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Touchette E, Fréchette-Boilard G, Petit D, Geoffroy MC, Pennestri MH, Côté S, Tremblay RE, Petitclerc A, Boivin M, Montplaisir J. Longitudinal study of childhood sleep trajectories and adolescent mental health problems. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2024; 5:zpae013. [PMID: 38559775 PMCID: PMC10981463 DOI: 10.1093/sleepadvances/zpae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/16/2024] [Indexed: 04/04/2024]
Abstract
Study Objective To investigate whether childhood sleep trajectories are associated with mental health symptoms such as social phobia, generalized anxiety, depression, attention deficit hyperactivity disorder (ADHD), conduct problems, and opposition at age 15. Methods A total of 2120 children took part in the Quebec Longitudinal Study of Child Development. Childhood sleep trajectories were computed from maternal reports at 2.5, 3.5, 4, 6, 8, 10, and/or 12 years. At age 15, 1446 adolescents filled out mental health and sleep questions. A path analysis model was assessed in the full sample. Results Four childhood nocturnal sleep duration trajectories were identified: (1) a short pattern (7.5%), (2) a short-increasing pattern (5.8%), (3) a 10 hours pattern (50.7%), and (4) an 11 hours pattern (36.0%). Three childhood sleep latency trajectories were found: (1) a short pattern (31.7%), (2) an intermediate pattern (59.9%), and (3) a long pattern (8.4%). Finally, two childhood wakefulness after sleep-onset trajectories were found: (1) a normative pattern (73.0%) and (2) a long pattern (27.0%). The path analysis model indicated that children following a long childhood sleep latency trajectory were more likely to experience symptoms of depression (β = 0.06, 95% CI: 0.01 to 0.12), ADHD (β = 0.07, 95% CI: 0.02 to 0.13), conduct problems (β = 0.05, 95% CI: 0.00 to 0.10) and opposition (β = 0.08, 95% CI: 0.02 to 0.13) at age 15. Conclusions This longitudinal study revealed that children presenting a long sleep latency throughout childhood are at greater risk of symptoms of depression, ADHD, conduct problems, and opposition in adolescence.
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Affiliation(s)
- Evelyne Touchette
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Québec city, Québec, Canada
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
| | | | - Dominique Petit
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Québec, Canada
| | - Marie-Claude Geoffroy
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Marie-Hélène Pennestri
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada
- Hôpital en Santé Mentale Rivière-des-Prairies, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, QC, Canada
| | - Sylvana Côté
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Richard E Tremblay
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Amélie Petitclerc
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychology, Laval University, Québec city, Québec, Canada
| | - Michel Boivin
- Research Unit on Children’s Psychosocial Maladjustment, Québec, Canada
- Department of Psychology, Laval University, Québec city, Québec, Canada
| | - Jacques Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montreal, Centre intégré universitaire de santé et de services sociaux du Nord-de-L’île-de-Montréal, Montréal, Québec, Canada
- Department of Psychiatry, University of Montreal, Montréal, Québec, Canada
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Schwartz KTG, Chronis-Tuscano A, Tillman R, Whalen D, Gilbert KE, Luby J. Parent-child psychotherapy targeting emotion development: unpacking the impact of parental depression on child, parenting and engagement outcomes. Eur Child Adolesc Psychiatry 2023; 32:2491-2501. [PMID: 36216984 DOI: 10.1007/s00787-022-02093-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/23/2022] [Indexed: 11/03/2022]
Abstract
Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) effectively treats depression and improves functioning in preschoolers. Parental depression has been associated with inconsistent parenting, depression onset and maintenance in offspring, and decreased treatment efficacy for youth. Given the intensity of parent involvement in PCIT-ED, this secondary data analysis aimed to evaluate parental depression severity (i.e., Beck Depression Inventory-II Total Score; BDI-II) as a moderator and predictor of child, parenting, and engagement outcomes, within the context of a randomized trial. Children (N = 229; ages 3-6.11) with early childhood depression and a consenting caregiver were randomly assigned to receive PCIT-ED or Waitlist (WL). Moderation results supported the superiority of PCIT-ED over WL on child and parenting outcomes, independent of parent-reported BDI-II at baseline (p ≥ 0.684 and p ≥ 0.476, respectively). BDI-II did not significantly predict child (p ≥ 0.836), parenting (p ≥ 0.114) or engagement (p ≥ 0.114) outcomes. Finally, BDI-II did not surpass chance in predicting whether children would maintain a depression diagnosis after PCIT-ED (AUC = 0.530) or prematurely terminate treatment (AUC = 0.545). Our results suggest that PCIT-ED is not contraindicated by minimal-to-moderate symptoms of depression in parents. Taken together with previous reports, PCIT-ED may indeed be a particularly beneficial treatment choice for this population. Further research in samples with more severe parental depression is needed. ClinicalTrials.gov identifier: NCT02076425.
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Affiliation(s)
- Karen T G Schwartz
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Psychology, University of Maryland, College Park, MD, USA.
| | | | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Diana Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Myers TL, Gladstone TRG, Beardslee WR. The Transition to Adulthood in Children of Depressed Parents: Long-Term Follow-Up Data from the Family Talk Preventive Intervention Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3313. [PMID: 36834008 PMCID: PMC9965635 DOI: 10.3390/ijerph20043313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Little is known about the effects of parental depression on offspring as they transition to adulthood-a challenging time developmentally, when late adolescents must separate from home, achieve intimate relationships, and develop a sense of identity. We present long-term quantitative and qualitative data from early adolescents with a depressed parent who were randomized to one of two family-based preventive interventions and followed over time, across the transition to young adulthood. Specifically, we present clinical measures of psychopathology and Likert-scale questionnaire data from young adults and their parents regarding the transition to adulthood and perceptions of the interventions. We also report in-depth qualitative interview data from young adults about the effects of parental depression on their transition to adulthood. Findings suggest that leaving home, establishing relationships, and coping with stressors may be challenging for emerging adults. Furthermore, the interviews highlight the importance of siblings, the burden of parental depression, and the development of self-understanding and empathy in young adults who grew up with a depressed parent. Data suggest that clinicians, policy makers, educators, and employers must address the preventive and clinical needs of young people and their families as they transition to young adulthood after growing up with depressed parents.
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Affiliation(s)
- Taylor L. Myers
- Wellesley Centers for Women, Wellesley College, 106 Central St., Wellesley, MA 02481, USA
| | - Tracy R. G. Gladstone
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, 121 South Main St., Providence, RI 02903, USA
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Lobel M, Preis H, Mahaffey B, Schaal NK, Yirmiya K, Atzil S, Reuveni I, Balestrieri M, Penengo C, Colli C, Garzitto M, Driul L, Ilska M, Brandt-Salmeri A, Kołodziej-Zaleska A, Caparros-Gonzalez RA, Castro RA, La Marca-Ghaemmaghami P, Meyerhoff H. Common model of stress, anxiety, and depressive symptoms in pregnant women from seven high-income Western countries at the COVID-19 pandemic onset. Soc Sci Med 2022; 315:115499. [PMID: 36399984 PMCID: PMC9622432 DOI: 10.1016/j.socscimed.2022.115499] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/14/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Increases in stress, anxiety, and depression among women pregnant during the COVID-19 pandemic have been reported internationally. Yet rigorous comparison of the prevalence of maternal mental health problems across countries is lacking. Moreover, whether stress is a common predictor of maternal mental health during the pandemic across countries is unknown. METHODS 8148 pregnant women from Germany, Israel, Italy, Poland, Spain, Switzerland, and the United States were enrolled in the International COVID-19 Pregnancy Experiences (I-COPE) Study between April 17 and May 31, 2020. Sociodemographic characteristics, pandemic-related stress, pregnancy-specific stress, anxiety, and depression were assessed with well-validated instruments. The magnitude of stress and mood disturbances was compared across countries. A path model predicting clinically significant levels of anxiety and depression from maternal characteristics and stress was tested for all study participants and then examined separately in each country with >200 participants. RESULTS Countries differed significantly in magnitude of pandemic-related pregnancy stress and pandemic-unrelated pregnancy-specific stress, and in prevalence of clinically significant anxiety and depression levels. A well-fitting common path model for the entire sample indicated that mood and anxiety disturbances were strongly predicted by pandemic-related and pregnancy-specific stress after accounting for maternal characteristics. The model was replicated in individual countries. CONCLUSIONS Although pregnant women in high-income Western countries experienced different levels of stress resulting from the COVID-19 pandemic, stress is a strong, common predictor of anxiety and depressive symptoms in these individuals. The common model can be used to inform research and clinical interventions to protect against adverse consequences of prenatal maternal stress, anxiety, and depression for mothers and infants.
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Affiliation(s)
- Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States.
| | - Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States; Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
| | - Nora K Schaal
- Institute of Experimental Psychology, Heinrich-Heine-University, Duesseldorf, Germany
| | - Karen Yirmiya
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzlia, Israel
| | - Shir Atzil
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Affiliated with the Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Chiara Penengo
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Chiara Colli
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Marco Garzitto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Lorenza Driul
- Obstetric-Gynecologic Clinic, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Michalina Ilska
- Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Anna Brandt-Salmeri
- Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | | | - Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain; Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Rita Amiel Castro
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Pearl La Marca-Ghaemmaghami
- Psychology Research and Counselling Institute for Sexuality, Marriage, and Family, International Academy for Human Sciences and Culture, Walenstadt, Switzerland
| | - Hannah Meyerhoff
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
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5
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Sutherland S, Nestor BA, Pine AE, Garber J. Characteristics of maternal depression and children's functioning: A meta-analytic review. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:671-680. [PMID: 34843324 PMCID: PMC9157221 DOI: 10.1037/fam0000940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Maternal depression is associated with cognitive, emotional, and behavioral problems in offspring, but the substantial heterogeneity of depression precludes a full understanding of these associations. Variation in course of depression, characterized by severity or chronicity, may be related differentially to children's development. The current meta-analytic review examined the relations of these characteristics of maternal depression to children's developmental outcomes. Twenty-nine studies were identified and reviewed; the majority (93%) of studies reported a negative association between some aspect of maternal depression and children's adjustment. Separate meta-analyses revealed significant effect sizes for severity (Fisher's z = -.243) and chronicity (adjusted Fisher's z = -.337) of maternal depression and children's cognitive or behavioral functioning. Findings are synthesized across features of maternal depression; methodological limitations within the empirical literature are discussed; and recommendations for future research are suggested. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Judy Garber
- Department of Psychology and Human Development
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Roetner J, Petry J, Niekamp J, Maschke J, Goecke TW, Fasching PA, Beckmann MW, Kornhuber J, Kratz O, Moll GH, Eichler A. [Maternal depression and child development: A prospective analysis of consequences, risk and protective factors]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 50:382-394. [PMID: 35321586 DOI: 10.1024/1422-4917/a000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Maternal depression and child development: A prospective analysis of consequences, risk and protective factors Abstract. Objective: Maternal stress, specifically maternal mental health problems, are considered risk factors for child development. The literature suggests that prenatal depressive symptoms as well as depressive symptoms are a widespread phenomenon during the further development of the child and have repeatedly been shown to have adverse effects on child mental health outcomes. The present study examined the longitudinal relationships between maternal depression (prenatal, postnatal, during childhood and adolescence) and child mental health from childhood to adolescence. Possible risk and protective factors were also considered. Method: N = 112 mothers were assessed for depressive symptoms via a questionnaire at four different timepoints (prenatal, T1; postnatal, T2; during childhood, T3; during adolescence, T4). Children's externalizing and internalizing symptoms (50.9 % girls) were assessed by their mothers both during childhood (M = 7.68, SD = 0.76 years) and during adolescence (M = 13.23, SD = 0.27 years). We evaluated the relationships between maternal depressive symptoms and children's externalizing/internalizing symptoms using multiple regression models and analyzed possible risk and protective factors using moderation analysis. Results: Externalizing/Internalizing symptoms were not directly associated with maternal depressive symptoms, while associations between such symptoms and maladaptive behavior were found in adolescents. The socioeconomic status of families showed a different risk profile for prenatal and postnatal depressive symptoms. The IQ of the children proved to be a risk factor for internalizing symptoms. Conclusions: Maternal depressive symptoms at any time during child development - in combination with further risk factors - have an impact on child mental health. The early identification of maternal symptoms followed by interventions to differentiate between prenatal and postnatal depression - especially in the context of socioeconomic status - are highly relevant for child development.
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Affiliation(s)
- Jakob Roetner
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Janna Petry
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Julia Niekamp
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Janina Maschke
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Tamme W Goecke
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen.,Klinik für Gynäkologie und Geburtshilfe, Ro-Med Klinikum Rosenheim, Rosenheim
| | - Peter A Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Matthias W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Oliver Kratz
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Gunther H Moll
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
| | - Anna Eichler
- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
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- Kinder- und Jugendabteilung für Psychische Gesundheit, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
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Advancing research on perinatal depression trajectories: Evidence from a longitudinal study of low-income women. J Affect Disord 2022; 301:44-51. [PMID: 34995707 DOI: 10.1016/j.jad.2022.01.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/02/2021] [Accepted: 01/02/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The current study aimed to describe and predict perinatal depression trajectories in a sample of low-income women from the first trimester of pregnancy to six months postpartum. METHODS The study sample consisted of 899 women in Wisconsin who received home visiting services. Eligible participants were screened for depressive symptoms by home visitors using the Edinburgh Postnatal Depression Scale at least three times across four time periods from the first trimester of pregnancy to six months postpartum. Growth Mixture Modeling was applied to identify distinct trajectory classes, and multinomial logistic regressions were performed to analyze predictors of class membership. RESULTS Mean depressive symptom scores in this racially/ethnically diverse sample of low-income women decreased significantly over time from a high of 8.1 at time1 to a low of 6.8 at time4. Four classes were identified, including a low-stable group (78.2% of sample), a high-stable group (10.6%) along with decreasing (7.1%) and increasing (4.1%) trajectories. Women with a history of abuse and mental health difficulties were more likely to be classified in the high-stable and decreasing depression groups than the low-stable group. Low social support was linked to an increasing trajectory that resulted in high levels of postpartum depression. CONCLUSIONS AND IMPLICATIONS Although most women exhibited stable and positive trajectories, more than one out of five presented with either persistently or intermittently high depression scores. Taken together, the findings underscore the importance of depression screening throughout the perinatal period and identifying factors that may be used to target resources to at-risk populations.
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Maternal Psychological Problems During Pregnancy and Child Externalizing Problems: Moderated Mediation Model with Child Self-regulated Compliance and Polygenic Risk Scores for Aggression. Child Psychiatry Hum Dev 2022; 53:654-666. [PMID: 33743096 PMCID: PMC9287202 DOI: 10.1007/s10578-021-01154-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/05/2022]
Abstract
A potential pathway underlying the association between prenatal exposure to maternal psychological problems and childhood externalizing problems is child self-regulation. This prospective study (N = 687) examined whether self-regulated compliance mediates the relation between maternal affective problems and hostility during pregnancy and childhood externalizing problems, and explored moderation by child polygenic risk scores for aggression and sex. Self-regulated compliance at age 3 was observed in mother-child interactions, and externalizing problems at age 6 were reported by mothers and teachers. Polygenic risk scores were calculated based on a genome-wide association study of aggressive behavior. Self-regulated compliance mediated the associations between maternal psychological problems and externalizing problems. Aggression PRS was associated with higher externalizing problems reported by mothers. No evidence was found of moderation by aggression PRS or sex. These findings support the hypothesis that maternal psychological problems during pregnancy might influence externalizing problems through early self-regulation, regardless of child genetic susceptibility or sex.
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9
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Choe R, Sim YF, Hong CHL, Mohideen S, Nadarajan R, Yap F, Shek LPC, Hsu CYS, Broekman BFP, Ferreira JN. Internalizing problems are associated with oral health-related quality of life in early childhood: Outcomes from an Asian multi-ethnic prospective birth cohort. PLoS One 2021; 16:e0256163. [PMID: 34383864 PMCID: PMC8360536 DOI: 10.1371/journal.pone.0256163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/30/2021] [Indexed: 11/18/2022] Open
Abstract
Oral health status ideally warrants for a holistic biopsychosocial approach to health and wellness. Little is known about the impact of behavioral problems on oral health-related quality of life (OHRQoL) in children due to the paucity of studies in early childhood, particularly in Asian multi-ethnic populations. This study evaluated the relationship between early child's socioemotional factors and OHRQoL, as well as its association with orofacial pain (OFP) and early childhood caries (ECC) in the Asian GUSTO birth cohort. Mother-child dyads were postnatally assessed at 3 time points. The Child Behavior Checklist (CBCL) was used to assess the child's socioemotional and behavioral problems at age 4-4.5 years together with other validated questionnaires to evaluate maternal anxiety and depression. ECC detection was performed at age 5, and OHRQoL (primary) and OFP (secondary) outcomes were assessed at age 6 from a total of 555 mother-child dyads. After a univariate regression analysis was performed to identify potential predictors and confounders, a multivariate regression model was run with predisposing factors (CBCL internalization and externalization problems, OFP, ECC) and adjusted for confounders (maternal psychosocial states, maternal education) to determine associations with OHRQoL. Results showed an association between CBCL internalization scores and poorer OHRQoL (RR = 1.03, p = 0.033, 95% CI 1.01 to 1.05), although the limited risk ratio may not have a practical applicability in psychosocially healthy children, alike the majority of those evaluated in this cohort. The average OHRQoL overall score among children with OFP was 2.39 times more than those without OFP (OR = 2.39, p < 0.001, 95% CI 2.00 to 2.86). Thus, in early childhood, OFP, and to lesser extent internalizing behaviors, may negatively impact OHRQoL. This study therefore highlights the complex relationship between OHRQoL and its predisposing socioemotional and somatic pain factors, and demands further investigations in clinically relevant populations.
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Affiliation(s)
- Ruth Choe
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Yu Fan Sim
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | | | - Sameema Mohideen
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - Ranjani Nadarajan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Lynette P.-C. Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Birit F. P. Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore, Singapore
- OLVG and Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Joao N. Ferreira
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Faculty of Dentistry, Exocrine Gland Biology and Regeneration Research Group, Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
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Mun IB, Lee S. The influence of parents’ depression on children’s online gaming addiction: testing the mediating effects of intrusive parenting and social motivation on children’s online gaming behavior. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01854-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Suradom C, Suttajit S, Oon-Arom A, Maneeton B, Srisurapanont M. Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials. Nord J Psychiatry 2021; 75:239-246. [PMID: 33190574 DOI: 10.1080/08039488.2020.1843710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Available interventions for preventing and treating perinatal depression remain unsatisfactory. AIMS We examined the prophylactic and therapeutic effects, as well as adverse effects, of n-3 PUFA supplementation in reducing depressive symptoms during perinatal periods. METHODS We included randomized, placebo-controlled trials that reported the changes of depression severity after the perinatal participants received n-3 PUFA supplementation. After the comprehensive searches in October 2019, we selected the trials, extracted the data, and assessed the quality of included trials. We compared the standardized mean differences (SMD) of depression score changes between groups using a random-effect model. RESULTS We included 11 trials in the meta-analysis and one more trial for qualitative analysis (N = 3,181). The pooled standardized mean of decreased depression scores revealed no statistically significant difference between the n-3 PUFA and the placebo groups (N = 920, SMDs = -0.05, 95% CI -0.20 to 0.10, I2 = 21%). The pooled SMDs showed no statistically significant efficacy of n-3 PUFA supplementation for prevention (N = 779, SMDs = -0.03, 95% CI -0.20 to 0.13, I2 = 24%) and treatment (N = 141, SMDs = -0.14, 95% CI -0.55 to 0.27, I2 = 31%) of perinatal depression. The efficacy of n-3 PUFA supplementation was not associated with the daily doses of DHA, EPA, or DHA plus EPA. No trial reported any serious adverse effect of n-3 PUFA supplements. CONCLUSIONS Although n-3 PUFA supplementation may improve maternal and infant outcomes, our meta-analysis found insufficient evidence to determine its benefit for perinatal depression.
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Affiliation(s)
- Chawisa Suradom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirijit Suttajit
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Awirut Oon-Arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Manit Srisurapanont
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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12
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Marçal KE. Pathways to Adolescent Emotional and Behavioral Problems: An Examination of Maternal Depression and Harsh Parenting. CHILD ABUSE & NEGLECT 2021; 113:104917. [PMID: 33454642 DOI: 10.1016/j.chiabu.2020.104917] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/02/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Maternal depression is linked with a range of child and adolescent outcomes. Prior research suggests adverse consequences for child and youth development, but less is known about the role of adverse parenting in the pathways from maternal depression to adolescent emotional and behavioral problems. OBJECTIVE The present study leveraged a large, longitudinal survey of families across the U.S. to investigate whether harsh parenting mediated the links between maternal depression and adolescent delinquency and depression. PARTICIPANTS AND SETTING Data came from a national longitudinal survey of families with children born in large U.S. cities 1998-2000 in which mothers had at least partial custody of children (N = 2,719). METHODS Structural equation modeling with latent variables estimated a measurement model using confirmatory factor analysis and a structural model testing direct and indirect pathways. RESULTS Maternal depression was directly associated with both physical and psychological aggression in parenting (β = 0.08, p < 0.001 and β = 0.12, p < 0.001, respectively), and psychological aggression related directly with adolescent delinquency (β = 0.24, p < 0.01). Furthermore, maternal depression was indirectly associated with adolescent delinquency via psychological aggression in parenting (β = 0.03, p < 0.05). Physical aggression in parenting did not mediate links between maternal depression and either adolescent outcome. CONCLUSIONS Findings provide insights into the parent-level drivers of adolescent emotional and behavioral outcomes. Screening for maternal depression and providing parenting support to vulnerable families offers promise for preventing adverse parenting and supporting healthy adolescent development.
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Affiliation(s)
- Katherine E Marçal
- University of Nevada, 4505 S. Maryland Parkway, Las Vegas, NV 89117, United States.
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13
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Morgan JE, Channon S, Penny H, Waters CS. Longitudinal studies examining the impact of prenatal and subsequent episodes of maternal depression on offspring antisocial behaviour. Eur Child Adolesc Psychiatry 2021; 30:5-40. [PMID: 31792693 PMCID: PMC7864821 DOI: 10.1007/s00787-019-01447-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 11/20/2019] [Indexed: 12/16/2022]
Abstract
Maternal depression is associated with adverse child outcomes including antisocial behaviour (ASB). Prospective longitudinal studies have focused on the timing and cumulative exposure to maternal depression to further delineate the association and mechanisms of effect. The objective of this systematic review was to synthesise and evaluate the findings of longitudinal studies of maternal depression and offspring antisocial behaviour. Three databases were searched (Psychinfo, Web of Science, and Medline). Twenty of 5936 studies met inclusion criteria. Study quality was assessed using the Critical Appraisal Skills Programme criteria [Critical Appraisal Skills Programme (2017) CASP (cohort observation checklist). https://casp-uk.net/wpcontent/uploads/2018/01/CASP-Cohort-Study-Checklist.pdf ]. Results of individual studies were highly varied, using diverse analytical approaches and not all studies explored the independent effects of different episodes. Only three studies examined hypothesised mechanisms. Prenatal, postnatal, and later episodes of depression were all predictive of antisocial outcomes. One particular time period of depression exposure did not emerge as more predictive of offspring ASB than another. However, measures of maternal depression after the perinatal period were limited and typically included a one-off assessment of mothers' depressive symptoms that was concurrent to the assessment of offspring ASB. When cumulative exposure to maternal depression and specific timing effects were measured within the same study it was cumulative exposure that conferred the greatest risk for offspring ASB-particularly when this exposure began during the perinatal period. Findings are discussed in terms of limitations in the literature and highlight the need for future research to examine the biological and environmental mechanisms that underpin associations between maternal depression and offspring antisocial behaviour during different stages of development.
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Affiliation(s)
- Joanne E Morgan
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Sue Channon
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Helen Penny
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK
| | - Cerith S Waters
- School of Psychology, Cardiff University, Cardiff, Wales, CF10 3AT, UK.
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14
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Chu EK, Smith LM, Derauf C, Newman E, Neal CR, Arria AM, Huestis MA, DellaGrotta SA, Roberts MB, Dansereau LM, Lester BM. Behavior Problems During Early Childhood in Children With Prenatal Methamphetamine Exposure. Pediatrics 2020; 146:peds.2019-0270. [PMID: 33172920 PMCID: PMC7706113 DOI: 10.1542/peds.2019-0270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The effects of in utero methamphetamine exposure on behavioral problems in school-aged children are unclear. Our objective for this study was to evaluate behavior problems in children at aged 3, 5, and 7.5 years who were prenatally exposed to methamphetamine. METHODS Subjects were enrolled in the Infant Development, Environment, and Lifestyle study, a longitudinal prospective study of prenatal methamphetamine exposure and child outcomes. Exposed and comparison groups were matched on birth weight, race, education, and health insurance. At ages 3, 5, and 7.5 years, 339 children (171 exposed) were assessed for behavior problems by using the Child Behavior Checklist. Generalized estimating equations were used to determine the effects of prenatal methamphetamine exposure, age, and the interaction of exposure and age on behavior problems. Caregiver psychological symptoms were assessed by using the Brief Symptom Inventory. RESULTS Analyses adjusted for covariates revealed that relative to age 3, children at 5 years had less externalizing and aggressive behavior and more internalizing behavior, somatic complaints, and withdrawn behavior. By age 7.5, aggressive behavior continued to decrease, attention problems increased and withdrawn behavior decreased. There were no main effects for methamphetamine exposure and no interactions of exposure and age. Caregiver psychological symptoms predicted all behavior problems and the quality of the home predicted externalizing problems and externalizing syndrome scores. CONCLUSIONS Behavioral effects longitudinally from ages 3 to 7.5 years were not associated with prenatal methamphetamine exposure, whereas caregiver psychological symptoms and the quality of the home were predictors of behavior problems.
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Affiliation(s)
- Elaine K. Chu
- Department of Pediatrics, Lundquist Institute, Harbor–University of California, Los Angeles Medical Center and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Lynne M. Smith
- Department of Pediatrics, Lundquist Institute, Harbor–University of California, Los Angeles Medical Center and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Chris Derauf
- Division of Community and Pediatric Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Elana Newman
- Department of Psychology, The University of Tulsa, Tulsa, Oklahoma
| | - Charles R. Neal
- Department of Pediatrics, University of Hawai‘i at Mānoa, Honolulu, Hawaii
| | - Amelia M. Arria
- Department of Family Science and Center on Young Adult Health and Development, School of Public Health, University of Maryland, College Park, Maryland
| | - Marilyn A. Huestis
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland; and
| | - Sheri A. DellaGrotta
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School, Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Mary B. Roberts
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School, Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Lynne M. Dansereau
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School, Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Warren Alpert Medical School, Brown University and Women and Infants Hospital of Rhode Island, Providence, Rhode Island
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15
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Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci Biobehav Rev 2020; 117:26-64. [DOI: 10.1016/j.neubiorev.2017.07.003] [Citation(s) in RCA: 438] [Impact Index Per Article: 109.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 04/09/2017] [Accepted: 07/11/2017] [Indexed: 01/17/2023]
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16
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Tien J, Lewis GD, Liu J. Prenatal risk factors for internalizing and externalizing problems in childhood. World J Pediatr 2020; 16:341-355. [PMID: 31617077 PMCID: PMC7923386 DOI: 10.1007/s12519-019-00319-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND A growing body of research has documented the effects of prenatal risk factors on a wide spectrum of adverse offspring health outcomes. Childhood behavior problems, such as externalizing and internalizing problems, are no exception. This comprehensive literature review aims to summarize and synthesize current research about commonly experienced prenatal risk factors associated with internalizing and externalizing problems, with a focus on their impact during childhood and adolescence. Potential mechanisms as well as implications are also outlined. DATA SOURCES The EBSCO, Web of Science, PubMed, Google Scholar, and Scopus databases were searched for studies examining the association between prenatal risk factors and offspring internalizing/externalizing problems, using keywords "prenatal" or "perinatal" or "birth complications" in combination with "internalizing" or "externalizing". Relevant articles, including experimental research, systematic reviews, meta-analyses, cross-sectional and longitudinal cohort studies, and theoretical literature, were reviewed and synthesized to form the basis of this integrative review. RESULTS Prenatal risk factors that have been widely investigated with regards to offspring internalizing and externalizing problems encompass health-related risk factors, including maternal overweight/obesity, substance use/abuse, environmental toxicant exposure, maternal infection/inflammation, as well as psychosocial risk factors, including intimate partner violence, and anxiety/depression. Collectively, both epidemiological and experimental studies support the adverse associations between these prenatal factors and increased risk of emotional/behavioral problem development during childhood and beyond. Potential mechanisms of action underlying these associations include hormonal and immune system alterations. Implications include prenatal education, screening, and intervention strategies. CONCLUSIONS Prenatal risk factors are associated with a constellation of offspring internalizing and externalizing problems. Identifying these risk factors and understanding potential mechanisms will help to develop effective, evidence-based prevention, and intervention strategies.
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Affiliation(s)
- Joyce Tien
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Gary D Lewis
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jianghong Liu
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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17
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Taka-Eilola Nèe Riekki T, Veijola J, Miettunen J, Koskela J, Kantojärvi L, Mäki P. Antisocial and borderline personality disorders in the offspring of antenatally depressed mothers - a follow-up until mid-adulthood in the Northern Finland 1966 birth cohort. Nord J Psychiatry 2020; 74:138-146. [PMID: 31647361 DOI: 10.1080/08039488.2019.1681508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background: Maternal depression is common during pregnancy, affecting 10-15% of mothers. In previous reports, the offspring of antenatally depressed mothers have had an elevated risk for antisocial, criminal and violent behaviour in adolescence, and for borderline personality features in childhood, but long-term outcomes are unknown.Aims: To study whether the adult offspring of antenatally depressed mothers have an elevated risk for antisocial (ASPD) or borderline personality disorder (BPD) when followed until mid-adulthood.Methods: In the general population-based Northern Finland 1966 Birth Cohort, mothers of 12,058 children were asked during mid-gestation if they felt depressed. Of the mothers, 14% reported being depressed. The offspring were followed for 49 years. The diagnoses of in- and outpatient-treated ASPD and BPD in the offspring were detected using the Finnish Care Register for Healthcare. Maternal antenatal smoking, newborn´s low birthweight or short gestational age, father's social class, and family type at birth were considered as confounding variables. Logistic regression analyses on the potential confounders were performed. Maternal postnatal depression and paternal ASPD information was not available.Results: In the male offspring of antenatally depressed mothers, the risk for ASPD was elevated (adjusted odds ratio 5.6; 95% confidence interval 1.8-17.8), but not in female offspring. The risk for BPD was not elevated in the offspring of antenatally depressed mothers in this study.Conclusions: The sons of antenatally depressed mothers had an increased risk for ASPD. Prevention and treatment of antenatal depression might present an opportunity to decrease the risk of antisocial personality in the offspring.
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Affiliation(s)
- Tiina Taka-Eilola Nèe Riekki
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Basic Health Care District of Kallio, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jari Koskela
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Liisa Kantojärvi
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Psychiatry, Länsi-Pohja Healthcare District, Kemi, Finland.,Department of Psychiatry, The Middle Ostrobothnia Central Hospital, Soite Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Mental Health Services and Basic Health Care District of Kallio, Finland.,Department of Psychiatry, Kainuu Central Hospital, Kainuu Social and Healthcare District, Kainuu, Finland
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18
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Bleker LS, Milgrom J, Sexton-Oates A, Parker D, Roseboom TJ, Gemmill AW, Holt CJ, Saffery R, Connelly A, Burger H, de Rooij SR. Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims. Front Psychiatry 2020; 11:34. [PMID: 32116849 PMCID: PMC7031203 DOI: 10.3389/fpsyt.2020.00034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/13/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE OF ARTICLE In a previous pilot randomized controlled trial including 54 pregnant women with depression, maternal mood improved after Cognitive Behavioural Therapy (CBT) compared to treatment as usual (TAU), showing medium to large effect sizes. The effect persisted up to 9 months postpartum, with infant outcomes also showing medium to large effects favoring CBT in various child domains. This perspective article summarizes the results of a follow-up that was performed approximately 5 years later in the same cohort, assessing the effects of antenatal Cognitive Behavioural Therapy for depression and anxiety on child buccal cell DNA-methylation, brain morphology, behavior and cognition. FINDINGS Children from the CBT group had overall lower DNA-methylation compared to children from the TAU group. Mean DNA-methylation of all NR3C1 promoter-associated probes did not differ significantly between the CBT and TAU groups. Children from the CBT group had a thicker right lateral occipital cortex and lingual gyrus. In the CBT group, Voxel-Based-Morphometry analysis identified one cluster showing increased gray matter concentration in the right medial temporal lobe, and fixel-based analysis revealed reduced fiber-bundle-cross-section in the Fornix, the Optical Tract, and the Stria Terminalis. No differences were observed in full-scale IQ or Total Problems Score. When the total of hypotheses tests in this study was considered, differences in DNA-methylation and brain measurements were no longer significant. SUMMARY Our explorative findings suggest that antenatal depression treatment decreases overall child DNA-methylation, increases cortical thickness, and decreases white matter fiber-bundle cross-section in regions involved in cognitive function and the stress response. Nevertheless, larger studies are warranted to confirm our preliminary conclusion that CBT in pregnancy alters neurobiological outcomes in children. Clinical relevance remains unclear as we found no effects of antenatal CBT on child behavior or cognition (yet).
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Affiliation(s)
- Laura S Bleker
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands.,Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Jeannette Milgrom
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Alexandra Sexton-Oates
- Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Donna Parker
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Tessa J Roseboom
- Academic Medical Centre, Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, Netherlands.,Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
| | - Alan W Gemmill
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Christopher J Holt
- Parent-Infant Research Institute, Austin Health, Melbourne, VIC, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute-Cancer and Disease Epigenetics, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Huibert Burger
- University Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, Netherlands.,Academic Medical Centre, Department of Psychiatry, Amsterdam UMC, Amsterdam, Netherlands
| | - Susanne R de Rooij
- Academic Medical Centre, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam, Netherlands
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19
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Lahti-Pulkkinen M, Mina TH, Riha RL, Räikkönen K, Pesonen AK, Drake AJ, Denison FC, Reynolds RM. Maternal antenatal daytime sleepiness and child neuropsychiatric and neurocognitive development. Psychol Med 2019; 49:2081-2090. [PMID: 30293538 DOI: 10.1017/s003329171800291x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prevalence of sleep problems among pregnant women is over 50%, and daytime sleepiness is among the most common sleep problems. Previous studies have associated antenatal sleep problems with adverse maternal health and neonatal outcomes, but the consequences of antenatal sleep problems and particularly daytime sleepiness on child psychological development have not been assessed prospectively. METHODS In this prospective cohort study including 111 mother-child dyads, we examined the associations of maternal daytime sleepiness during pregnancy, assessed at 17 and 28 weeks of gestation using the Epworth Sleepiness Scale, with child neuropsychiatric problems and neuropsychological development, assessed with mother-rated questionnaires and individually administered neuropsychological tests, at child age 2.6-5.7 years (mean = 4.3 years). RESULTS Independently of sociodemographic and perinatal covariates and maternal depressive and anxiety symptoms during and/or after pregnancy, maternal antenatal daytime sleepiness was associated with increased total [unstandardized regression coefficient (B) = 0.25 standard deviation (s.d.) units; 95% confidence interval (CI) 0.01-0.48] and internalizing (B = 0.25 s.d.s: 95% CI 0.01-0.49) psychiatric problems and ADHD symptoms (B = 0.27 s.d.s: 95% CI 0.04-0.50) in children, and with poorer executive function, particularly in the areas of attention, working memory and inhibitory control (B = -0.39 s.d.s: 95% CI -0.69 to -0.10). CONCLUSIONS Maternal antenatal daytime sleepiness carries adverse consequences for offspring psychological development. The assessment of sleep problems may be an important addition to standard antenatal care.
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Affiliation(s)
- M Lahti-Pulkkinen
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - T H Mina
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland, UK
| | - R L Riha
- Department of Sleep Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - K Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - A K Pesonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - A J Drake
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - F C Denison
- Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland, UK
- MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland, UK
| | - R M Reynolds
- British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Tommy's Centre for Maternal and Fetal Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, Scotland, UK
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20
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The Impact of Family Rituals and Maternal Depressive Symptoms on Child Externalizing Behaviors: An Urban–Rural Comparison. CHILD & YOUTH CARE FORUM 2019. [DOI: 10.1007/s10566-019-09512-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Hope S, Pearce A, Chittleborough C, Deighton J, Maika A, Micali N, Mittinty M, Law C, Lynch J. Temporal effects of maternal psychological distress on child mental health problems at ages 3, 5, 7 and 11: analysis from the UK Millennium Cohort Study. Psychol Med 2019; 49:664-674. [PMID: 29886852 PMCID: PMC6378410 DOI: 10.1017/s0033291718001368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 12/15/2017] [Accepted: 04/26/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Psychological distress is common among women of childbearing age, and limited longitudinal research suggests prolonged exposure to maternal distress is linked to child mental health problems. Estimating effects of maternal distress over time is difficult due to potential influences of child mental health problems on maternal distress and time-varying confounding by family circumstances. METHODS We analysed the UK Millennium Cohort Study, a nationally representative sample with data collected throughout childhood. Adopting a marginal structural modelling framework, we investigated effects of exposure to medium/high levels of maternal psychological distress (Kessler-6 score 8+) on child mental health problems (Strengths and Difficulties Questionnaire borderline/abnormal behaviour cut-off) using maternal and child mental health data at 3, 5, 7 and 11 years, accounting for the influence of child mental health on subsequent maternal distress, and baseline and time-varying confounding. RESULTS Prior and concurrent exposures to maternal distress were associated with higher levels of child mental health problems at ages 3, 5, 7 and 11 years. For example, elevated risks of child mental health problems at 11 years were associated with exposure to maternal distress from 3 years [risk ratio (RR) 1.27 (95% confidence interval (CI) 1.08-1.49)] to 11 years [RR 2.15 (95% CI 1.89-2.45)]. Prolonged exposure to maternal distress at ages 3, 5, 7 and 11 resulted in an almost fivefold increased risk of child mental health problems. CONCLUSIONS Prior, concurrent and, particularly, prolonged exposure to maternal distress raises risks for child mental health problems. Greater support for mothers experiencing distress is likely to benefit the mental health of their children.
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Affiliation(s)
- Steven Hope
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Anna Pearce
- UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Jessica Deighton
- UCL and Anna Freud National Centre for Children and Families, London, UK
| | - Amelia Maika
- Faculty of Social and Political Science, Gadjah Mada University, Yogyakarta, Indonesia
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Murthy Mittinty
- School of Public Health, University of Adelaide, Adelaide, Australia
| | - Catherine Law
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - John Lynch
- School of Public Health, University of Adelaide, Adelaide, Australia
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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22
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Bleker LS, de Rooij SR, Roseboom TJ. Malnutrition and depression in pregnancy and associations with child behaviour and cognitive function: a review of recent evidence on unique and joint effects 1. Can J Physiol Pharmacol 2019; 97:158-173. [PMID: 30624959 DOI: 10.1139/cjpp-2018-0381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Accumulating studies suggest that prenatal experiences can shape a child's neurodevelopment. Malnutrition and depression occur in pregnancy relatively often and may affect child neurodevelopment independently as well as synergistically. We aimed to provide an overview of recent studies that have examined malnutrition and (or) depression in pregnancy and associations with child behavioural problems and cognitive function. We conducted a literature search in PubMed, using the following main search terms: "depression", "nutrition", "BMI", "pregnancy", "offspring", "cognition", and "behaviour". We included studies in human populations published from 2013 onwards. The literature search yielded 1531 articles, of which 55 were included in the current review. We presented the evidence on the associations between prenatal markers of nutritional status and (or) depression and child behaviour and (or) cognitive function. We additionally discussed interventions and mechanisms. Both malnutrition and depression in pregnancy are associated with increased externalizing behavioural problems and attentional deficits, and to some extent with poorer cognitive function in the child, but the evidence is not conclusive. Studies on synergistic effects of both factors on child behaviour and cognitive function are still scarce, and more research is needed. Potential shared mechanisms include the hypothalamic-pituitary-adrenal axis, the immune system, epigenetics, and oxidative stress.
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Affiliation(s)
- Laura S Bleker
- a Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.,b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Susanne R de Rooij
- b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Tessa J Roseboom
- a Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.,b Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Fetal programming of neuropsychiatric disorders by maternal pregnancy depression: a systematic mini review. Pediatr Res 2019; 85:134-145. [PMID: 30297878 DOI: 10.1038/s41390-018-0173-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/10/2018] [Accepted: 08/24/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Maternal depression complicates a large proportion of pregnancies. Current evidence shows numerous harmful effects on the offspring. Reviews, which include depression, concluded that stress has harmful effects on the offspring's outcomes neuro-cognitive development, temperament traits, and mental disorders. OBJECTIVE This mini review of recent studies, sought to narrow the scope of exposure and identify studies specifically assessing prenatal depression and offspring neuropsychiatric outcomes. STUDY ELIGIBILITY CRITERIA The review included longitudinal, cohort, cross-sectional, clinical, quasi-experimental, epidemiological, or intervention study designs published in English from 2014 to 2018. PARTICIPANTS Study populations included mother-child dyads, mother-father-child triads, mother-alternative caregiver-child triads, and family studies utilizing sibling comparisons. METHODS We searched PubMED and Web of Science. Study inclusion and data extraction were based on standardized templates. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS Thirteen studies examining neuropsychiatric outcomes were included. We judged the evidence to be moderate to high quality. CONCLUSIONS Our review supports that maternal prenatal depression is associated with neuropsychiatric adversities in children. IMPLICATIONS Future investigations should unravel the biological underpinnings and target timely interventions as early in pregnancy as possible to prevent offspring neuropsychiatric harms.
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Côté SM, Ahun MN, Herba CM, Brendgen M, Geoffroy MC, Orri M, Liu X, Vitaro F, Melchior M, Boivin M, Tremblay RE. Why Is Maternal Depression Related to Adolescent Internalizing Problems? A 15-Year Population-Based Study. J Am Acad Child Adolesc Psychiatry 2018; 57:916-924. [PMID: 30522737 DOI: 10.1016/j.jaac.2018.04.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 04/25/2018] [Accepted: 06/20/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Exposure to maternal depression during early childhood is a well-documented risk factor for offspring's internalizing problems, but the long-term risk and the psychosocial mechanisms underlying the association remain largely unknown. We examined whether maternal depression during early childhood was associated with offspring internalizing problems in adolescence, and the extent to which negative parenting, peer victimization, and poor friendship quality during middle childhood mediated this association. METHOD We report on a population-based sample of children (n = 1,443) followed-up from 5 months to 15 years. We use yearly assessments of the exposure variable, that is, maternal depression (5 months to 5 years); the putative mediators, that is, peer victimization, friendship quality, and parenting practices (6-12 years); and assessment of the outcome variables at 15 years: self-reported major depressive (MD), generalized anxiety (GA), and social phobia (SP) symptoms. Structural equation modeling was used to test mediation by peer and family relationships. RESULTS Exposure to maternal depression during early childhood was associated with higher levels of adolescent MD, GA, and SP. Peer victimization was the only significant mediator and explained 35.9% of the association with adolescent MD, 22.1% of that with GA, and 22.1% of that with SP. CONCLUSION Exposure to maternal depression prior to age 5 years was associated with depression, anxiety, and social phobia extending to adolescence via its impact on peer victimization during middle childhood. Particular attention should be paid to victimization as one potential psychosocial factor via which maternal depression is associated with adolescent internalizing problems.
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Affiliation(s)
- Sylvana M Côté
- University of Montreal, Québec, Canada; INSERM U1219, Bordeaux, France.
| | | | | | | | - Marie-Claude Geoffroy
- McGill University, Montreal, Québec, Canada, and the Douglas Mental Health University Institute, Montreal, Québec, Canada
| | - Massimiliano Orri
- McGill University, Montreal, Québec, Canada, and the Douglas Mental Health University Institute, Montreal, Québec, Canada
| | | | | | | | - Michel Boivin
- Laval University, Québec City, Québec, Canada, and Tomsk State University, Russia
| | - Richard E Tremblay
- University of Montreal, Québec, Canada; University College Dublin, Ireland
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Kaasbøll J, Lydersen S, Ranøyen I, Nilsen W, Indredavik MS. Parental chronic pain and internalizing symptoms in offspring: the role of adolescents' social competence - the HUNT study. J Pain Res 2018; 11:2915-2928. [PMID: 30538531 PMCID: PMC6254984 DOI: 10.2147/jpr.s173787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background A growing body of research suggests that the children of parents with chronic pain are at risk for internalizing symptoms. The mechanisms of such associations have not been as thoroughly examined. The aim of the present study was to investigate whether adolescents’ social competence mediates the association between parental chronic pain and offspring internalizing symptoms as well as whether these associations are moderated by adolescent gender. Methods The current study was based on cross-sectional data from the Nord-Trøndelag Health Study (HUNT 3), a Norwegian population-based health survey conducted in 2006–2008. The present sample comprised adolescents who had both parents participating (n=9,681). Structural equation modeling was used for the data analysis. Results Our results indicated that the association between concurrent maternal and paternal chronic pain and offspring’s symptoms of anxiety and depression was partly mediated by low social competence for girls (b(SE)=0.060 [0.030], P=0.043) but not for boys (b(SE)=−0.059 [0.040], P=0.146). This suggests that these associations are moderated by offspring gender. Conclusion The study extends the existing literature on the possible pathways between parental chronic pain and internalizing symptoms in the offspring. Identifying protective factors in the pathways between parental chronic pain and mental distress in children could guide measures that promote the wellbeing of the child and family of chronic pain sufferers.
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Affiliation(s)
- Jannike Kaasbøll
- Department of Health Research, SINTEF, Trondheim, Norway, .,Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway,
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway,
| | - Ingunn Ranøyen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway, .,Department of Children and Youth, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Wendy Nilsen
- The Work Research Institute, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Marit S Indredavik
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway, .,Department of Children and Youth, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Schepanski S, Buss C, Hanganu-Opatz IL, Arck PC. Prenatal Immune and Endocrine Modulators of Offspring's Brain Development and Cognitive Functions Later in Life. Front Immunol 2018; 9:2186. [PMID: 30319639 PMCID: PMC6168638 DOI: 10.3389/fimmu.2018.02186] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/04/2018] [Indexed: 12/17/2022] Open
Abstract
Milestones of brain development in mammals are completed before birth, which provide the prerequisite for cognitive and intellectual performances of the offspring. Prenatal challenges, such as maternal stress experience or infections, have been linked to impaired cognitive development, poor intellectual performances as well as neurodevelopmental and psychiatric disorders in the offspring later in life. Fetal microglial cells may be the target of such challenges and could be functionally modified by maternal markers. Maternal markers can cross the placenta and reach the fetus, a phenomenon commonly referred to as “vertical transfer.” These maternal markers include hormones, such as glucocorticoids, and also maternal immune cells and cytokines, all of which can be altered in response to prenatal challenges. Whilst it is difficult to discriminate between the maternal or fetal origin of glucocorticoids and cytokines in the offspring, immune cells of maternal origin—although low in frequency—can be clearly set apart from offspring's cells in the fetal and adult brain. To date, insights into the functional role of these cells are limited, but it is emergingly recognized that these maternal microchimeric cells may affect fetal brain development, as well as post-natal cognitive performances and behavior. Moreover, the inheritance of vertically transferred cells across generations has been proposed, yielding to the presence of a microchiome in individuals. Hence, it will be one of the scientific challenges in the field of neuroimmunology to identify the functional role of maternal microchimeric cells as well as the brain microchiome. Maternal microchimeric cells, along with hormones and cytokines, may induce epigenetic changes in the fetal brain. Recent data underpin that brain development in response to prenatal stress challenges can be altered across several generations, independent of a genetic predisposition, supporting an epigenetic inheritance. We here discuss how fetal brain development and offspring's cognitive functions later in life is modulated in the turnstile of prenatal challenges by introducing novel and recently emerging pathway, involving maternal hormones and immune markers.
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Affiliation(s)
- Steven Schepanski
- Laboratory of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Developmental Neurophysiology, Institute of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Buss
- Institute of Medical Psychology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Development, Health, and Disease Research Program, University of California, Irvine, Orange, CA, United States
| | - Ileana L Hanganu-Opatz
- Developmental Neurophysiology, Institute of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra C Arck
- Laboratory of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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MacKinnon N, Kingsbury M, Mahedy L, Evans J, Colman I. The Association Between Prenatal Stress and Externalizing Symptoms in Childhood: Evidence From the Avon Longitudinal Study of Parents and Children. Biol Psychiatry 2018; 83:100-108. [PMID: 28893381 DOI: 10.1016/j.biopsych.2017.07.010] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND It has been suggested that prenatal maternal stress may increase the risk of childhood externalizing disorders, yet no large cohort study has investigated this association across a large range of acute stressors. Our objective was to estimate the association between prenatal stressful events and risk of offspring conduct disorder and hyperactivity. METHODS We used data from 10,184 mother-offspring pairs from the United Kingdom-based Avon Longitudinal Study of Parents and Children. Mothers self-reported 42 prenatal stressful life events at 18 weeks' gestation. Symptoms of conduct disorder and hyperactivity in their offspring were measured at 6, 9, 11, 13, and 16 years of age using the Strengths and Difficulties Questionnaire. The primary outcome was membership in high-symptom trajectories of 1) conduct disorder and 2) hyperactivity throughout childhood, identified using latent class growth modeling. Multinomial logistic regression models estimated the association between prenatal stress and both conduct disorder and hyperactivity, after adjusting for sex, parental education, low birth weight, preterm birth, parental social class, maternal smoking and drinking, maternal mental health, offspring stressful life events, and offspring depressive and anxious symptoms. RESULTS Those exposed to the highest quartile of prenatal stress were more likely to belong to the high symptom trajectory for hyperactivity (B = 0.46, p < .05) and conduct disorder (B = 0.88, p < .01), respectively. Prenatal stress further demonstrated a positive, dose-response relationship with symptoms of externalizing disorders at independent time points. CONCLUSIONS The findings suggest that prenatal stressful events may be an independent risk factor for offspring externalizing symptoms, regardless of maternal mental health and offspring internalizing.
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Affiliation(s)
- Nathalie MacKinnon
- School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Mila Kingsbury
- School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Liam Mahedy
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jonathan Evans
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Ian Colman
- School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Neuroepigenetics of Prenatal Psychological Stress. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2018; 158:83-104. [DOI: 10.1016/bs.pmbts.2018.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Angelotta C, Wisner KL. Treating Depression during Pregnancy: Are We Asking the Right Questions? Birth Defects Res 2017; 109:879-887. [DOI: 10.1002/bdr2.1074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/13/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Cara Angelotta
- Northwestern University; Feinberg School of Medicine, Department of Psychiatry
| | - Katherine L. Wisner
- Northwestern University; Feinberg School of Medicine, Department of Psychiatry
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Mikkonen J, Moustgaard H, Remes H, Martikainen P. Intergenerational transmission of depressive symptoms - The role of gender, socioeconomic circumstances, and the accumulation of parental symptoms. J Affect Disord 2016; 204:74-82. [PMID: 27341423 DOI: 10.1016/j.jad.2016.06.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/12/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The relationship between parental and offspring depression is well established. Evidence regarding the significance of gender, socioeconomic circumstances, and the accumulation of parental symptoms in intergenerational transmission is, however, mixed and scarce. METHODS Using a 20% random sample of Finns born between 1986 and 1996 (n=138,559), we performed a Cox proportional hazards regression to analyze the incidence of depressive symptoms between ages 15-20 by exposure to maternal and paternal depressive symptoms earlier in life. Depressive symptoms were inferred from antidepressant purchases and/or a diagnosis of depression at outpatient or inpatient health services. RESULTS Exposure to maternal depressive symptoms posed an equal risk for girls and boys (hazard ratio, HR, 2.09 vs. 2.28 respectively, p=0.077), whereas the effect of paternal depressive symptoms was weaker for girls (HR 1.77 vs. 2.22, p<0.001). Parental socioeconomic status neither confounded nor moderated these effects. Dual exposure to both maternal and paternal depressive symptoms posed a larger risk than single exposure, and children exposed recurrently at ages 0-5 and 9-14 faced an elevated risk compared with those exposed at only one period. LIMITATIONS Since depressive symptoms were inferred from prescription purchases and treatment records, we were unable to observe untreated depression or to determine the underlying condition the antidepressants were prescribed for. CONCLUSIONS Our results support the idea that maternal depression affects both genders equally, whereas paternal depression affects girls less than boys. We show that parental depression and low socioeconomic status are mainly independent risk factors of adolescent depressive symptoms and do not cause an interactive effect.
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Affiliation(s)
- Janne Mikkonen
- Population Research Unit, Department of Social Research, University of Helsinki, Finland.
| | - Heta Moustgaard
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
| | - Hanna Remes
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Finland; Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Sweden; The Max Planck Institute for Demographic Research, Germany
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Thyroid peroxidase autoantibodies and perinatal depression risk: A systematic review. J Affect Disord 2016; 198:108-21. [PMID: 27011366 DOI: 10.1016/j.jad.2016.03.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/15/2016] [Accepted: 03/07/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND While thyroid autoantibodies have been linked to depression in general population samples, it is unclear if the immunological milieu of pregnancy alters this association. As a result, we systematically reviewed the literature to determine if abnormal levels of autoantibodies that target thyroperoxidase (TPO-AB) during the perinatal period are associated with an increased risk of antenatal and postnatal depression. METHODS MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched through February 2016. Primary studies that examined TPO-AB titers during pregnancy or the postpartum period, and antenatal or postnatal depression were eligible. The quality of each study was assessed using the Newcastle-Ottawa Scale. RESULTS Among the eleven articles selected for synthesis, three of these examined associations between TPO-AB and depression both during pregnancy and in the postpartum period. Three of five studies reported statistically significant associations between elevated TPO-AB titers (TPO-AB+) and concurrent depression at 12-25 weeks gestation. Four of five studies found significant associations between TPO-AB+ status at 12-25 weeks gestation and depression in the postpartum period. Two of four studies found links between postpartum TPO-AB and depression concurrently in the puerperium. LIMITATIONS Lack of adjustment for confounding variables limits causal inference and conclusions about the predictive power of TPO-AB. CONCLUSIONS Studies suggest that TPO-AB+ in early to mid-pregnancy is associated with concurrent depression and may be predictive of depression in the postpartum period. Future studies with improved methodology are required to better understand the full pathophysiological implications and predictive utility of TPO-AB in perinatal depression.
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Child mental health and maternal depression history in Pakistan. Soc Psychiatry Psychiatr Epidemiol 2016; 51:49-62. [PMID: 26561398 PMCID: PMC6658413 DOI: 10.1007/s00127-015-1143-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/13/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE We address the significant gaps in knowledge of prevalence and correlates of child mental health (CMH) problems outside of high income countries. We describe the prevalence of CMH problems and their correlates with a focus on the association with maternal depression in a sample of seven-year-old children in rural Pakistan. METHODS This study was nested in a long-term follow-up of a perinatal depression intervention together with a reference group of non-depressed women, yielding a population representative sample. The Total Difficulties (TD) and component scores of the Strength and Difficulties Questionnaire (SDQ) were used to measure emotional and behavioral difficulties. RESULTS The mean SDQ TD score was 10.6 (standard deviation = 8.3), with 12.5 % of children categorized as "abnormal" using standard cutoffs. Boys had a roughly 1 point higher (worse) SDQ TD score than girls (p value = 0.04). Children of mothers who were depressed prenatally as well as currently had SDQ TD scores 2.87 points higher than children whose mothers were not depressed at either time point (p value < 0.01). This association was stronger for boys. There was no evidence of elevated SDQ TD score among children whose mothers were depressed only prenatally or only currently. Some deviations from this pattern were observed with specific components of the SDQ. CONCLUSIONS In this low resource, South Asian setting, we found evidence of elevated levels of emotional and behavioral problems, highlighting the need for effective interventions. Given the strong association of CMH with maternal depression, any intervention efforts should give strong consideration to maternal mental health.
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Kaasbøll J, Ranøyen I, Nilsen W, Lydersen S, Indredavik MS. Associations between parental chronic pain and self-esteem, social competence, and family cohesion in adolescent girls and boys--family linkage data from the HUNT study. BMC Public Health 2015; 15:817. [PMID: 26296339 PMCID: PMC4546097 DOI: 10.1186/s12889-015-2164-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 08/17/2015] [Indexed: 01/22/2023] Open
Abstract
Background Parental chronic pain has been associated with adverse outcomes in offspring. However, knowledge on individual and family resilience factors in adolescent offspring of chronic pain sufferers is scarce. This study thus aimed to investigate the associations between parental chronic pain and self-esteem, social competence, and family cohesion levels reported by adolescent girls and boys. Methods Based on cross-sectional surveys from the Nord Trøndelag Health Study (the HUNT 3 study), the study used independent self-reports from adolescents aged 13 to 18 years (n = 3227) and their parents and conducted separate linear regression analyses for girls and boys. Results Concurrent maternal and paternal chronic pain was associated with reduced self-esteem, social competence, and family cohesion in girls. Moreover, maternal chronic pain was associated with higher social competence in boys and reduced self-esteem in girls. The majority of the observed associations were significantly different between girls and boys. Paternal chronic pain was not found to be associated with child outcomes. Conclusions The findings indicate that the presence of both maternal and paternal chronic pain could be a potential risk factor for lower levels of individual and family resilience factors reported by girls. Further research on the relationship between parental pain and sex-specific offspring characteristics, including positive resilience factors, is warranted. The study demonstrates the importance of targeting the entire family in chronic pain care.
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Affiliation(s)
- Jannike Kaasbøll
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) of Central Norway, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, Medisinsk teknisk forskningssenter (MTFS), N-7491, Trondheim, Norway.
| | - Ingunn Ranøyen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) of Central Norway, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, Medisinsk teknisk forskningssenter (MTFS), N-7491, Trondheim, Norway.
| | - Wendy Nilsen
- Department of Child Development and Mental Health, Division of Mental Health, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) of Central Norway, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, Medisinsk teknisk forskningssenter (MTFS), N-7491, Trondheim, Norway.
| | - Marit S Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) of Central Norway, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postbox 8905, Medisinsk teknisk forskningssenter (MTFS), N-7491, Trondheim, Norway. .,Department of Child and Adolescent Psychiatry, St. Olav's Hospital, Trondheim University Hospital, Postbox 6810, Elgeseter, N-7433, Trondheim, Norway.
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van der Waerden J, Galéra C, Larroque B, Saurel-Cubizolles MJ, Sutter-Dallay AL, Melchior M. Maternal Depression Trajectories and Children's Behavior at Age 5 Years. J Pediatr 2015; 166:1440-8.e1. [PMID: 25866387 DOI: 10.1016/j.jpeds.2015.03.002] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/12/2015] [Accepted: 03/02/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the relationship between trajectories of maternal depression from pregnancy to the child's age of 5 years and children's emotional and behavioral difficulties at age 5 years. STUDY DESIGN Mother-child pairs (n = 1183) from the EDEN mother-child birth cohort study based in France were followed from 24 to 28 weeks of pregnancy to the child's fifth birthday. Children's behavior at age 5 years was assessed with the Strengths and Difficulties Questionnaire. Maternal depression was assessed repeatedly with the Center for Epidemiological Studies Depression questionnaire (pregnancy, 3, and 5 years of age) and the Edinburgh Postnatal Depression Scale (4, 8, and 12 months postpartum). Homogeneous latent trajectory groups of maternal depression were identified within the study population and correlated with Strengths and Difficulties Questionnaire scores by the use of multivariate linear regression analyzes. RESULTS Five trajectories of maternal symptoms of depression were identified: no symptoms (62.0%); persistent intermediate-level depressive symptoms (25.3%); persistent high depressive symptoms (4.6%); high symptoms in pregnancy only (3.6%); and high symptoms in the child's preschool period only (4.6%). Children whose mothers had persistent depressive symptoms--either intermediate or high--had the greatest levels of emotional and behavioral difficulties at age 5 years. In addition, compared with children whose mothers were never depressed, those whose mothers had high symptoms in the preschool period also had increased levels of emotional symptoms, conduct problems, and peer problems. CONCLUSIONS Maternal depression symptoms are related to children's emotional and behavioral problems, particularly if they are persistent (29.9%) or occur during early childhood (4.6%).
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Affiliation(s)
- Judith van der Waerden
- Department of Social Epidemiology, INSERM UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; Sorbonne Universités, UPMC University of Paris 06, Paris, France.
| | - Cédric Galéra
- Department of Child and Adolescent Psychiatry, Charles Perrens Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France; INSERM U897, Center for Research in Epidemiology and Biostatistics, Prévention et Prise en Charge des Traumatismes, Bordeaux, France
| | - Béatrice Larroque
- Sorbonne Universités, UPMC University of Paris 06, Paris, France; INSERM, UMR_S 953, Epidemiological Research on Perinatal Health and Women's and Children's Health, Villejuif, France
| | - Marie-Josèphe Saurel-Cubizolles
- Sorbonne Universités, UPMC University of Paris 06, Paris, France; INSERM, UMR_S 953, Epidemiological Research on Perinatal Health and Women's and Children's Health, Villejuif, France
| | - Anne-Laure Sutter-Dallay
- Bordeaux University, Bordeaux, France; INSERM U657, Bordeaux, France; University Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- Department of Social Epidemiology, INSERM UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France; Sorbonne Universités, UPMC University of Paris 06, Paris, France
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Luoma I, Korhonen M, Salmelin RK, Helminen M, Tamminen T. Long-term trajectories of maternal depressive symptoms and their antenatal predictors. J Affect Disord 2015; 170:30-8. [PMID: 25218734 DOI: 10.1016/j.jad.2014.08.017] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 08/04/2014] [Accepted: 08/11/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depressive symptoms, often long-term or recurrent, are common among mothers of young children and a well-known risk for child well-being. We aimed to explore the antecedents of the long-term trajectories of maternal depressive symptoms and to define the antenatal factors predicting the high-symptom trajectories. METHODS The sample comprised 329 mothers from maternity centers. Maternal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) antenatally and at two months, six months, 4-5 years, 8-9 years and 16-17 years after delivery. Maternal expectations concerning the baby were assessed with the Neonatal Perception Inventory (NPI). Background information was gathered with questionnaires. RESULTS A model including four symptom trajectories (very low, low-stable, high-stable and intermittent) was selected to describe the symptom patterns over time. The high-stable and the intermittent trajectory were both predicted pairwise by a high antenatal EPDS sum score as well as high EPDS anxiety and depression subscores but the other predictors were specific for each trajectory. In multivariate analyses, the high-stable trajectory was predicted by a high antenatal EPDS sum score, a high EPDS anxiety subscore, diminished life satisfaction, loneliness and more negative expectations of babies on average. The intermittent trajectory was predicted by a high antenatal EPDS sum score, a poor relationship with own mother and urgent desire to conceive. LIMITATIONS Only self-report questionnaires were used. The sample size was rather small. CONCLUSIONS The results suggest a heterogeneous course and background of maternal depressive symptoms. This should be considered in intervention planning.
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Affiliation(s)
- Ilona Luoma
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland.
| | - Marie Korhonen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland
| | - Raili K Salmelin
- Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland; University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland
| | - Mika Helminen
- University of Tampere, School of Health Sciences, University of Tampere, FI-33014, Finland; Pirkanmaa Hospital District, Science Center, PO Box 2000, FI-33521 Tampere, Finland
| | - Tuula Tamminen
- University of Tampere, School of Medicine, University of Tampere, FI-33014, Finland; Tampere University Hospital, Department of Child Psychiatry, PO Box 2000, FI-33521 Tampere, Finland
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Prenatal maternal depression is associated with low birth weight through shorter gestational age in term infants in Korea. Early Hum Dev 2014; 90:15-20. [PMID: 24331828 PMCID: PMC5365071 DOI: 10.1016/j.earlhumdev.2013.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Maternal prenatal depression is associated with lower offspring birth weight, yet the impact of gestational age on this association remains inadequately understood. AIMS We aimed to investigate the effect of prenatal depression on low birth weight, gestational age, and weight for gestational age at term. STUDY DESIGN Prospective cohort study. SUBJECT Data were collected from 691 women in their third trimester of pregnancy who went on to give birth to a singleton at term without perinatal complications. One hundred and fifty-two women had a Center for Epidemiologic Studies Depression Scale-10 score ≥10 and were classed as prenatally depressed. OUTCOME MEASURES Low birth weight (<2500g), gestational age at birth, and birth weight percentile for gestational age. RESULTS Offspring of prenatally depressed women were more likely to be low birth weight (Odds ratio [OR] 2.94, 95% confidence interval [CI] 1.14-7.58) than offspring of prenatally non-depressed women, but the association was attenuated (OR 1.66, 95% CI 0.55-5.02) when adjusted for gestational age. Offspring of prenatally depressed women had lower gestational age in weeks (OR for one week increase in gestational age: 0.66, 95% CI 0.47-0.93) than offspring of prenatally non-depressed women. There was no association between prenatal depression and birth weight percentile for gestational age. CONCLUSIONS Prenatal depression was not associated with low birth weight at term, but was associated with gestational age, suggesting that association between maternal depression and birth weight may be a reflection of the impact of depression on offspring gestational age.
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