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

Published online by Cambridge University Press:  11 March 2014

M. M. Weissman ,
P. Wickramaratne ,
D. J. Pilowsky ,
E. Poh ,
M. Hernandez ,
L. A. Batten ,
M. F. Flament ,
J. W. Stewart  and
P. Blier
M. M. Weissman*
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Epidemiology at the Mailman School of Public Health at Columbia University, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
P. Wickramaratne
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
D. J. Pilowsky
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Epidemiology at the Mailman School of Public Health at Columbia University, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
E. Poh
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
M. Hernandez
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA
L. A. Batten
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Carleton University, Ottawa, ON, Canada
M. F. Flament
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
J. W. Stewart
Affiliation:
Division of Epidemiology, New York State Psychiatric Institute, New York, NY, USA Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
P. Blier
Affiliation:
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
*
*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)
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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.

Keywords

Child depressionmaternal depressionparental functioningremission
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 13 , October 2014 , pp. 2811 - 2824
Copyright
Copyright © Cambridge University Press 2014 

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