Childhood Depression May Lead to Heart Disease by Teen Years
Children with depression are more likely to be obese, smoke and be inactive, and can show the effects of heart disease as early as their teen years, according to a newly published study by University of South Florida Associate Professor of Psychology Jonathan Rottenberg.
The research, by Rottenberg and his colleagues at Washington University and the University of Pittsburgh, suggests that depression may increase the risk of heart problems later in life. The researchers also observed higher rates of heart disease in the parents of adolescents that had been depressed as children. The research is published online in Psychosomatic Medicine and will be included in the medical journal’s February 2014 issue.
“Given that the parents in this sample were relatively young, we were quite surprised to find that the parents of the affected adolescents were reporting a history of heart attacks and other serious events,” Rottenberg explained.
Cardiologists and mental health professionals have long known a link exists between depression and heart disease. Depressed adults are more likely to suffer a heart attack, and if they do have a heart attack, it’s more likely to be fatal.
However it was unclear when the association between clinical depression and cardiac risk develops, or how early in life the association can be detected. These findings suggest improved prevention and treatment of childhood depression could reduce adult cardiovascular disease.
Heart disease is the leading cause of death for men and women- accounting for one in every four deaths in the United States every year, according to the Centers for Disease Control and Prevention.
During the study, Rottenberg and his colleagues followed up on Hungarian children who had participated in a 2004 study of the genetics of depression. The researchers compared heart disease risk factors - such as smoking, obesity, physical activity level, and parental history - across three categories of adolescents.
The Association Between Major Depressive Disorder in Childhood and Risk Factors for Cardiovascular Disease in Adolescence
Cardiovascular disease (CVD) is a leading cause of mortality worldwide and accounts for approximately 30% of all deaths. Depression in adults has been identified as an independent risk factor both for incident coronary heart disease and for cardiac events among patients with established heart disease. Repeated exposure to major depression has been associated with measures of preclinical CHD, such as coronary artery calcification both cross sectionally and longitudinally. Moreover, well-established risk factors for CVD tend to be more common and more severe in depressed than in nondepressed adults: depressed adults are more likely to smoke, have a higher body mass index (BMI) and be more sedentary than their nondepressed counterparts.
Critically, because research linking depression to CVD risk factors has typically involved middle-aged and older adults, it is unclear when in the life course clinical depression first becomes associated with traditional risk factors for CVD. Most research linking depression to established CVD risk factors has involved middle-aged and older adults. There are some indications that this association may be detectable with childhood or adolescent samples, although most studies have examined a single CVD risk factor in isolation. The clearest evidence for childhood or adolescent depression contributing to future elevation on a CVD risk factor is obesity.
For example, a follow-up of a sample of children and adolescents, psychiatrically diagnosed as having major depression at ages 6 to 17 years, found that childhood depression predicted adult BMI approximately 10 to 15 years later. However, most studies of youths have relied on self-rated, questionnaire measures of depression, which typically assess current symptom levels only and are likely to underestimate true effect sizes.
Furthermore, such questionnaires do not provide information about whether an individual has a history of a diagnosable depressive disorder.
###
JONATHAN ROTTENBERG,PHD, ILYA YAROSLAVSKY,PHD, ROBERT M. CARNEY,PHD, KENNETH E. FREEDLAND,PHD
The investigators surveyed more than 200 children with a history of clinical depression, as well as about 200 of their siblings who have never suffered from depression. They also gathered information from more than 150 unrelated children of the same age and gender with no history of depression.
Rottenberg plans to conduct additional research in order to understand why depression early in life may put people at increased risk for cardiovascular disease. Further studies planned with the Hungarian group will also examine whether any early warning signs of heart disease are present as these adolescents move into young adulthood.
Rottenberg is a leading researcher in the area of emotion and psychopathology, where he has focused on major depression. His previous work covering on the causes and consequences of crying has received national and international media coverage. He’s also the author of the forthcoming book, The Depths: The Evolutionary Origins of the Depression Epidemic.
Adam Freeman is a media and public affairs coordinator for USF. He can be reached at .(JavaScript must be enabled to view this email address)
###
By Adam Freeman
USF News