Abstract
Maternal depression is a major public health problem that typically occurs in the period surrounding childbirth. The neurobiological mechanisms underlying maternal depression have been the focus of increasing research and studies pointed to the crucial role of the HPA axis in this disorder. However, most studies focused on cortisol expression and regulation while recent attention has shifted to include the sulfate steroids DHEA and DHEA-S. A community cohort of 1,983 women with no comorbid risk was recruited at birth and depression was assessed periodically across the first postpartum year. At 6 years, 156 families were re-visited: 46 mothers were defined as chronically-depressed and 103 controls reported no depression from birth to six years. Mothers and children were diagnosed by structured psychiatric interviews and mother-child interactions were observed. Maternal diurnal cortisol (CT) and dehydroepiandrosterone (DHEA) were assessed. Depressed mothers had lower levels of DHEA (AUCg), flattened DHEA diurnal variability (AUCi), and smaller DHEA-to-CT Ratio. Regression analysis demonstrated that maternal sensitivity during mother-child interaction was independently predicted by maternal depression, DHEA levels, child CT, and child social withdrawal. Results underscore the need for multi-level understanding of the dynamic interplay between maternal psychopathology, mother-child relationship, and pituitary–adrenal-cortex-to-medulla balance in studying the cross generational transfer of psychiatric vulnerability from depressed mothers to their children.
Highlights
Maternal Depression is a common condition and constitutes a major public health problem
Consistent with ecological models on the determinants of sensitive parenting [25], which suggested that both child biological factors and parental characteristics contribute to the development of sensitive parenting, in addition to recent evidence that child and maternal cortisol are inter-correlated in the context of maternal depression [26] we expected that maternal hormones and depression will predict the degree of maternal sensitivity during naturalistic interactions with her child
The major novel finding of this study was the close association between maternal depression and maternal DHEA hormonal activity
Summary
Maternal Depression is a common condition and constitutes a major public health problem. The adrenal androgen dehydroepiandrosterone (DHEA) plays a critical role in controlling mood and anxiety, and changes in DHEA levels have been reported in conditions pertaining to increased stress and psychiatric disorders [9, 10] It had been recognized as early as 1952, that lower DHEA/DHEAS in adult life is associated with neuropsychiatric disorders (eg schizophrenia, depression). Davies [11] has stressed the important role of the steroid sulfate axis for maternal mental health and there evidence suggesting that maternal caregiving may affect the psychological adjustment of offspring via these hormonal mechanisms. These hormones seem to have some therapeutic value [11]. Consistent with ecological models on the determinants of sensitive parenting [25], which suggested that both child biological factors and parental characteristics contribute to the development of sensitive parenting, in addition to recent evidence that child and maternal cortisol are inter-correlated in the context of maternal depression [26] we expected that maternal hormones and depression will predict the degree of maternal sensitivity during naturalistic interactions with her child
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