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Frost A, Hagaman A, Bibi A, Bhalotra S, Chung EO, Haight SC, Sikander S, Maselko J. Childhood parental bonding and depression in adulthood: A study of mothers in rural Pakistan. J Affect Disord 2024; 356:715-721. [PMID: 38663557 DOI: 10.1016/j.jad.2024.04.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Parent-child relationship quality can have long-term impacts on child mental health into adulthood. The impact of parental behaviors on the future mental health of children has been understudied in South Asia, where parenting approaches differ from the dominant western approaches often represented in the literature. METHODS Mothers in rural Pakistan (N = 828) reported on their own mothers' parenting behaviors using the Parental Bonding Instrument (PBI) and were assessed for depression using the Structured Clinical Interview for DSM Disorders (SCID). The PBI includes scales for warmth (care scale) and over-control (protection scale), as well as subscales for behavioral control and psychological control. We used structural equation modeling to test the associations between depression and all PBI scales/subscales. RESULTS Increased parental care was associated with lower probability of depression (B = -0.19, SE = 0.09). Parental protection was associated with higher probability of depression (B = 0.25, SE = 0.11). Among the protection subscales, behavioral control was associated with increased risk of depression (B = 0.24, 95 % SE = 0.11) and psychological control was associated with decreased risk of depression (B = -0.28, SE = 0.12). LIMITATIONS This cross-sectional study used retrospective self-reports of parenting experiences. Participants only reported on their mothers, not fathers or other caregivers. CONCLUSIONS In a rural Pakistani sample, maternal warmth was protective against adulthood depression. The association between maternal control and depression varied based on the type of control (behavioral or psychological), emphasizing the importance of nuanced measures of parental control in this context.
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Affiliation(s)
- Allison Frost
- Carolina Population Center, University of North Carolina, Chapel Hill, United States of America.
| | - Ashley Hagaman
- Social Behavioral Sciences, Yale School of Public Health, Yale University, United States of America
| | - Amina Bibi
- Human Development Research Foundation, Islamabad, Pakistan
| | | | - Esther O Chung
- Carolina Population Center, University of North Carolina, Chapel Hill, United States of America; Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, United States of America
| | - Sarah C Haight
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, United States of America
| | - Siham Sikander
- Pakistan Institute of Living and Learning, Karachi, Pakistan; Department of Primary Care & Mental Health, University of Liverpool, UK
| | - Joanna Maselko
- Carolina Population Center, University of North Carolina, Chapel Hill, United States of America; Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, United States of America
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Gates K, Chahin S, Damashek A, Dickson C, Lubwama G, Lenz D, Bautista T, Kothari C. The Relation of Maternal Psychosocial Risk Factors to Infant Safe Sleep Practices. Matern Child Health J 2024; 28:1061-1071. [PMID: 38460074 DOI: 10.1007/s10995-023-03880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVES Sleep-related infant deaths are a common and preventable cause of infant mortality in the United States. Moreover, infants of color are at a greater risk of sleep-related deaths than are White infants. The American Academy of Pediatrics (AAP) published safe sleep guidelines to minimize the number of sleep-related infant deaths; however, many families face barriers to following these guidelines. Research on the role of psychosocial risk factors (i.e., depression, stress, domestic violence, substance use) in mothers' engagement in safe sleep practices is limited. The present study examined the role of maternal psychosocial risk factors on maternal safe sleep practices and the moderating effects of maternal race on this relationship. METHODS Participants in this study were mothers (N = 274) who were recruited from a Midwestern hospital postpartum. Data on the participants' psychosocial risk factors, and safe sleep practices were collected via telephone interview 2-4 months following the birth of their infant. RESULTS Predictive models indicated that depression and stress impacted mothers' engagement in following the safe sleep guidelines. Specifically, higher levels of maternal depression predicted greater likelihood of co-sleeping, regardless of mothers' race. Higher levels of maternal stress also predicted lower engagement in safe sleep behaviors for White mothers only. CONCLUSION FOR PRACTICE Early interventions to address stress and depression may help to increase maternal adherence to the AAP's safe sleep guidelines. Additional research on the underlying mechanisms of depression and stress on maternal safe sleep engagement is needed.
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Affiliation(s)
- Kalani Gates
- Department of Psychology, Western Michigan University, 1903 W. Michigan, Kalamazoo, MI, 49008, USA
| | - Summer Chahin
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA
| | - Amy Damashek
- Department of Psychology, Western Michigan University, 1903 W. Michigan, Kalamazoo, MI, 49008, USA.
| | - Cheryl Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA
| | - Grace Lubwama
- Kalamazoo Community Foundation, 402 E. Michigan, Kalamazoo, MI, 49007, USA
| | - Debra Lenz
- Kalamazoo County Health and Community Services Department, 311 E. Alcott St., Kalamazoo, MI, 49006, USA
| | | | - Catherine Kothari
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Dr., Kalamazoo, MI, 49008, USA
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Fu X, Bolton SH, Morningstar M, Mattson WI, Feng X, Nelson EE. Young Children of Mothers with a History of Depression Show Attention Bias to Sad Faces: An Eye-tracking Study. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01205-w. [PMID: 38713348 DOI: 10.1007/s10802-024-01205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/08/2024]
Abstract
Maternal depression is a predictor of the emergence of depression in the offspring. Attention bias (AB) to negative emotional stimuli in children may serve as a risk factor for children of depressed parents. The present study aimed to examine the effect of maternal major depressive disorder (MDD) history on AB to emotional faces in children at age four, before the age of onset for full-blown psychiatric symptoms. The study also compared AB patterns between mothers and their offspring. Fifty-eight mothers and their four-year-old children participated in this study, of which 27 high-risk (HR) children had mothers with MDD during their children's lifetime. Attention to emotional faces was measured in both children and their mothers using an eye-tracking visual search task. HR children exhibited faster detection and longer dwell time toward the sad than happy target faces. The low-risk (LR) children also displayed a sad bias but to a lesser degree. Children across both groups showed AB towards angry target faces, likely reflecting a normative AB pattern. Our findings indicate that AB to sad faces may serve as an early marker of depression risk. However, we provided limited support for the mother-child association of AB. Future research is needed to examine the longitudinal intergenerational transmission of AB related to depression and possible mechanisms underlying the emergence of AB in offspring of depressed parents.
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Affiliation(s)
- Xiaoxue Fu
- Department of Psychology, University of South Carolina, 29201, Columbia, SC, USA.
| | - Scout H Bolton
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | | | - Whitney I Mattson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Xin Feng
- Department of Human and Family Sciences, Ohio State University, Columbus, OH, USA
| | - Eric E Nelson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, Ohio State University, Columbus, OH, USA
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Shrestha D, K C Bhandari A, Ogawa K, Tanaka H, Miyayama C, Horikawa R, Urayama KY, Morisaki N. Effect of postpartum depression and role of infant feeding practices on relative weight of child at 1 and 3 years of age. BMC Pregnancy Childbirth 2024; 24:336. [PMID: 38698333 PMCID: PMC11067203 DOI: 10.1186/s12884-024-06483-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Childhood obesity has increased and is considered one of the most serious public health challenges of the 21st century globally, and may be exacerbated by postpartum depression (PPD). The purpose of this study was to examine the association between PPD at 1st and 6th month postpartum, infant feeding practices, and body mass index (BMI) z-score of the child at one and three years of age. METHODS This study used data from an ongoing prospective maternal-child birth cohort performed at the National Center for Child Health and Development (NCCHD) in suburban Tokyo, Japan with the period of recruitment from May 13, 2010 to November 28, 2013. Out of 2,309 total number of mothers, 1,279 mother-child dyads were assessed in the study. We performed multivariable linear regression analysis to examine the association between PPD and child's BMI z-score stratified by the child's age at 1 year and 3 years of age. RESULTS The prevalence of PPD at 1 month postpartum (17%) was found to be higher than at 6 months (12%). In multivariable linear regression analysis we observed that children at 3 years who had mothers with PPD at 6 months had, on average, a BMI z-score 0.25 higher than children of mothers who did not have PPD at 6 months (ß coefficient 0.25, 95% CI [0.04 to 0.46], p value 0.02), holding all other covariates constant. Also, initiation of weaning food when child is at six months of age was associated with higher BMI z-score of the child at 3 years after adjusting for all covariates (ß coefficient = 0.18, 95% CI [0.03 to 0.34], p-value < 0.05). CONCLUSION The significant association between PPD at 6 months and child's BMI z-score at 3 years of age, in conjunction with birth trends and high prevalence of PPD, can add to the body of evidence that there is need for multiple assessment across the first postpartum year to rule out PPD as early screening and early interventions may benefit both maternal health and child development outcomes. These findings can indicate the need for establishing support systems for care-giving activities for mothers with PPD.
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Affiliation(s)
- Drishti Shrestha
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
| | - Aliza K C Bhandari
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kohei Ogawa
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Hisako Tanaka
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Chiharu Miyayama
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Kevin Y Urayama
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.
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Obikane E, Yamana H, Ono S, Yasunaga H, Kawakami N. "Association between perinatal mood disorders of parents and child health outcomes". Arch Womens Ment Health 2024:10.1007/s00737-024-01463-z. [PMID: 38589683 DOI: 10.1007/s00737-024-01463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE Perinatal mood disorders affect both parents, impacting their children negatively. Little is known on the association between parental perinatal mood disorders and pediatric outcomes in Japan considering relevant covariates. Our objective was to investigate the association between paternal and maternal perinatal mood disorders and adverse physical and psychological child outcomes by the age of 36 months, adjusting for covariates such as the child's sex, age of parent at child's birth, perinatal mood disorders of the other parent, and perinatal antidepressant use. METHODS We identified parents in the JMDC Claims Database in Japan from 2012 to 2020. Perinatal mood disorders were defined using International Classification of Diseases, 10th codes for mood disorders during the perinatal period combined with psychiatric treatment codes. We evaluated the association between parental perinatal mood disorders and pediatric adverse outcomes by the age of 36 months using Cox proportional hazard models adjusted for the covariates. RESULTS Of the 116,423 father-mother-child triads, 2.8% of fathers and 2.3% of mothers had perinatal mood disorders. Paternal perinatal mood disorders were not significantly associated with adverse child outcomes. After adjusting for paternal perinatal mood disorders and antidepressant use, maternal perinatal mood disorders were associated with delayed motor development, language development disorders, autism spectrum disorders, and behavioral and emotional disorders (adjusted hazard ratio [95% confidence interval]: 1.65 [1.01-2.69], 2.26 [1.36-3.75], 4.16 [2.64-6.55], and 6.12 [1.35-27.81], respectively). CONCLUSIONS Paternal perinatal mood disorders were not associated with adverse child outcomes in this population. Maternal perinatal mood disorders were associated with multiple child outcomes.
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Affiliation(s)
- Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan.
- Department of Social Medicine, National Center for Child Health and Development, Setagaya, Japan.
| | - Hayato Yamana
- Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
- Data Science Center, Jichi Medical University, Shimotsuke, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo, Japan
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Benny C, Pietrosanu M, Lowe SAJ, Yamamoto SS, Kong L, McDonald S, Pabayo R. An investigation into the relationship between community engagement and maternal mental health in Calgary, Alberta using the All Our Families cohort. Soc Psychiatry Psychiatr Epidemiol 2024; 59:695-704. [PMID: 37017657 DOI: 10.1007/s00127-023-02456-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/27/2023] [Indexed: 04/06/2023]
Abstract
INTRODUCTION Existing literature shows that increased community engagement is associated with decreased depressive symptoms. To our knowledge, no existing studies have investigated the relationship between community engagement and adverse mental health among mothers in a Canadian context, nor has this relationship been studied over time. The current study aims to address these gaps by modelling the association between community engagement and anxiety and depression longitudinally using a cohort of prenatal and postnatal mothers living in Calgary, Alberta. METHODS We used data from the All our Families (AOF) study, a prospective cohort study of expectant and new mothers in Calgary, Alberta from 2008 to 2017 across seven timepoints. We used three-level latent growth curves to model the relationship between individual-level community engagement and maternal depression and anxiety scores, while adjusting for both individual and neighborhood-level characteristics. RESULTS The study sample consisted of 2129 mothers across 174 neighborhoods in Calgary. Adjusted latent growth curve models demonstrated that community engagement was associated with lower depression (b = - 0.28, 95% CI - 0.33, - 0.23) and anxiety (b = - 0.07, 95% CI - 0.12, - 0.02) scores among mothers over time. DISCUSSION Adjusted results show that community engagement has a protective effect against depression and anxiety amongst mothers. The results of this study are in line with existing evidence suggesting that social cohesion, civic participation, and community engagement are protective against adverse mental health outcomes.
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Affiliation(s)
- Claire Benny
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Matthew Pietrosanu
- CAB 632, Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, T6G 2G1, Canada
| | - Samuel A J Lowe
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Shelby S Yamamoto
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Linglong Kong
- CAB 632, Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, T6G 2G1, Canada
| | - Sheila McDonald
- Child Development Centre 391, University of Calgary, 3820-24 Avenue NW, Calgary, AB, T2M 1Z7, Canada
| | - Roman Pabayo
- 3-300 Edmonton Clinic Health Academy, University of Alberta School of Public Health, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
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Granros M, Burkhouse KL, Feurer C. Relations Between Neighborhood Disadvantage and Electrocortical Reward Processing in Youth at High and Low Risk for Depression. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01180-2. [PMID: 38502404 DOI: 10.1007/s10802-024-01180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
Neighborhood-level disadvantage during childhood is a determinant of health that is hypothesized to confer risk for psychopathology via alterations in neuro-affective processing, including reward responsiveness. However, little research has examined the impact of socioeconomic disadvantage assessed at the community-level on reward processing, which may have important implications for targeted dissemination efforts. Furthermore, not all youth exposed to neighborhood disadvantage may exhibit alterations in reward reactivity, highlighting the need to consider factors that may exacerbate risk for blunted reward reactivity. The current study examined associations between geocoded indices of neighborhood disadvantage and electrocortical reward responsivity in youth and tested whether findings were moderated by maternal history of depression. The sample included 137 youth recruited for studies on the intergenerational transmission of depression. Neighborhood disadvantage was assessed using the Area Deprivation Index (ADI) while the reward positivity (RewP), an event-related potential, indexed reward response. Results revealed a significant interaction between ADI and maternal history of depression on youth RewP, such that greater neighborhood disadvantage was significantly associated with lower reward responsiveness, but only for youth with a maternal history of depression. Results were maintained controlling for youth internalizing symptoms and individual-level socioeconomic factors. Findings suggest that neighborhood disadvantage may impact youth neural reward processing, at least partially independently of individual risk factors, for youth with a maternal history of depression. If replicated, results suggest intervention efforts may be implemented at the community level to enhance reward responsiveness, specifically for youth living in low-resourced neighborhoods with a maternal history of depression.
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Affiliation(s)
- Maria Granros
- Department of Psychiatry, University of Illinois Chicago, Chicago, IL, USA.
| | - Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | - Cope Feurer
- Department of Psychiatry, University of Illinois Chicago, Chicago, IL, USA
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Koc D, El Marroun H, Stricker BH, Muetzel RL, Tiemeier H. Intrauterine Exposure to Antidepressants or Maternal Depressive Symptoms and Offspring Brain White Matter Trajectories From Late Childhood to Adolescence. Biol Psychiatry Cogn Neurosci Neuroimaging 2024; 9:217-226. [PMID: 37926188 DOI: 10.1016/j.bpsc.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND During pregnancy, both selective serotonin reuptake inhibitor (SSRI) exposure and maternal depression have been associated with poor offspring neurodevelopmental outcomes. In a population-based cohort, we investigated the association between intrauterine exposure to SSRIs and depressive symptoms and offspring white matter development from childhood to adolescence. METHODS Self-reported SSRI use was verified by pharmacy records. In midpregnancy, women reported on depressive symptoms using the Brief Symptom Inventory. Using diffusion tensor imaging, offspring white matter microstructure, including whole-brain and tract-specific fractional anisotropy (FA) and mean diffusivity, was measured at 3 assessments between ages 7 to 15 years. The participants were divided into 4 groups: prenatal SSRI exposure (n = 37 with 60 scans), prenatal depression exposure (n = 229 with 367 scans), SSRI use before pregnancy (n = 72 with 95 scans), and reference (n = 2640 with 4030 scans). RESULTS Intrauterine exposure to SSRIs and depressive symptoms were associated with lower FA in the whole-brain and the forceps minor at 7 years. Exposure to higher prenatal depressive symptom scores was associated with lower FA in the uncinate fasciculus, cingulum bundle, superior and inferior longitudinal fasciculi, and corticospinal tracts. From ages 7 to 15 years, children exposed to prenatal depressive symptoms showed a faster increase in FA in these white matter tracts. Prenatal SSRI exposure was not related to white matter microstructure growth over and above exposure to depressive symptoms. CONCLUSIONS These results suggest that prenatal exposure to maternal depressive symptoms was negatively associated with white matter microstructure in childhood, but these differences attenuated during development, suggesting catch-up growth.
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Affiliation(s)
- Dogukan Koc
- Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Science, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Santos CAD, Paula AP, Filho GGF, Alves MM, Nery AF, Pontes MGA, Macedo EYL, Oliveira RM, Freitas SM, Lima S, Varela FVC, Viana ALS, Silva ALP, Silva ÉGC, D'Souza-Li L. Developmental impairment in children exposed during pregnancy to maternal SARS-COV2: A Brazilian cohort study. Int J Infect Dis 2024; 139:146-152. [PMID: 38061413 DOI: 10.1016/j.ijid.2023.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/31/2023] Open
Abstract
OBJECTIVES To determine the effects of in-utero exposure to maternal SARS-CoV-2 infection on offspring's neurodevelopment during the first year of life. METHODS We performed a prospective cohort of babies exposed to SARS-CoV-2 during pregnancy, and a control group (CG) of unexposed babies in a low-income area in Brazil. Children's neurodevelopment was assessed using the guide for Monitoring Child Development in the Integrated Management of Childhood Illness context for both groups (at 1,2,3,4,5,6, 9, and 12 months), and the Ages & Stages Questionnaire (ASQ-3) for the exposed group (EG) (at 4, 6 and 12 months). RESULTS We followed 137 children for 1 year, 69 in the COVID-19-EG, and 68 in the CG. All mothers were unvaccinated at the time of cohort inclusion, and maternal demographics were similar in the two groups. 20.3% of EG children and 5.9% of the CG received a diagnosis of neurodevelopmental delay within 12 months of life (P = 0.013, relative risk = 3.44; 95% confidence interval, 1.19- 9.95). For the EG, the prevalence of neurodevelopment impairment using Ages & Stages Questionnaire was 35.7% at 4 months, 7% at 6 months, and 32.1% at 12 months. CONCLUSION SARS-CoV-2 exposure was associated with neurodevelopmental impairment, and specific guidelines are needed for the follow-up of these high-risk children to mitigate the long-term effects on children's health.
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Affiliation(s)
- Carolina A D Santos
- University of Campinas, UNICAMP, Faculty of Medical Science, Campinas, Brazil; Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil.
| | - Artemis P Paula
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Gentil G Fonseca Filho
- Federal University of Rio Grande do Norte, Natal, Brazil; Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Manoella M Alves
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil; Federal University of Rio Grande do Norte, Natal, Brazil
| | - Andréia F Nery
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - Monise G A Pontes
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Erianna Y L Macedo
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Ruy M Oliveira
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Sabrinna M Freitas
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Sarah Lima
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Fernanda V C Varela
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Andrezza L S Viana
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Aline L P Silva
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Érika G C Silva
- Santos Dumont Institute, Anita Garibaldi Center for Education and Research in Health, Macaíba, Brazil
| | - Lília D'Souza-Li
- University of Campinas, UNICAMP, Faculty of Medical Science, Department of Pediatrics, Campinas, Brazil
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Ritter C, Abdullahi SU, Gambo S, Murtala HA, Kabir H, Shamsu KA, Gwarzo G, Banaei Y, Acra SA, Stallings VA, Rodeghier M, DeBaun MR, Klein LJ. Impact of maternal depression on malnutrition treatment outcomes in older children with sickle cell anemia. BMC Nutr 2024; 10:18. [PMID: 38268013 PMCID: PMC10809526 DOI: 10.1186/s40795-024-00826-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Malnutrition and sickle cell anemia (SCA) result in high childhood mortality rates. Although maternal depression is an established risk factor for malnutrition in younger children, little is known about its impact on treatment response in children with malnutrition. We aimed to determine the relationship, if any, between maternal depression scores and malnutrition treatment outcomes in older children with SCA. METHODS We conducted a planned ancillary study to our randomized controlled feasibility trial for managing severe acute malnutrition in children aged 5-12 with SCA in northern Nigeria (NCT03634488). Mothers of participants completed a depression screen using the Patient Health Questionnaire (PHQ-9).We used a multivariable linear regression model to describe the relationship between the baseline maternal PHQ-9 score and the trial participant's final body mass index (BMI) z-score. RESULTS Out of 108 mother-child dyads, 101 with maternal baseline PHQ-9 scores were eligible for inclusion in this analysis. At baseline, 25.7% of mothers (26 of 101) screened positive for at least mild depression (PHQ-9 score of 5 or above). The baseline maternal PHQ-9 score was negatively associated with the child's BMI z-score after 12 weeks of malnutrition treatment (β=-0.045, p = 0.041). CONCLUSIONS Maternal depressive symptoms has an impact on malnutrition treatment outcomes. Treatment of malnutrition in older children with sickle cell anemia should include screening for maternal depression and, if indicated, appropriate maternal referral for depression evaluation and treatment. TRIAL REGISTRATION The trial was registered at clinicaltrials.gov (#NCT03634488) on January 30, 2018, https://clinicaltrials.gov/study/NCT03634488 .
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Affiliation(s)
| | - Shehu U Abdullahi
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Safiya Gambo
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Hassan Adam Murtala
- Department of Pediatrics, Murtala Mohammed Specialist Hospital, Kano, Nigeria
| | - Halima Kabir
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Khadija A Shamsu
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Garba Gwarzo
- Department of Pediatrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Sari A Acra
- Department of Pediatrics, D. Brent Polk Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Virginia A Stallings
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | | | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Institute for Global Health, Nashville, TN, USA
| | - Lauren J Klein
- Department of Pediatrics, D. Brent Polk Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
- Vanderbilt Institute for Global Health, Nashville, TN, USA.
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Vanwoerden S, Silk JS, Forbes EE, Morgan JK. Current maternal depression associated with worsened children's social outcomes during middle childhood: Exploring the role of positive affect socialization. J Affect Disord 2024; 345:59-69. [PMID: 37865344 PMCID: PMC10872725 DOI: 10.1016/j.jad.2023.10.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/28/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Maternal depression negatively predicts aspects of the mother-child relationship and social functioning in offspring. This study evaluated interrelations between mothers' depression history and current severity with dynamic indices of positive affect socialization and indices of offspring' social outcomes. METHODS N = 66 mother-child dyads in which approximately 50 % of mothers had a history of maternal depression were recruited. Children were 6-8 years old and 47.7 % male. Dyads completed a positive interaction task, which was coded for mother and child positive affect. Mothers and children reported on peer functioning and social problems and children reported on the quality of their best friendships at 1-year follow-up. RESULTS Current level of maternal depression, but not depression history, was related to more social problems and lower best friend relationship quality. Indices of positive affect socialization were not related to history or current levels of maternal depression, or social outcomes, with the exception of maternal depression history predicting greater likelihood of mothers joining their children in expressing positive affect. Exploratory, supplementary analysis revealed that this may be due to treatment history among these mothers. LIMITATIONS Conclusions should be tempered by the small sample size, which limited the types of analyses that were conducted. CONCLUSION Results suggest that the effect of maternal depression on aspects of child social outcomes could be specific to current levels. Our data also did not support previously found associations between maternal depression and positive affect socialization. Results suggest positive implications for the effect of treatment for maternal depression for mother-child dynamics.
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Affiliation(s)
- Salome Vanwoerden
- University of Pittsburgh, Department of Psychiatry, United States of America.
| | - Jennifer S Silk
- University of Pittsburgh, Department of Psychology, United States of America
| | - Erika E Forbes
- University of Pittsburgh, Department of Psychiatry, United States of America
| | - Judith K Morgan
- University of Pittsburgh, Department of Psychiatry, United States of America
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12
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Bowman S, Morris TT, Dickson M, Rice F, Howe LD, Hughes AM. Maternal depressive symptoms and young people's higher education participation and choice of university: Evidence from a longitudinal cohort study. J Affect Disord 2024; 344:339-346. [PMID: 37848086 DOI: 10.1016/j.jad.2023.10.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Participation in higher education has significant and long-lasting consequences for people's socioeconomic trajectories. Maternal depression is linked to poorer educational achievement for children in school, but its impact on university attendance is unclear. METHODS In an English longitudinal cohort study (N = 8952), we explore whether young people whose mothers experienced elevated depressive symptoms are less likely to attend university, and the role of potential mediators in the young person: educational achievement in school, depressive symptoms, and locus of control. We also examine whether maternal depressive symptoms influence young people's choice of university, and non-attendees' reasons for not participating in higher education. RESULTS Young people whose mothers experienced more recurrent depressive symptoms were less likely to attend university (OR = 0.88, CI = 0.82,0.94, p < 0.001) per occasion of elevated maternal depressive symptoms) after adjusting for confounders. Mediation analysis indicated this was largely explained by educational achievement in school (e.g., 82.7 % mediated by age 16 achievement) and locus of control at 16. There was mixed evidence for an impact on choice of university. For participants who did not study at university, maternal depressive symptoms were linked to stating as a reason having had other priorities to do with family or children (OR: 1.17, CI = 1.02,1.35). LIMITATIONS Lack of data on the other parent's depression, loss to follow-up, possibly selective non-response. CONCLUSIONS Young people whose mothers experience elevated depressive symptoms on multiple occasions are less likely to participate in higher education; educational achievement in secondary school, but not the young people's own depressive symptoms, substantially mediated the effect.
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Affiliation(s)
- Sally Bowman
- Avon & Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Tim T Morris
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Matt Dickson
- Institute for Policy Research, University of Bath, Bristol, UK
| | - Frances Rice
- Wolfson Centre for Young People's Mental Health, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Bristol, UK
| | - Laura D Howe
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Amanda M Hughes
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
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Pinheiro GSMA, Lemos SMA, Martins IDA, Januário GC, Cintra ML, Farias AVSR, Oliveira RMDS, Januário JN, Azevedo VMGDO, Bentes AA, Alves CRL. Effects of SARS-CoV-2 gestational exposure and risk factors on neurodevelopment until 12 months: A prospective cohort study in Brazil. Early Hum Dev 2024; 188:105918. [PMID: 38104363 DOI: 10.1016/j.earlhumdev.2023.105918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The effects of SARS-CoV-2 gestational exposure on child development remain inconclusive. AIMS To analyze the effects of SARS-CoV-2 gestational exposure on neurodevelopment until 12 months. STUDY DESIGN Prospective cohort study conducted in five municipalities in Southeast Brazil from August 2021 to September 2022. SUBJECTS Infants were recruited from a serological survey performed during neonatal screening and followed up to 12 months old. We included 224 infants exposed to SARS-CoV-2 during pregnancy and 225 non-exposed, according to the serology results of the newborn as well as their mothers and the maternal antenatal RT-PCR results. OUTCOME MEASURES Developmental assessments were performed at 6 and 12 months using the Survey of Wellbeing of Young Children-Brazilian Version (SWYC-BR). Children with suspected developmental delay (SDD) at 6 and 12 months were considered at high risk for developmental delay (HRDD). Additionally, risk factors associated with SDD were examined. RESULTS There were 111 children identified with SDD and 52 with HRDD. SARS-CoV-2 gestational exposure was not associated with SDD. Exposure in the first gestational trimester increased SDD risk by 2.15 times compared to the third. Cesarean delivery predicted SDD (OR 1.56; 95%CI 1.01-2.42) and HRDD (OR 1.91; 95%CI 1.04-3.48). Additionally, suspected maternal depression predicted SDD (OR 1.76; 95%CI 1.01-3.10). CONCLUSION SARS-CoV-2 gestational exposure did not increase the developmental delay risk. However, our findings suggest that the earlier the gestational exposure, the greater the developmental delay risk at 12 months. Cesarean delivery and suspected maternal depression increased the developmental delay risk, independent of virus exposure.
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Affiliation(s)
| | - Stela Maris Aguiar Lemos
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | - Isadora de Araújo Martins
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | - Gabriela Cintra Januário
- Secretaria de Estado de Saúde de Minas Gerais, Rodovia Papa João Paulo II, 4143. Cidade Administrativa - Serra Verde, Belo Horizonte, MG 31630-900, Brazil
| | - Mila Lemos Cintra
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | | | | | - José Nélio Januário
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
| | | | - Aline Almeida Bentes
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
| | - Claudia Regina Lindgren Alves
- Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil.
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Ghahyazi K, Familiar-Lopez I, Culbert O, Uruchima J, Van Engen A, Cevallos W, Eisenberg JNS, Levy K, Lee GO. Correlates of maternal depression, anxiety and functioning across an urban-rural gradient in northern Ecuador. Glob Public Health 2024; 19:2291697. [PMID: 38084739 PMCID: PMC10787496 DOI: 10.1080/17441692.2023.2291697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023]
Abstract
Maternal depression remains under characterised in many low- and middle-income countries, especially in rural settings. We aimed to describe maternal depression and anxiety symptoms in rural and urban communities in northern Ecuador and to identify socioeconomic and demographic factors associated with these symptoms. Data from 508 mothers participating in a longitudinal cohort study were included. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist (HSCL-25), and maternal psychological functioning was assessed using a checklist of daily activities. Tobit regression models were used to examine associations with sociodemographic variables and urbanicity. The median HSCL-25 score was 1.2 (IQR: 0.4) and 14% of women scored above the threshold for clinically relevant symptoms. Rural women reported similar food insecurity, less education, younger age of first pregnancy, and lower socio-economic status compared to their urban counterparts. After adjusting for these factors, rural women reported lower HSCL-25 scores compared to women lin urban areas (β = -0.48, 95%CI:0.65, -0.31). Rural residence was also associated with lower depression and anxiety HSCL-25 sub-scale scores, and similar levels of maternal functioning, compared to urban residence. Our results suggest that both household and community-level factors are risk factors for maternal depression and anxiety in this context.
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Affiliation(s)
- Kiana Ghahyazi
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | - Oriana Culbert
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey, USA
| | - Jessica Uruchima
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Amanda Van Engen
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - William Cevallos
- Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador
| | - Joseph N S Eisenberg
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington, USA
| | - Gwenyth O Lee
- Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey, USA
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15
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Kumpulainen V, Copeland A, Pulli EP, Silver E, Kataja EL, Saukko E, Merisaari H, Lewis JD, Karlsson L, Karlsson H, Tuulari JJ. Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner. Biol Psychiatry 2023; 94:924-935. [PMID: 37220833 DOI: 10.1016/j.biopsych.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth. METHODS WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy. RESULTS Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure. CONCLUSIONS These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.
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Affiliation(s)
- Venla Kumpulainen
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland.
| | - Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Elmo P Pulli
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva-Leena Kataja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Radiology, Turku University Hospital, Turku, Finland
| | - John D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland; Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland; Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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16
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Reesor-Oyer L, Marshall AN, Hernandez DC. Examination of co-parenting support and parenting stress as mediators of the food insecurity- maternal depression/anxiety relationship. J Affect Disord 2023; 341:96-103. [PMID: 37625705 DOI: 10.1016/j.jad.2023.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Identifying family environment factors related to food insecurity and maternal mental health could inform additional support for mothers who experience food insecurity. This study seeks to examine the mechanistic roles of co-parenting support and parenting stress on the food insecurity-maternal mental health relationship. METHODS Data from the Future of Families and Child Well-being Study, which recruited mothers post-delivery from 75 urban hospitals, was utilized. Analysis includes 1808 mothers followed for 15 years. Food insecurity was assessed at year 5, co-parenting support and parenting stress at year 9, and maternal depression and anxiety at year 15. Structural equation models evaluated the role of food insecurity on maternal depression (model 1) and anxiety (model 2) through co-parenting support and parenting stress simultaneously, adjusting for socio-demographics. RESULTS Co-parenting support did not mediate the relationships of food insecurity and maternal depression and anxiety, controlling for parenting stress. Controlling for co-parenting support, parenting stress did not mediate the food insecurity-maternal depression relationship, but partially mediated the food insecurity-maternal anxiety relationship (specific indirect: B = 0.026, CI:0.01, 0.05; specific direct: B = 0.131, CI:-0.04, 0.32). LIMITATIONS There was a significant period of time (10 years) between assessment of food insecurity and assessment of maternal mental health. Self-reported data on sensitive topics may be susceptible to bias. With observational research, it is possible that unobserved confounding variables impact the findings. CONCLUSIONS Cumulative support in the form of - parenting, economic (e.g., utilities), and food - may help reduce parenting stress and anxiety among mothers who experience food insecurity.
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Affiliation(s)
- Layton Reesor-Oyer
- Department of Health Education & Behavior, University of Florida, Gainesville, PO Box 118210, Gainesville, FL 32611-8210, USA.
| | - Allison N Marshall
- Cizik School of Nursing, University of Texas Health Science Center-Houston, 6901 Bertner Avenue, Houston, TX 77030, USA.
| | - Daphne C Hernandez
- Cizik School of Nursing, University of Texas Health Science Center-Houston, 6901 Bertner Avenue, Houston, TX 77030, USA.
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Hong L, Yang A, Liang Q, He Y, Wang Y, Tao S, Chen L. Wife-Mother Role Conflict at the Critical Child-Rearing Stage: A Machine-Learning Approach to Identify What and How Matters in Maternal Depression Symptoms in China. Prev Sci 2023:10.1007/s11121-023-01610-5. [PMID: 37897552 DOI: 10.1007/s11121-023-01610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
Maternal depression (MD) was one of the most prevalent psychiatric problems worldwide. However, it easily remains untreated and misses the best time to prevent the emergence or worsening of major depressive symptoms due to under-observed stigma and the lack of effective screening tools. Thus, this study aims to develop and validate a machine learning-based MD symptoms prediction model integrating more observable and objective factors to early detect and monitor MD risk. A cross-sectional study was conducted in 10 community vaccination centers in Wenzhou, China, and a total of 1099 mothers were surveyed by using purposive sampling. A questionnaire containing questions regarding socio-demographic variables, psychophysiological variables, wife role-related variables, and mother role-related variables was used to collect data. A framework of data preprocessing, feature selection, and model evaluation was implemented to develop an optimal risk prediction model. Results demonstrated that the XG-Boost algorithm provided robust performance with the highest AUC and well-balanced sensitivity and specificity (AUC = 0.90, sensitivity = 0.74, specificity = 0.90). Furthermore, the causal mediation analysis indicated that wife-mother role conflict positively predicted MD symptoms, and it also exerted influence on mothers suffering through the mediation of anxiety and insomnia. Findings from the present study may help guide the development of MD screening tools to early detect and provide the modifiable risk factor information for timely tailored prevention.
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Affiliation(s)
- Liuzhi Hong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Ai Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Qi Liang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yuhan He
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yulin Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Shuhan Tao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Li Chen
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, 325035, China.
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18
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Anns F, Waldie KE, Peterson ER, Walker C, Morton SMB, D'Souza S. Behavioural outcomes of children exposed to antidepressants and unmedicated depression during pregnancy. J Affect Disord 2023; 338:144-154. [PMID: 37295656 DOI: 10.1016/j.jad.2023.05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Antenatal exposure to both antidepressants and maternal depression has been associated with child behavioural difficulties. However, previous research has not adequately distinguished between the effects of the antidepressants and the underlying maternal depression. METHODS Child behavioural difficulties were assessed using the Strengths and Difficulties Questionnaire at 2-, 4.5-, and 8-years of age by mothers in the Growing Up in New Zealand study (N = 6233 at 2-years; N = 6066 at 4.5-years; N = 4632 at 8-years). Mothers were classified as either on antidepressants, unmedicated depression, or neither based on self-reported antidepressant intake during pregnancy and the Edinburgh Postnatal Depression Scale. Hierarchical multiple logistic regressions were used to examine whether antenatal exposure to antidepressants and unmedicated depression had a differential association with child behavioural outcomes relative to no exposure. RESULTS When later life depression in the mother and a range of birth and sociodemographic variables were accounted for, neither antenatal exposure to unmedicated depression or antidepressants remained associated with an increased risk of behavioural difficulties at the ages investigated. However, maternal later life depression was associated with behavioural difficulties in the fully adjusted analyses at all three ages investigated. LIMITATIONS The current study relied on mother-report of child behaviour which may be susceptible to bias due to maternal mental health problems. CONCLUSIONS Adjusted results did not show an adverse association between antenatal antidepressant exposure or unmedicated depression in relation to child behaviour. Findings also suggest that efforts to improve child behaviour need to include more family-based approaches that support maternal wellbeing.
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Affiliation(s)
- Francesca Anns
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Elizabeth R Peterson
- School of Psychology, The University of Auckland, Auckland, New Zealand; Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Caroline Walker
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand; School of Population Health, The University of Auckland, Auckland, New Zealand; INSIGHT, University of Technology Sydney, Sydney, Australia
| | - Stephanie D'Souza
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand; School of Social Sciences, The University of Auckland, Auckland, New Zealand.
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De Asis-Cruz J, Kim JH, Krishnamurthy D, Lopez C, Kapse K, Andescavage N, Vezina G, Limperopoulos C. Examining the relationship between fetal cortical thickness, gestational age, and maternal psychological distress. Dev Cogn Neurosci 2023; 63:101282. [PMID: 37515833 PMCID: PMC10407290 DOI: 10.1016/j.dcn.2023.101282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023] Open
Abstract
In utero exposure to maternal stress, anxiety, and depression has been associated with reduced cortical thickness (CT), and CT changes, in turn, to adverse neuropsychiatric outcomes. Here, we investigated global and regional (G/RCT) changes associated with fetal exposure to maternal psychological distress in 265 brain MRI studies from 177 healthy fetuses of low-risk pregnant women. GCT was measured from cortical gray matter (CGM) voxels; RCT was estimated from 82 cortical regions. GCT and RCT in 87% of regions strongly correlated with GA. Fetal exposure was most strongly associated with RCT in the parahippocampal region, ventromedial prefrontal cortex, and supramarginal gyrus suggesting that cortical alterations commonly associated with prenatal exposure could emerge in-utero. However, we note that while regional fetal brain involvement conformed to patterns observed in newborns and children exposed to prenatal maternal psychological distress, the reported associations did not survive multiple comparisons correction. This could be because the effects are more subtle in this early developmental window or because majority of the pregnant women in our study did not experience high levels of maternal distress. It is our hope that the current findings will spur future hypothesis-driven studies that include a full spectrum of maternal mental health scores.
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Affiliation(s)
| | - Jung-Hoon Kim
- Developing Brain Institute, Children's National, Washington, DC, USA
| | | | - Catherine Lopez
- Developing Brain Institute, Children's National, Washington, DC, USA
| | - Kushal Kapse
- Developing Brain Institute, Children's National, Washington, DC, USA
| | - Nickie Andescavage
- Developing Brain Institute, Children's National, Washington, DC, USA; Division of Neonatology, Children's National Medical Center, Washington, DC, USA
| | - Gilbert Vezina
- Division of Diagnostic Imaging and Radiology, Children's National, Washington, DC, USA
| | - Catherine Limperopoulos
- Developing Brain Institute, Children's National, Washington, DC, USA; Division of Diagnostic Imaging and Radiology, Children's National, Washington, DC, USA.
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20
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Maruyama JM, Valente JY, Tovo-Rodrigues L, Santos IS, Barros AJD, Munhoz TN, Barros FC, Murray J, Matijasevich A. Maternal depression trajectories in childhood, subsequent maltreatment, and adolescent emotion regulation and self-esteem: the 2004 Pelotas birth cohort. Eur Child Adolesc Psychiatry 2023; 32:1935-1945. [PMID: 35731302 PMCID: PMC9214189 DOI: 10.1007/s00787-022-02022-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
This study aimed to examine the impact of maternal depressive symptoms trajectories on 15-year-old adolescents' self-esteem and emotion regulation and test the mediating role of child maltreatment in this association. The 2004 Pelotas Birth Cohort is an ongoing cohort study originally comprised of 4231 live births in a southern Brazilian city. We examined a subsample of 1949 adolescents at age 15 years. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Trajectories of maternal depression from 3 months until the 11-year follow-up were calculated using a group-based modeling approach. Child maltreatment at age 11 years was measured using the parent-report version of the Parent-Child Conflict Tactics Scale. Adolescent outcomes at age 15 years were assessed by the self-report version of the Rosenberg Self-esteem Scale and the Emotion Regulation Index for Children and Adolescents. Path model analysis was conducted using a structural equation modeling framework in Mplus software. All maternal depression trajectories were negatively associated with offspring self-esteem and emotion regulation compared to the reference group (low depression trajectory). There was a significant indirect effect of maternal depression trajectories on emotion regulation mediated via child maltreatment. No evidence of moderation by sex was found for any pathway. The effects of maternal depression on adolescents' emotion regulation are partly mediated by child maltreatment at age 11.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil.
| | - Juliana Y Valente
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Pediatrics and Child Health, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Aluísio J D Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Tiago N Munhoz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Faculty of Psychology, Federal University of Pelotas, Pelotas, Brazil
| | - Fernando C Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de, Pelotas, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, Av. Dr. Arnaldo 455, 2nd Floor, São Paulo, SP, CEP 01246-903, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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21
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Dhaliwal SK, Dabelea D, Lee-Winn AE, Crume T, Wilkening G, Perng W. Maternal psychosocial stress during pregnancy and offspring neurobehavioral outcomes during early childhood in the Healthy Start Study. Ann Epidemiol 2023; 86:16-24.e3. [PMID: 37321280 DOI: 10.1016/j.annepidem.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/17/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE We evaluate singular and combined effects of prenatal maternal depression and stress on early childhood neurobehavioral outcomes among 536 mother-child pairs. METHODS First, we used multivariable linear regression to investigate associations of women's Edinburgh Postnatal Depression Scale (EPDS) score and Perceived Stress Scale (PSS) score, separately, with offspring Child Behavior Checklist score. Next, to assess the combined effect of EPDS and PSS, we dichotomized each score at the fourth versus first to third quartiles and created a four-level variable comprising combinations of high and low depression and stress. Across all models, we accounted for household chaos, hubbub, and order scale (CHAOS) score, an indicator of the household environment associated with offspring behavioral outcomes. RESULTS Each one-unit increment in maternal EPDS and PSS scores corresponded with 0.75 (95% CI: 0.53, 0.96) and 0.72 (95% CI: 0.48, 0.95) units higher offspring total problems T-score, respectively. Children of women with high EPDS and PSS had highest T-scores for total problems. All associations remained materially unchanged after adjustment for CHAOS score. CONCLUSIONS Prenatal maternal depression and stress is associated with worse neurobehavioral outcomes among offspring, with the most unfavorable outcomes among children whose mothers had high scores for both EPDS and PSS.
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Affiliation(s)
- Satvinder K Dhaliwal
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO.
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Pediatrics, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Angela E Lee-Winn
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Tessa Crume
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
| | - Greta Wilkening
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department or Neuropsychology, Colorado Children's Hospital, Aurora, CO
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO; Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO
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22
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Köhler-Dauner F, Dalhof Gulde M, Hart L, Ziegenhain U, Fegert JM. The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment. BMC Psychol 2023; 11:292. [PMID: 37759267 PMCID: PMC10523770 DOI: 10.1186/s40359-023-01327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period. OBJECTIVE It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic. METHOD Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used. RESULTS The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints. CONCLUSIONS Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.
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Affiliation(s)
- Franziska Köhler-Dauner
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany.
| | - Manuela Dalhof Gulde
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Lara Hart
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital of Ulm, Steinhövelstraße 5, 89075, Ulm, Germany
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23
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Penner-Goeke L, Belows M, Kristjanson A, Andrade BF, Cameron EE, Giuliano R, Katz LY, Kelly LE, Letourneau N, Mota N, Reynolds K, Zalewski M, Pharazyn A, Roos LE. Protocol for a randomized control trial of the Building Regulation in Dual Generations Program (BRIDGE): preventing the intergenerational transmission of mental illness in at-risk preschool children. Trials 2023; 24:597. [PMID: 37726821 PMCID: PMC10507827 DOI: 10.1186/s13063-023-07591-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/16/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic, the worldwide prevalence of maternal depression has risen sharply; it is now estimated that one quarter of mothers experience clinically significant depression symptoms. Exposure to maternal depression during early childhood increases the risk for the development of childhood mental illness (MI) in offspring, with altered parenting practices mediating the association between maternal depression and child outcomes. Dual-generation interventions, which aim to simultaneously treat parent and child mental health, show promise for improving outcomes for mothers with depression and their young children. The Building Regulation in Dual Generations (BRIDGE) program combines Dialectical Behavior Therapy (DBT) and parenting skills training to concurrently treat maternal depression and improve parenting practices. In pilot within-group studies, BRIDGE has led to large reductions in maternal depression and child MI symptoms. The aim of the current study is to evaluate the efficacy of BRIDGE in reducing maternal depression and child MI symptoms (primary outcomes) as well as parenting stress and harsh parenting (secondary outcomes). METHODS A three-armed randomized control trial with equal group sizes will be conducted to compare the efficacy of (1) BRIDGE (DBT + parenting skills), (2) DBT skills training, and (3) services-as-usual. Participants (n = 180) will be mothers of 3- to 5-year-old children who report elevated depression symptoms. Those randomized to BRIDGE or DBT skills training will complete a 16-week group therapy intervention. Assessments will be administered at pre-intervention(T1) post-intervention (T2), and 6-month follow-up (T3). DISCUSSION Dual-generation programs offer an innovative approach to prevent the intergenerational transmission of mental illness. The current study will add to the evidence base for BRIDGE by comparing it to a stand-alone mental health intervention and a services-as-usual group. These comparisons will provide valuable information on the relative efficacy of including parenting support in a mental health intervention for parents. The results will contribute to our understanding of how maternal depression affects children's development and how intervening at both a mental health and parenting level may affect child and family outcomes. TRIAL REGISTRATION Name of registry: Clinical Trials Protocol Registration and Results System; trial registration number: NCT05959538; date of registry: July 24, 2023; available: https://classic. CLINICALTRIALS gov/ct2/show/NCT05959538.
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Affiliation(s)
| | | | | | - Brendan F Andrade
- McCain Centre for Child Youth and Family Mental Health, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | | | | | - Lauren E Kelly
- Depts of Pharmacology and Therapeutics, Community Health Sciences, University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
| | | | | | | | | | | | - Leslie E Roos
- University of Manitoba, Children's Hospital Research Institute of Manitoba, Winnipeg, Canada
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24
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Umemoto A, Zhou Z, Millon EM, Koshy CS, Taylor SM, Spann MN, Monk C, Marsh R, Rosellini AJ, Auerbach RP. Intergenerational transmission of cognitive control capacity among children at risk for depression. Biol Psychol 2023; 182:108652. [PMID: 37516422 PMCID: PMC10528753 DOI: 10.1016/j.biopsycho.2023.108652] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 07/31/2023]
Abstract
A maternal history of major depressive disorder (MDD) is a well-known risk factor for depression in offspring. However, the mechanism through which familial risk is transmitted remains unclear. Cognitive control alterations are common in MDD, and thus, the current study investigated whether altered control capacity is transmitted intergenerationally, and whether it then contributes to the developmental pathways through which depression is passed from mothers to children. We recruited children (N = 65) ages 4-10-years-old, of which 47.7 % (n = 31) reported a maternal history of MDD, and their biological mother (N = 65). Children performed a child-friendly Go/NoGo task while electroencephalography (EEG) data were recorded, and mothers performed a Flanker task. Children exhibited heightened sensitivity to error versus correct responses, which was characterized by an error-related negativity (ERN), error positivity (Pe) as well as prominent delta and frontal midline theta (FMT) oscillations. Interestingly, worse maternal performance on the Flanker task associated with an increased Go/NoGo error rate and a smaller ERN and Pe in children. However, there was no association between maternal or child control indices with child depression symptoms. Our results suggest a familial influence of cognitive control capacity in mother-child dyads, but it remains unclear whether this confers risk for depressive symptoms in children. Further research is necessary to determine whether alterations in cognitive control over time may influence symptom development in at-risk children.
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Affiliation(s)
- Akina Umemoto
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Zhixin Zhou
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Christina S Koshy
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Sydney M Taylor
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Marisa N Spann
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Catherine Monk
- Department of Psychiatry, Columbia University, New York, NY, USA; Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA; Division of Behavioral Medicine, New York State Psychiatric Institute, New York, NY, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | | | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA; Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA; Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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25
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Franck LS, Gay CL, Hoffmann TJ, Kriz RM, Bisgaard R, Cormier DM, Joe P, Lothe B, Sun Y. Maternal mental health after infant discharge: a quasi-experimental clinical trial of family integrated care versus family-centered care for preterm infants in U.S. NICUs. BMC Pediatr 2023; 23:396. [PMID: 37563722 PMCID: PMC10413600 DOI: 10.1186/s12887-023-04211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Involvement in caregiving and tailored support services may reduce the risk of mental health symptoms for mothers after their preterm infant's neonatal intensive care unit (NICU) discharge. We aimed to compare Family-Centered Care (FCC) with mobile-enhanced Family-Integrated Care (mFICare) on post-discharge maternal mental health symptoms. METHOD This quasi-experimental study enrolled preterm infant (≤ 33 weeks)/parent dyads from three NICUs into sequential cohorts: FCC or mFICare. We analyzed post-discharge symptoms of perinatal post-traumatic stress disorder (PTSD) and depression using intention-to-treat and per protocol approaches. RESULTS 178 mothers (89 FCC; 89 mFICare) completed measures. We found no main effect of group assignment. We found an interaction between group and stress, indicating fewer PTSD and depression symptoms among mothers who had higher NICU-related stress and received mFICare, compared with mothers who had high stress and received FCC (PTSD: interaction β=-1.18, 95% CI: -2.10, -0.26; depression: interaction β=-0.76, 95% CI: -1.53, 0.006). Per protocol analyses of mFICare components suggested fewer PTSD and depression symptoms among mothers who had higher NICU stress scores and participated in clinical team rounds and/or group classes, compared with mothers who had high stress and did not participate in rounds or classes. CONCLUSION Overall, post-discharge maternal mental health symptoms did not differ between the mFICare and FCC groups. However, for mothers with high levels of stress during the NICU stay, mFICare was associated with fewer post-discharge PTSD and depression symptoms.
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Affiliation(s)
- Linda S Franck
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Caryl L Gay
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA
| | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, Office of Research, School of Nursing, UCSF, San Francisco, CA, USA
| | - Rebecca M Kriz
- Department of Family Health Care Nursing, University of California San Francisco (UCSF), 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | - Diana M Cormier
- NICU and Pediatrics, Community Regional Medical Center, Fresno, CA, USA
| | - Priscilla Joe
- Division of Neonatology, UCSF Benioff Children's Hospital, Oakland, CA, USA
| | | | - Yao Sun
- Division of Neonatology, Department of Pediatrics, UCSF, San Francisco, CA, USA
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26
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Li CC, Hwang JL, Ko YL, Chen HH, Chien LY. Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment. Acta Psychol (Amst) 2023; 238:103987. [PMID: 37467654 DOI: 10.1016/j.actpsy.2023.103987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/21/2023] Open
Abstract
Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2-6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.
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Affiliation(s)
- Chuan-Chen Li
- Department of Nursing, Fu Jen Catholic University Hospital, New Taipei City, Taiwan; Department of Nursing, Fu Jen Catholic Univeristy, New Taipei City, Taiwan
| | - Jiann-Loung Hwang
- Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei IVF Center for Reproduction and Genetics, Taipei, Taiwan; Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
| | - Yi-Li Ko
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan.
| | - Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan Univeristy Hospital, Taipei, Taiwan.
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan.
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27
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Nakidde G, Kumakech E, Mugisha JF. Maternal mental health screening and management by health workers in southwestern Uganda: a qualitative analysis of knowledge, practices, and challenges. BMC Pregnancy Childbirth 2023; 23:477. [PMID: 37370024 DOI: 10.1186/s12884-023-05763-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Maternal mental health (MMH) problems, such as perinatal depression, maternal anxiety, suicide ideation and puerperal psychosis among others, have a significant impact on maternal morbidity and mortality, as well as the health and development of children. One in every four pregnant women and one in every five postpartum women in low-income countries, suffer from maternal mental health (MMH) problems. Despite this, MMH screening, diagnosis, and reporting remain scanty in Uganda. Consequently, this study aimed to investigate the knowledge, practices, and impediments that maternity care workers face when screening and managing women with maternal mental health disorders in health facilities in south-western Uganda. METHODS In-depth interviews were conducted with 22 health-care professionals who work in maternity care departments in primary and tertiary healthcare facilities in southwestern Uganda to investigate their medical knowledge, clinical practices, and challenges related to the screening and management of maternal mental health problems. Using qualitative content analysis, distinct categories and subcategories were found. RESULTS Medical staff especially midwives lacked specialized training in screening and managing women with maternal mental health problems They screened and managed MMH problems solely based on history and physical examination, and they referred nearly every mother displaying signs of mental illness because they felt ill-prepared to handle them. On the other hand, medical staff with some level of specialized training in mental health particularly staff working in mental health units, were more likely to use a mental health screening tool in addition to history and physical examination; and to treat any women exhibiting signs and symptoms of maternal mental problems without referring them. Lack of in-service training on maternal mental health, poorly coordinated referral systems, reluctance of mentally ill to visit medical facilities, scarcity of mental health specialists, and shortage of relevant medications were identified as the major challenges. Age, experience level, or gender had no effect on screening or management practices. CONCLUSIONS The results suggest that specialized training in mental health, and particularly maternal mental health, is essential for the effective screening and management of maternal mental health conditions in South Western Uganda.
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Affiliation(s)
- Gladys Nakidde
- Department of Obstetrics and Gynecology, College of medicine, Pan African University of life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria.
- Department of Nursing, Faculty of Nursing and Health sciences, Bishop Stuart University, Mbarara, Uganda.
| | - Edward Kumakech
- Department of Nursing and midwifery, Faculty health sciences, Lira University, Lira, Uganda
| | - John F Mugisha
- Department of Obstetrics and Gynecology, College of medicine, Pan African University of life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria
- Department of Health sciences, Faculty of Science and Technology, Cavendish University, Kampala, Uganda
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28
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Weiland C, Page L, Musaddiq T, Martin E, Homitsky S. The Efficacy of Text-Based Mentoring for Postpartum Mothers: A Pilot Study. Matern Child Health J 2023:10.1007/s10995-023-03704-6. [PMID: 37358777 DOI: 10.1007/s10995-023-03704-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Technology-based outreach offers promise for providing support to a broad population of postpartum mothers while keeping costs low. However, research on the efficacy of this approach is scarce. We conducted a pre-registered randomized pilot trial of the effects of a novel technology-based approach for supporting postpartum mothers - via text-based mentoring - from infant's birth through 18 months. METHODS Mothers (n = 201) were recruited at West Penn Hospital in Pittsburgh, PA in the days immediately following delivery. Treatment mothers were matched with volunteer mentors who communicated with them entirely via text messages. Control mothers received monthly one-way texts on basic safety topics. Measures were collected via hospital records and mother surveys. We estimated treatment effects on mothers' parenting stress, mental health, knowledge of child development, engagement in language and literacy activities, and child milestones at 4- and 18-months postpartum. We used a systematic coding approach and simple descriptive statistics to analyze the treatment mother-mentor texting transcripts. RESULTS We found no statistically significant impacts on targeted outcomes. However, impacts for some outcomes were meaningfully large (> 0.2 SDs). Analyses of texting transcripts showed that most mothers stayed engaged for the full 18-month study period and that mother-mentor pairs primarily discussed maternal wellbeing and child-focused topics. CONCLUSIONS FOR PRACTICE Postpartum mothers will engage with mentors in a text-based mentoring program around important maternal and child health topics. More research and development on technology-based supports for parents in the early childhood years is needed.
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Thompson AJ, Henrich CC. Maternal depression and child telomere length: The role of genetic sensitivity. J Affect Disord 2023; 334:77-82. [PMID: 37146910 DOI: 10.1016/j.jad.2023.04.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 04/15/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND The stress of a mother's depression may increasingly tax psychobiological systems that help children with self-regulation, increasing children's allostatic load over time. Some evidence supports children exposed to maternal depression tend to have shorter telomeres and tend to have more somatic and psychological problems. Children having one or more A1 alleles of dopamine receptor 2 (DRD2, rs1800497), tend to have greater sensitivity to maternal depression and could experience more adverse child outcomes that contribute to greater allostatic load. METHODS Using the Future Families and Child Wellbeing dataset, secondary-data analyses were used to test the effect of repeated exposure to maternal depression during early childhood on children's telomere length during middle childhood moderated by children's DRD2 genotype (N = 2884). RESULTS Greater maternal depression was not significantly associated with shorter child telomere length and this association was not moderated by DRD2 genotypes while controlling for factors associated with child telomere length. IMPLICATIONS The effect of maternal depression on children's TL may not be significant in populations from diverse racial-ethnic and family backgrounds during middle childhood. These findings could help further our current understanding psychobiological systems affected by maternal depression that result in adverse child outcomes. LIMITATIONS Even though this study used a relatively large and diverse sample, replication of DRD2 moderation in even larger samples is an important next step.
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Rotheram-Borus MJ, Tomlinson M, Worthman CM, Norwood P, le Roux I, O'Connor MJ. Maternal depression, alcohol use, and transient effects of perinatal paraprofessional home visiting in South Africa: Eight-year follow-up of a cluster randomized controlled trial. Soc Sci Med 2023; 324:115853. [PMID: 37001280 PMCID: PMC10121853 DOI: 10.1016/j.socscimed.2023.115853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/28/2023]
Abstract
BACKGROUND South African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries. METHODS We examined maternal outcomes at 5- and 8-years' post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time. RESULTS Maternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period. CONCLUSIONS Dissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains from targeted interventions and address community social-cultural factors. HIV/AIDS continues to spread in this population.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 10920 Wilshire Blvd. Suite 350, Los Angeles, CA, 90024, USA.
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Education Building, Francie Van Zijl Drive, Stellenbosch University, Tygerberg 7505, South Africa.
| | - Carol M Worthman
- Department of Anthropology, Emory University, 1557 Dickey Dr., Atlanta, GA, 30307, USA.
| | - Peter Norwood
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 10920 Wilshire Blvd. Suite 350, Los Angeles, CA, 90024, USA.
| | - Ingrid le Roux
- Philani Maternal, Child Health and Nutrition Trust, P.O. Box 40188, Elonwabeni 7791, Cape Town, South Africa.
| | - Mary J O'Connor
- Semel Institute Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA.
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Penner F, Khoury JE, Bosquet Enlow M, Lyons-Ruth K. Threat versus deprivation in mother's childhood: Differential relations to hair cortisol and psychopathology in pregnancy. Child Abuse Negl 2023; 139:106107. [PMID: 36870268 PMCID: PMC10101698 DOI: 10.1016/j.chiabu.2023.106107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The negative effects of childhood maltreatment can be intergenerational, and the prenatal period may play an important role in this intergenerational transmission. Maternal hypothalamic-pituitary-adrenal (HPA) axis dysfunction and maternal psychopathology represent two mechanisms through which the effects of childhood maltreatment are hypothesized to be transmitted across generations. OBJECTIVE This study first sought to extend prior research on pathways of intergenerational transmission by examining whether mothers' childhood experiences of abuse versus neglect differentially relate to maternal HPA activity and to maternal psychopathology during the prenatal period. Second, exploratory analyses examined the links between maternal variables and their State Protective Service involvement as a parent, as an indicator of maladaptive caregiving. METHODS During the third trimester of pregnancy, 51 women reported on experiences of childhood maltreatment, on State Protective Service involvement as an adult parent, and on current depressive and post-traumatic stress symptoms, and provided a hair sample for cortisol assay. RESULTS Regression analyses indicated that greater severity of abuse, but not neglect, in childhood was associated with higher maternal depressive symptoms (β = 0.488, p = .020). In contrast, greater severity of neglect, but not abuse, in mothers' childhood was associated with lower maternal hair cortisol concentration (β = -0.437, p = .031). Lower maternal hair cortisol concentration, but not maternal psychopathology or severity of childhood abuse or neglect, in turn, was associated with State Protective Service involvement (β = -0.785, p < .001). CONCLUSIONS Findings extend prior work by suggesting that childhood abuse and neglect may have different sequelae for mothers during pregnancy and that these sequelae may have different relations to parenting.
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Affiliation(s)
- Francesca Penner
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
| | - Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Karlen Lyons-Ruth
- Department of Psychiatry, Cambridge Hospital, Harvard Medical School, Cambridge, MA, USA
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Shieh PL, Cheng LY, Hsu WS, Li RH. Mother-Infant Group Intervention on Maternal Depression and Bonding: A Quasi-Experimental Study. Matern Child Health J 2023; 27:1114-1125. [PMID: 37031319 DOI: 10.1007/s10995-023-03654-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVES Parent-Infant Psychotherapy (PIP) aims at improving the interaction between parents and their infants. Group intervention has advantages in facilitating universality, support, and social learning. However, the researches on PIP adoption in a group format are limited. This study aims to explore the outcome of a mother-infant group on bonding and maternal depression. METHODS Eighty-two infant mothers with subjective distress on parenting or depressed mood were recruited to participate in the intervention group (IG). Another sample of one hundred and ninety-four postpartum women was recruited as the control group (CG). Instruments for outcome measure were the Mother-Infant Bonding Scale, Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory-Second Edition (BDI-II), and Social Network Interaction System Questionnaire. Twelve courses of mother-infant groups were conducted for IG women. Each course consisted of twelve 90-min sessions. IG women joined the intervention with their infants and replied to the instruments at baseline, post-intervention, and follow-up. CG women replied to the instruments at similar intervals. Primary data analyses were performed by the intent-to-treat analysis, ANOVA, and GEE. RESULTS Relative to CG participants, the IG women experienced significant benefits in most mother-infant bonding scores at both post-intervention and follow-up (ps = .000 - .026). IG women also experienced a greater reduction in follow-up depressive symptoms measured by EPDS (p = .023). However, no significant reduction was noted on BDI-II. CONCLUSIONS Mother-infant group intervention has preliminary effects on improving bonding and reducing depressive symptoms for women with infants. Further studies are warranted to replicate the results.
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Affiliation(s)
- Pey-Ling Shieh
- Department of Psychology, Chung Shan Medical University, No.110, Sec.1, Jianguo N. Rd., South District, Taichung City, 40201, Taiwan, ROC.
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No.110, Sec.1, Jianguo N. Rd., South District, Taichung City, 40201, Taiwan, ROC.
| | - Ling-Yee Cheng
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan, ROC
| | - Wen-Shih Hsu
- Mental Health Division, Department of Health, Taipei City Government, No.1, City Hall Rd., Xinyi District, Taipei City, 110204, Taiwan, ROC
| | - Ren-Hau Li
- Department of Psychology, Chung Shan Medical University, No.110, Sec.1, Jianguo N. Rd., South District, Taichung City, 40201, Taiwan, ROC
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Platt B. Understanding emotion processing in offspring of mothers with depression - A commentary on Burkhouse and Kujawa (2023). J Child Psychol Psychiatry 2023; 64:608-610. [PMID: 36796785 DOI: 10.1111/jcpp.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/18/2023]
Abstract
In the JCPP Annual Research Review, Burkhouse and Kujawa (Journal of Child Psychology and Psychiatry, 2022) report a systematic review of 64 studies assessing the association between maternal depression and neural and physiological markers of children's emotion processing. This comprehensive review makes a novel contribution to models of transgenerational depression with important implications for future research in this field. In this commentary I reflect more generally on the role of emotion processing in the transmission of depression from parents to children and the clinical implications of neural and physiological studies.
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Affiliation(s)
- Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital LMU Munich, Munich, Germany
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Burkhouse KL, Kujawa A. Annual Research Review: Emotion processing in offspring of mothers with depression diagnoses - a systematic review of neural and physiological research. J Child Psychol Psychiatry 2023; 64:583-607. [PMID: 36511171 DOI: 10.1111/jcpp.13734] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Theories of the intergenerational transmission of depression emphasize alterations in emotion processing among offspring of depressed mothers as a key risk mechanism, raising questions about biological processes contributing to these alterations. The objective of this systematic annual research review was to examine and integrate studies of the associations between maternal depression diagnoses and offspring's emotion processing from birth through adolescence across biological measures including autonomic psychophysiology, electroencephalography (EEG), magnetoencephalography (MEG), event-related potentials (ERP), and structural and functional magnetic resonance imaging (MRI). METHODS The review was conducted in accordance with the PRISMA 2020 standards. A systematic search was conducted in PsycInfo and PubMed in 2022 for studies that included, 1) mothers with and without DSM-defined depressive disorders assessed via a clinical or diagnostic interview, and 2) measures of offspring emotion processing assessed at the psychophysiological or neural level between birth and 18 years of age. RESULTS Findings from 64 studies indicated that young offspring of mothers with depression histories exhibit heightened corticolimbic activation to negative emotional stimuli, reduced left frontal brain activation, and reduced ERP and mesocorticolimbic responses to reward cues compared to offspring of never-depressed mothers. Further, activation of resting-state networks involved in affective processing differentiate offspring of depressed relative to nondepressed mothers. Some of these alterations were only apparent among youth of depressed mothers exposed to negative environmental contexts or exhibiting current emotional problems. Further, some of these patterns were observable in infancy, reflecting very early emerging vulnerabilities. CONCLUSIONS This systematic review provides evidence that maternal depression is associated with alterations in emotion processing across several biological units of analysis in offspring. We present a preliminary conceptual model of the role of deficient emotion processing in pathways from maternal depression to offspring psychopathology and discuss future research avenues addressing limitations of the existing research and clinical implications.
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Affiliation(s)
- Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Maková M, Kašparová S, Tvrdík T, Noguera M, Belovičová K, Csatlosová K, Dubovický M. Mirtazapine modulates Glutamate and GABA levels in the animal model of maternal depression. MRI and 1H MRS study in female rats. Behav Brain Res 2023; 442:114296. [PMID: 36641082 DOI: 10.1016/j.bbr.2023.114296] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 12/19/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
We aimed to determine, using in vivo magnetic resonance, whether maternal depression induced by chronic unpredictable stress (CUS) in the pre-gestational period in female rats would be evidenced by structural or neurometabolic changes in the hippocampal region of the brain. At the same time, appropriate behavioral tests were also administered after a relatively long two-month period of a stress paradigm. The objective of the study was not only to study an animal model of CUS using magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H MRS) focused on the hippocampus, but also to use this technique to verify the effectiveness of mirtazapine antidepressant treatment. In the group with CUS, we found a significant decrease in the relative concentration of γ-aminobutyric acid (GABA/tCr) and glutamate+glutamine (Glx/tCr) compared to the control group, while we did not observe any statistically significant change in hippocampal volumes. Moreover, the forced swim test revealed an increase in depression-like behavior. The most important finding was the return of GABA/tCr and Glx/tCr levels to control levels during mirtazapine treatment; however, behavioral tests did not demonstrate any effects from mirtazapine treatment. In vivo1H MRS confirmed mirtazapine modulation of CUS in an animal model more robustly than behavioral tests.
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Affiliation(s)
- Marianna Maková
- Slovak University of Technology in Bratislava, Central Laboratory of Faculty of Food and Chemical Technology, Radlinského 9, Bratislava 81237, Slovak Republic.
| | - Svatava Kašparová
- Slovak University of Technology in Bratislava, Central Laboratory of Faculty of Food and Chemical Technology, Radlinského 9, Bratislava 81237, Slovak Republic.
| | - Tomáš Tvrdík
- Slovak University of Technology in Bratislava, Central Laboratory of Faculty of Food and Chemical Technology, Radlinského 9, Bratislava 81237, Slovak Republic; Department of Radiology, Faculty of Medicine of Comenius University in Bratislava, Slovak Medical University and University Hospital Bratislava, Limbová 12, Bratislava 83303, Slovak Republic.
| | - Mireia Noguera
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy Sciences, Dúbravská cesta 9, Bratislava 84104, Slovak Republic.
| | - Kristína Belovičová
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy Sciences, Dúbravská cesta 9, Bratislava 84104, Slovak Republic.
| | - Kristína Csatlosová
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy Sciences, Dúbravská cesta 9, Bratislava 84104, Slovak Republic.
| | - Michal Dubovický
- Centre of Experimental Medicine, Institute of Experimental Pharmacology and Toxicology, Slovak Academy Sciences, Dúbravská cesta 9, Bratislava 84104, Slovak Republic.
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Fatori D, Zuccolo P, Xavier MO, Matijasevich A, Polanczyk GV. Smartphone-assisted online brief cognitive behavioral therapy to treat maternal depression: findings of a randomized controlled trial. Braz J Psychiatry 2023; 45:50-53. [PMID: 36049141 PMCID: PMC9976920 DOI: 10.47626/1516-4446-2022-2679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/14/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To test the efficacy of smartphone-assisted online brief cognitive behavioral therapy (b-CBT) to treat maternal depression compared to online brief CBT plus an active control app. METHODS A randomized controlled trial was conducted. Assessments were performed at baseline (T0), midpoint (T1, week 4-5), post-treatment (T2, week 8), and follow-up (T3, 2-month postnatal follow-up) by blinded interviewers. The primary outcome was depression measured by the Edinburgh Postnatal Depression Scale (EPDS) at T2. We also assessed anxiety, stress, sleep quality, well-being, physical activity, treatment response, and offspring child behavior problems. RESULTS Eighty-one participants were randomized to the intervention (n=37) or active control (n=44) groups. Seventy-one participants completed the post-treatment assessment or reported primary outcome data. No differences were found between the intervention and active control groups regarding maternal depression or other mental health outcomes. Overall, we found large within-group effect sizes, with 80% of the total sample responding to treatment. CONCLUSIONS Our data showed no difference between the groups, suggesting that adding apps to psychotherapy treatment may not enhance treatment effects on prenatal depression. A within-groups analysis showed that most participants with depression responded to treatment; however, future studies are needed to confirm whether this effect is related to factors other than the intervention.
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Affiliation(s)
- Daniel Fatori
- Departamento de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Pedro Zuccolo
- Departamento de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Mariana O Xavier
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Universidade Federal de Pelotas (UFPel), São Paulo, SP, Brazil
| | | | - Guilherme V Polanczyk
- Departamento de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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Simon CD, Bendelow A, Bryan M, Garfield CF. Mental health as a family experience: Relationship of paternal characteristics with maternal perinatal depressive symptoms in a matched sample. Arch Womens Ment Health 2023; 26:135-9. [PMID: 35982295 DOI: 10.1007/s00737-022-01254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/02/2022]
Abstract
The present study investigates the relationship between perinatal maternal depressive symptoms and paternal factors using linked maternal-paternal survey data. From October 2018 to July 2019, among a representative sample and 2-6 months following the birth of an infant, mothers and fathers completed surveys and reported depressive symptoms. Results from the linked dyadic data (n = 243) show the prevalence of maternal depressive symptoms, both overall (16%) and by marital status and paternal health care involvement. Viewing mental health as a family experience may further understanding of postpartum maternal mental illness.
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Zhang T, Luo ZC, Ji Y, Chen Y, Ma R, Fan P, Tang N, Li J, Tian Y, Zhang J, Ouyang F. The impact of maternal depression, anxiety, and stress on early neurodevelopment in boys and girls. J Affect Disord 2023; 321:74-82. [PMID: 36280196 DOI: 10.1016/j.jad.2022.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/02/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine the effects of prenatal maternal depression, anxiety and stress, and postnatal depression on infant early neurodevelopment, and the sex dimorphism. STUDY DESIGN We used data from 3379 mother-infant pairs from the Shanghai Birth Cohort. Maternal mental health was assessed using the Center for Epidemiological Studies-Depression Scale, Zung Self-Rating Anxiety Scale, Perceived Stress Scale at mid-pregnancy, and the Edinburgh Postnatal Depression Scale at postpartum. Infant neurodevelopment was evaluated using the Ages & Stages Questionnaires and Bayley Scales at ages 6, 12, and 24 months, respectively. Linear mixed models and linear regression models were used. RESULTS Among 3379 mothers, 11.07 %, 5.42 %, and 34.85 % of women experienced depression, anxiety, and elevated stress, separately. As maternal prenatal mental scores increased per 1SD, infant social-emotional scores decreased -2.82 (-3.86, -1.79) vs -2.86 (-3.94, -1.79) for depression, -2.34 (-3.38, -1.31) vs -2.72 (-3.81, -1.64) for anxiety, and -2.55 (-3.60, -1.50) vs -3.41 (-4.48, -2.35) for stress among boys and girls at age 24 months, respectively. Associations were also observed on social-emotional and communication scores in boys and girls, and fine motor in girls at age 6 and 12 months. These associations were not observed for postpartum depression. LIMITATION Generalizability of the results to other population remains to be determined. CONCLUSIONS Prenatal maternal depression, anxiety, and stress were negatively associated with infant early neurodevelopment, which were not observed for postpartum depression. We underscore the importance of maternal prenatal mental health in optimizing infant neuropsychiatric development.
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Affiliation(s)
- Ting Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong-Cheng Luo
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Prosserman Center for Population Health Research, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto M5G 1X5, Canada
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yuanzhi Chen
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Ma
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pianpian Fan
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ning Tang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Li
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Tian
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zaccarelli-Magalhães J, Abreu GR, Fukushima AR, Pantaleon LP, Ribeiro BB, Munhoz C, Manes M, de Lima MA, Miglioli J, Flório JC, Lebrun I, Waziry PAF, Fonseca TL, Bocco BMLC, Bianco AC, Ricci EL, Spinosa HS. Postpartum depression in rats causes poor maternal care and neurochemical alterations on dams and long-lasting impairment in sociability on the offspring. Behav Brain Res 2023; 436:114082. [PMID: 36041571 PMCID: PMC10823501 DOI: 10.1016/j.bbr.2022.114082] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022]
Abstract
Postpartum depression is a mentally disabling disease with multifactorial etiology that affects women worldwide. It can also influence child development and lead to behavioral and cognitive alterations. Despite the high prevalence, the disease is underdiagnosed and poorly studied. To study the postpartum depression caused by maternal separation model in rats, dams were separated from their litter for 3 h daily starting from lactating day (LD) 2 through LD12. Maternal studies were conducted from LD5 to LD21 and the offspring studies from postnatal day (PND) 2 through PND90. The stress caused by the dam-offspring separation led to poor maternal care and a transient increase in anxiety in the offspring detected during infancy. The female offspring also exhibited a permanent impairment in sociability during adult life. These changes were associated with neurochemical alterations in the prefrontal cortex and hippocampus, and low TSH concentrations in the dams, and in the hypothalamus, hippocampus and striatum of the offspring. These results indicate that the postpartum depression resulted in a depressive phenotype, changes in the brain neurochemistry and in thyroid economy that remained until the end of lactation. Changes observed in the offspring were long-lasting and resemble what is observed in children of depressant mothers.
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Affiliation(s)
- Julia Zaccarelli-Magalhães
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil.
| | - Gabriel R Abreu
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - André R Fukushima
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil; School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil; Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Lorena P Pantaleon
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Beatriz B Ribeiro
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Camila Munhoz
- Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Marianna Manes
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Mayara A de Lima
- Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Júlia Miglioli
- Centro Universitário das Américas, Rua Augusta, 1508, 01304-001 São Paulo, Brazil
| | - Jorge C Flório
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
| | - Ivo Lebrun
- Laboratory of Biochemistry and Biophysics, Butantan Institute, Avenida Vital Brazil, 1500, 05503-900 São Paulo, Brazil
| | - Paula A F Waziry
- Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328, United States
| | - Tatiana L Fonseca
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Bárbara M L C Bocco
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Antônio C Bianco
- Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, United States
| | - Esther L Ricci
- School of Health Sciences IGESP, Rua da Consolação, 1025, 01301-000 São Paulo, Brazil; Health Science Institute, Presbyterian Mackenzie University, Rua da Consolação, 930, 01302-907 São Paulo, Brazil
| | - Helenice S Spinosa
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, Avenida Professor Doutor Orlando Marques de Paiva, 87, 05508-270 São Paulo, Brazil
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Guldi M, Hamersma S. The effects of pregnancy-related Medicaid expansions on maternal, infant, and child health. J Health Econ 2023; 87:102695. [PMID: 36502571 DOI: 10.1016/j.jhealeco.2022.102695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/19/2022] [Accepted: 10/22/2022] [Indexed: 06/17/2023]
Abstract
Prior research has examined how late 1980s pregnancy-related Medicaid eligibility expansions influenced outcomes around the time of birth and, more recently, adult outcomes. We offer a close examination of early childhood effects to better understand the mechanism(s) underlying the improved longer-term outcomes. The restricted-access National Maternal and Infant Health Survey allows us to explore the effects of these expansions on maternal and child outcomes near the time of birth as well as three years post-birth. Our evidence suggests earlier connection with prenatal care and possible modest improvements in birthweight and gestational age. In our follow-up data, we also identify evidence of persistent effects as measured by child developmental scores. However, the most consistent finding is our strong evidence of reduced levels of maternal depression-both during the child's infancy and three years later. We conclude that the alleviation of maternal stress is one likely mechanism for the longer-term improvements in later-life outcomes identified in studies of children exposed to Medicaid in-utero and in early infancy.
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Affiliation(s)
- Melanie Guldi
- University of Central Florida, Orlando, FL, United States
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41
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Menta G, Lepinteur A, Clark AE, Ghislandi S, D'Ambrosio C. Maternal genetic risk for depression and child human capital. J Health Econ 2023; 87:102718. [PMID: 36565586 DOI: 10.1016/j.jhealeco.2022.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
We here address the causal relationship between the maternal genetic risk for depression and child human capital using UK birth-cohort data. We find that an increase of one standard deviation (SD) in the maternal polygenic risk score for depression reduces their children's cognitive and non-cognitive skill scores by 5 to 7% of a SD throughout adolescence. Our results are robust to a battery of sensitivity tests addressing, among others, concerns about pleiotropy and dynastic effects. Our Gelbach decomposition analysis suggests that the strongest mediator is genetic nurture (through maternal depression itself), with genetic inheritance playing only a marginal role.
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Affiliation(s)
- Giorgia Menta
- Luxembourg Institute of Socio-Economic Research (LISER), Luxembourg
| | | | - Andrew E Clark
- University of Luxembourg, Luxembourg; Paris School of Economics - CNRS, France
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Roos LE, Kaminski L, Stienwandt S, Hunter S, Giuliano R, Mota N, Katz LY, Zalewski M. The Building Regulation in Dual-Generations Program (BRIDGE): A Mixed-Methods Feasibility Pilot of a Parenting Program for Depressed Mothers of Preschoolers, Matched with Dialectical Behavior Therapy Skills. Child Psychiatry Hum Dev 2023; 54:34-50. [PMID: 34347227 PMCID: PMC8335713 DOI: 10.1007/s10578-021-01219-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 01/27/2023]
Abstract
Early exposure to maternal depression is a key risk factor for child mental illness (MI), but there are limited programs that interrupt intergenerational transmission. The BRIDGE "Building Regulation in Dual Generations" Program treats maternal MI using Dialectical Behavior Therapy Skills with a paired curriculum that promotes non-reactive and emotionally validating parenting designed to improve child mental health and ultimately prevent MI. The pilot feasibility trial (n = 28 dyads) included mothers and their preschool-aged children. The 20-week program was completed in a group-based format using mixed methods questionnaires and interviews. Results indicate high feasibility and acceptability (86% retention). Consistent improvements were seen across program targets and outcomes including maternal depression (d = 1.02) and child mental health (d = 1.08), with clinically significant symptom reductions for 85% of clients. Mothers with higher adversity exhibited greater reductions in parenting stress. Qualitative results highlighted efficacy in promoting positive parent-child relationships, rewarding parenting experiences, competence, and child development. Evidence suggests high feasibility and accessibility for BRIDGE in addressing intergenerational mental health needs. There was strong satisfaction with the program material and efficacy across key outcomes. BRIDGE holds promise for offering a transdiagnostic approach to preventing child MI in families of at-risk preschool aged children.
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Affiliation(s)
- Leslie E Roos
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada.
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada.
| | - Lauren Kaminski
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Shaelyn Stienwandt
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Hunter
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Ryan Giuliano
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Laurence Y Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Rokoff LB, Cardenas A, Lin PID, Rifas-Shiman SL, Wright RO, Bosquet Enlow M, Coull BA, Oken E, Korrick SA. Early pregnancy essential and non-essential metal mixtures and maternal antepartum and postpartum depressive symptoms. Neurotoxicology 2023; 94:206-216. [PMID: 36526156 PMCID: PMC9839522 DOI: 10.1016/j.neuro.2022.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/20/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Mood disorders are common during and after pregnancy, and environmental metals may contribute to increased risk. Antepartum metal exposures have not been well characterized in relation to maternal depression. We evaluated the extent to which early pregnancy erythrocyte concentrations of essential and non-essential metals were prospectively associated with antepartum and postpartum depressive symptoms. METHODS Participants were 1226 women in Project Viva, a longitudinal cohort recruited during pregnancy (1999-2002). We measured concentrations of 11 metals in maternal first trimester erythrocytes (arsenic, barium, cadmium, cesium, copper, mercury, magnesium, manganese, lead, selenium, zinc). Using the Edinburgh Postnatal Depression Scale (EPDS), we assessed elevated depressive symptoms (≥13; 0-30 scale) at mid-pregnancy and at 6 and 12 months postpartum. We applied latent class mixed modeling to identify symptom trajectories. Adjusting for maternal sociodemographics and co-exposures, we examined associations between the metal mixture and depressive symptoms using logistic (for EPDS≥13)/multinomial (for symptom trajectories) regression and quantile g-computation. RESULTS In this cohort of moderately high socioeconomic status participants (e.g., 72 % college graduate), low-level metal concentrations were weakly to moderately correlated (Spearman: -0.24 to 0.59); the prevalence of depressive symptoms ranged from 9 % (mid-pregnancy) to 6 % (12 months postpartum); and three trajectories (stable low; elevated mid-pregnancy, then decreasing; moderate mid-pregnancy, then increasing) best fit the EPDS data. The early pregnancy erythrocyte metal mixture was not associated with maternal depressive symptoms in logistic, multinomial, or mixture models. For individual metals, most confidence intervals (CI) included the null. There was weak evidence that arsenic, lead, and selenium were moderately associated with elevated odds of depressive symptoms and/or trajectories. However, the odds ratios (95 % CI) per doubling of these three metals were imprecise [e.g., arsenic: 1.13 (0.94, 1.40) for EPDS≥13 at six months postpartum; lead: 1.19 (0.80, 1.77) for EPDS≥13 at mid-pregnancy; selenium: 2.35 (0.84, 6.57) for elevated mid-pregnancy, then decreasing versus stable low trajectory]. DISCUSSION We did not observe strong, consistent evidence of associations between early pregnancy erythrocyte metal concentrations and subsequent maternal antepartum and postpartum depressive symptoms.
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Affiliation(s)
- Lisa B Rokoff
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Population Health Sciences Program, Harvard University, Cambridge, MA, USA.
| | - Andres Cardenas
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Pi-I D Lin
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Susan A Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Dittmann D, Reindl V, Herpertz-Dahlmann B, Dahmen B, Firk C, Borzikowsky C, Konrad K. Challenging the Sensitive Window Hypothesis: Timing Effects of Maternal Depressive Symptoms on the Intergenerational Transmission of Maltreatment and Psychopathology in the Next Generation. Psychopathology 2023; 56:75-89. [PMID: 35917795 DOI: 10.1159/000525760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/24/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The current study explored the role of maternal depressive symptoms in the intergenerational transmission of childhood maltreatment and developmental psychopathology. Based on the sensitive window hypothesis, the effects of earlier versus later maternal depression symptoms on child development were analysed. METHOD Ninety-nine mother-child dyads, 65% of which had high-risk teenage mothers, participated in a longitudinal study with three assessments in the first 18 months of the child's life (T1-T3) and a 4th reassessment (T4) at the child's preschool age. Using serial mediation analyses, we tested whether the relationship between the mother's own maltreatment history (Childhood Experience of Care and Abuse Questionnaire) and the child's psychopathological outcome at preschool age was mediated in a causal effect chain by maternal depression in the first 2 years of life, by current maternal depression (Beck Depression Inventory-II) and by current maternal child abuse potential (Child Abuse Potential Inventory). The children's emotional problems and externalizing symptoms were assessed at preschool age by parent or teacher Strengths and Difficulties Questionnaire ratings. RESULTS The results indicated that especially later maternal depression mediated the relationship between maternal childhood maltreatment and negative developmental outcomes in the next generation. The effects of maltreatment type on maternal depression were rather nonspecific. However, mental abuse affected existing risk factors more directly over time compared to physical and sexual abuse. Additionally, the impact of early life maltreatment and maternal depression on child psychopathology varied by rater. The pathway to externalizing symptoms was significant only in teacher ratings and for the pathway to emotional problems only in maternal ratings. CONCLUSIONS The present findings suggest that early maternal depression followed by ongoing maternal depression plays a mediating role in the intergenerational cycle of maltreatment. Therefore, in the future, interventions should be offered at an early stage, but also extend well beyond the first 2 years of a child's life, addressing maternal depression and trauma.
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Affiliation(s)
- Denise Dittmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Aachen, Aachen, Germany.,Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany
| | - Vanessa Reindl
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany.,Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Aachen, Aachen, Germany
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Aachen, Aachen, Germany
| | - Christine Firk
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany.,Catholic University of North Rhine-Westphalia, Aachen, Germany
| | - Christoph Borzikowsky
- Institute of Medical Informatics and Statistics, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany.,JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Aachen, Germany
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Huang J, Zheng J, Ling-Ling G. Individual and dyadic network analyses of depressive symptoms in Chinese postpartum couples: A cross-sectional study. Midwifery 2023; 116:103529. [PMID: 36323077 DOI: 10.1016/j.midw.2022.103529] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 09/10/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The network approach to psychopathology is symptom oriented and may open new possibilities for intervention development and health care practices in postpartum depression. OBJECTIVE To investigate the individual and dyadic symptom network of postpartum depression in Chinese mothers and fathers in the very early postpartum period. DESIGN A cross-sectional study was conducted. SETTINGS AND PARTICIPANTS A total of 457 couples in the 2∼3 days postpartum period was recruited consecutively from a hospital in Guangzhou, China from September 2020 to April 2021. METHODS The Edinburgh Postnatal Depression Scale and socio-demographic and obstetric data sheet were used to collect data. We estimated the individual symptom networks of postpartum mothers and fathers separately and a dyadic symptom network that consisted of symptoms of both spouses. Network characteristics including global strength and node centralities were analyzed and systematically compared. RESULTS Strength centralities in the individual networks showed acceptable stability [Correlation stability coefficient (CS) for mothers = 0.60; CS for fathers = 0.52]. The central depressive symptoms in mothers were Crying (Zstrength = 1.32), Overwhelmed (Zstrength = 1.01) and Sad mood (Zstrength = 0.93). The central depressive symptom in fathers was Sad Mood (Zstrength = 1.35). The symptom "Crying" had a distinctive link to thoughts of self-harm in fathers. The symptom network of mothers (global strength = 4.15) was more interconnected than that of fathers (global strength = 3.74). There was a statistically significant but unstable within-couple connection of thoughts of self-harm (CS = 0.21). CONCLUSIONS Postpartum mothers are more vulnerable to activation spreads of depressive symptoms than postpartum fathers. Symptoms including "Sad mood", "Overwhelmed" and "Crying" warrant the attention of health care providers. Investigations with larger sample sizes and gender-sensitive instruments are needed to further unfold the individual and dyadic symptom dynamics of postpartum depression.
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Affiliation(s)
- Jiasheng Huang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jie Zheng
- School of Nursing, Peking University, Beijing, China
| | - Gao Ling-Ling
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Engelhard C, Hishinuma E, Rehuher D. The impact of maternal depression on child mental health treatment and models for integrating care: a systematic review. Arch Womens Ment Health 2022; 25:1041-1065. [PMID: 36327004 DOI: 10.1007/s00737-022-01272-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Maternal depression negatively impacts child mental health and is a well-known risk factor for child psychopathology. However, maternal depression treatment and child mental health treatment are rarely integrated. The purpose of this review was to assess the impact of maternal depression on child mental health treatment, including (1) how treatment of maternal depression affects child mental health outcomes, (2) the impact of maternal depression on children receiving mental health care, and (3) emerging models that address maternal depression in primary-care pediatrics and child mental health settings. A systematic literature review was conducted using PubMed and PsycInfo. Initial search yielded 224 records, and after exclusion, 29 papers were reviewed. Effective treatment of maternal depression is associated with a significant decrease in child psychiatric symptoms. Maternal depression negatively affects child mental health treatment in that there is a high rate of untreated mental illness among mothers of psychiatrically ill children, and maternal depression impedes effective child mental health treatment. Current models to address maternal depression in child settings include screening in pediatric primary care, psychotherapy for depressed mothers of psychiatrically ill children, and emerging models that integrate maternal and child mental health treatment. Effective treatment of maternal depression significantly improves child mental health and should be better integrated into child treatment. Opportunities to improve care include more robust screening for parental mental illness, supports to refer parents to psychiatric care, and on-site services for parents. Such interventions hold promise, but require significant support from a multidisciplinary team.
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Affiliation(s)
- Caitlin Engelhard
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA.
| | - Earl Hishinuma
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA
| | - Davis Rehuher
- Department of Psychiatry, University of Hawai'i at Mānoa, 1356 Lusitana Street, 4th Floor, Honolulu, Hawai'i, 96813, USA
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Wei X, Li X, Teng X, Bai J, Ren F. Intergenerational Transmission of Depression during Adolescence: The Mediating Roles of Hostile Attribution Bias, Empathic Concern, and Social Self-Concept. J Psychol 2022; 157:13-31. [PMID: 36279252 DOI: 10.1080/00223980.2022.2134276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Few studies have empirically examined the role of peer microsystem in the intergenerational transmission of depression, and more importantly, little is known about the mechanisms underlying this potential pathway of intergenerational transmission. The purpose of the current study was to examine the sequential mediation effects of adolescent hostile attribution bias, empathic concern, and social self-concept on the association between maternal depression and adolescent depression. An urban Chinese sample of 761 mother-child dyads was investigated when the adolescents were in secondary school (M = 14.36 years, range =12.33-16.92 years, 52.3% female). The results provided evidence of cross-generational continuity in depression during adolescence, and the hypothesized sequential mediation model was supported. The findings highlight the importance of peer-related factors during the intergenerational transmission of depression and have important implications for interpersonal interventions that aim to prevent depression during adolescence. The limitations of the study and suggestions for future research are briefly discussed.
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Abitante G, Haraden DA, Pine A, Cole D, Garber J. Trajectories of positive and negative affect across adolescence: Maternal history of depression and adolescent sex as predictors. J Affect Disord 2022; 315:96-104. [PMID: 35878831 PMCID: PMC9447402 DOI: 10.1016/j.jad.2022.07.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/09/2022] [Accepted: 07/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Trajectories of affect vary across development, with normative increases in positive affect occurring during childhood and declines in positive affect appearing across adolescence. Little is known, however, about predictors of the trajectories of affect across adolescence. The present study examined associations between changes in adolescent affect across adolescence and maternal history of depression and child sex. METHODS Participants were 240 adolescents and their mothers; 185 mothers had a history of depression (i.e., high risk) and 55 mothers did not (i.e., low risk). Youth were assessed annually from 6th grade (meanage = 11.86 years, SD = 0.57, 54.2 % female, 82 % White) through 12th grade. Latent growth models tested the relation of maternal depression history and adolescent sex with trajectories of adolescent affect. RESULTS High-risk adolescents exhibited lower levels of PA as compared to low-risk youth (coefficient = -3.51, p = .008, 95 % CI [-6.11, -0.91]). Girls experienced earlier increases in negative affect (NA) as compared to boys, with more positive linear (coefficient = 2.07, p = .002, 95 % CI [0.774, 3.368]) and quadratic (coefficient = -0.29, p = .025, 95 % CI [-0.55, -0.04]) slopes. LIMITATIONS Use of self-report measures and limited generalizability. CONCLUSION Maternal depression significantly predicted decreases in offspring PA and distinct trajectories of NA in girls and boys. Interventions aimed at reducing risk in adolescent offspring of depressed parents may benefit from targeting PA and supporting girls in early adolescence.
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Affiliation(s)
| | - Dustin A Haraden
- University of Illinois Urbana-Champaign, United States of America
| | | | - David Cole
- Vanderbilt University, United States of America
| | - Judy Garber
- Vanderbilt University, United States of America
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Yang J, Xu A, Zhang Y, Deng J, Lin X, Xie L, Deng X, Liu H, Chen P, Huang Y. Promoter methylation changes in the placenta involved in the relationship between prenatal depression and small for gestational age. BMC Pregnancy Childbirth 2022; 22:741. [PMID: 36184597 PMCID: PMC9528156 DOI: 10.1186/s12884-022-05066-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/20/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent studies suggest that the incidence of small for gestational age (SGA) birth related to maternal depression, but the mechanism is unclear. The aim of this study was to explore the changes of promoter methylation in the placenta which may be involved in the relationship between prenatal depression and SGA. METHODS Three hundred forty-five pregnant women were enrolled in this prospective cohort study. Perinatal emotion and sleep quality in the second and third trimesters were assessed using self-rating depression scale, self-rating anxiety scale, and Pittsburgh sleep quality index. According to the exposure (depressed emotion of mother) and outcome (SGA), the placentas were divided into four groups. Methylation of the promoter regions of the placental CRH, HSD11β2, SLA16A10, DIO3, and MTNR1B genes was determined using next generation sequencing based on bisulfite sequencing PCR. RESULTS There were 97 (28.1%) and 95 (27.5%) pregnant women who had depression in the second trimester and third trimester, respectively. Thirty-five pregnant women had an SGA birth. The incidence of SGA births in this prospective cohort was 10.1%. The risk factors of SGA birth were low BMI of pregnancy women (RR = 0.71, 95%CI = 0.54 ~ 0.92), hypertensive disorder complicating pregnancy (HDCP, RR = 4.7, 95%CI = 1.18 ~ 18.72), and maternal depression in the second trimester (RR = 3.71, 95%CI = 1.31 ~ 12.16). We found that the CRH and HSD11β2 methylation levels were higher in the depression group than those in the non-depression group. Methylation levels of DIO3 were higher in SGA group than that in the non-SGA group. Higher methylation levels of CRH correlated with higher methylation levels of DIO3 in the placenta. CONCLUSIONS Maternal depression in the second trimester may lead to the changes of methylation levels in the promoter region of CRH and HSD11β2 gene, while the changes of methylation of DIO3 in subsequent could related to SGA. This study suggests that maternal depressed emotion during pregnancy may result in SGA due to the epigenetic changes of placenta.
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Affiliation(s)
- Jianhui Yang
- Department of Neonatology, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
- Huizhou Central People's Hospital, North Erling Road, Huizhou, 516003, Guangdong, China
| | - Aitong Xu
- Shantou University Medical College, Xinling Road, Shantou, 515041, Guangdong, China
| | - YuMin Zhang
- Department of Neonatology, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Jiahui Deng
- Department of Neonatology, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Xuemei Lin
- Department of Neonatology, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Lili Xie
- Department of Obstetrics, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Xiaochun Deng
- Department of Obstetrics, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Honglin Liu
- Department of Obstetrics, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Peishan Chen
- Department of Obstetrics, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
| | - Yuejun Huang
- Department of Neonatology, Second Affiliated Hospital of Shantou University Medical College, North Dongxia Road, Shantou, 515041, Guangdong, China
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Ierardi E, Dascalu A, Shai D, Spencer R, Riva Crugnola C. Parental embodied mentalizing: Associations with maternal depression, anxiety, verbal mentalizing, and maternal styles of interaction. J Affect Disord 2022; 311:472-8. [PMID: 35609764 DOI: 10.1016/j.jad.2022.05.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Maternal depression and anxiety in the perinatal period affect the quality of maternal sensitivity and mentalizing abilities. Few studies analyzed implicit mentalizing in relation to maternal distress. The aims of the study were: to examine the relation between nonverbal mentalizing - parental embodied mentalizing (PEM) - and maternal depression and anxiety, verbal mentalizing, and maternal styles of interaction; and to test PEM as a mediator of the effect of maternal distress on styles of interaction. METHOD 81 mother-infant dyads have been recruited. At infant three months, maternal depression was assessed using the Edinburgh Postnatal Depression Scale, anxiety with State Trait Anxiety Inventory, and reflective functioning with Reflective Functioning Scale. Mother-infant interactions were coded with various approaches: PEM for nonverbal mentalizing, Mind-mindedness coding system for Mind-mindedness, and CARE-Index for maternal styles of interaction. RESULTS Maternal depression and state anxiety were negatively correlated with PEM. PEM was also negatively correlated to maternal controlling style. Mothers with psychopathological problems (vs. mothers with no psychopathological problems) had lower PEM and sensitivity and more controlling style. Moreover, maternal depression and anxiety had direct effects on maternal sensitivity and had indirect effects mediated by PEM on controlling style. LIMITATIONS The study evaluates interactions at three months; longitudinal studies will be able to examine maternal mentalizing and sensitivity in various stages and identify the effect on the child's attachment. CONCLUSIONS PEM is associated to maternal anxiety and depression and mediates the effects of depression and anxiety on mother controlling style. These results emphasize the importance of early prevention programs for mothers focused also on implicit mentalizing.
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