Skip to main content Accessibility help
×
Home

The effects on children of depressed mothers' remission and relapse over 9 months

  • M. M. Weissman (a1) (a2) (a3), P. Wickramaratne (a1) (a3), D. J. Pilowsky (a1) (a2) (a3), E. Poh (a1), M. Hernandez (a1), L. A. Batten (a4) (a5), M. F. Flament (a4), J. W. Stewart (a1) (a3) and P. Blier (a4)...

Abstract

Background

The high rate of depression among children of depressed mothers is well known. Suggestions that improvement in maternal acute depression has a positive effect on the child have emerged. However, data on the mechanisms of change have been sparse. The aim was to understand how remission and relapse in the mother might explain the changes in the child's outcome.

Method

Participants were 76 depressed mothers who entered into a medication clinical trial for depression and 135 of their eligible offspring ages 7–17 years. The mothers and children were assessed at baseline and periodically over 9 months by independent teams to understand the relationship between changes in children's symptoms and functioning and maternal remission or relapse. The main outcome measures were, for mothers, the Hamilton Depression Rating Scale (HAMD), the Social Adjustment Scale (SAS) and the Parental Bonding Instrument (PBI) and, for children, the Children's Depression Inventory (CDI), the Columbia Impairment Scale (CIS), the Multidimensional Anxiety Scale for Children (MASC) and the Children's Global Assessment Scale (CGAS).

Results

Maternal remission was associated with a decrease in the child's depressive symptoms. The mother's subsequent relapse was associated with an increase in the child's symptoms over 9 months. The effect of maternal remission on the child's improvement was partially explained by an improvement in the mother's parenting, particularly the change in the mother's ability to listen and talk to her child, but also reflected in her improvement in parental bonding. These findings could not be explained by the child's treatment.

Conclusions

A depressed mother's remission is associated with her improvement in parenting and a decrease in her child's symptoms. Her relapse is associated with an increase in her child's symptoms.

Copyright

Corresponding author

* Address for correspondence: M. M. Weissman, Ph.D., Diane Goldman Kemper Family Professor of Epidemiology in Psychiatry, College of Physicians & Surgeons, Mailman School of Public Health, Columbia University, Chief, Division of Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive – Unit 24, New York, NY 10032, USA. (Email: mmw3@columbia.edu)

References

Hide All
Batten, LA, Hernandez, M, Pilowsky, DJ, Stewart, JW, Blier, P, Flament, MF, Poh, E, Wickramaratne, P, Weissman, MM (2012). Children of treatment-seeking depressed mothers: a comparison with the sequenced treatment alternatives to relieve depression (STAR*D) Child Study. Journal of the American Academy of Child and Adolescent Psychiatry 51, 11851196.
Beardslee, WR, Brent, DA, Weersing, VR, Clarke, GN, Porta, G, Hollon, SD, Gladstone, TRG, Gallop, R, Lynch, FL, Iyengar, S, DeBar, L, Garber, J (2013). Prevention of depression in at-risk adolescents: longer-term effects. Journal of the American Medical Association Psychiatry 70, 11611170.
Beardslee, WR, Gladstone, TR, O'Connor, EE (2011). Transmission and prevention of mood disorders among children of affectively ill parents: a review. Journal of the American Academy of Child and Adolescent Psychiatry 50, 10981109.
Berensky, RA, Talcott, JA, Weeks, JC (2000). Binary data with two non-nested sources of clustering: an analysis of physician recommendations for early prostate cancer treatment. Biostatistics 1, 219230.
Bird, HR, Shaffer, D, Fisher, P, Gould, MS, Canino, G, Rubio-Stipec, M (1993). The Columbia Impairment Scale (CIS): pilot findings on a measure of global impairment for children and adolescents. International Journal of Methods in Psychiatric Research 3, 167176.
Brotman, LM, Kamboukos, D, Theise, R (2008). Symptom-specific measures for disorders usually first diagnosed in infancy, childhood or adolescence. In Handbook of Psychiatric Measures (ed. Rush, A. J., First, M. B. and Blacker, D.), 2nd edn, pp. 333335. American Psychiatric Press: Washington, DC.
De Silva, MJ, Cooper, S, Lishi, H, Li, L, Lund, C, Patel, V (2013). Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis. British Journal of Psychiatry 202, 253260.
Endicott, J, Cohen, J, Nee, J, Fleiss, J, Sarantakos, S (1981). Hamilton Depression Rating Scale. Extracted from Regular and Change Versions of the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 38, 98103.
First, MB, Gibbon, M, Williams, JBW (2008). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1). In Handbook of Psychiatric Measures (ed. Rush, A. J., First, M. B. and Blacker, D.), pp. 4043. American Psychiatric Press: Washington, DC.
Gameroff, MJ, Wickramaratne, P, Weissman, MM (2012). Testing the Short and Screener versions of the Social Adjustment Scale-Self-report (SAS-SR). International Journal of Methods in Psychiatric Research 21, 5265.
Garber, J, Ciesla, JA, McCauley, E, Diamond, G, Schloredt, KA (2011). Remission of depression in parents: links to healthy functioning in their children. Child Development 82, 226243.
Garber, J, Clarke, GN, Weersing, VR, Beardslee, WR, Brent, DA, Gladstone, TR, DeBar, LL, Lynch, FL, D'Angelo, E, Hollon, SD, Shamseddeen, W, Iyengar, S (2009). Prevention of depression in at-risk adolescents: a randomized controlled trial. Journal of the American Medical Association 301, 22152224.
Gunlicks, ML, Weissman, MM (2008). Change in child psychopathology with improvement in parental depression: a systematic review. Journal of the American Academy of Child and Adolescent Psychiatry 47, 379389.
Hamilton, M (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology 6, 278296.
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, Williamson, D, Ryan, N (1997). Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 36, 980988.
Kovacs, M (1992). The Children's Depression Inventory Manual. MultiHealth Systems: Toronto, ON.
Lam, WKK, Fals-Stewart, W, Kelley, ML (2008). Effects of parent skills training with behavioral couples therapy for alcoholism on children: a randomized clinical pilot trial. Addictive Behaviors 33, 10761080.
Liang, KY, Zeger, SL (1986). Longitudinal data analysis using generalized linear models. Biometrika 73, 1322.
Lieb, R, Isensee, B, Hofler, M, Pfister, H, Wittchen, HU (2002). Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Archives of General Psychiatry 59, 365374.
March, JS (1997). Manual for the Multidimensional Anxiety Scale for Children (MASC) . MultiHealth Systems: Toronto, ON.
March, JS, Parker, JDA (1999). The Multidimensional Anxiety Scale for Children (MASC). In The Use of Psychological Testing for Treatment Planning and Outcomes Assessment (ed. Maruish, M. E.), pp. 299322. Lawrence Erlbaum Associates: Mahwah, NJ.
March, JS, Parker, JDA, Sullivan, K, Stallings, P, Connors, CK (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry 36, 554565.
Murphy, E, Wickramaratne, P, Weissman, M (2010). The stability of parental bonding reports: a 20-year follow-up. Journal of Affective Disorders 125, 307315.
Parker, G, Tupling, H, Brown, LB (1979). A parental bonding instrument. British Journal of Medical Psychology 52, 110.
Pilowsky, DJ, Wickramaratne, P, Talati, A, Tang, M, Hughes, CW, Garber, J, Malloy, E, King, C, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH (2008). Children of depressed mothers 1 year after the initiation of maternal treatment: findings from the STAR*D-Child Study. American Journal of Psychiatry 165, 11361147.
Shaffer, D, Gould, MS, Brasic, J, Ambrosini, P, Fisher, P, Bird, H, Aluwahlia, S (1983). A Children's Global Assessment Scale (CGAS). Archives of General Psychiatry 40, 12281231.
Simon, GE, Ludman, EJ, Rutter, CM (2009). Incremental benefit and cost of telephone care management and telephone psychotherapy for depression in primary care. Archives of General Psychiatry 66, 10811089.
Singer, JD (1998). Using SAC PROC Mixed to fit multilevel models, hierarchical models, and individual growth models. Journal of Education and Behavioral Statistics 29, 323355.
Stewart, JW, McGrath, PJ, Blondeau, C, Deliyannides, DA, Hellerstein, D, Norris, S, Amat, J, Pilowski, D, Tessier, P, Laberge, L, O'Shea, D, Chen, Y, Withers, A, Bergeron, R, Blier, P (2013). Combination antidepressant therapy for major depressive disorder: speed and probability of remission. Journal of Psychiatric Research. Published online: 17 12 2013 . doi:org/10.1016/j.jpsychires.2013.12.001.
Weissman, MM, Olfson, M (2009). Translating intergenerational research on depression into clinical practice. Journal of the American Medical Association 302, 26952696.
Weissman, MM, Pilowsky, DJ, Wickramaratne, PJ, Talati, A, Wisniewski, SR, Fava, M, Hughes, CW, Garber, J, Malloy, E, King, CA, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH, Rush, AJ; STAR*D-Child Team (2006a). Remissions in maternal depression and child psychopathology: a STAR*D-child report. Journal of the American Medical Association 295, 13891398 [Erratum in Journal of the American Medical Association (2006) 296, 1234].
Weissman, MM, Prusoff, BA, Thompson, WD, Harding, PS, Myers, JK (1978). Social adjustment by self-report in a community sample and in psychiatric outpatients. Journal of Nervous and Mental Disease 166, 317326.
Weissman, MM, Wickramaratne, P, Nomura, Y, Warner, V, Pilowsky, D, Verdeli, H (2006 b). Offspring of depressed parents: 20 years later. American Journal of Psychiatry 163, 10011008.
Wickramaratne, P, Gameroff, MJ, Pilosky, DJ, Hughes, CW, Garber, J, Malloy, E, King, C, Cerda, G, Sood, AB, Alpert, JE, Trivedi, MH, Fava, M, Rush, AJ, Wisniewski, S, Weissman, MM (2011). Children of depressed mothers 1 year after remission of maternal depression: findings from the STAR*D-child study. American Journal of Psychiatry 168, 593602.

Keywords

Type Description Title
UNKNOWN
Supplementary materials

Weissman Supplementary Material
Table S1

 Unknown (50 KB)
50 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed