Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-28T01:37:13.609Z Has data issue: false hasContentIssue false
  • English
  • Français

The effects on children of depressed mothers' remission and relapse over 9 months

Published online by Cambridge University Press:  11 March 2014

M. M. Weissman ,
P. Wickramaratne ,
D. J. Pilowsky ,
E. Poh ,
M. Hernandez ,
L. A. Batten ,
M. F. Flament ,
J. W. Stewart  and
P. Blier
M. M. Weissman*
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Epidemiology at the Mailman School of Public Health at Columbia University, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
P. Wickramaratne
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
D. J. Pilowsky
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Epidemiology at the Mailman School of Public Health at Columbia University, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
E. Poh
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
M. Hernandez
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
L. A. Batten
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Carleton University, Ottawa, ON, Canada
M. F. Flament
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
J. W. Stewart
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
P. Blier
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
*
*Address for correspondence: M. M. Weissman, Ph.D., Diane Goldman Kemper Family Professor of Epidemiology in Psychiatry, College of Physicians & Surgeons, Mailman School of Public Health, Columbia University, Chief, Division of Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive – Unit 24, New York, NY 10032, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The high rate of depression among children of depressed mothers is well known. Suggestions that improvement in maternal acute depression has a positive effect on the child have emerged. However, data on the mechanisms of change have been sparse. The aim was to understand how remission and relapse in the mother might explain the changes in the child's outcome.

Method

Participants were 76 depressed mothers who entered into a medication clinical trial for depression and 135 of their eligible offspring ages 7–17 years. The mothers and children were assessed at baseline and periodically over 9 months by independent teams to understand the relationship between changes in children's symptoms and functioning and maternal remission or relapse. The main outcome measures were, for mothers, the Hamilton Depression Rating Scale (HAMD), the Social Adjustment Scale (SAS) and the Parental Bonding Instrument (PBI) and, for children, the Children's Depression Inventory (CDI), the Columbia Impairment Scale (CIS), the Multidimensional Anxiety Scale for Children (MASC) and the Children's Global Assessment Scale (CGAS).

Results

Maternal remission was associated with a decrease in the child's depressive symptoms. The mother's subsequent relapse was associated with an increase in the child's symptoms over 9 months. The effect of maternal remission on the child's improvement was partially explained by an improvement in the mother's parenting, particularly the change in the mother's ability to listen and talk to her child, but also reflected in her improvement in parental bonding. These findings could not be explained by the child's treatment.

Conclusions

A depressed mother's remission is associated with her improvement in parenting and a decrease in her child's symptoms. Her relapse is associated with an increase in her child's symptoms.

Keywords

Child depressionmaternal depressionparental functioningremission
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 13 , October 2014 , pp. 2811 - 2824
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Batten, LA, Hernandez, M, Pilowsky, DJ, Stewart, JW, Blier, P, Flament, MF, Poh, E, Wickramaratne, P, Weissman, MM (2012). Children of treatment-seeking depressed mothers: a comparison with the sequenced treatment alternatives to relieve depression (STAR*D) Child Study. Journal of the American Academy of Child and Adolescent Psychiatry 51, 1185–1196.CrossRefGoogle ScholarPubMed
Beardslee, WR, Brent, DA, Weersing, VR, Clarke, GN, Porta, G, Hollon, SD, Gladstone, TRG, Gallop, R, Lynch, FL, Iyengar, S, DeBar, L, Garber, J (2013). Prevention of depression in at-risk adolescents: longer-term effects. Journal of the American Medical Association Psychiatry 70, 1161–1170.Google ScholarPubMed
Beardslee, WR, Gladstone, TR, O'Connor, EE (2011). Transmission and prevention of mood disorders among children of affectively ill parents: a review. Journal of the American Academy of Child and Adolescent Psychiatry 50, 1098–1109.CrossRefGoogle ScholarPubMed
Berensky, RA, Talcott, JA, Weeks, JC (2000). Binary data with two non-nested sources of clustering: an analysis of physician recommendations for early prostate cancer treatment. Biostatistics 1, 219–230.CrossRefGoogle Scholar
Bird, HR, Shaffer, D, Fisher, P, Gould, MS, Canino, G, Rubio-Stipec, M (1993). The Columbia Impairment Scale (CIS): pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research 3, 167–176.Google Scholar
Brotman, LM, Kamboukos, D, Theise, R (2008). Symptom-specific measures for disorders usually first diagnosed in infancy, childhood or adolescence. In Handbook of Psychiatric Measures (ed. Rush, A. J., First, M. B. and Blacker, D.), 2nd edn, pp. 333–335. American Psychiatric Press: Washington, DC.Google Scholar
De Silva, MJ, Cooper, S, Lishi, H, Li, L, Lund, C, Patel, V (2013). Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis. British Journal of Psychiatry 202, 253–260.Google Scholar
Endicott, J, Cohen, J, Nee, J, Fleiss, J, Sarantakos, S (1981). Hamilton Depression Rating Scale. Extracted from Regular and Change Versions of the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 38, 98–103.Google Scholar
First, MB, Gibbon, M, Williams, JBW (2008). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1). In Handbook of Psychiatric Measures (ed. Rush, A. J., First, M. B. and Blacker, D.), pp. 40–43. American Psychiatric Press: Washington, DC.Google Scholar
Gameroff, MJ, Wickramaratne, P, Weissman, MM (2012). Testing the Short and Screener versions of the Social Adjustment Scale-Self-report (SAS-SR). International Journal of Methods in Psychiatric Research 21, 52–65.Google Scholar
Garber, J, Ciesla, JA, McCauley, E, Diamond, G, Schloredt, KA (2011). Remission of depression in parents: links to healthy functioning in their children. Child Development 82, 226–243.CrossRefGoogle ScholarPubMed
Garber, J, Clarke, GN, Weersing, VR, Beardslee, WR, Brent, DA, Gladstone, TR, DeBar, LL, Lynch, FL, D'Angelo, E, Hollon, SD, Shamseddeen, W, Iyengar, S (2009). Prevention of depression in at-risk adolescents: a randomized controlled trial. Journal of the American Medical Association 301, 2215–2224.CrossRefGoogle ScholarPubMed
Gunlicks, ML, Weissman, MM (2008). Change in child psychopathology with improvement in parental depression: a systematic review. Journal of the American Academy of Child and Adolescent Psychiatry 47, 379–389.CrossRefGoogle ScholarPubMed
Hamilton, M (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6, 278–296.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, Williamson, D, Ryan, N (1997). Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 36, 980–988.CrossRefGoogle ScholarPubMed
Kovacs, M (1992). The Children's Depression Inventory Manual. MultiHealth Systems: Toronto, ON.Google Scholar
Lam, WKK, Fals-Stewart, W, Kelley, ML (2008). Effects of parent skills training with behavioral couples therapy for alcoholism on children: a randomized clinical pilot trial. Addictive Behaviors 33, 1076–1080.CrossRefGoogle ScholarPubMed
Liang, KY, Zeger, SL (1986). Longitudinal data analysis using generalized linear models. Biometrika 73, 13–22.CrossRefGoogle Scholar
Lieb, R, Isensee, B, Hofler, M, Pfister, H, Wittchen, HU (2002). Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Archives of General Psychiatry 59, 365–374.CrossRefGoogle ScholarPubMed
March, JS (1997). Manual for the Multidimensional Anxiety Scale for Children (MASC) . MultiHealth Systems: Toronto, ON.Google Scholar
March, JS, Parker, JDA (1999). The Multidimensional Anxiety Scale for Children (MASC). In The Use of Psychological Testing for Treatment Planning and Outcomes Assessment (ed. Maruish, M. E.), pp. 299–322. Lawrence Erlbaum Associates: Mahwah, NJ.Google Scholar
March, JS, Parker, JDA, Sullivan, K, Stallings, P, Connors, CK (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry 36, 554–565.Google Scholar
Murphy, E, Wickramaratne, P, Weissman, M (2010). The stability of parental bonding reports: a 20-year follow-up. Journal of Affective Disorders 125, 307–315.Google Scholar
Parker, G, Tupling, H, Brown, LB (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 1–10.Google Scholar
Pilowsky, DJ, Wickramaratne, P, Talati, A, Tang, M, Hughes, CW, Garber, J, Malloy, E, King, C, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH (2008). Children of depressed mothers 1 year after the initiation of maternal treatment: findings from the STAR*D-Child Study. American Journal of Psychiatry 165, 1136–1147.CrossRefGoogle ScholarPubMed
Shaffer, D, Gould, MS, Brasic, J, Ambrosini, P, Fisher, P, Bird, H, Aluwahlia, S (1983). A Children's Global Assessment Scale (CGAS). Archives of General Psychiatry 40, 1228–1231.CrossRefGoogle ScholarPubMed
Simon, GE, Ludman, EJ, Rutter, CM (2009). Incremental benefit and cost of telephone care management and telephone psychotherapy for depression in primary care. Archives of General Psychiatry 66, 1081–1089.Google Scholar
Singer, JD (1998). Using SAC PROC Mixed to fit multilevel models, hierarchical models, and individual growth models. Journal of Education and Behavioral Statistics 29, 323–355.CrossRefGoogle Scholar
Stewart, JW, McGrath, PJ, Blondeau, C, Deliyannides, DA, Hellerstein, D, Norris, S, Amat, J, Pilowski, D, Tessier, P, Laberge, L, O'Shea, D, Chen, Y, Withers, A, Bergeron, R, Blier, P (2013). Combination antidepressant therapy for major depressive disorder: speed and probability of remission. Journal of Psychiatric Research. Published online: 17 12 2013 . doi:org/10.1016/j.jpsychires.2013.12.001.Google Scholar
Weissman, MM, Olfson, M (2009). Translating intergenerational research on depression into clinical practice. Journal of the American Medical Association 302, 2695–2696.CrossRefGoogle ScholarPubMed
Weissman, MM, Pilowsky, DJ, Wickramaratne, PJ, Talati, A, Wisniewski, SR, Fava, M, Hughes, CW, Garber, J, Malloy, E, King, CA, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH, Rush, AJ; STAR*D-Child Team (2006a). Remissions in maternal depression and child psychopathology: a STAR*D-child report. Journal of the American Medical Association 295, 1389–1398 [Erratum in Journal of the American Medical Association (2006) 296, 1234].Google Scholar
Weissman, MM, Prusoff, BA, Thompson, WD, Harding, PS, Myers, JK (1978). Social adjustment by self-report in a community sample and in psychiatric outpatients. Journal of Nervous and Mental Disease 166, 317–326.Google Scholar
Weissman, MM, Wickramaratne, P, Nomura, Y, Warner, V, Pilowsky, D, Verdeli, H (2006 b). Offspring of depressed parents: 20 years later. American Journal of Psychiatry 163, 1001–1008.CrossRefGoogle ScholarPubMed
Wickramaratne, P, Gameroff, MJ, Pilosky, DJ, Hughes, CW, Garber, J, Malloy, E, King, C, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH, Fava, M, Rush, AJ, Wisniewski, S, Weissman, MM (2011). Children of depressed mothers 1 year after remission of maternal depression: findings from the STAR*D-child study. American Journal of Psychiatry 168, 593–602.Google Scholar
Supplementary material: File

Weissman Supplementary Material

Table S1

Download Weissman Supplementary Material(File)
File 50.1 KB