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Family history as a predictor of poor long-term outcome in depression

Published online by Cambridge University Press:  03 January 2018

Conor Duggan*
East Midlands Centre for Forensic Mental Health, Arnold Lodge, Leicester
Pak Sham
Department of Psychological Medicine Institute of Psychiatry and King's College Hospital, Denmark Hill, London
Carine Minne
Tavistock and Portman NHS Trust, Portman Clinic, London
Alan Lee
Department of Psychiatry University Hospital Queens Medical Centre, Nottingham
Robin Murray
Department of Psychological Medicine Institute of Psychiatry and King's College Hospital, Denmark Hill, London
Professor Conor Duggan, Head of the Division of Forensic Mental Health. Arnold Lodge, Cordelia Close, Leicester LE5 0LE



We investigated whether family history had prognostic significance in depression in a study which addressed some of the methodological shortcomings of previous studies.


We collected family history data on a consecutive series of 89 patients admitted with RDC major depression, blind to the outcome of the proband. This comprised 116, 283 and 120 first-degree relatives examined with the SADS–L, FH–RDC and case note data, respectively. The outcome of 74 of these probands (83%), previously categorised into four operationally defined groups, was then examined.


A positive family history of severe psychiatric illness (i.e. a relative with a history of either a psychosis, hospitalised depression or suicide) was associated with poor outcome in the proband. This association persisted after controlling for variable family size, age structure and gender. As family history was correlated with neither Kendell's neurotic/psychotic index nor the probands neuroticism score, an individual with high scores an all three would have a greatly increased chance of having a poor outcome.


A family history of severe psychiatric illness in a first-degree relative may be useful as one of the vulnerability factors for predicting poor long-term outcome in depression.

Copyright © 1998 The Royal College of Psychiatrists 

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