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The Association Between Major Depressive Disorder in Childhood and Risk Factors for Cardiovascular Disease in Adolescence

Rottenberg, Jonathan PhD; Yaroslavsky, Ilya PhD; Carney, Robert M. PhD; Freedland, Kenneth E. PhD; George, Charles J. MS; Baji, Ildikó MD, PhD; Dochnal, Roberta MD; Gádoros, Júlia MD, PhD; Halas, Kitti MSc; Kapornai, Krisztina MD, PhD; Kiss, EnikŐ MD, PhD; Osváth, Viola MSc; Varga, Hedvig MSc, PhD; Vetró, Ágnes MD, PhD; Kovacs, Maria PhD

doi: 10.1097/PSY.0000000000000028
Original Articles

Objective Depression in adults is associated with risk factors for cardiovascular disease (CVD). It is unclear, however, when the association between clinical depression and cardiac risk factors develops or how early in life this association can be detected.

Methods In an ongoing study of pediatric depression, we compared CVD risk factors including smoking, obesity, physical activity level, sedentary behavior, and parental history of CVD across three samples of adolescents: probands with established histories of childhood-onset major depressive disorder (n = 210), never-depressed siblings of probands (n = 195), and controls with no history of any major psychiatric disorder (n = 161).

Results When assessed during adolescence, 85% of the probands were not in a major depressive episode. Nevertheless, at that assessment, probands had a higher prevalence of regular smoking (odds ratio [OR] = 12.54, 95% confidence interval [CI] = 4.36–36.12) and were less physically active than controls (OR = 0.59, CI = 0.43–0.81) and siblings (OR = 0.70, CI = 0.52–0.94) and had a higher rate of obesity than did controls (OR = 3.67, CI = 1.42–9.52). Parents of probands reported high rates of CVD (significantly higher than did parents of controls), including myocardial infarction and CVD-related hospitalization (ORs = 1.62–4.36, CIs = 1.03–15.40). Differences in CVD risk factors between probands and controls were independent of parental CVD.

Conclusions Major depression in childhood is associated with an unfavorable CVD risk profile in adolescence, and risks for pediatric depression and CVD may coincide in families. Effective prevention and treatment of childhood depression may be a means to reduce the incidence of adult CVD.

From the Department of Psychology (J.R.), University of South Florida, Tampa, Florida; Department of Psychiatry (I.Y., C.J.G., M.K.), University of Pittsburgh Medical School, Pittsburgh, Pennsylvania; Department of Psychiatry (R.M.C., K.E.F.), Washington University Medical School, St Louis, Missouri; Department for Child and Adolescent Psychiatry (I.B., R.D., K.H., K.K., E.K.,V.O., H.V., A.V.), Szeged University, Szeged, Hungary; Vadaskert Hospital (J.G.), Budapest, Hungary.

Address correspondence and reprint requests to: Jonathan Rottenberg, PhD, Department of Psychology, University of South Florida, 4202 E. Fowler Ave, PCD 4118G, Tampa, FL 33620-7200. E-mail:

Received for publication January 7, 2013; revision received November 9, 2013.

Copyright © 2014 by American Psychosomatic Society
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