MAJOR DEPRESSION IN THE POPULATION: A PUBLIC HEALTH APPROACH

William W. Eaton, PhD, Johns Hopkins University, 2013

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Lecture 4. The Search for Etiologic Clues

William W. Eaton, PhD, Johns Hopkins University, 2013

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Epidemiology of Depression: Risk Factors

A.  Inheritance B.  Stress and Diathesis C.  Social supports D.  Work, Family, and Life Stage E.  Recency of birth

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Section A: Inheritance

Evidence on Inheritance of Depressive Disorder Selected Family Studies Reference   Number  of  First  Degree  Rela5ves   Risk  (%)  in  First  Degree  Rela5ves  

Cases   Controls   Cases   Controls  

Gershon  et  al  1982  

133   208   16.6   5.8  

Winokur  et  al,  1982  

305   344   11.2   7.3  

Leckman  et  al,  1984  

810   521   14.9   5.6  

Heun  &  Maier,  1993  

306   221   19   7.7  

Source: Selected from Table 8-3 in Zandi et al, Chapter 8, Public Mental Health, 2012

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Evidence on Inheritance of Depressive Disorder Selected Twin Studies

Reference   MZ  pairs    

DZ  pairs    

Popula5on    

Concordance   Heritability  

MZ   DZ  

McGuffin  et  al  1991  

84   130   Hospital   53   28   43  

Lyons  et  al  1998  

268   266   Veterans  Twin  Registry  

22.5   14   36  

Bierut  et  al,  1999  

1323   755  same  1415  opposite  

Volunteers   38  (F)    20  (M)  

23  (MM)  25  (FF)  22  (FM)  36  (MF)  

44  

Kendler  et  al  2006  

4091   11,402   General  Popula3on  

44  (F)  31  (M)  

16  (FF)  11  (MM)  11  (Opposite)  

38  

Source: Selected from Table 8-4 in Zandi et al, Chapter 8, Public Mental Health, 2012 6  

Many genes Big samples

No results!

What happened to the heritability of depressive disorder?

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Berndt  SI,  Gustafsson  S.,  et  al,  Nat  Genet.  2013  May;45(5):501-­‐12.  doi:  10.1038/ng.2606.  Epub  2013  Apr  7.  Genome-­‐wide  meta-­‐analysis  iden3fies  11  new  loci  for  anthropometric  traits  and  provides  insights  into  gene3c  architecture.  

This is the “Manhattan plot” for inheritance of height: it looks like Manhattan!

Value of 8

What happened to the heritability of depressive disorder?

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Value of 8

This is the “Manhattan plot” for inheritance of depressive disorder: it looks like Ames, Iowa!

What happened to the heritability of depressive disorder?

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