Journal of AJJecttue Disorders, 15 (1988) 279-290 Elsevier 219 JAD 00592 Parental concordance for affective disorders: psychopathology in offspring Kathleen R. Merikangas , 1.2 Brigitte A. Prusoff ’ and Myrna M. Weissman 3 Departments of ’ Psychuq and ’ Epidemiologv, Yale University School of Medtctne, New Haven, CT, U.S.A. and ’ College oJPhyslcians and Surgeons of Columbta University, New York State Psychmric Institute, New York, i‘:Y, U.S.A. (Accepted 30 May 1988) Summary This paper examines the effects of parental concordance for affective disorders and psychopathology among the 219 offspring of probands with major depression and normal controls. The lifetime prevalence of psychiatric disorders was significantly higher among the spouses of depressed probands as compared to those of normal controls. The spouses of 37% of the normals and 69% of the depressed probands met criteria for a diagnosis of major depression, an anxiety disorder, or alcoholism. Parental concordance for diagnoses, particularly for anxiety disorders, substantially increased the risk of major depression and anxiety disorders in their children. Moreover, the marital relationship, some aspects of family adjustment and severity of current symptoms were significantly worse among the couples who exhibited diagnostic concordance for anxiety, alcoholism and/or depression. The major implication of these findings is that the diagnostic status of both parents should be considered in the design and analysis of studies of children. The findings of the present study also underscore the importance of assessment of comorbid disorders in parents and offspring. Although the original study design focused on the risk of depression in children of parents in treatment for major depression, stronger transmissibility was found for anxiety disorders plus depression than for major depression alone. However, the exclusion criteria of a lifetime history of mania or hypomania led to an extremely low proportion of probands with pure major depression without concomitant anxiety disorders. These findings confirm the results of previous studies which have demonstrated a strong degree of overlap between affective and anxiety syndromes. The increased risk of anxiety disorders in the offspring of parents who had sought treatment for non-bipolar major depression suggests that anxiety may constitute an early form of expression of affective disorders. Confirmation of the finding of age-dependent expression of anxiety and depression in prospective longitudinal studies of children is indicated. Key words: Parental concordance; Assortative mating; Psychopathology in children; Family study; Affec- tive disorders; Anxiety disorders Introduction Address for correspondence: Kathleen R. Merikangas, Ph.D.. Department of Psychiatry, Yale University School of Although a positive family history constitutes Medicine, New Haven, CT, U.S.A. the strongest and most consistent risk factor for 0165-0327/88/$03.50 0 1988 Elsevier Science Publishers B.V. (Biomedical Division)