Parental Mental Disorders Research Articles

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Maternal antenatal depression may alter offspring neurodevelopment, but long follow-up studies are lacking. We studied the risks for mood disorders and schizophrenia in adult offspring of antenatally depressed mothers, taking account parental severe mental disorders.In the general population-based Northern Finland 1966 Birth Cohort with 12,058 children, 13.9% of the mothers reported themselves depressed at mid-gestation. The offspring were followed 43 years. Severe mood disorders and schizophrenia in the offspring and severe mental disorders in the parents were detected using the Care Register for Healthcare. Maternal smoking during pregnancy, perinatal complications, fathers´ social class, family type at birth, and grand multiparity were considered as confounding variables.The offspring of antenatally depressed mothers had an elevated risk for depression (adjusted OR 1.5; 95% CI 1.03–2.2), compared to cohort members without maternal antenatal depressed mood. The offspring with maternal antenatal depressed mood and parental severe mental disorder had markedly elevated risks for depression (3.3; 1.8–6.2), and schizophrenia (3.9; 2.0–7.5), compared to the offspring without one or both of these risk factors.Maternal antenatal depressed mood was determined by one question and did not necessarily signify a clinical condition. Data on maternal postnatal mood was not available.The offspring with maternal antenatal depressed mood and parental severe mental disorder had high risk for depression and schizophrenia. Early interventions in parental severe mental disorder might present an opportunity for decreasing the risk for mood disorders and schizophrenia in the offspring.

Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences.

Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents’ behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.

Family Functioning and Psychological Health of Children with Mentally Ill Parents.

Parental mental illness can be linked to reduced family functioning, which is associated with more conflicts, less adaptability and cohesion as well as a disorganized pattern of everyday planning. Concurrently, family functioning is an important moderator for the influence of parental mental disorders on the development of the children. Consequently, the current study addresses the correlation of family functioning in families with mentally ill parents and the psychological health of the children. The sample consists of 67 mentally ill parents. Both parents and therapists completed questionnaires related to family functioning and the psychological health of the children. Family functioning was rated as dysfunctional in 38% of the families. The psychological health of the children was classified as clinical or subclinical in 43% of the cases. 52% of the children were rated to have no psychological problems. In families with good family functioning, children were assessed to have less psychological problems than in families with poor functioning. Children outside the clinical range lived in families with good family functioning and vice versa. Significant positive correlations were found between the FB-A scales, the CBCL/4-18 syndrome scales and the CBCL/4–18 total score. Results indicate that family functioning and psychological health of children in families with mentally ill parents correlate closely and represent potential targets for future family interventions.

Children With Early-Onset Disruptive Behavior: Parental Mental Disorders Predict Poor Psychosocial Functioning in Adolescence.

Parental mental disorders (MD) and child early-onset disruptive behavior (DB) are well-established risk factors for poor outcomes in adolescence. However, it is not clear whether parental MD increases risk of future maladjustment among children who already display DB. Parents of 9-year-old children reported on child DB, whereas a patient registry was used to determine parental MD. At follow-ups at ages 15 (n= 6,319) and 18 (n= 3,068) years, information about various problems were collected via registries, parent-, and self-reports. In the total sample, child DB was related to all outcomes (mean odds ratio [OR]= 1.18; range= 1.07-1.51; p values< .01), paternal MD to criminality, aggression, truancy, poor school performance, and a cumulative risk index of poor functioning, and maternal MD to peer problems, rule breaking, and truancy (mean OR= 1.67; range= 1.19-2.71; p values< .05). In the subsample of children with DB, paternal MD predicted criminality, consequences of antisocial behavior, truancy, poor school performance, and cumulative risk, whereas maternal MD predicted peer problems (mean OR= 1.94; range= 1.30-2.40; p values< .05). This study provides novel evidence that parental MD places 9-year-olds with DB at risk for negative outcomes in adolescence. In addition, paternal MD is a better predictor than maternal MD, regardless of child DB at age 9, suggesting that fathers should be given increased attention in future research. Treatment-as-usual of children with DB could be augmented with additional screening and, if necessary, treatment of mental health problems in their parents.

Parental alcohol use disorder with and without other mental disorders and offspring alcohol use disorder.

To examine the association between parental alcohol use disorder (AUD) with and without other mental disorders and offspring AUD. Using data from Danish nationwide registers, we identified 15477 offspring with parental AUD and 154392 reference individuals from the general population. Parental AUD was defined as registration for AUD treatment. Parental mental disorders were identified in medical registers and comprised psychotic, mood, anxiety, personality, drug use, and other non-alcohol-related mental disorders. AUD in offspring was identified from medical, pharmacy, treatment and cause of death registers. Hazard ratios (HRs) of AUD were estimated using Cox regression models. AUD in one or both parents was associated with higher risks of AUD in offspring compared with reference individuals. Paternal AUD plus other mental disorder (HR=2.27, 95% confidence interval (CI): 2.10-2.46) and paternal AUD alone (HR=2.21, 95% CI: 2.07-2.36) were associated with higher offspring AUD risk. Similarly, maternal AUD plus other mental disorder (HR=3.02, 95% CI: 2.66-3.43) and maternal AUD alone (HR=2.57, 95% CI: 2.20-3.01) were associated with higher offspring AUD risk. Offspring with parental AUD are at increased risk of AUD irrespective of exposure to other parental mental disorders.

Severe mood disorders and schizophrenia in the adult offspring of antenatally depressed mothers in the Northern Finland 1966 Birth Cohort: Relationship to parental severe mental disorder

BackgroundMaternal antenatal depression may alter offspring neurodevelopment, but long follow-up studies are lacking. We studied the risks for mood disorders and schizophrenia in adult offspring of antenatally depressed mothers, taking account parental severe mental disorders. MethodsIn the general population-based Northern Finland 1966 Birth Cohort with 12,058 children, 13.9% of the mothers reported themselves depressed at mid-gestation. The offspring were followed 43 years. Severe mood disorders and schizophrenia in the offspring and severe mental disorders in the parents were detected using the Care Register for Healthcare. Maternal smoking during pregnancy, perinatal complications, fathers´ social class, family type at birth, and grand multiparity were considered as confounding variables. ResultsThe offspring of antenatally depressed mothers had an elevated risk for depression (adjusted OR 1.5; 95% CI 1.03–2.2), compared to cohort members without maternal antenatal depressed mood. The offspring with maternal antenatal depressed mood and parental severe mental disorder had markedly elevated risks for depression (3.3; 1.8–6.2), and schizophrenia (3.9; 2.0–7.5), compared to the offspring without one or both of these risk factors. LimitationsMaternal antenatal depressed mood was determined by one question and did not necessarily signify a clinical condition. Data on maternal postnatal mood was not available. ConclusionThe offspring with maternal antenatal depressed mood and parental severe mental disorder had high risk for depression and schizophrenia. Early interventions in parental severe mental disorder might present an opportunity for decreasing the risk for mood disorders and schizophrenia in the offspring.

Child Protection in Families with Parental Mental Illness

Child Protection in Families with Parental Mental Illness Children and adolescents from families with parental mental illness face an increased risk to experience abuse, neglect and maltreatment. The effects of imminent, intermittent or chronic distress on the development of the child and to differentiate these from neglect or maltreatment are not easily assignable in such families. Questionnaires and diagnostic instruments can be supportive tools for professionals in hospitals and private practices to identify and differentiate between burdens of children and families and potential endangerment. Different instruments are presented for the assessment of child abuse: For professionals the "Wahrnehmungsbogen für Kinderschutz" (Thurn et al., 2017). As methods of screening at risk the "Eltern-Belastungsbogen zur Kindeswohlgefährdung" (Deegener, Spangler, Körner, Becker, 2009) and the Childhood Trauma Questionnaire (Wingenfeld et al., 2010). For the comprehensive assessment of abuse, we present the Maternal Interview Child Maltreatment (Cicchetti, Toth, Manly, 2003). The prevalence of mentally ill parents is presented based on two samples of patients attending the child protection outpatient clinic or and the trauma outpatient clinic of the Charité. In the child protection outpatient clinic 15.8 % of the mothers and 11.4 % of the fathers fulfilled criteria for psychiatric disorders. In the trauma outpatient clinic we diagnosed a parental mental disorder in 20 % of all cases. A fictitious case report reveals the emotional maltreatment of a child by its mentally ill mother, which suffers from an isolated delusional disorder. Empirical based classification tools seem to be very appropriate to ascertain physical and sexual maltreatment and child neglect in children of parents with mental disorders, as permanent or severe neglect is frequently detectable in these families.

Efficiency of the differentiated use of physiobalneotherapy for borderline mental disorders in mothers of children with cerebral palsy

Child disability, especially as a result of nervous system diseases, affects all aspects of family life, causing extreme emotional and physical exhaustion in parents. However, today there is not enough scientific evidence on the features of development of nonpsychotic mental disorders in parents raising children with cerebral palsy and on the possibilities of using modern physiotherapy methods to correct these conditions and comorbidities. Considering that sanatorium-resort rehabilitation in children with cerebral palsy is accompanied by their parents, it is urgent to optimize clinical and functional approaches to treating mothers with borderline mental disorders with the simultaneous rehabilitation of children in sanatorium-resort conditions. To study the efficiency of sanatorium-resort treatment aimed at the psychological correction of mothers accompanying children with cerebral palsy to a sanatorium. The study enrolled 151 mothers who had borderline mental disorders and raised children with cerebral palsy. A study group included 103 women aged 33.2±0.6 years; a comparison group consisted of 48 mothers aged 31.8±0.5 years. The examination was conducted before sanatorium-resort treatment and after a therapy cycle. The mothers underwent clinical and psychodiagnostic examinations via the standardized Minnesota Multiphasic Personality Inventory (a short form) MMPI-mini (adapted by L.N. Sobchik, 2000); emotional and motivational sphere study the WAM (well-being, activity, mood) questionnaire, the Spielberger-Khanin Inventory, and the Depression Rating Scale (adapted by T.I. Balashova). The patients of both groups received combination treatment: the comparison group (n=48) had a general sanatorium-resort therapeutic complex and group psychotherapy; the study group (n=103) additionally took valerian-bromine baths based on sodium chloride water with a mineralization of 20 g/dm3), and a transcranial magnetic therapy cycle. The general sanatorium-and-resort complex with psychotherapy predominantly affected the quality of night sleep (p<0.01) and reduced personality disorders according to the hypochondria scale (from 74.60±7.52 to 52.91±4.04 scores, p<0.01). The additional use of transcranial magnetic therapy and valerian-bromine baths based on sodium chloride water in the mothers had a psychocorrecting effect recorded according to basic (hysteria, psychopathy, psychasthenia) scales. Reduced depression was noted in 36.4% of the mothers (7% in the comparison group). Transcranial magnetic therapy used in combination with valerian-bromine baths based on sodium chloride water and with psychotherapy in mothers with borderline mental disorders, by taking into account psychological dysregulation, contributed to increases in the body's clinical and functional reserves within 6-8 months and to the preservation of psychological adaptation in 54.7% of cases. Incorporation of a maternal psychocorrective complex into the sanatorium-resort treatment of a child with cerebral palsy is a promising method for improving the quality of treatment outcomes in a sanatorium.

Associations between Childhood Disadvantage and Adult Body Mass Index Trajectories: A Follow-Up Study among Midlife Finnish Municipal Employees

Objective: Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. Methods: Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000–2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants’ (n =5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. Results: Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. Conclusions: Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.

Predictors of emotional and behavioral problems among Indian adolescents: A clinic-based study.

Emotional and behavioral problems place a heavy burden on the adolescents and their families. Many factors are known to influence adolescent mental health. The current study was designed to determine the predictors of emotional and behavioral problems among Indian adolescents. The parents of adolescents in the age group of 10 to 18 (N = 81) were recruited from the National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Alabama Parenting Questionnaire (Parent version), Strength and Difficulty Questionnaire (Parent version) and, the Parent Interview Schedule (PIS) were used to assess the parental practices, emotional and behavioral problems and abnormal psychosocial environment of the adolescents. The data were analyzed with stepwise multiple linear and Quantile regression to find out significant predictors of emotional and behavioral problems among adolescents. Adolescent's age, parental involvement, and paternal age are the significant predictors of emotional problems. Parental mental disorder or deviance, gender, and inconsistent discipline are the significant predictors for conduct problems. Poor monitoring and supervision, paternal and maternal age are statistically significant predictors of prosocial skills among the adolescents. Inadequate or distorted intrafamilial communication and parental mental disorder are the significant predictors of total difficulties among the adolescents. The study validates the role of abnormal psychosocial environments and negative parenting practices as risk factors for emotional and behavioral problems among the adolescents. A comprehensive analysis which covers all possible variables related to adolescent mental health is mandatory for the health professionals before planning the intervention.

Infections, Anti-infective Agents, and Risk of Deliberate Self-harm and Suicide in a Young Cohort: A Nationwide Study

BackgroundEvidence links infections to mental disorders and suicidal behavior. However, knowledge is sparse regarding less severe infections, anti-infective treatment, and deliberate self-harm. Using nationwide Danish longitudinal registers, we estimated associations between infections treated with anti-infective agents and infections requiring hospitalization with the risk of deliberate self-harm. MethodsA total of 1.3 million people born between 1977 and 2002 were followed during the period from 1995 to 2013. In total, 15,042 individuals were recorded with deliberate self-harm (92% had been treated with anti-infective agents and 19% had been hospitalized for infections) and 114 died by suicide (64% had been treated with anti-infective agents and 13% had been hospitalized for infections). Hazard rate ratios were obtained while adjusting for age, gender, calendar period, education, hospitalizations with infections, prescribed anti-infective agents during childhood, parental mental disorders, and parental deliberate self-harm. ResultsIndividuals with infections treated with anti-infective agents had an increased risk of deliberate self-harm with a hazard rate ratio of 1.80 (95% confidence interval = 1.68–1.91). The associations fitted a dose–response relationship (p < .001) and remained significant up to 5 years after last infection. An additive effect was found for individuals with an additional hospitalization for infections with an increased hazard rate ratio of 3.20 (95% confidence interval = 2.96–3.45) for deliberate self-harm. ConclusionsAn increased risk of deliberate self-harm was found among individuals with infections treated with anti-infective agents in temporal and dose–response associations. These results add to the growing literature on a possible link between infections and the pathophysiological mechanisms of suicidal behavior.

Pathways from parental mental disorders to offspring’s work disability: the Finnish birth cohort

Pathways from parental mental disorders to offspring’s work disability: the Finnish birth cohort

Pathways from parental mental disorders to offspring’s work disability: the Finnish birth cohort

Pathways from parental mental disorders to offspring’s work disability: the Finnish birth cohort

Pathways from parental mental disorders to offspring's work disability due to depressive or anxiety disorders in early adulthood-The 1987 Finnish Birth Cohort.

Parental mental disorders have been shown to predict offspring's mental health problems. We examined whether pathways from parental mental disorders to offspring's psychiatric work disability in early adulthood are mediated through offspring's mental disorders and social disadvantage in adolescence. Study population consisted of the 1987 Finnish Birth Cohort. Data on parents' psychiatric care or work disability due to mental diagnosis between 1987 and 2000 and the cohort participants' health and social factors between 2001 and 2005 were derived from administrative national registers. From 2006 through 2015, 52,182 cohort participants were followed for admittance of psychiatric work disability due to depressive or anxiety disorders. First, we applied a pathway analysis to examine the occurrence of each path. We then used mediation analysis to assess the proportion of association between parental mental disorders and work disability mediated by offspring's health and social disadvantage. The pathway model indicated that the association from parental mental disorders to offspring's work disability due to depressive or anxiety disorder is through mental disorders and social disadvantage in adolescence. Odds Ratio for the total effect of parental mental disorders on offspring's psychiatric work disability was 1.85 (95% confidence interval [CI] 1.46-2.34) in the model including offspring's mental disorders that mediated this association by 35%. Corresponding results were 1.86 (95% CI 1.47-2.35) and 28% for social disadvantage in adolescence. These findings suggest that intergenerational determination of work disability due to mental disorders could be addressed by actions supporting mental health and social circumstances in adolescence.

The role of gender in the structure of networks of childhood adversity

The objective of present study is to investigate the relationship between different childhood adversities. The potential impact of early adversity on prevention programs is discussed. Data on twelve childhood adversities was collected from a representative sample of 5037 members of the general population living in a large metropolitan area. Data were analyzed through network analysis, to estimate and compare network connectivity and centrality measures by gender. Over half the respondents had been exposed to at least one adversity during their earlier developmental stage. Among adversity-exposed persons, 48.4% presented simultaneous adversities, most of which were related to ‘family dysfunction’ and ‘maltreatment’ (mean = 2.9 adversities). Women reported more adversities than men (59.0% vs. 47.6%). Although the ‘global’ network connectivity across adversities was similar in both genders, ‘regional’ distinctions in the network structure were found. While ‘neglect’ and ‘parental death’ were more important for women than men, ‘parental mental disorders’ was more important for men. Gender-related childhood adversities were clustered experiences. Adversities related to ‘early family dysfunction’ and ‘maltreatment’ were prominent features in the networks of both boys and girls. Differential preventive and intervention programs should take into account gender-related patterns of exposure and reporting patterns of early adversity.

Childhood Infections and Subsequent School Achievement Among 598,553 Danish Children.

Hospitalizations for infections have been associated with subsequent decreased cognitive ability, but it is uncertain if childhood infections influence subsequent scholastic achievement (SA). We aimed to estimate the association between infections during childhood and SA. Nationwide prospective cohort study including 598,553 children born in Denmark between 1987 and 1997 and their parents. Exposures were hospitalization for infections and treatment with anti-infective agents. Outcomes were completion of ninth grade and ninth grade test scores. Data were analyzed with logistic and linear regression analysis techniques and adjusted for any mental disorder, birthweight, Apgar score, malformations at birth, chronic somatic diseases, first-born child, parental educational level and parental mental disorders. Hospitalization with infections was linked to lower completion of ninth grade with an odds ratio of 0.82 (95% confidence interval: 0.79-0.85) compared with children without prior hospitalizations for infections. Dose-response relationships were observed with respect to number of hospital contacts for infections and a shorter time since last hospitalization (all P < 0.001). Among those who completed the ninth grade test score, we found a dose-response and time-since relationship between number of prior severe infections and subsequent lower grade scores (P < 0.001). Treatment of nonsevere infections with anti-infective agents did not predict lower completion of ninth grade but was associated with lower grade scores (P < 0.001). Infections, particularly those requiring hospitalizations, were associated with subsequent affected cognitive ability as indicated by lower SA. These findings might also be explained by missed school days or socioeconomic factors associated with the susceptibility of acquiring infections.

Gender-related dimensions of childhood adversities in the general population.

Objective:Childhood adversities (CAs) comprise a group of negative experiences individuals may suffer in their lifetimes. The goal of the present study was to investigate the cluster discrimination of CAs through psychometric determination of the common attributes of such experiences for men and women.Methods:Parental mental illness, substance misuse, criminality, death, divorce, other parental loss, family violence, physical abuse, sexual abuse, neglect, physical illness, and economic adversity were assessed in a general-population sample (n=5,037). Exploratory and confirmatory factor analysis determined gender-related dimensions of CA. The contribution of each individual adversity was explored through Rasch analysis.Results:Adversities were reported by 53.6% of the sample. A three-factor model of CA dimensions fit the data better for men, and a two-factor model for women. For both genders, the dimension of family maladjustment – encompassing physical abuse, neglect, parental mental disorders, and family violence – was the core cluster of CAs. Women endorsed more CAs than men. Rasch analysis found that sexual abuse, physical illness, parental criminal behavior, parental divorce, and economic adversity were difficult to report in face-to-face interviews.Conclusion:CAs embrace sensitive personal information, clustering of which differed by gender. Acknowledging CAs may have an impact on medical and psychiatric outcomes in adulthood.

T127. OFFSPRING OF ANTENATALLY DEPRESSED MOTHERS AND PARENTS WITH SEVERE MENTAL DISORDER – A LONG FOLLOW-UP IN THE NORTHERN FINLAND 1966 BIRTH COHORT

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.

The impact of parental mental illness across the full diagnostic spectrum on externalising and internalising vulnerabilities in young offspring.

The intergenerational risk for mental illness is well established within diagnostic categories, but the risk is unlikely to respect diagnostic boundaries and may be reflected more broadly in early life vulnerabilities. We aimed to establish patterns of association between externalising and internalising vulnerabilities in early childhood and parental mental disorder across the full spectrum of diagnoses. A cohort of Australian children (n = 69 116) entering the first year of school in 2009 were assessed using the Australian Early Development Census, providing measures of externalising and internalising vulnerability. Parental psychiatric diagnostic status was determined utilising record-linkage to administrative health datasets. Parental mental illness, across diagnostic categories, was associated with all child externalising and internalising domains of vulnerability. There was little evidence to support interaction by parental or offspring sex. These findings have important implications for informing early identification and intervention strategies in high-risk offspring and for research into the causes of mental illness. There may be benefits to focusing less on diagnostic categories in both cases.

Investigation of alexithymia, depression and childhood ADHD symptom levels in parents of children with ADHD

Objective: The aim of this study was to compare the severity of alexithymia, depression and childhood attention deficit hyperactivity disorder (ADHD) symptoms in the biological parents of children with ADHD and to investigate the relationship between scale scores. Methods: Sixty-four children diagnosed with ADHD according to the DSM-5 criterion based on clinical interview and Schedule of Affective Disorders and Schizophrenia Interview for School Children and their parents who admitted to Adnan Menderes University Department of Child and Adolescent Mental Health Outpatient Clinic and 64 children who did not have a psychiatric diagnosis and their parents admitted to Pediatrics Outpatient Clinic between January 2015 and December 2015 were included. Parents filled out socio-demographic data form, DSM-IV-Based Child and Adolescent Disruptive Behavior Disorders Screening and Rating Scale-parent form (T-DSM-IV-S), Wender-Utah Rating Scale, Toronto Alexithymia Scale (TAS-20), and Beck De-pression Inventory. Results: It was found that childhood ADHD symptom levels and present depressive symptom levels in parents of children with ADHD were higher than the control group. There were no significant differences between the two groups in terms of alexithymia levels. In addition, there was a positive moderate correlation be-tween total score, hyperactivity subscale, opposition defiant disorder subscale of T-DSM-IV-S and difficulty de-scribing feelings, total and difficulty identifying feelings subscale scores of TAS-20 whereas there was no significant relationship between total score and subscale scores of T-DSM-IV-S and TAS-20 externally-oriented thinking. Discussion: Results showed that parents of children with ADHD whose hyperactivity and opposing defiant symp-tom severity are high, are more likely to experience difficulty in describing and identifying feelings. Additionally, due to the high severity of depressive symptoms in parents of children with ADHD, we believe that investigation the presence of mental disorders in parents and the implementation of appropriate parental intervention programs will contribute positively to the success of follow-up and treatment of children with ADHD