Abstract

BackgroundDepression during pregnancy is common, but long-term outcomes in the offspring of antenatally depressed mothers are unknown. Among severe mental disorders at least schizophrenia is considered to be a neurodevelopmental disorder acting already in utero with high genetic vulnerability. The aim was to study whether offspring of antenatally depressed mothers have an elevated risk for severe mood disorders till middle adulthood, taking account parental severe mental disorder.MethodsThe general population-based Northern Finland 1966 Birth Cohort includes 12,058 children, whose mothers were asked at mid-gestation if they felt depressed. The offspring were followed for over 40 years, and hospitalised severe mental disorders were detected using the Finnish Hospital Discharge Register. It was also used for identifying severe mental disorders in the parents till 1984, when the offspring were of age.ResultsOf the mothers, 14% self-reported depression during pregnancy. Of the parents, 10% had suffered from a hospitalised severe mental disorder.Adult offspring of antenatally depressed mothers had modestly increased risk for mood disorders both non-psychotic (crude OR 1.6; 95%CI 1.1–2.2) and psychotic (2.0; 1.0–4.1) but not for schizophrenia nor substance use disorder, when compared with the children of mothers without antenatal depression.Maternal depression during pregnancy combined with parental severe mental disorder increased the risks for severe mental disorders in the offspring widely. The risks for both non-psychotic (crude OR 3.8; 95%CI 2.1–6.6) and psychotic mood disorder (5.4; 1.6–18.1) and also for schizophrenia (4.3; 2.3–8.2) and substance use disorder (2.8; 1.7–4.7) were higher in the offspring with both maternal antenatal depression and parental severe mental disorder than in those without maternal depression and with severe mental disorder in the parent (for non-psychotic 1.5; 1.0–2.4 and psychotic mood disorder 4.2; 1.9–9.2, for schizophrenia 1.3; 0.8–2.4 and for substance disorder 1.5; 1.1–2.2) or in those with a depressed mother but without parental severe mental disorder (for non-psychotic 1.3; 0.9–1.9, and for psychotic mood disorder 2.1; 0.9–5.0, for schizophrenia 0.9; 0.5–1.6 and substance disorder 1.4; 1.1–2.0). The reference group was birth cohort members without maternal antenatal depression and without paren¬tal hospital-treated mental disorder. The risks remained statistically significant even after adjustment for maternal smoking during pregnancy, perinatal complications, father’s social class and family type at birth. In the offspring of antenatally depressed mother and a father with severe mental disorder the risk was elevated only for schizophrenia (7.5; 2.2–26.2).DiscussionMaternal depression during pregnancy increased the risk for mood disorders in the offspring slightly but not for schizophrenia nor substance use disorder when compared with the children of mothers without antenatal depression. Maternal antenatal depression combined with parental severe mental disorder increased the risks for all of these severe mental disorders in the adult offspring.The risk was highest for schizophrenia in the offspring of antenatally depressed mother and a father with severe mental disorder.To our knowledge, this is the first study of mood disorders, schizophrenia and substance use disorder in the offspring of antenatally depressed mothers with long follow-up till middle age where familial vulnerability for severe mental disorders was taken into account in a general population-based sample.

Highlights

  • Estimates of treatment resistant schizophrenia (TRS) vary due to lack of consensus definition

  • We evaluated 2,244 subjects (6–12 years old) using the Community Assessment of Psychotic Experiences (CAPE) and an adapted version of the Comprehensive Assessment of At-risk Mental States (CAARMS) by self-report and clinician ratings, respectively

  • Baseline PE increased the risk of any depressive disorder at follow-up, and baseline Attention Deficit Hyperactivity Disorder (ADHD) was associated with PE at 3-year follow-up

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Summary

Background

Previous research has shown that people with psychotic disorders have impaired functioning prior to the onset of the illness. Methods: We examined unique premorbid data from IDF archives, including narrative summaries of pre-induction interviews of 17 years-old adolescents. This nested case-controlled study sample included two groups: 168 male adolescents who were later hospitalized for psychotic disorders, and 168 matched control subjects who were not diagnosed with psychotic illness during their military service. Afterwards, the factors that were identified as significantly different in between-group comparisons, were included in a classification tree analyses to examine possible predictors of outcome. Future psychotic disorder patients, compared with matched controls, showed more premorbid adaptation difficulties.

Findings
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