Childhood family problems are strongly associated with the chronicity of both bipolar and unipolar mood disorders. Data from the Zurich cohort study also supports the hypothesis that childhood adversity may create vulnerabilities—specifically in the form of an anxious childhood personality, low self-esteem, and poor sense of mastery—that predispose individuals to chronic mood disorders.

Syracuse University

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- This was a cohort study done in Zurich, Switzerland with participants from ages 19/20 to 40/41 with six waves of interviews that was meant to measure, chronic depression, bipolar disorder, and unipolar depression in relation to childhood and conduct problems.
- Interview sample (N=591) was screened with Symptom checklist 90-R (SCL-90-R). the sample was stratified by high versus low scores on the General Severity Index of the SCL -90-R) (high risk vs low risk subjects) with oversampling of risk cases.
- Over the 20 years, attrition rate was 38% (44 p men 31p women). Only subjects participating in waves 3-6 (ages 27/28 -40/41) could be considered for the present analysis because the temporal criteria for dysthymia had not yet been developed. (1986-1999).





Zurich Study 

https://link.springer.com/article/10.1007/s00406-010-0120-3

Childhood adversity and chronicity of mood disorder

- diagnosis of chronic major and minor depressive episodes required temporal chronicity criterion for DSM-IV dysthymia or mood changes daily for a year before the interview. 
- unipolar depression and bipolar disorders were defined broadly by DSM-IV as well. 
- Master and self esteem measured by the Scales of Pearlin and Schooler at age 20/21.
- The Symptom Checklist 90 R (SCL-90-R) was used for the self-assessment of depression, anxiety, somatisation and vegetative lability at age 19/20.
- Childhood problems were assessed in retrospect at ages
27/28 and 29/30.

Measurements 


- identified 104 major or minor bipolar (BP) subjects and 110 major or minor unipolar depressives (UP). The respective weighted cumulative incidence rates including the last interview (which are statistical estimates of the lower bound of population prevalence) were 15.4% (BP) and 14.8% (UP). There was no significant gender difference: 60.6% of BP (weighted 62.6%) and 60.0% of UP (weighted 61.4%) were women.
- Thirty-eight BP subjects were chronic and 66 acute; among UP there were 43 chronic and 67 acute.
- The 38 chronic BP subjects included 25 with MDE (67%), 14 of whom also met criteria for dysthymia. In all, 22 (58%) of the 38 chronic BP cases suffered from dysthymia. The remaining five non-dysthymic chronic cases suffered from recurrent brief depression (N = 4) and minor depression (N = 1).
- The 43 chronic UP subjects consisted of 34 with MDE (79.1%), 21 of whom were also dysthymics. In all, 27 subjects (62.8%) with chronic UP were diagnosed as dysthymics. Of the remaining three non-dysthymic chronic UP cases, two suffered from recurrent brief depression and 1 from minor depression.


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