Parental Depression: Long-term Impact on Children

Nancy A. Melville

February 05, 2016

Children of depressed parents show significant reductions in academic performance at the age of 16 years, adding to various other known adverse effects of parental depression on offspring, new research shows.

"Our results suggest that diagnoses of parental depression may have a far-reaching effect on an important aspect of child development, with implications for future life course outcomes," the authors write.

The study was published online February 3 in JAMA Psychiatry.

Possible Mechanisms

The investigators analyzed data on parental depression diagnoses and school grades for 1,124,162 children born in Sweden between 1984 and 1994.

Investigators, with first author Brian K. Lee, PhD, of the Drexel University School of Public Health, in Philadelphia, Pennsylvania, evaluated inpatient records from 1969 and outpatient records beginning in 2001. They further identified 33,906 mothers and 23,724 fathers who had depression before the final year of a child's compulsory education.

The unadjusted results showed that depression in either the mother or father at any time prior to the final year of school was associated with poorer school performance.

After adjustment for factors that included sex, birth year, and birth order of the child, pregnancy characteristics, parental ages, education, income, smoking status, and others, decreases were still noted of -0.45 (95% confidence interval [CI], -0.48 to -0.42) lower deciles in school grades for maternal depression and -0.40 (95% CI, −0.43 to -0.37) for paternal depression. The effects were similar to those that have been found to be associated with the highest and lowest quintiles of family income, the authors say.

Maternal and paternal depression in all periods of a child's life, including before birth, after birth, and from ages 1 to 5 years, 6 to 10 years, and 11 to 16 years, was associated with worse school performance. Paternal depression during the postnatal period did not have a statistically significant effect.

Further analysis showed maternal depression to have a larger negative influence on school performance of girls compared with boys.

Previous research has shown an array of other effects of parental depression on children, with links to neurodevelopmental, behavioral, and emotional psychiatric problems.

In terms of how parental depression could affect school performance, the authors speculate that mechanisms could range from genetic influences to influences on neurodevelopment and on social pathways by contributing to parent-child conflict.

Treating Parents Helps Children

In an accompanying editorial, Myrna M. Weissman, PhD, of the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York City, commented that the findings add to the many known adverse effects of parental depression on children.

"One of the best-replicated findings in clinical psychiatry is that the biological offspring of depressed parents (usually mothers are studied) themselves have considerable emotional and functional problems, usually depression and anxiety," Dr Weissman writes.

There is encouraging evidence, however, that those effects can be reduced with treatment.

"Depression in a parent is a modifiable risk factor because the parent's symptoms can be treated," she notes, adding that bringing the depressed parent into remission may help the child.

"Fortunately, [studies] have also been performed and have shown that remission of the depressed mother, whether by medication or by psychotherapy, can reduce the child's problems."

"We can state with confidence that treatment for a depressed parent should be readily available, sustained, and aggressive to achieve remission. Furthermore, a child with emotional problems or even serious school problems indicates that the parent's own clinical needs should also be considered," she adds.

JAMA Psychiatry. Published online February 3, 2016. Abstract, Editorial

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