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Relationship Between Dysthymia And Major Depression: An Analysis Of Family Study Data

Goodman, Daniel W.; Goldstein, Rise B.; Adams, Phillip B.; Horwath, Ewald; Sobin, Christina; Wickramaratne, Priya; Weissman, Myrna M.

Although there is high comorbidity between major depression (MDD) and dysthymia, the nature of this relationship is unclear. An ongoing family study provided an opportunity to examine this relationship. Data are presented on 435 directly interviewed adult first degree relatives of 193 probands in four diagnostic groups: panic disorder only, panic disorder plus MDD, early onset MDD without panic, and screened normal controls. Many of the psychiatrically ill probands also had comorbid dysthymia. Best estimate diagnoses on all relatives were made blind to proband diagnostic status using direct information obtained with the SADS-LA and/or family history information from multiple informants obtained using a modified version of the FH-RDC. We sought to determine the relationship between panic disorder and/or MDD and DSM-III-R dysthymia and to assess whether or not dysthymia is specifically transmitted within families. Controlling for comorbidity in probands, we found no familial association between panic disorder and dysthymia but we did find an increased risk of dysthymia in relatives of probands with early onset MDD. Additionally we found specific transmission of dysthymia to relatives independent of presence of comorbid panic disorder and/or MDD in probands. These findings support the validity of dysthymia as a specific disorder and suggest as well that dysthymia may be on the spectrum of early onset MDD.


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February 1, 2022