Abstract
It is well-established that offspring of depressed mothers are at increased risk for suicidal ideation. However, pathways involved in the transmission of risk for suicidal ideation from depressed mothers to offspring are poorly understood. The aim of this study was to examine the contribution of potential mediators of this association, including maternal suicide attempt, offspring psychiatric disorder and the parent-child relationship. Data were utilized from a population-based birth cohort (ALSPAC). Three distinct classes of maternal depression symptoms across the first 11 years of the child's life had already been identified (minimal, moderate, chronic-severe). Offspring suicidal ideation was assessed at age 16 years. Data were analysed using structural equation modelling. There was evidence for increased risk of suicidal ideation in offspring of mothers with chronic-severe depression symptoms compared to offspring of mothers with minimal symptoms (odds ratio 3.04, 95% confidence interval 2.19-4.21). The majority of this association was explained through maternal suicide attempt and offspring psychiatric disorder. There was also evidence for an independent indirect effect via the parent-child relationship in middle childhood. There was no longer evidence of a direct effect of maternal depression on offspring suicidal ideation after accounting for all three mediators. The pattern of results was similar when examining mechanisms for maternal moderate depression symptoms. Findings highlight that suicide prevention efforts in offspring of depressed mothers should be particularly targeted at both offspring with a psychiatric disorder and offspring whose mothers have made a suicide attempt. Interventions aimed at improving the parent-child relationship may also be beneficial.
Highlights
It is well-established that offspring of mothers with depression are at increased risk for suicide-related behaviour including ideation (Garber et al 1998), suicide attempt (Lewinsohn et al 2005) and suicide (Von Borczyskowski et al 2011)
Fifteen percent of adolescents [95% confidence interval (CI) 14–17; 11% of males, 20% of females] reported past year suicidal ideation at age 16 years’ assessment† and 9% of adolescents met DSM-IV or ICD-10 criteria for ‘any disorder’ at 15 years
The majority of the association between maternal chronic-severe depression and offspring suicidal ideation was explained through maternal suicide attempt and offspring psychiatric disorder, there was evidence for an independent indirect effect via the parent–child relationship in middle childhood
Summary
It is well-established that offspring of mothers with depression are at increased risk for suicide-related behaviour including ideation (Garber et al 1998), suicide attempt (Lewinsohn et al 2005) and suicide (Von Borczyskowski et al 2011). The pathways that explain suicidal risk in the offspring of mothers with depression are poorly understood. Targeted prevention for suicidal ideation can be effective (Brent et al 2013) but relies on a good understanding of mechanisms underlying the intergenerational transmission of risk, establishing why offspring of depressed mothers are at increased suicide risk compared to offspring of non-depressed mothers is crucial. It is well-established that offspring of depressed mothers are at increased risk for suicidal ideation. The aim of this study was to examine the contribution of potential mediators of this association, including maternal suicide attempt, offspring psychiatric disorder and the parent–child relationship
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