Abstract
BackgroundOffspring of patients with anxiety or depression are at high risk for developing anxiety or depression. Despite the positive findings regarding effectiveness of prevention programs, recruitment for prevention activities and trials is notoriously difficult. Our randomized controlled prevention trial was terminated due to lack of patient inclusion. Research on mentally-ill parents’ perceptions of offspring’s risk and need for preventive intervention may shed light on this issue, and may enhance family participation in prevention activities and trials.MethodsQualitative data were collected through semi-structured interviews with 24 parents (patients with anxiety or depression, or their partners). An inductive content analysis of the data was performed. Five research questions were investigated regarding parents’ perceptions of anxiety, depression, and offspring risk; anxiety, depression, and parenting; the need for offspring intervention and prevention; and barriers to and experiences with participation in preventive research.ResultsParental perceptions of the impact of parental anxiety and depression on offspring greatly differed. Parents articulated concerns about children’s symptomatology, however, most parents did not perceive a direct link between parent symptoms and offspring quality of life. They experienced an influence of parental symptoms on family quality of life, but chose not to discuss that with their children in order to protect them. Parents were not well aware of the possibilities regarding professional help for offspring and preferred parent-focused rather than offspring-focused interventions such as parent psycho-education. Important barriers to participation in preventive research included parental overburden, shame and stigma, and perceived lack of necessity for intervention.ConclusionsThis study highlights the importance of educating parents in adult health care. Providing psycho-education regarding offspring risk, communication in the family, and parenting in order to increase parental knowledge and parent–child communication, and decrease guilt and shame are important first steps in motivating parents to participate in preventive treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/2050-7283-2-17) contains supplementary material, which is available to authorized users.
Highlights
Offspring of patients with anxiety or depression are at high risk for developing anxiety or depression
Offspring vulnerability and resilience in relation to parent depressive and anxiety disorders Related to the first research question, two key themes emerged: Impact on the Quality of Life (QoL) of the children, and Parents’ concerns about the mental health status of children
Impact on the Quality of Life (QoL) of the children Parents’ perceptions on the relationship between their own or partner’s disorder and their children greatly differed. Most parents believed their problems did not influence offspring QoL, and that parents can keep that part of their life away from their children
Summary
Offspring of patients with anxiety or depression are at high risk for developing anxiety or depression. To the best of our knowledge, five randomized controlled trials have focused on preventing psychopathology in offspring of patients with anxiety (Ginsburg 2009) or depressive disorders (Beardslee et al 2007; Clarke et al 2001; Compas et al 2009) Results of these prevention interventions seem positive, with interventions decreasing the risk for anxiety and depression by 41% (relative risk = 0.59) (Siegenthaler et al 2012). In the sample used by (Clarke et al 2001), the 94 adolescent offspring (aged 13–18) of adults treated for depression were derived from an initial sample of nearly 3000 parents and 3400 youth, of which 2250 families actively declined participation To contribute to this body of research, our own group designed a prevention study for offspring, consisting of a screening and a randomized controlled trial. It assessed additional risk factors, in order to select a high risk group to enhance treatment impact (Nauta et al 2012)
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