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Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression

  • Ruth Sellers (a1), Stephan Collishaw (a1), Frances Rice (a2), Ajay K. Thapar (a3), Robert Potter (a4), Becky Mars (a5), Gordon T. Harold (a6), Daniel J. Smith (a7), Michael J. Owen (a5), Nick Craddock (a8) and Anita Thapar (a8)...
Abstract
Background

Offspring of mothers with depression are at heightened risk of psychiatric disorder. Many mothers with depression have comorbid psychopathology. How these co-occurring problems affect child outcomes has rarely been considered.

Aims

To consider whether the overall burden of co-occurring psychopathology in mothers with recurrent depression predicts new-onset psychopathology in offspring.

Method

Mothers with recurrent depression and their adolescent offspring (9–17 years at baseline) were assessed in 2007 and on two further occasions up to 2011. Mothers completed questionnaires assessing depression severity, anxiety, alcohol problems and antisocial behaviour. Psychiatric disorder in offspring was assessed using the Child and Adolescent Psychiatric Assessment.

Results

The number of co-occurring problems in mothers (0, 1 or 2+) predicted new-onset offspring disorder (odds ratio (OR) = 1.80, 95% CI 1.17–2.77, P = 0.007). Rates varied from 15.7 to 34.8% depending on the number of co-occurring clinical problems. This remained significant after controlling for maternal depression severity (OR = 1.73, 95% CI 1.03–2.89, P = 0.040).

Conclusions

The burden of co-occurring psychopathology among mothers with recurrent depression indexes increased risk of future onset of psychiatric disorder for offspring. This knowledge can be used in targeting preventive measures in children at high risk of psychiatric disorder.

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Copyright
Corresponding author
Stephan Collishaw, Child & Adolescent Psychiatry Section, Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, 4th Floor B-C link Corridor, Heath Park, Cardiff CF14 4XN, UK. Email: collishaws@cf.ac.uk
Footnotes
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See editorial, pp. 84-85, this issue

Declaration of interest

D.J.S. has received honoraria for speaking ateducational meetings organised by AstraZeneca and Lilly.

Footnotes
References
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Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression

  • Ruth Sellers (a1), Stephan Collishaw (a1), Frances Rice (a2), Ajay K. Thapar (a3), Robert Potter (a4), Becky Mars (a5), Gordon T. Harold (a6), Daniel J. Smith (a7), Michael J. Owen (a5), Nick Craddock (a8) and Anita Thapar (a8)...
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Letter re: Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression. Sellers et al.

MALLIKA PUNUKOLLU, SPECIALIST REGISTRAR CAMHS
25 February 2013

I read with great interest the article by Sellers et al. It is an important study looking at risk of psychopathology in children with mothers with recurrent depression and comorbid psychopathology (1). There are however some more factors in addition to the mentioned ones which predict risk. They include parental conflict, divorce (2) and domestic violence (3) which can have an impact on a child's emotional and psychological development. In addition the study seeks to look at early intervention but perhaps early intervention would be more beneficial if looking at children younger than in the study cohort as neurodevelopment is from in utero to the age of three (4) and behavioural problems can be recognised in children less than three years (3) and so it may be beneficial to learn more about the mother's antenatal and postnatal mentalhealth and comorbidities. As discussed in the study maternal psychopathology might have an effect on attachment (1) for which evidence supports an increased risk of psychopathology in children (5). There may be benefit in assessing maternal attachment style with standardised tests such as the attachment style interview (ASI) (6) to see if this varies with comorbidies.

1)Sellers R, Collishaw S, Rice F, Thapar AK, Potter R, Mars B, Harold GT, Smith DJ, Owen MJ, Craddock N, Thapar A. Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression. BJP February 2013 202:108-114; doi:10.1192/bjp.bp.111.104984

2)Lizardi D, Thompson RG, Keyes K, Hasin D. Parental divorce, parental depression, and gender differences in adult offspring suicide attempt. Nerv Ment Dis. 2009 Dec;197(12):899-904. doi: 10.1097/NMD.0b013e3181c299ac.

3)Flash C, Leese M, Heron J, Evans J, Feder G, Sharp D, Howard L. Antenatal domestic violence, maternal mental health and subsequent child behaviour: a cohort study. BJOG 2011; DOI: 10.1111/j.1471-0528.2011.03040.x

4)Rice D, Barone Jr S. Critical periods of vulnerability for the developing nervous system: evidence from humans and animal models. Environmental Health Perspectives, 2000, 108(S3):511-533

5)Graham CA, Easterbrooks MA. School-aged children's vulnerability to depressive symptomatology: the role of attachment security, maternal depressive symptomatology, and economic risk. Dev Psychopathology. 2000 Spring;12(2):201-13.

6)Bifulco A, Figueiredo B, Guedeney N, Gorman LL, Hayes S, Muzik M, Glatigny-Dallay E, Valoriani V, Kammerer M, Henshaw CA and TCS-PND group.Maternal attachment style and depression associated with childbirth: preliminary results from a European and US cross-cultural study BJP February 2004 184:s31-s37; doi:10.1192/03-335

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Conflict of interest: None declared

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