Episodes Of Maternal Depression Research Articles

Association of birth order with adolescent mental health and suicide attempts: a population-based longitudinal study

Previous cohort studies have observed higher birth order to be associated with increased risk of suicidal behaviour. However, the mechanisms underlying this association are unclear. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we used multivariable logistic regression models and mediation analysis to investigate the associations of birth order with adolescent suicide attempts and psychiatric disorder. We investigated whether the number of maternal depressive episodes and father absence mediated the associations found. In fully adjusted models (n = 2571), higher birth order was associated with an increased risk of both suicide attempts (OR = 1.42, CI = 1.10–1.84) and psychiatric disorder (OR = 1.29, CI = 0.99–1.69). Maternal depression and father absence only partially mediated (8%; 12%) these associations. Whilst maternal depression and paternal absence partially mediated the associations between birth order, and suicidal behaviour and psychiatric disorder, other pathways may account for much of these associations. Future studies should investigate alternative mediating pathways.

Exposure to maternal depressive symptoms in childhood and suicide-related thoughts and attempts in Canadian youth: test of effect-modifying factors.

To (1) determine the association between exposure to maternal depressive symptoms in childhood and offspring suicide-related thoughts (SRT) and attempts (SA) in youth and young adults and (2) identify effect measure modifiers (offspring sex, family structure, maternal perceived social support, and social cohesion) of the association in 1. A cohort was constructed by linking all cycles from the National Longitudinal Survey of Children and Youth, a Canadian nationally representative survey, from 1994 to 2009 in 16,903 subjects 0 to 25years. Exposure to maternal-reported depressive symptoms was measured when offspring were between 0 and 10years. Offspring self-reported incident and recurrent SRT and SA were measured between 11 and 25years. Time-to-event models under a counting process framework were used to estimate adjusted hazard ratios (HR) and relative rates (RR) and 95% confidence intervals (CI). Effect measure modifiers were examined across adjusted stratum-specific estimates. In offspring exposed to maternal depressive symptoms, the adjusted rates of incident SRT and SA (HR: 1.67, 95% CI 1.37, 2.08; HR: 1.93, 95% CI 1.43, 2.50) and of recurrent SRT and SA (RR: 1.61, 95% CI 1.33, 1.96; RR: 1.87, 95% CI 1.40, 2.36) were significantly elevated compared to non-exposed offspring. The stratum-specific rates of incident and recurrent SRT and SA were significantly elevated in females but not in males. Girls exposed to maternal depressive symptoms in childhood are a target group for childhood suicide preventive strategies. Family-based preventions, and strategies to identify and effectively treat maternal depressive episodes could be beneficial for suicide prevention in offspring.

Association between maternal depression and anxiety episodes and rates of childhood injuries: a cohort study from England

BackgroundMaternal depression is common and associated with several child health outcomes. The impact on childhood injuries is underexplored, with existing studies relying on maternal reporting of injury occurrences. Using population...

Maternal depression in the 5 years after childbirth among women with and without perinatal depression: a population-based cohort study

BackgroundMany studies estimate the burden of perinatal depression, yet few have assessed continuing patterns of maternal depression in the initial years after childbirth. Since numerous child outcomes are related to perinatal depression, understanding ongoing childhood exposure has potentially important implications for families and clinical practice. We aimed to describe episodes of maternal depression during the first 5 years of children's lives in relation to the presence of maternal antenatal depression, postnatal depression, or both. MethodsWe used a population-based cohort of mother–child pairs from England who had linked primary care and hospital admission data from, respectively, the Clinical Practice Research Datalink and Hospital Episode Statistics for 1997–2014. Incidence of maternal depression was estimated per 100 person-years from 6 months after childbirth to the child's fifth birthday, stratified by whether the mother had antenatal depression, postnatal depression, or both. Incidence rate ratios (IRRs), adjusting for maternal age at delivery, socioeconomic status, and number of children aged 0–4 years in the household, were estimated with Poisson regression. Clinical diagnoses, antidepressant treatment, and admissions to hospital were used to identify episodes of depression. The study was approved by the Independent Scientific Advisory Committee for the Medicines and Healthcare products Regulatory Agency in February, 2014. FindingsOf the 209 418 mothers in the cohort, 5091 (2·4%) had antenatal depression, 13 526 (6·5%) postnatal depression, and 6663 (3·2%) both. Incidence rates of maternal depression when the child was aged 6 months to 4 years were 22·5/100 person-years (95% CI 21·7–23·3) after antenatal depression, 16·0 (15·6–16·4) after postnatal depression, and 14·5 (14·0–15·1) after both, compared with 6·4 (6·3–6·5) for women without perinatal depression. After adjustment, depression rates remained more than twice as high among women with perinatal depression as those without (adjusted IRR 3·28 [3·16–3·39] after antenatal depression, 2·32 [2·26–2·39] after postnatal depression, and 2·18 [2·08–2·27] after both). InterpretationWomen with perinatal depression have an increased risk of subsequent depressive episodes during the first 5 years of their child's life. Studies assessing perinatal depression as a risk factor for child outcomes need also to consider the effect of recurrent maternal depressive episodes occurring in the child's early years. This study only captured depressive episodes where medical attention was sought, and was unable to assess the effect of marital status and social support on risk of depression. FundingRB is funded by the National Institute for Health Research (NIHR) School for Primary Care Research and the University of Nottingham.

Child Gain Approach and Loss Avoidance Behavior: Relationships With Depression Risk, Negative Mood, and Anhedonia

Reduced reward responsiveness and altered response to loss of reward are observed in adults with major depressive disorder (MDD) and adolescents at increased risk for MDD based on family history. However, it is unclear whether altered behavioral responsiveness to reward/loss is a lifelong marker of MDD risk, which is evident before the normative adolescent increase in incentive responding. Healthy 7- to 10-year-old children of mothers with MDD (high risk: n= 27) or without MDD (low risk: n= 42) performed 2 signal detection tasks assessing response bias toward reward (approach) and away from loss (avoidance). Differences in approach/avoidance were related to MDD risk, child general depressive symptoms (maternal report), child-reported anhedonic symptoms, and child-reported negative mood symptoms via repeated-measures analysis of variance. MDD risk did not significantly relate to gain approach or loss avoidance. However, within high-risk children, higher numbers of maternal depressive episodes predicted blunted loss avoidance. Blunted gain approach was related to elevated anhedonic symptoms, whereas enhanced loss avoidance was related to elevated negative mood. Elevated negative mood was further related to blunted gain approach in high-risk children but related to enhanced gain approach in low-risk children. In children, individual differences in specific depressive symptoms and recurrence of maternal depression significantly predicted gain approach/loss avoidance, but the presence/absence of maternal MDD did not. Child depressive symptoms characterized by low positive affect (anhedonia) were related to blunted gain responsiveness, whereas elevated depressed/negative mood was related to enhanced loss responsiveness. Findings suggest that relations between gain approach and negative mood may be an important distinction between those at high versus low risk for MDD.

Effects of Child Psychopathology on Maternal Depression: The Mediating Role of Child-Related Acute and Chronic Stressors

In light of recent research highlighting the potential effects of children's behavior on mothers' mental health, the current study examined 679 mothers and their adolescent children from a community-based sample to determine the effects of youth psychopathology on maternal depression and levels of child-related stress in mothers' lives. It was hypothesized that the number of past clinical diagnoses in 15-year-old adolescents would predict the presence of maternal depression at youth age 15 and 5 years later, as well as more episodes of maternal depression during the follow-up period. Furthermore, it was hypothesized that increased levels of child-related stress in mothers' lives would mediate these relationships. Regression analyses indicated that past youth diagnoses do confer risk for the presence of current and future maternal depression, as well as more episodes of maternal depression, and mediation analyses revealed that child-related acute and chronic stress were mediators of the relationship between youth diagnoses and the presence of maternal depression at follow-up. Findings suggest that increased levels of child-related objective stress in mothers' lives are one mechanism by which children's psychopathology affects mothers' future risk for depression.

Maternal state of mind regarding attachment, maternal depression and children's family drawings in the early school years

The current study explored how children's family drawings in the early school years might be related to their exposure to recurrent episodes of maternal depression. We also examined prospectively relations among maternal state of mind regarding attachment derived from the Adult Attachment Interview and earlier mother–child attachment from the Strange Situation Procedure (both measured when the child was 12–15 months old) and later family drawings. Seventy-five mothers were assessed for symptoms of depression periodically between birth and child age 6–8 years. At this age, children completed a family drawing rated using an attachment-based scoring system. Both mothers' state of mind regarding attachment and their overall depression were modestly, but significantly, correlated with a global rating of the child's drawings. When both predictors were considered together, however, neither was significant, reflecting collinearity between the two variables. In this study, women with a non-autonomous state of mind regarding attachment were significantly more likely to experience recurrent depression. The earlier classification of the child's attachment to the mother from the Strange Situation Procedure was not related to the family drawing.

Maternal depression and psychiatric outcomes in adolescent offspring: A 13-year longitudinal study

Background Maternal postnatal depression (PND) has been associated with adverse outcomes in young children, but an association with longer-term psychiatric disorder has not been demonstrated. We present the preliminary findings of a 13-year longitudinal study. Methods In the course of a prospective longitudinal study, we examined DSM-IV Axis I disorders in 13-year-old adolescents who had ( n = 53) or had not ( n = 41) been exposed to maternal PND. We also detailed the occurrence of depression in mothers throughout the 13-year follow-up period. Results Maternal PND was associated with higher rates of affective disorders in adolescent offspring. However, mothers who developed PND were also substantially more likely than those who did not to experience depression subsequently, a fact that contributed to the development of depressive disorder in offspring. Maternal PND was associated with increased risk for depression in adolescent offspring only if there had also been later episodes of maternal depression. In contrast, anxiety disorders in offspring were elevated in the maternal PND group regardless of the occurrence of subsequent maternal depression. Limitations Due to the modest sample size and consequently limited power, findings must be regarded as preliminary. Conclusions The particular association between early maternal depression and anxiety disorders in offspring was consistent with theories that emphasise the primacy of early environmental exposures. This position was not supported with respect to offspring depressive disorder, where overall duration of maternal depression was a significant factor. PND was associated with recurrent episodes of depression in the majority of cases, underlining the need for monitoring of this population beyond the postnatal period.

Emotion regulation strategies in offspring of childhood‐onset depressed mothers

This study examines emotion regulation strategies used by children of mothers with childhood-onset depression (COD) and children of never-depressed mothers (NCOD). Participants were 49 COD offspring (ages 4-7) and 37 NCOD offspring (ages 4-7) and their mothers. Emotion regulation strategies were assessed observationally during a laboratory mood induction paradigm. COD offspring were more likely to focus on the delay object or task than NCOD offspring. Daughters of COD mothers were also more likely to wait passively and less likely to engage in active distraction than daughters of NCOD mothers. These findings were replicated using number of maternal depressive episodes. COD offspring, especially daughters, exhibit a more passive style of regulating emotion that may place them at risk for developing psychopathology.

Depressive Spectrum Disorders in High-Risk Adolescents: Episode Duration and Predictors of Time to Recovery

Durations of first episodes of major depression, dysthymia, adjustment disorders with depressed mood or with mixed emotional features, and minor depressions were examined in a community high-risk adolescent sample. Factors associated with longer recovery times were examined for each disorder. Semistructured diagnostic interviews were conducted annually (6th through 12th grade) to assess children's current and lifetime history of psychopathology. Cox regressions were used to explore factors associated with longer time to recovery. Episode durations were consistent with prior community studies and generally shorter than those reported in clinical samples. A greater number of maternal depressive episodes predicted a more prolonged time to recovery from major depression, and greater adolescent impairment was associated with longer episode duration of both major and minor depression. Treatment and prevention efforts should be directed toward offspring of parents with recurrent mood disorders, particularly adolescents with minor as well as major depression. The authors also recommend that the median rather than the mean be used to evaluate the duration of depressive disorders.

Depression in 11–16‐year‐old Girls: The Role of Past Parental Psychopathology and Exposure to Recent Life Events

Interviews with parents of a non-referred sample of 11-16-year-old girls (n = 82) revealed that a significantly greater proportion of mothers with a lifetime history of any psychiatric disorder also reported one or more recent undesirable life events focused on the adolescent compared with mothers with no such history. Lifetime episodes of maternal depression and recent undesirable life events exerted significant additive effects on the likelihood of depression occurring in the previous 12 months in adolescent girls. Some families may be "life event prone" as a consequence of lifetime episodes of parental psychopathology.