Psychological and physical wellbeing in adults who grew up with a mentally ill parent: A systematic mixed-studies review

Prevalence of anxiety, depression, and suicidality in adolescents with parental severe mental illness: a controlled study in China

BACKGROUND

Children of parents with mental illness (COPMI) have not received sufficient support in China despite their genetic and environmental risk of adverse mental health outcomes.

AIMS

This study was conducted for the first time in China to assess mental distress in adolescent COPMI compared with the population-based control (PBC) group of parents without mental disorders.

METHODS

A total of 1,114 participants including 558 COPMI and 556 PBC, aged 12-17, were recruited from the communities and assessed by self-report scales about anxiety, depression, and suicidality. Regression and mediation analyses were used to identify risk factors for mental distress.

RESULTS

The estimated prevalence of anxiety and depression in the COPMI group was significantly higher than in the PBC group (anxiety: 3.9% vs. 1.6%, depression: 5.9% vs. 3.4%). A history of parental mental illness was associated with the lack of family communication, which in turn had a significant (BootCI = (0.020 - 0.062)) indirect effect on the increased anxiety and depression levels of the adolescent offspring.

CONCLUSIONS

Our findings emphasized the necessity to early identify mental distress in COPMI and provide timely and targeted intervention to improve family communication and mental health well-being for these high-risk adolescents.

Efficacy of psychosocial interventions for young offspring of parents with a serious physical or mental illness: Systematic review and meta-analysis

Serious parental physical or mental illness significantly increases the risk of adverse adjustment outcomes in adolescents and young adults. This systematic review and meta-analysis evaluates the efficacy of psychosocial interventions targeting this vulnerable group. Eligible randomized control trials (RCTs) were searched through the Medline, Web of Science, PsycINFO, PsycArticles, Cinahl, and ProQuest Dissertation and Theses databases. Young offspring outcomes included: psychological (including internalizing and externalizing problems), positive, and interpersonal adjustment. Thirty-one manuscripts reporting on twenty-seven independent RCTs, including 3590 adolescent and young adult offspring, met eligibility criteria. Most of the studies targeted adolescents with a mean age within ±1 SD of 12.17-16.33 years, with only one study directly targeting young adults. Three-quarters of studies included parental mental illness, and the remaining parental physical illness. Results highlighted a small post-intervention effect for psychological adjustment (d = 0.17,[0.05,0.29], p = .006), maintained at short-term (3-12 months) follow-up (d = 0.33 [0.12,0.54], p = .002), but not at long-term (15 months or longer) follow-up (d = -0.00 [-0.19,0.19], p = .98). A similar pattern emerged for internalizing problems, while for externalizing problems, no significant post-intervention effect was detected. Results also showed a small post-intervention effect for positive adjustment (d = 0.36,[0.10,0.61], p = .006), which increased to a medium effect at short-term follow-up (d = 0.62,[0.15,1.09], p = .010). Post-intervention effects were not present for interpersonal adjustment. Intervention duration moderated effects on post-intervention outcomes, while intervention setting and gender balance moderated outcomes at follow-ups. Psychosocial interventions for young offspring of parents with serious illnesses appear effective in improving psychological and positive outcomes with small-to-moderate effects at post-intervention and short-term follow-up.

Association of parental mental illness with anxiety and depression in adulthood: The role of potentially contributing factors

OBJECTIVE

Children of parents with a mental illness (COPMI) are at risk of developing mental disorders in adulthood, especially anxiety disorders and depression. The role of the family environment and demographic factors as related to adult anxiety and depression is insufficiently understood. We examined potentially contributing factors in the associations between a COPMI background with anxiety and depressive symptoms in adulthood.

METHOD

Cross-sectional general population-based study. Instruments were the General Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) and a questionnaire to evaluate self-reported history of a COPMI background and family-related experiences (CEPMIF). Multiple regression analyses were used to examine the role of demographic and family-related factors in the association of a self-reported COPMI background with the level of anxiety and depressive symptoms.

RESULTS

Of the 942 participants (mean age 48.1 (SD = 16.2) years; 53.7 % women), 116 (12.3 %) had a COPMI background. A COPMI background was associated with higher levels of anxiety and depressive symptoms. Within individuals with a COPMI background, relationship problems within the family were associated with elevated levels of anxiety and depression.

LIMITATIONS

The cross-sectional design does not allow for causal inferences, COPMI background was based on participant's self-report, and the type of parental mental disorder was not considered.

CONCLUSIONS

Adults with a COPMI background have higher levels of anxiety and depressive symptoms. Dysfunctional family relationships during childhood were associated with the severity of mental health problems of adults who grew up with a mentally ill parent. There is a need for targeted interventions for adult COPMI.

The relationship between adverse childhood experiences and depressive symptoms in rural left-behind adolescents: A cross-sectional survey

Objective

We assessed the current status of depressive symptoms and the associated factors in rural left-behind adolescents. Moreover, we investigated the relationship between adverse childhood experiences and depressive symptoms.

Methods

Students from two rural junior high schools in Huaihua City were enrolled from July to September 2022. Before distributing the questionnaires, guardians of the students were contacted, and consent was obtained from the students themselves. The questionnaires were filled out anonymously and collected on-site.

Results

The prevalence of depressive symptoms among the 325 left-behind teenagers was 23.40%; the rate of emotional abuse in adverse childhood experiences was 17.50%, physical abuse was 15.70%, sexual abuse was 9.50%, emotional neglect was 24.60%, while physical neglect was 27.70%. The five dimensions of adverse childhood experiences were associated with depressive symptoms (r = 0.597, 0.395, 0.410, 0.498, 0.741, p < 0.01).

Conclusions

Depressive symptoms were common among rural left-behind adolescents. Adverse childhood experiences were associated with depressive symptoms in rural left-behind adolescents. Occurrence of adverse childhood experiences should be reduced to improve on depressive symptoms.

Protective factors enhancing resilience in children of parents with a mental illness: a systematic review

Objectives

A systematic review was conducted to (1) investigate protective factors enhancing resilience in children of parents with a mental illness (COPMI), and (2) examine theoretical and methodological issues in the existing literature.

Method

Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed and Embase. After screening 5,073 articles 37 fulfilled inclusion criteria and were extracted for review. Results of the present review indicate that there are several ways to help build resilience in COPMI. More specifically, five protective factors emerged from the reviewed literature: Information, Support, Family functioning and Connectedness, Child coping, and Parenting.

Discussion

Research on protective factors in children confronted with parental mental illness is still scarce and for some factors no clear conclusions can be drawn based on the available evidence. To further our understanding of the building blocks and underlying mechanisms of resilience in COPMI, additional rigorously designed studies are needed.

Electrophysiological biomarkers and age characterize phenotypic heterogeneity among individuals with major depressive disorder

Introduction: Despite the high need for effective treatments for major depressive disorder (MDD), the development of novel medicines is hampered by clinical, genetic and biological heterogeneity, unclear links between symptoms and neural dysfunction, and tenuous biomarkers for clinical trial contexts of use. Methods: In this study, we examined the International Study to Predict Optimized Treatment in Depression (iSPOT-D) clinical trial database for new relationships between auditory event-related potential (ERP) responses, demographic features, and clinical symptoms and behavior, to inform strategies for biomarker-driven patient stratification that could be used to optimize future clinical trial design and drug development strategy in MDD. Results: We replicate findings from previous analyses of the classic auditory oddball task in the iSPOT-D sample showing smaller than typical N1 and P300 response amplitudes and longer P300 latencies for target and standard stimuli in patients with MDD, suggesting altered bottom-up sensory and top-down attentional processes. We further demonstrate that age is an important contributor to clinical group differences, affecting both topographic distribution of the clinically informative ERP responses and the types of the stimuli sensitive to group differences. In addition, the observed brain-behavior associations indicate that levels of anxiety and stress are major contributing factors to atypical sensory and attentional processing among patients with MDD, particularly in the older subgroups. Discussion: Our novel findings support the possibility of accelerated cognitive aging in patients with MDD and identify the frontal P300 latency as an additional candidate biomarker of MDD. These results from a large, well-phenotyped sample support the view that heterogeneity of the clinical population with MDD can be systematically characterized based on age and neural biomarkers of sensory and attentional processing, informing patient stratification strategies in the design of clinical trials.