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Mom's Depression Can Put Kids at Same Risk

Those treated successfully lower their child's chance of developing a psychiatric disorder

TUESDAY, March 21, 2006 (HealthDay News) -- The children of mothers who are successfully treated for depression have a markedly reduced risk of developing psychiatric disorders themselves.

But if a mother's depression continues, her children face an increased risk of also having such problems, a new study showed.

The message is clear.

"If you have a depression mother, you ought to do everything you can to get her better, because there's a double effect," said study author Myrna Weissman, a professor of psychiatry and epidemiology at Columbia University and the New York State Psychiatric Institute in New York City. "While depression may be a genetic disorder, it has a strong environmental component. And, for a child, a parent's illness is a very strong environmental effect. You want to reduce that effect so that you can have a beneficial effect on the child."

"If a mother is sick, it's going to impact the entire family," added Dr. Eva Ritvo, an associate professor of psychiatry at the University of Miami's Miller School of Medicine. "[The study] showed beautifully how children's symptoms went down in a really rapid time frame, and that's encouraging. As a profession, we need to be aggressive about recognizing, diagnosing and treating depression, and we have to be more cognizant of the impact on extended family."

Previous research has consistently shown that parental depression is a major risk factor for anxiety, depression and disruptive behavior in children. Indeed, offspring of depressed parents have a two-to-three-times higher risk of these problems compared with children of parents who are not depressed.

Although some studies have suggested that reducing symptoms in the parent has a salutary effect on children, none have directly treated the parents.

This trial, part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D), is "the first study to document prospectively the relationship between mother's getting better and the child's state," Weissman said.

The results are published in the March 22/29 issue of the Journal of the American Medical Association, a special issue focusing on women's health.

The study, conducted between December 2001 and April 2004, involved 151 mother-child pairs from eight primary care and 11 psychiatric outpatient clinics. The children were aged 7 to 17, and more than one-third came into the study with a psychiatric disorder.

The mothers were all treated with medication for depression while the children were simultaneously evaluated for psychiatric disorders.

Researchers noted a substantial 11 percent reduction in children's diagnoses and symptoms within three months of a mother's remission. Children of mothers whose depression did not get better had about an 8 percent increase in rates of diagnoses.

Among children who had a diagnosis at the start of the study, remission was reported in 33 percent of those whose mothers' depression also remitted. That compares to a 12 percent remission rate among children whose mothers' depression did not get better.

All children of mothers whose depression lifted and who had no psychiatric diagnoses themselves at the beginning of the study, continued to have no diagnoses. On the other hand, 17 percent of children whose mothers' depression continued actually acquired a diagnosis during the study time.

Similar results are likely with other forms of treatment and with treating fathers, the authors stated. "We focused on mothers because depression is more common in women than men, and women are more apt to come for treatment," Weissman said. "But we suspect the same with depressed fathers."

The rapidity at which problems resolved (within three months) was one of the most striking aspects of the study. "We were amazed at these findings, and amazed at how strong they were," Weissman said.

But this may just have to do with the life cycle. "Children change a lot faster than adults do, and kids are remarkably resilient," Ritvo said.

In all, the findings are a strong acknowledgement of environmental influences on mental health.

"We always knew that the environment has a very strong effect on the onset of depression," Weissman said. "With children particularly, if you can delay the onset for as long as possible or even prevent it, you can do a great service to a child."

The study also highlights the impact of depression on the entire family. "We know that depression affects not just the person who is suffering but the whole family," Ritvo said. "It was so encouraging that if the women got better, the kids got better. Who doesn't want a well child?"

The researchers continue to follow the mothers and children and, so far, the results are still encouraging, they said.

More information

If you are an adult who experienced depression before the age of 30 and who also has family members with depression, visit Depression Genetics to learn more about participating in a clinical trial.

SOURCES: Myrna Weissman, Ph.D., professor, psychiatry and epidemiology, Columbia University and New York State Psychiatric Institute, New York City; Eva Ritvo, associate professor, psychiatry, Miller School of Medicine, University of Miami, and chairwoman, department of psychiatry, Mount Sinai Medical Center, Miami Beach; March 22/29, 2006, Journal of the American Medical Association
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