Hostname: page-component-6bf8c574d5-2jptb Total loading time: 0 Render date: 2025-02-18T09:48:45.123Z Has data issue: false hasContentIssue false
  • English
  • Français

Perinatal depression and child development: exploring the economic consequences from a South London cohort

Published online by Cambridge University Press:  20 June 2014

A. Bauer ,
S. Pawlby ,
D. T. Plant ,
D. King ,
C. M. Pariante  and
M. Knapp
A. Bauer*
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
S. Pawlby
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
D. T. Plant
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
D. King
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
C. M. Pariante
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
M. Knapp
Affiliation:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
*
* Address for correspondence: A. Bauer, Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Depression in mothers during pregnancy and in the postnatal period has been recognized to have wide-ranging adverse impacts on offspring. Our study examines some of the outcomes and long-term economic implications experienced by offspring who have been exposed to perinatal depression.

Method

We analysed the effects of perinatal depression on child development outcomes of children at ages 11 and 16 years from the community-based South London Child Development Study. Economic consequences were attached to those outcomes through simple decision-analytic techniques, building on evidence from studies of epidemiology, health-related quality of life, public sector costs and employment. The economic analysis takes a life-course perspective from the viewpoints of the public sector, individual and society.

Results

Additional risks that children exposed to perinatal depression develop emotional, behavioural or cognitive problems ranged from 5% to 21%. In addition, there was a high risk (24%) that children would have special educational needs. We present results in the form of cost consequences attached to adverse child outcomes. For each child exposed to perinatal depression, public sector costs exceeded £3030, costs due to reduced earnings were £1400 and health-related quality of life loss was valued at £3760.

Conclusions

Action to prevent or treat mothers' depression during pregnancy and after birth is likely to reduce public sector costs, increase earnings and improve quality of life for children who were exposed to the condition.

Keywords

Child developmentcost consequenceseconomic modellinglong-term effectsperinatal depression
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 51 - 61
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

Barker, ED, Jaffee, SR, Uher, R, Maughan, B (2011). The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depression and Anxiety 28, 696–702.CrossRefGoogle ScholarPubMed
Bauer, A, Knapp, M, McDaid, D (2011). Health visiting and reducing post-natal depression. In Mental Health Promotion and Mental Illness Prevention: The Economic Case (ed. Knapp, M., McDaid, D. and Parsonage, M.), pp. 4–5. Department of Health: London.Google Scholar
Bonin, EM, Stevens, M, Beecham, J, Byford, S, Parsonage, M (2011). Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study. BMC Public Health 11, 803.Google Scholar
Boyle, D, Burton, E (2004). Making Sense of SEN – Special Educational Needs: A Guide for Donors and Grant-makers. New Philanthropy Capital: London.Google Scholar
Brugha, T, Morrell, CJ, Slade, P, Walters, SJ (2011). Universal prevention of depression postnatally: cluster randomized trial evidence in primary care. Psychological Medicine 41, 739–748.CrossRefGoogle ScholarPubMed
Colman, I, Murray, J, Abbott, RA, Maughan, B, Kuh, D, Croudance, TJ, Jones, PB (2009). Outcomes of conduct problems in adolescence: 40 year follow-up of national cohort. British Medical Journal 338, a2981.Google Scholar
Colman, I, Ploubidis, G, Wadsworth, M, Jones, P, Croudace, T (2007). A longitudinal typology of symptoms of depression and anxiety over the life course. Biological Psychiatry 62, 1265–1271.Google Scholar
Cuijpers, P, Brännmark, JG, Straten van, A (2008). Psychological treatment of postpartum depression: a meta-analysis. Journal of Clinical Psychology 64, 103–118.CrossRefGoogle ScholarPubMed
Curtis, L (2011). Unit Costs of Health and Social Care 2011. Personal Social Services Research Unit: University of Kent.Google Scholar
Dagher, RK, McGovern, PM, Dowd, BE, Lundberg, U (2011). Postpartum depressive symptoms and the combined load of paid and unpaid work: a longitudinal analysis. International Archives of Occupational and Environmental Health 84, 735–743.Google Scholar
Danese, A, Moffitt, TE, Harrington, H, Milne, BJ, Polanczyk, G, Pariante, CM, Poulton, R, Caspi, A (2009). Adverse childhood experiences and adult risk factors for age-related disease. Archives of Pediatrics and Adolescent Medicine 163, 1135–1143.CrossRefGoogle ScholarPubMed
Department of Work and Pensions (2011). Statistical and Accounting Data, Benefit Expenditure by Country, Region and Local Authority, 2009/10 (http://research.dwp.gov.uk/asd/asd4/la_expenditure.xls). Accessed 15 April 2011.Google Scholar
Essex, M, Klein, M, Mich, R, Smider, N (2001). Timing of initial exposure to maternal major depression and children's mental health symptoms in kindergarten. British Journal of Psychiatry 179, 151–156.CrossRefGoogle ScholarPubMed
Fihrer, I, McMahon, CA, Taylor, AJ (2009). The impact of postnatal and concurrent maternal depression on child behaviour during the early school years. Journal of Affective Disorders 119, 116–123.Google Scholar
Friedli, L, Parsonage, M (2007). Mental Health Promotion: Building an Economic Case. Northern Ireland Association for Mental Health: Belfast.Google Scholar
Friedli, L, Parsonage, M (2009). Promoting Mental Health and Preventing Mental Illness: The Economic Case for Investment in Wales. Mental Health Promotion Network: Cardiff.Google Scholar
Gavin, NI, Gaynes, BI, Lohr, KN, Meltzer-Brody, S, Gartlehner, G, Swinson, T (2005). Perinatal depression: a systematic review of prevalence and incidence. Journal of Obstetrics and Gynecology 106, 1071–1083.Google Scholar
Goldberg, DP, Cooper, B, Eastwood, MR, Kedward, HB, Shepherd, M (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventive Social Medicine 24, 18–23.Google Scholar
Goodman, A, Joyce, R, Smith, JP (2011). The long shadow cast by childhood physical and mental problems on adult life. Proceedings of the National Academy of Sciences USA 108, 6032–6037.Google Scholar
Goodman, R (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry 38, 581–586.CrossRefGoogle ScholarPubMed
Grace, SL, Evindar, A, Stewart, DE (2003). The effect of postpartum depression on child cognitive development and behaviour: a review and critical analysis of the literature. Archives of Women's Mental Health 6, 263–274.Google Scholar
Grant, BF, Hasin, DS, Blanco, C, Stinson, FS, Chou, SP, Goldstein, RB, Dawson, DA, Smith, S, Saha, TD, Huang, B (2005). The epidemiology of social anxiety disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 66, 1351–1361.Google Scholar
Halligan, SL, Murray, L, Martins, C, Cooper, PJ (2007). Maternal depression and psychiatric outcomes in adolescent offspring: a 13-year longitudinal study. Journal of Affective Disorders 97, 145–154.Google Scholar
Hay, DF, Pawlby, S, Angold, A, Harold, GT, Sharp, D (2003). Pathways to violence in the children of mothers who were depressed postpartum. Developmental Psychology 39, 1083–1094.CrossRefGoogle ScholarPubMed
Hay, DF, Pawlby, S, Sharp, D, Asten, P, Mills, A, Kumar, R (2001). Intellectual problems shown by 11-year-old children whose mothers had postnatal depression. Journal of Child Psychology and Psychiatry and Allied Disciplines 42, 871–889.Google Scholar
Hay, DF, Pawlby, S, Waters, CS, Perra, O, Sharp, D (2010). Mothers’ antenatal depression and their children's antisocial outcomes. Child Development 81, 149–165.Google Scholar
Healey, A, Knapp, M, Farrington, DP (2004). Adult labour market implications of antisocial behaviour in childhood and adolescence: findings from a UK longitudinal study. Applied Economics 36, 93–105.Google Scholar
Henderson, JJ, Evans, SF, Straton, JAY, Priest, SR, Hagan, R (2003). Impact of postnatal depression on breastfeeding duration. Birth 30, 175–180.CrossRefGoogle ScholarPubMed
Johnston, DW, Schurer, S, Shields, MA (2011). Evidence on the Long Shadow of Poor Mental Health Across Three Generations. Discussion Paper Series IZA DP No. 6014. Institute for the Study of Labor (IZA): Bonn.Google Scholar
Kessler, RC, Greenberg, PE (2002). The economic burden of anxiety and stress disorders. In Neuropsychopharmacology: The Fifth Generation of Progress (ed. Davis, K. L., Charney, D., Coyle, J. T. and Nemeroff, C.), pp. 981–992. Lippincott, Williams, and Wilkins: Philadelphia.Google Scholar
Knapp, M, King, D, Healey, A, Thomas, C (2011). Economic outcomes in adulthood and their associations with antisocial conduct, attention deficit and anxiety problems in childhood. Journal of Mental Health Policy and Economics 14, 137–147.Google Scholar
Marchand, JF, Hock, E, Widaman, K (2002). Mutual relations between mothers’ depressive symptoms and hostile-controlling behaviour and young children's externalizing and internalizing behavior problems. Parenting: Science and Practice 2, 335–353.Google Scholar
McCabe, C, Sutcliffe, P, Kaltenthaler, E (2005). Parent-Training Programmes in the Management of Conduct Disorder: A Report from the NICE Decision Support Unit and the ScHARR Technology Assessment Group. NICE: Sheffield.Google Scholar
McCrone, P, Knapp, M, Fombonne, E (2005). The Maudsley long-term follow-up of child and adolescent depression. Predicting costs in adulthood. European Child Adolescent Psychiatry 14, 407–413.Google Scholar
McMahon, C, Trapolini, T, Barnett, B (2008). Maternal state of mind regarding attachment predicts persistence of postnatal depression in the preschool years. Journal of Affective Disorders 107, 199–203.Google Scholar
Meltzer, H, Gatward, R, Corbin, T, Goodman, R, Ford, T (2003). Persistence, Onset, Risk Factors and Outcomes of Childhood Mental Disorders. The Stationery Office: London.Google Scholar
Morrell, CJ, Warner, R, Slade, P, Dixon, S, Walters, S, Paley, G, Brugha, T (2009). Psychological interventions for postnatal depression: cluster randomised trial and economic evaluation: the PoNDER trial. Health Technology Assessment 13, 1–153.Google Scholar
Murray, L, Cooper, P (1997). Effects of postnatal depression on infant development. Archives of Disease in Childhood 77, 99–101.Google Scholar
National Institute for Health and Care Excellence (2013). Guide to the methods of technological appraisal. NICE: London.Google Scholar
Office for National Statistics (2011). Earnings by qualification, 2011 (http://www.ons.gov.uk/ons/dcp171776_229888.pdf). Accessed 12 April 2013.Google Scholar
Pawlby, S, Hay, DF, Sharp, D, Waters, CS, O'Keane, V (2009). Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community-based study. Journal of Affective Disorders 113, 236–243.CrossRefGoogle ScholarPubMed
Pawlby, S, Hay, DF, Sharp, D, Waters, CS, Pariante, CM (2011). Antenatal depression and offspring psychopathology: the influence of childhood maltreatment. British Journal of Psychiatry 199, 106–112.Google Scholar
Perkins, R, Farmer, P, Litchfield, P (2009). Realising Ambitions: Better Employment Support for People with a Mental Health Condition: A Review to Government. Department of Work and Pensions: London.Google Scholar
Petrou, S, Johnson, S, Wolke, D, Hollis, C, Kochhar, P, Marlow, N (2010). Economic costs and preference-based health-related quality of life outcomes associated with childhood psychiatric disorders. British Journal of Psychiatry 197, 395–404.CrossRefGoogle ScholarPubMed
Pigott, G (2011). Focus on London 2011: Labour Market: Beyond Headlines. Greater London Authority: London.Google Scholar
Plant, DT, Barker, ED, Waters, CS, Pawlby, S, Pariante, CM (2013). Intergenerational transmission of maltreatment and psychopathology: the role of antenatal depression. Psychological Medicine 43, 519–528.Google Scholar
Romeo, R, Knapp, M, Scott, S (2006). Economic cost of severe antisocial behaviour in children – and who pays it. British Journal of Psychiatry 188, 547–553.CrossRefGoogle Scholar
Scott, S, Knapp, M, Henderson, J, Maughan, B (2001). Financial cost of social exclusion: follow up study of antisocial children into adulthood. British Medical Journal 323, 191.CrossRefGoogle ScholarPubMed
Snell, T, Knapp, M, Healey, A, Guglani, S, Evans-Lacko, S, Fernandez, JL, Meltzer, H, Ford, T (2013). Economic impact of childhood psychiatric disorder on public sector services in Britain: estimates from national survey data. Journal of Child Psychology and Psychiatry 54, 977–985.Google Scholar
Thomas, CM, Morris, S (2003). Cost of depression among adults in England in 2000. British Journal of Psychiatry 183, 514–519.Google Scholar
Toghanian, S, DiBonaventura, M, Järbrink, K, Locklear, J (2010). PMH16 the economic and humanistic burden of generalised anxiety disorder (GAD): a retrospective database analysis in Europe. Value in Health 13, 7 Google Scholar
Velders, FP, Dieleman, G, Henrichs, J, Jaddoe, VW, Hofman, A, Verhulst, FC, Hudziak, JJ, Tiemeier, H (2011). Prenatal and postnatal psychological symptoms of parents and family functioning: the impact on child emotional and behavioural problems. European Child and Adolescent Psychiatry 20, 341–350.Google Scholar
Wechsler, D (1992). The Wechsler Intelligence Scale for Children (WISC–III UK). The Psychological Corporation: London.Google Scholar