Effects of parental psychiatric and physical illness on child development

Abstract

Abstract A broad range of physical and psychiatric illnesses commonly affect adults of parenting age. For example, approximately 13 per cent of women are affected by depression in the postnatal period, and the prevalence of depression in parents of all ages remains high. Many parents will also experience severe physical illness; breast cancer affects approximately 1 in 12 women in the United Kingdom, about a third of whom have children of school age. Worldwide HIV has an enormous impact on adults of parenting age. In some parts of sub-Saharan Africa up to 40 per cent of women attending antenatal clinics are HIV positive. Many of these parental disorders are associated with an increased risk of adverse emotional and social development in their children, and in some cases cognitive development and physical health are also compromized. It must be emphasized that a significant proportion of children at high risk do not develop problems and demonstrate resilience, and, many parents manage to rear their children well despite their own illness. Nonetheless these risks represent a significant additional impact and burden of adult disease (both physical and psychiatric) that is often overlooked. This chapter reviews the current state of evidence regarding selected examples of psychiatric and physical conditions, from which general themes can be extracted to guide clinical practice. Some of the key mechanisms whereby childhood disturbance does or does not develop in conjunction with parental illness are considered, and strategies for management and intervention reviewed.