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23 March 2006
Remission of maternal depression within the first 3 months of treatment appears to reduce the likelihood of children developing psychiatric disorders such as mood or disruptive behavior disorders during this time, study findings show.
"To our knowledge, this is the first published study to document prospectively the relation between remission of a mother's depression and her child's clinical state," say Myrna Weissman (Columbia University, New York, USA) and colleagues.
"These findings are intriguing because they suggest that an environmental influence (ie, the impact of maternal depression remission) had a measurable impact on the child's psychopathology."
The researchers explored the impact effective treatment of major depression in 151 mothers had on psychological symptoms and disorders in their children as part of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial.
Assessment of the children using the Kiddie Schedule for Affective Disorders and Schizophrenia showed that one third had a current psychiatric disorder including anxiety, depressive, or disruptive behavior disorders.
After 3 months of medication treatment, follow-up data available for 114 mothers showed that 28 (33%) met the remission criteria of a score of 7 or lower on the Hamilton Rating Scale for Depression.
Moreover, there was an 11% decrease in the rates of diagnoses in the children of these mothers, dropping from 35% to 24%. For children born to mothers whose depression continued, however, there was an 8% increase in diagnoses, from 35% to 43%.
Among the children who had psychiatric diagnoses at baseline, those whose mothers experienced remission of depression also showed remission of their own diagnoses, whereas only 12% of children born to mothers with continued depression achieved remission.
Children who had no psychiatric disorders at baseline all remained free of psychopathology at the 3-month follow-up if their mothers' depression remitted. This compared with just 17% of children whose mothers remained depressed or relapsed over this period.
"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," says Weissman and team in the Journal of the American Medical Association.
"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."
Source: JAMA 2006; 295: 1389–1398
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