Enhancing understanding of depression symptom interactions between parents and associations with subsequent child emotional difficulties will inform targeted treatment of depression to prevent transmission within families.

To use a network approach to identify ‘bridge’ symptoms that reinforce mother and father depression, and whether bridge symptoms, as well as other symptoms, impact subsequent child emotional difficulties.

Symptoms were examined using two unregularized partial correlation network models. The study included 4,492 mother-father-child trios from a prospective, population-based cohort in the United Kingdom. Mother and father reports of depression symptoms were assessed when the child was twenty-one months old. Child emotional difficulties were reported by the mother at ages nine, eleven and thirteen years.

Bridge symptoms mutually reinforcing mother and father depression symptoms were feelings of guilt and self-harm ideation, whereas anhedonia acted as a bridge from the father to the mother, but not vice-versa (fig.1, network 1). The symptom of feelings of guilt in mothers was the only bridge symptom which directly associated with child emotional difficulties. Other symptoms that directly associated with child emotional difficulties were feeling overwhelmed for fathers and anhedonia, sadness, and panic in mothers (fig.1, network 2).

Specific symptom interactions are central to the co-occurrence of depression symptoms between parents. Of interest, only one of the bridge symptoms associated with later child emotional difficulties. In addition, specific symptom-to-child outcomes were identified, suggesting that different symptoms in mothers and fathers are central for increased vulnerability in children.

No significant relationships.

In 2007 the Mental Health Act in England and Wales was amended and the definition of Mental Disorder was broadened. This change affected people with Personality Disorders who now can be admitted for hospital treatment without consent, often for prolonged period of time.

This poster reviews clinicians’ attitudes towards the new legislation and its consequences and also presents the research on the different perspectives about the new law.

To review clinicians’ attitudes with regard to interfaces between Personality Disorders and the new law.

Use of the specifically designed questionnaire for clinicians providing hospital care for patients with Borderline Personality Disorders. MEDLINE and PsycINFO databases were also searched for all English-language articles published between 2008 and 2012 containing the keywords “rsonality Disorder”, “Mental Health Act” and “clinicians view on compulsory treatment of persons with Borderline Personality Disorder”. Additional key articles published before 2008 were reviewed. The most relevant articles were selected for the review.

There is still no common consensus in regard to the benefit of compulsory hospital admission of persons with Borderline Personality Disorders. Results from questionnaires are under review.

In 2007 the Mental Health Act in England and Wales was amended and the definition of Mental Disorder was broadened. This change affected people with Personality Disorders who now can be admitted for hospital treatment without consent, often for prolonged period of time.

This poster reviews patients’ attitudes towards the new legislation and its consequences and also presents the research on the different perspectives about the new law.

To review patients’ attitudes with regard to interfaces between Personality Disorders and the new law.

Use of the specifically designed questionnaire for patients with Borderline Personality Disorders hospitalized under Mental Health Act. MEDLINE and PsycINFO databases were also searched for all English-language articles published between 2008 and 2012 containing the keywords “Personality Disorder”, “Mental Health Act” and “patients’ view on compulsory treatment”. Additional key articles published before 2008 were reviewed. The most relevant articles were selected for review.

There is still no common consensus in regard to the benefit of compulsory hospital admission of persons with Borderline Personality Disorders. Results from questionnaires are under review.

There is now a well-established link between childhood adversity (CA) and schizophrenia. Similar structural abnormalities to those found in schizophrenia including alterations in grey-matter volume have also been shown in those who experience CA.

We examined whether global estimates of cortical thickness or surface area were altered in those familial high-risk subjects who had been referred to a social worker or the Children's Panel compared to those who had not.

We found that the cortical surface area of those who were referred to the Children's Panel was significantly smaller than those who had not been referred, but cortical thickness was not significantly altered. There was also an effect of social work referral on cortical surface area but not on thickness.

Cortical surface area increases post-natally more than cortical thickness. Our findings suggest that CA can influence structural changes in the brain and it is likely to have a greater impact on cortical surface area than on cortical thickness.

Maternal depression and unhealthy diet are well-known risk factors for adverse child emotional–behavioural outcomes, but their developmental relationships during the prenatal and postnatal periods are largely uncharted. This study sought to examine the inter-relationships between maternal depression symptoms and unhealthy diet (assessed during pregnancy and postnatal periods) in relation to child emotional–behavioural dysregulation (assessed at the ages of 2, 4 and 7 years).

In a large prospective birth cohort of 7814 mother–child pairs, path analysis was used to examine the independent and inter-related associations of maternal depression symptoms and unhealthy diet with child dysregulation.

Higher prenatal maternal depression symptoms were prospectively associated with higher unhealthy diet, both during pregnancy and the postnatal period, which, in turn, was associated with higher child dysregulation up to the age of 7 years. In addition, during pregnancy, higher maternal depression symptoms and unhealthy diet were each independently associated with higher child dysregulation up to the age of 7 years. These results were robust to other prenatal, perinatal and postnatal confounders (such as parity and birth complications, poverty, maternal education, etc.).

Maternal depression symptoms and unhealthy diet show important developmental associations, but are also independent risk factors for abnormal child development.

Late preterm births constitute the majority of preterm births. However, most evidence suggesting that preterm birth predicts the risk of mental disorders comes from studies on earlier preterm births. We examined if late preterm birth predicts the risks of severe mental disorders from early to late adulthood. We also studied whether adulthood mental disorders are associated with post-term birth or with being born small (SGA) or large (LGA) for gestational age, which have been previously associated with psychopathology risk in younger ages.

Of 12 597 Helsinki Birth Cohort Study participants, born 1934–1944, 664 were born late preterm, 1221 post-term, 287 SGA, and 301 LGA. The diagnoses of mental disorders were identified from national hospital discharge and cause of death registers from 1969 to 2010. In total, 1660 (13.2%) participants had severe mental disorders.

Individuals born late preterm did not differ from term-born individuals in their risk of any severe mental disorder. However, men born late preterm had a significantly increased risk of suicide. Post-term birth predicted significantly increased risks of any mental disorder in general and particularly of substance use and anxiety disorders. Individuals born SGA had significantly increased risks of any mental and substance use disorders. Women born LGA had an increased risk of psychotic disorders.

Although men born late preterm had an increased suicide risk, late preterm birth did not exert widespread effects on adult psychopathology. In contrast, the risks of severe mental disorders across adulthood were increased among individuals born SGA and individuals born post-term.

White matter (WM) abnormalities are proposed as potential endophenotypic markers of bipolar disorder (BD). In a diffusion tensor imaging (DTI) voxel-based analysis (VBA) study of families multiply affected with BD, we previously reported that widespread abnormalities of fractional anisotropy (FA) are associated with both BD and genetic liability for illness. In the present study, we further investigated the endophenotypic potential of WM abnormalities by applying DTI tractography to specifically investigate tracts implicated in the pathophysiology of BD.

Diffusion magnetic resonance imaging (MRI) data were acquired from 19 patients with BD type I from multiply affected families, 21 of their unaffected first-degree relatives and 18 healthy volunteers. DTI tractography was used to identify the cingulum, uncinate fasciculus (UF), arcuate portion of the superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), corpus callosum, and the anterior limb of the internal capsule (ALIC). Regression analyses were conducted to investigate the effect of participant group and genetic liability on FA and radial diffusivity (RD) in each tract.

We detected a significant effect of group on both FA and RD in the cingulum, SLF, callosal splenium and ILF driven by reduced FA and increased RD in patients compared to controls and relatives. Increasing genetic liability was associated with decreased FA and increased RD in the UF, and decreased FA in the SLF, among patients.

WM microstructural abnormalities in limbic, temporal and callosal pathways represent microstructural abnormalities associated with BD whereas alterations in the SLF and UF may represent potential markers of endophenotypic risk.

Risk factors that are associated with depression in the mother also negatively affect the child. This research sought to extend current knowledge by examining the duration and timing of maternal depression as a moderator of: (1) the impact of dependent interpersonal stress (DIS), such as partner conflict or low social support, and contextual risk (e.g. poverty) on child dysregulation; and (2) continuity in early child dysregulation.

Mother–child pairs (n = 12 152) who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC) were examined between pregnancy and age 4 years. Data on maternal depression were collected five times between pregnancy and 33 months postpartum; on DIS and contextual risk three times between pregnancy and 33 months; and on child dysregulation at age 2 and 4 years.

Longitudinal latent class analysis identified a class of mothers (10%) who evinced a chronic level of depression between pregnancy and 33 months. For chronic-depressed versus non-depressed mothers, the results indicate that: (1) DIS predicted higher child dysregulation if experienced between pregnancy and age 2; (2) contextual risk had a differential effect on child dysregulation if experienced during pregnancy; and (3) children had higher continuity in dysregulation between age 2 and age 4.

Assessing the impact of the timing and duration of maternal depression, and different types of co-occurring risk factors, on child well-being is important. Maternal depression and associated DIS, in comparison to contextual risk, may be more responsive to intervention.

Maternal experience of childhood maltreatment and maternal antenatal depressionare both associated with offspring childhood maltreatment and offspring adjustmentproblems. We have investigated the relative impact of maternal childhoodmaltreatment and exposure to depression in utero on offspringmaltreatment and psychopathology.

The sample included 125 families from the South London Child Development Study. Aprospective longitudinal design was used. Data on maternal childhood maltreatment,maternal antenatal depression (36 weeks of pregnancy), offspring childhoodmaltreatment (age 11 years) and offspring adolescent antisocial behaviour anddepression (ages 11 and 16 years) were obtained from parents and offspring throughclinical interview.

Mothers who experienced childhood maltreatment were significantly more likely tobe depressed during pregnancy [odds ratio (OR) 10.00]. Offspring of mothers whoexperienced only childhood maltreatment or only antenatal depression were no moreat risk of being maltreated or having psychopathology; however, offspring ofmothers who experienced both maternal childhood maltreatment and antenataldepression were exposed to significantly greater levels of childhood maltreatmentand exhibited significantly higher levels of adolescent antisocial behaviourcompared with offspring not so exposed. Furthermore, maternal childhoodmaltreatment accounted for a significant proportion of the variance in offspringchildhood maltreatment in only those offspring exposed to depression in utero.

Maternal childhood maltreatment and maternal antenatal depression are highlyassociated. The co-occurrence of both insults significantly increases the risk ofoffspring adversity. The antenatal period is an optimum period to identifyvulnerable women and to provide interventions.