Association between parental depression during offspring adolescence and offspring depression from adolescence to early adulthood: A prospective cohort study in China.

Exposure to parental depression is a risk factor for offspring mental illness. To examine the association between the timing of exposure to parental depression, from pregnancy to young adulthood, and adult offspring mental health. This prospective longitudinal cohort study of adult offspring aged 22 to 27 years in the Avon Longitudinal Study of Parents and Children, a British birth cohort, was conducted from September 1990 to July 2020. Data were analyzed from March 2024 to January 2026. Parental depressive symptoms were assessed repeatedly using the Edinburgh Postnatal Depression Scale (score range, 0 to 30, with higher scores indicating more severe depressive symptoms) beginning in pregnancy through offspring age of 21 years. The main outcomes were offspring symptoms of depression at age 27 years, anxiety at age 25 years, psychotic disorders at age 24 years, and alcohol use disorder (AUD) at age 22 years. Covariates included socioeconomic status and maternal-offspring polygenic risk for multiple psychiatric disorders. A total of 5329 adult offspring (3276 females [61.5%]) provided at least 1 outcome measure, which included 3795 participants providing symptoms of depression (mean [SD] age, 27.8 [0.5] years), 3505 participants providing symptoms of anxiety (mean [SD] age, 25.3 [0.6] years), 3342 participants with assessments for psychotic disorders (mean [SD] age, 24.5 [0.8] years), and 3392 participants reporting on symptoms of AUD (mean [SD] age, 22.9 [0.5] years). Cumulative exposure to parental depression across all time points was associated with increased odds of offspring depression (maternal: AOR, 2.36 [95% CI, 1.91-2.92]; paternal: AOR, 2.13 [95% CI, 1.60-2.83]) and anxiety (maternal: AOR, 2.58 [95% CI, 2.06-3.23]; paternal: AOR, 1.98 [95% CI, 1.49-2.63]). Only maternal depression was associated with increased odds of psychosis symptoms (maternal: AOR, 1.90 [95% CI, 1.27-2.82]; paternal: AOR, 1.63 [95% CI, 0.95-2.80]). There were no statistically significant associations with AUD. Significant associations between maternal depression and adult offspring depression were observed from 32 weeks' gestation (AOR, 1.08 [95% CI, 1.01-1.15]) to age 18 years (AOR, 1.08 [95% CI, 1.01-1.16]). Maternal depression from the 8-month postnatal period (AOR, 1.06 [95% CI, 1.01-1.11]) onward (aged 21 years: AOR, 1.13 [95% CI, 1.02-1.24]) was associated with offspring anxiety symptoms. Paternal depression was significantly associated with offspring depression from mid-childhood (AOR, 1.08 [95% CI, 1.01-1.15]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]), with similar associations between paternal depression and offspring anxiety from mid-childhood (aged 5 years: AOR, 1.11 [95% CI, 1.03-1.18]) onward (aged 21 years: AOR, 1.22 [95% CI, 1.04-1.43]). Only maternal prenatal depression at 32 weeks' gestation was associated with offspring psychotic symptoms (AOR, 1.20 [95% CI, 1.03-1.41]). In this cohort study, analyses of 2 decades of data found distinct temporal associations between maternal and paternal depression and offspring psychiatric symptoms, and pregnancy was found to be a sensitive period in the association between maternal depression and offspring psychotic experiences. The findings suggest a substantial role of timing for specifying the association between parental depression and psychiatric outcomes in young adults and emphasize the need to support parental mental health from pregnancy onward.

Paternal depression during the postnatal period has been associated with adverse child outcomes. Family environment has been reported as a pathway for risk transmission from fathers to children. The influence of paternal depression during the postnatal period on offspring depression remains to be clarified. To investigate the association between paternal depression in the postnatal period and offspring depression and explore potential mediating and moderating factors that influence any association between paternal and offspring depression. This prospective study of a UK community-based birth cohort (the Avon Longitudinal Study of Parents and Children) of parents and their adolescent offspring investigated associations between paternal depression during the postnatal period and offspring depression at age 18 years. We tested a hypothesized moderator (ie, sex) and conducted path analysis to examine hypothesized mediators (ie, depression in the other parent, couple conflict, and paternal involvement and emotional problems, conduct problems, and hyperactivity in offspring at age 3.5 years) of the associations between both paternal and maternal depression and offspring depression. Data collection for the Avon Longitudinal Study of Parents and Children began in 1991 and is ongoing. Data analysis for this study was conducted from June 2015 to September 2018. Depression symptoms in fathers at 8 weeks after the birth of their children. Offspring depression symptoms at age 18 years, using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. A total of 3176 father-offspring pairs were analyzed; of the children, 1764 were girls (55.5%) and 1412 (44.5%) were boys. Paternal mean (SD) age at delivery was 29.6 (9.6) years. The offspring of fathers who had depression during the postnatal period were at increased risk of experiencing depression symptoms at age 18 years (β = 0.053 [95% CI, 0.02-0.09]). The association is mediated by maternal depression at 8 months after birth (β = 0.011 [95% CI, 0.0008-0.02]; 21% [0.011/0.053]) and conduct problems at 42 months after birth (β = 0.004; [95% CI , -0.00004 to 0.009]; 7.5% [0.004/0.053]). Couple conflict and paternal involvement do not mediate this association. The increased risk is seen in girls but not boys (interaction β = 0.095; P = .01). The association between paternal depression in the postnatal period and depression in girls at age 18 years is partially explained by maternal depression. Couple conflict and paternal involvement were not found to play a role in the risk of transmission; this contrasts with the role that couple conflict was found to play in the risk of childhood behavior problems. Conduct problems in childhood appear to be a pathway for risk transmission between paternal depression and subsequent depression in offspring at age 18 years.

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessTwo Parents With Depression Don’t Spell Double Trouble for OffspringJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:7 Jun 2002https://doi.org/10.1176/pn.37.11.0021aCan one predict the mental health destiny of children who have one or two parents with a history of major depression? Past research has suggested that it is possible to do so. And now a large longitudinal, prospective, community study bolsters that hypothesis.The study was conducted by Rosalind Lieb, Ph.D., of the Max Planck Institute of Psychiatry in Munich, Germany, and colleagues and was reported in the April Archives of General Psychiatry.The study was based on some 2,400 14- to 24-year-olds in the Munich area. Half of these young persons had one or more parents who experienced a major depression at some point in their lives. The other half did not. Information about depression in the parents was obtained both from the parents and the young study subjects.The subjects were assessed for the presence of various mental disorders at the start of the study and two more times over a four-year period. Diagnoses were based on DSM-IV, with information obtained with the Munich-Composite International Diagnostic Interview, an updated version of the World Health Organization’s Composite International Diagnostic Interview.Lieb and her coworkers then used the data about the young people and their parents to see whether having one or more parents with a history of major depression could influence children’s mental health futuresIndeed, having either one or two parents with a history of major depression increased young people’s risk of also suffering a depression later in life, the researchers found. This finding was consistent with most previous reports by other researchers. It was, however, an extension of previous research, because associations were explored in a sample representative of the community and because young people were examined before they succumbed to mental illness. Also, the large sample size that Lieb and her coworkers studied gave extra strength to their finding.What’s more, the young persons who later developed a major depression and who had parents with a history of major depression tended to experience a more malignant course than did those who became depressed but did not have parents with such a history. This finding was consistent with clinical studies that have linked parental depression with greater illness severity.However, having two parents instead of one with a history of major depression did not increase young persons’ risk of developing a major depression, Lieb and her team discovered. This finding suggests that the familial transmission of major depression does not follow simple genetic patterns of transmission.Also, having either a depressed mother or a depressed father appeared to impose a comparable risk of major depression on their subjects, they found. This result agreed with that of family genetic studies that had found no sex-specific effects in the familial transmission of a risk for major depression.And can having parents with a history of major depression also increase a young person’s risk of developing a mental disorder other than major depression? The answer is yes, Lieb and her team determined. When the offspring of parents with no history of major depression were compared with the offspring of parents with such a history, the latter were found to experience higher rates of anxiety disorders, bipolar disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and substance abuse disorders.The researchers found that within-disorder associations—for example, parental depression with depression in offspring—were in most cases considerably higher than were cross-disorder associations such as parental depression with anxiety disorders in offspring. “Nevertheless, our cross-disorder findings also deserve attention,” they stressed in their study report. “The higher risk for nicotine dependence in offspring is especially interesting, as it has never before been reported.”The study was funded by the German Ministry of Research and Technology.An abstract of the study, “Parental Major Depression and the Risk of Depression and Other Mental Disorders in Offspring,” is posted on the Web at http://archpsyc.ama-assn.org/issues/v59n4/abs/yoa01030.html. ▪ ISSUES NewArchived

There is an increased risk for depression in the offspring of depressed parents. This is in part mediated by maladaptive parenting. Females are more vulnerable to parenting behavior and were found to be at increased risk of depression compared to male offspring of depressed parents. Previous work suggested a reduced risk for depression in the offspring of parents with remitted depression. Offspring gender differences in this association were rarely considered. Here, we are examining the hypothesis that female offspring are more likely to benefit from treating parental depression using data from the U.S. National Comorbidity Survey Replication (NCS-R). The NCS-R is a nationally representative household survey of adults 18 years and older carried out between February 2001 and April 2003. The World Health Organization World Mental Health Composite International Diagnostic Interview (WHO WMH-CIDI) was used to assess DSM-IV Major Depressive Disorder (MDD). Multiple logistic regressions were used to assess the association between parental treatment and offspring risk for MDD. An interaction term was added to study the effect of offspring's gender on this risk. The age-adjusted odds ratio for treatment of parental depression was 1.15 (95% CI: 0.78, 1.72). There was no effect modification by gender (p = 0.42). Surprisingly, treatment of parental depression did not reduce their offspring's risk for depression. Gender of the offspring had no effect on the risk of depression in the adult offspring of treated versus untreated depressed parents. A focus on mediators like parenting behavior and its gender specific effect needs to be explored in future studies.

The relationships between offspring depression profiles across adolescence and different timings of parental depression during the perinatal period remain unknown. To explore different timings of maternal and paternal perinatal depression in relation to patterns of change in offspring depressive mood over a 14 year period. Data were obtained from the Avon Longitudinal Study of Parents and Children (ALSPAC). Parental antenatal depression (ANTD) was assessed at 18 weeks gestation, and postnatal depression (PNTD) at 8 weeks postpartum. Population-averaged trajectories of offspring depressive symptoms were estimated using the Short Mood and Feelings Questionnaire (SMFQ) on nine occasions between 10 and 24 years of age. Full data were available for 5029 individuals. Offspring exposed to both timings of maternal depression had higher depressive symptoms across adolescence compared with offspring not exposed to ANTD or PNTD, characterised by higher depressive symptoms at age 16 (7.07 SMFQ points (95% CI = 6.19, 7.95; P < 0.001)) and a greater rate of linear change (0.698 SMFQ points (95% CI = 0.47, 0.93; P = 0.002)). Isolated maternal ANTD and to a lesser extent PNTD were also both associated with higher depressive symptoms at age 16, yet isolated maternal PNTD showed greater evidence for an increased rate of linear change across adolescence. A similar pattern was observed for paternal ANTD and PNTD, although effect sizes were attenuated. This study adds to the literature demonstrating that exposure to two timings of maternal depression (ANTD and PNTD) is strongly associated with greater offspring trajectories of depressive symptoms.

Intergenerational transmission of depressive symptoms – The role of gender, socioeconomic circumstances, and the accumulation of parental symptoms

Family dissolution and offspring depression and depressive symptoms: A systematic review of moderation effects

Prevention of Depression in Children and Adolescents

We examined whether parents' stressors and avoidance coping when offspring were children helped to explain associations between parent depression at baseline and offspring's avoidance coping and depression in adulthood. Self‐report data were collected at baseline and 1 year from parents (N = 326) and at 23 years from adult offspring (N = 326). Associations between parents' depression symptoms at baseline, and their adult offspring's depression symptoms and avoidance coping 23 years later, were partially explained by parents' reliance on avoidance coping in response to negative events at 1 year after baseline.

The authors examined the specificity and course of psychiatric disorders from early childhood through adolescence in offspring of parents with confirmed panic disorder and major depressive disorder. The authors examined rates of psychiatric disorders at 10-year-follow-up (mean age, 14 years) in four groups: offspring of referred parents with panic and depression (N=137), offspring of referred parents with panic without depression (N=26), offspring of referred parents with depression without panic (N=48), and offspring of nonreferred parents with neither disorder (N=80). Follow-up assessments relied on structured interviews with the adolescents and their mothers; diagnoses were rated present if endorsed by either. Parental panic disorder, independently of parental depression, predicted lifetime rates in offspring of multiple anxiety disorders, panic disorder, agoraphobia, social phobia, and obsessive-compulsive disorder. Parental depression independently predicted offspring bipolar, drug use, and disruptive behavior disorders. Parental panic and depression interacted to predict specific phobia and major depressive disorder. Phobias were elevated in all at-risk groups, and depression was elevated in both offspring groups of parents with depression (with or without panic disorder), with the highest rates in the offspring of parents with depression only. Parental depression independently predicted new onset of depression, parental panic disorder independently predicted new onset of social phobia, and the two interacted to predict new onset of specific phobia and generalized anxiety disorder. At-risk offspring continue to develop new disorders as they progress through adolescence. These results support the need to screen and monitor the offspring of adults presenting for treatment of panic disorder or major depressive disorder.

Children of depressed parents are at heightened risk for developing depression, yet relatively little is known about the specific mechanisms responsible. Since preventive interventions for this risk group show small effects which diminish overtime, it is crucial to uncover the key risk factors for depression. This study compared various potential mechanisms in children of depressed (high-risk; n = 74) versus non-depressed (low-risk; n = 37) parents and explored mediators of parental depression and risk in offspring. A German sample of N = 111 boys and girls aged 8 to 17 years were compared regarding children’s (i) symptoms of depression and general psychopathology, (ii) emotion regulation strategies, (iii) attributional style, (iv) perceived parenting style and (v) life events. Children in the high-risk group showed significantly more symptoms of depression and general psychopathology, less adaptive emotion regulation strategies, fewer positive life events and fewer positive parenting strategies in comparison with the low-risk group. Group differences in positive and negative attributional style were small and not statistically significant in a MANOVA test. Maladaptive emotion regulation strategies and negative life events were identified as partial mediators of the association between parental depression and children’s risk of depression. The study highlights the elevated risk of depression in children of depressed parents and provides empirical support for existing models of the mechanisms underlying transmission. Interestingly, the high-risk group was characterised by a lack of protective rather than increased vulnerability factors. These results are crucial for developing more effective preventive interventions for this high-risk population.

Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention. To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression. Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring. Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision. Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression. The findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.

Association of parental depression with offspring attention deficit hyperactivity disorder and autism spectrum disorder: A nationwide birth cohort study

Characteristics of depressed and nondepressed adult offspring of depressed and matched nondepressed parents

Identifying Depression in Neonatal Intensive Care Unit Parents: Then What?