Early risk factors and adult person--environment relationships in affective disorder

BACKGROUND: Lower cognitive ability, higher neuroticism and symptoms of anxiety and depression in childhood predict non-psychotic disorder in adulthood. This study examined whether these early risk factors act by modifying relationships with life events close to disease onset in adulthood. METHODS: Childhood measures of neuroticism (N) (including maternal N), cognitive ability (CA) and symptoms of anxiety and depression were measured in a national British birth cohort of 5362 individuals born in the week 3-9 March, 1946. At ages 36 and 43 years, mental state examinations were carried out by trained interviewers, and subjects were asked about the occurrence of stressful life events in the previous year (SLE). RESULTS: The effect of aggregated SLEs on mental health was greater in women, in individuals with higher childhood N and poorer childhood mental health. Higher maternal N was also associated with greater sensitivity to SLEs, independent of subject's N, suggesting possible familial transmission of vulnerability. In addition, higher childhood N predicted, independent of later mental health, greater likelihood of reported exposure to SLEs. In general, individuals with higher childhood CA also reported more SLEs. CONCLUSIONS: The results suggest that early risk factors for affective disorder exert effects by modifying person-environment relationships close to onset of adult symptoms. Sensitivity to life events may be transmitted from parents to offspring; psychopathological continuity over the life-span may be explained in part by continuity of altered stress sensitivity.