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Parent psychopathology and offspring mental disorders: Results from the WHO World Mental Health Surveys

  • Katie A. McLaughlin (a1), Anne M. Gadermann (a2), Irving Hwang (a2), Nancy A. Sampson (a2), Ali Al-Hamzawi (a3), Laura Helena Andrade (a4), Matthias C. Angermeyer (a5), Corina Benjet (a6), Evelyn J. Bromet (a7), Ronny Bruffaerts (a8), José Miguel Caldas-de-Almeida (a9), Giovanni de Girolamo (a10), Ron de Graaf (a11), Silvia Florescu (a12), Oye Gureje (a13), Josep Maria Haro (a14), Hristo Ruskov Hinkov (a15), Itsuko Horiguchi (a16), Chiyi Hu (a17), Aimee Nasser Karam (a18), Viviane Kovess-Masfety (a19), Sing Lee (a20), Samuel D. Murphy (a21), S. Haque Nizamie (a22), José Posada-Villa (a23), David R. Williams (a24) and Ronald C. Kessler (a2)...
Abstract
Background

Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity.

Aims

To examine the associations of parent with respondent disorders.

Method

Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews.

Results

Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0–19.9%) than other (7.1–14.0%) disorders.

Conclusions

Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders.

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Copyright
Corresponding author
Katie A. McLaughlin, Division of General Pediatrics, Children's Hospital Boston, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. Email: Katie.McLaughlin@childrens.harvard.edu.
Footnotes
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Declaration of interest

R.C.K. has been a consultant for AstraZeneca, Analysis Group, Bristol-Myers Squibb, Cerner-Galt Associates, Eli Lilly & Company, GlaxoSmithKline, HealthCore, Health Dialog, Integrated Benefits Institute, John Snow, Kaiser Permanente, Matria, Mensante, Merck & Co, Ortho-McNeil Janssen Scientific Affairs, Pfizer, Primary Care Network, Research Triangle Institute, Sanofi-Aventis Groupe, Shire US, SRA International, Takeda Global Research & Development, Transcept Pharmaceuticals and Wyeth-Ayerst; has served on advisory boards for Appliance Computing II, Eli Lilly & Company, Mindsite, Ortho-McNeil Janssen Scientific Affairs, Plus One Health Management and Wyeth-Ayerst; and has had research support for his epidemiological studies from Analysis Group, Bristol-Myers Squibb, Eli Lilly & Company, EPI-Q, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Ortho-McNeil Janssen Scientific Affairs, Pfizer, Sanofi-Aventis Groupe and Shire US.

Footnotes
References
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Parent psychopathology and offspring mental disorders: Results from the WHO World Mental Health Surveys

  • Katie A. McLaughlin (a1), Anne M. Gadermann (a2), Irving Hwang (a2), Nancy A. Sampson (a2), Ali Al-Hamzawi (a3), Laura Helena Andrade (a4), Matthias C. Angermeyer (a5), Corina Benjet (a6), Evelyn J. Bromet (a7), Ronny Bruffaerts (a8), José Miguel Caldas-de-Almeida (a9), Giovanni de Girolamo (a10), Ron de Graaf (a11), Silvia Florescu (a12), Oye Gureje (a13), Josep Maria Haro (a14), Hristo Ruskov Hinkov (a15), Itsuko Horiguchi (a16), Chiyi Hu (a17), Aimee Nasser Karam (a18), Viviane Kovess-Masfety (a19), Sing Lee (a20), Samuel D. Murphy (a21), S. Haque Nizamie (a22), José Posada-Villa (a23), David R. Williams (a24) and Ronald C. Kessler (a2)...
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eLetters

Non-specific nature of intergenerational transmission of risk for mental disorder

Kimberlie Dean
20 April 2012

We note with interest the findings recently reported by McLaughlin etal(1) from their study of parental and offspring psychopathology utilisingdata from the WHO World Mental Health Surveys. The authors' conclusion that parent psychopathology is a non-specific predictor of offspring disorder is in line with our previously published population-based register study of all offspring born in Denmark between 1980 and 1994 (N=865 078) (2). We also found that parental history of mental disorder was significantly associated with virtually all specific offspring disorders considered, including those not hitherto regarded as clinically related (e.g. offspring born to two parents with non-affective or affective psychosis were found to be 8 times more likely to suffer a substance misuse disorder).

Importantly, our findings were not subject to the same potential biases acknowledged by McLaughlin et al with regard to the source of parental disorder data (i.e. informant reports provided by offspring subjects) since we obtained such data from the same national register source as was utilised for offspring. We were also able to examine the pattern of offspring psychopathology in relation to parental history not only of common mental disorders but of severe mental disorder. With regard to the latter, the strongest evidence for concordant disorder risk was found for bipolar disorder while offspring born to parent(s) with non-affective psychosis demonstrated only moderate concordance (i.e. risk extended beyond the boundaries of concordant or clinically-related diagnoses).

Taken together, the results of these studies support the notion of shared vulnerabilities, be they genetic or environmental in origin, givingrise to the development of a range of mental disorders with little respectfor diagnostic boundaries.

1.McLaughlin KA, Gadermann AM, Hwang I, Sampson NA, Al-Hamzawi A, Andrade LH, et al. Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys. Br J Psychiatry2012 Apr;200:290-9.

2.Dean K, Stevens H, Mortensen PB, Murray RM, Walsh E, Pedersen CB. Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry2010 Aug;67(8):822-9.

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Conflict of interest: None declared

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