter, M. (1995). Behaviour problems in childhood and stressors in early adult life. I. A 20-year follow-up of London school children. Psychological Medicine, 25, 231246.CrossRefGoogle Scholar
Eaves, L. J., Silberg, J. L., Meyer, J. M., Maes, H. H., Simonoff, E., Pickles, A., Rutter, M. et al. , (1996). Genetics and developmental psychopathology: 2. The main effects of genes and environment on behavioral problems in the Virginia Twin Study of Adolescent Behavioral Development. Manuscript submitted for publication.Google Scholar
Garber, J., Kriss, M. R., Koch, M., & Lindholm, L. (1988). Recurrent depression in adolescents: a follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry, 27, 4954.CrossRefGoogle ScholarPubMed
Goodyer, I. M. (1990). Life Experiences, Development and Childhood Psychopathology. Chichester: Wiley.Google Scholar
Harrington, R. C. (1993). Depressive Disorder in Childhood and Adolescence. Chichester Wiley.Google Scholar
Harrington, R. C. (1994). Affective disorders. In Rutter, M., Taylor, E., & Hersov, L. (Eds.), Child and Adolescent Psychiatry: Modern Approaches. Third Edition (pp. 330350). Oxford: Blackwell Scientific.Google Scholar
Harrington, R. C., & Shariff, A. (1992). Choosing an instrument to assess depression in young people. Newsletter of the Association for Child Psychology and Psychiatry, 14, 279282.Google Scholar
Harrington, R. C., Bredenkamp, D., Groothues, C., Rutter, M., Fudge, H., & Pickles, A. (1994). Adult outcomes of childhood and adolescent depression. III. Links with suicidal behaviours. Journal of Child Psychology and Psychiatry, 35, 13801391.CrossRefGoogle ScholarPubMed
Harrington, R. C., Fudge, H., Rutter, M., Bredenkamp, D., Groothues, C., & Pridham, J. (1993). Child and adult depression: a test of continuities with data from a family study. British Journal of Psychiatry, 162, 627633.CrossRefGoogle ScholarPubMed
Harrington, R. C., Fudge, H., Rutter, M., Pickles, A., & Hill, J. (1990). Adult outcomes of childhood and adolescent depression: I. Psychiatric status. Archives of General Psychiatry, 47, 465473.CrossRefGoogle ScholarPubMed
Harrington, R. C., Fudge, H., Rutter, M., Pickles, A., & Hill, J. (1991). Adult outcomes of childhood and adolescent depression: II. Risk for antisocial disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 30, 434439.CrossRefGoogle ScholarPubMed
Harrington, R. C., Hill, J., Rutter, M., John, K., Fudge, H., Zoccolillo, M., & Weissman, M. M. (1988). The assessment of lifetime psychopathology: a comparison of two interviewing styles. Psychological Medicine, 18, 487493.CrossRefGoogle ScholarPubMed
Harrington, R. C., Rutter, M., Pickles, A., Fudge, H., Groothues, C., & Bredenkamp, D. (1996). Age trends in depressive symptomatology during early adolescence: Comparison with other psychological symptoms. Manuscript in preparation.Google Scholar
Harrington, R. C., Rutter, M., Weissman, M., Fudge, H., Groothues, C., Bredenkamp, D., Rende, R., Pickles, A., & Wickramaratne, P. (1996). Psychiatric disorders in the relatives of depressed probands. I. Comparison of prepubertal, adolescent and early adult onset forms. Journal of Affective Disorders.Google Scholar
Hewitt, J. K., Silberg, J. L., Rutter, M., Simonoff, E., Meyer, J. M., Maes, H., Pickles, A. et al. , (1996). Genetics and developmental psychopathology. 1. Phenotypic assessment in the Virginia Twin Study of Adolescent Behavioral Development. Manuscript submitted for publication.Google Scholar
Hill, J., Fudge, H., Harrington, R., Rutter, M., & Pickles, A. (1995). The Adult Personality Functioning Assessment (APFA): Factors influencing agreement between subject and informant. Psychological Medicine, 25, 263275.CrossRefGoogle ScholarPubMed
Hill, J., Harrington, R. C., Fudge, H., Rutter, M., & Pickles, A. (1989). Adult Personality Functioning Assessment (APFA): an investigator based standardized interview. British Journal of Psychiatry, 155, 2435.CrossRefGoogle Scholar
Kandel, D. B., & Davies, M. (1986). Adult sequelae of adolescent depressive symptoms. Archives of General Psychiatry, 43, 255262.CrossRefGoogle ScholarPubMed
Pearce, J. B. (1974). Childhood Depression. MPhil Thesis, Univ. of London.Google Scholar
Pearce, J. B. (1978). The recognition of depressive disorder in children. Journal of the Royal Society of Medicine, 71, 494500.CrossRefGoogle ScholarPubMed
Rao, U., Ryan, N. D., Birmaher, B., Dahl, R. E., Williamson, D. E., Kaufman, J., Rao, R., & Nelson, B. (1995). Unipolar depression in adolescence: clinical outcome in adulthood. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 566578.CrossRefGoogle ScholarPubMed
Rao, U., Weissman, M. M., Martin, J. A., & Hammond, R. W. (1993). Childhood depression and risk of suicide: preliminary report of a longitudinal study. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 2127.CrossRefGoogle ScholarPubMed
Rutter, M. (1991). Childhood experiences and adult social functioning. In Rock, G. R. & Whelan, J. (Eds.), Vie Childhood Environment and Adult Disease. Ciba Foundation Symposium No. 156 (pp. 189200). Chichester Wiley.Google Scholar
Rutter, M., Champion, L., Quinton, D., Maughan, B., & Pickles, A. (1995). Origins of individual differences in environmental risk exposure. In Moen, P., Elder, G., & Luscher, K. (Eds.), Examining Lives in Context: Perspectives on the Ecology of Human Development (pp. 6193). Washington DC: American Psychological Association.CrossRefGoogle Scholar
Rutter, M., Graham, P., Chadwick, O. F., & Yule, W. (1976). Adolescent turmoil: fact or fiction? Journal of Child Psychology and Psychiatry, 17, 3556.CrossRefGoogle ScholarPubMed
Rutter, M., Harrington, R., Quinton, D., & Pickles, A. (1994). Adult outcome of conduct disorder in childhood: implications for concepts and definitions of patterns of psychopathology. In Ketterlinus, R. D. & Lamb, M. E. (Eds.), Adolescent Problem Behaviors (pp. 5780). Hillsdale, NJ: Erlbaum.Google Scholar
Rutter, M., Tizard, J., & Whitmore, K. (Eds.). (1970). Education, Health and Behaviour. London: Longmans.Google Scholar
Simonoff, E., Pickles, A., Meyer, J., Silberg, J., Maes, H., Loeber, R., Rutter, M., Hewitt, J., & Eaves, M. (1996). Epidemiology of child psychopathology in the Virginia Twin Study of Adolescent Behavioral Development: Influences of age, gender and impairment on rates of disorder. Manuscript submitted for publication.Google Scholar
Smith, A. L., & Weissman, M. M. (1992). Epidemiology. In Paykel, E. S. (Ed.), Handbook of Affective Disorders (2nd ed.) (pp. 111129). Edinburgh: Churchill Livingstone.Google Scholar
Spitzer, R. L., Endicott, J., & Robins, E. (1978). Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773782.CrossRefGoogle ScholarPubMed
Weissman, M. M., Gammon, G. D., John, K., Merikan-gas, K. R., Warner, V., Prusoff, B. A., & Sholomskas, D. (1987). Children of depressed parents: increased psychopathology and early onset of major depression. Archives of General Psychiatry, 44, 847853.CrossRefGoogle ScholarPubMed
Zeitlin, H. (1986). Vie Natural History of Psychiatric Disorder in Children. Oxford: Oxford University Press.Google Scholar