Depression May Be Caused By Environmental Factors in Childhood – Depressed Mothers May Increase Risk of Health Problems In their Children

March 22nd 2006

Mother Child Link

Reducing a mother’s depression within the first three months of treatment lessens the chance of her children having psychiatric disorders, according to a new study. Mothers may have more to do with their children’s depression than we previously thought. The child’s disorders may include mood or disruptive behavior disorders, within that same time period.

According to new research presented at the JAMA media briefing on women's health in New York, parental depression is among the most consistent risk factors for childhood anxiety and disruptive behavior disorders. There is a 2 to 3 fold increased risk in offspring of depressed parents compared with control subjects.

This appears to be the first documented study that shows a relation between remission of a mother's depression and her child's clinical state. These findings are intriguing because they suggest that an environmental influence (i.e., the impact of maternal depression remission) had a measurable impact on the child's psychopathology.

Treatment of mothers may reverse symptoms of their children, according to the researchers. The study authors wrote “Our studies suggest that a reduction in stress associated with maternal remission may reverse the long-standing symptoms in children who are likely to be genetically vulnerable, although we have not genotyped the children in the study."

The psychological problems usually begin in puberty and continue into adolescence and even adulthood. The researchers say these conditions can be passed this way from generation to generation. Depression in the mother may impair the long-term social and occupational functioning, and increase the risk of “medical problems” in their children.

The researchers do not completely discount the genetic component in depression. They say that “Although early onset major depression is highly familial and has a strong genetic component, environmental factors, such as disrupted parent-child attachment and poor parent-child bonding may affect the impact of parental depression on children's symptoms.”

The study included 151 mother-child pairs who were part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. The STAR*D program was conducted from December 2001 to April 2004. The children were age 7 to 17 years and were assessed by a team of evaluators not involved in maternal treatment and unaware of maternal outcomes.

The researchers found that after 3 months of treatment with medication there was an 11 percent decrease in rates of diagnoses (from 35 percent to 24 percent) in children of mothers in remission vs. an 8 percent increase (from 35 percent to 43 percent) in children of mothers with continuing depression. They found that of the offspring who had psychiatric diagnoses at baseline and whose mother's depression remitted, 33 percent of the children's own diagnoses had remitted, whereas only 12 percent of the children of women whose depression remained lost their diagnosis.

Of the Of the children who had no psychiatric disorder at baseline, all remained free of psychiatric disorders at the 3-month follow-up if the maternal depression remitted, whereas 17 percent of children of mothers who remained depressed had an onset or relapse over this period.

In conclusion the researchers found that “"From a clinical vantage point, our findings suggest that vigorous treatment of depressed mothers to achieve remission is associated with positive outcomes in their children as well, whereas failure to treat depressed mothers may increase the burden of illness in their children. At a time when there are many questions about the appropriate and safe treatment of psychiatric disorders in children, these findings suggest that it is important to provide vigorous treatment to mothers if they are depressed."

The lead author of the study was Myrna M. Weissman, Ph.D., of Columbia University Medical Center and the New York State Psychiatric Institute, New York. The complete study appears in the March 22/29 issue of JAMA, a theme issue on women's health.