Screening for depression in mothers bringing their offspring for evaluation or treatment of depression

Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 04/2000; 157(3):375-9. DOI: 10.1176/appi.ajp.157.3.375
Source: PubMed

ABSTRACT Numerous studies have shown that the highest risk for first onset of depression occurs in women of childbearing years and that there is a strong association between lifetime rates of depressive disorders in mothers and their offspring. This association is found regardless of whether the mother or child is the targeted patient. However, little is known about rates of current depression in mothers who bring their offspring to outpatient clinics for evaluation and/or treatment of depression. This information might be useful in developing intervention strategies.
One hundred seventeen mothers bringing their offspring for evaluation or treatment for depression were screened with the Patient Problem Questionnaire to determine current symptoms of depression, anxiety disorders, and substance abuse as well as current psychiatric treatment.
Thirty-six (31%) of the mothers screened positive on the Patient Problem Questionnaire for a current psychiatric disorder. Sixteen (14%) screened positive for current major depression, 20 (17%) for panic disorder, 20 (17%) for generalized anxiety disorder, two (2%) for alcohol abuse, and one (1%) for drug abuse. In addition, 50 (43%) of the mothers had psychiatric symptoms that did not meet the diagnostic threshold for any of the above disorders. Twenty-six (22%) of mothers expressed suicidal ideation or intent. Only five (31%) of the 16 mothers diagnosed with major depression were currently receiving any psychiatric treatment.
A substantial number of mothers bringing their offspring for evaluation or treatment of depression were themselves currently depressed and untreated. The treatment of depressed mothers may help both the mothers and their depressed offspring.

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    • "Although dopamine is the most important neurotransmitter involved in maternal behaviour (MB) (Bridges et al. 1985, 1990; Hansen 1994; Lonstein et al. 1997), it has been suggested that the serotonergic system is associated with specific components of MB and oxytocin secretion in animal models (Barofsky et al. 1983; Saydoff et al. 1991; Bagdy et al. 1992; Bagdy and Kalogeras 1993; Uvnäs-Moberg et al. 1996; Nissen et al. 1998; Ferreira et al. 2000). It has been estimated that depression occurs in 8%–20% of women of child-bearing age (Weissman et al. 1988; Kessler et al. 1993; Ferro et al. 2000). The most prescribed antidepressant during pregnancy is fluoxetine (FLX), a selective serotonin reuptake inhibitor (SSRI). "
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    ABSTRACT: Fluoxetine (FLX) is a selective serotonin reuptake inhibitor (SSRI) antidepressant commonly prescribed during pregnancy and lactation. Pre- and post-partum depression, as well as SSRI treatment during these periods, may change maternal care, interfering with offspring development. Moreover, it is known that SSRIs may alter testes structure and function in offspring. The present study investigated the effects of maternal FLX exposure on maternal behaviour and testes function in offspring. Female Wistar rats were treated with 7.5mgkg-1 FLX or tap water (control group) by gavage from the Day 1 of pregnancy until 21 days after birth (postnatal Day (PND) 21). Maternal behaviour was evaluated and morphofunctional analyses of offspring testes were conducted on PND 21 and 50. There were no significant differences between the FLX-treated and control groups regarding maternal behaviour. Nor did maternal treatment with FLX have any effect on bodyweight gain, anogenital distance, day of preputial separation, testis weight and the gonadosomatic index in male offspring. However, there was a decreased number of Sertoli cells at both PND 21 and 50 in FLX-exposed male offspring. The findings of the present study demonstrate that maternal exposure to FLX can impair testicular function in weanling and pubertal animals.
    Reproduction Fertility and Development 01/2015; DOI:10.1071/RD14199 · 2.40 Impact Factor
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    • "Approximately 20 % of women experience depression during their lifetime (Weissman et al. 1996), and lowincome women, of which African American and Latina women are disproportionately represented, are at particularly high risk of onset (Grote et al. 2007; Kessler 2003; Knitzer et al. 2008). A sizable number of women who suffer from depression are also mothers (Swartz et al. 2008), especially caregivers of youth with mental health needs (Bailey et al. 2007; Ferro et al. 2000; Swartz et al. 2008). In addition to the strain associated with managing their child's mental health needs, they commonly encounter stigma and blame by family, friends, their child's school and providers because of their child's difficulties . "
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    ABSTRACT: This paper describes a feasibility study of a peer-delivered prevention intervention to identify mothers at high risk for depression and facilitate engagement in mental health services for their emotional health. Sixteen family peer advocates and their supervisors partnered with academic researchers over a period of 6 months to develop a four-session intervention that focused on identifying symptoms of depression, providing education about depression and treatment, actively linking caregivers to treatment for their own emotional health, and assisting caregivers in becoming active participants in their mental health care. Collaborating with peers to develop the model enhanced its perceived relevance and utility, and resulted in an intervention that was complimentary to their roles and the mission of peer-delivered support services. Peer/professional partnerships may be beneficial for enhancing the feasibility and acceptability of research efforts; the impact of peers’ participation in the current project and the need for future research to develop and study peer-delivered models is discussed.
    Journal of Child and Family Studies 07/2014; 23(5). DOI:10.1007/s10826-013-9736-z · 1.42 Impact Factor
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    • "(iv) Two studies did not compare incidence of MDD or BD in FDRs and/or SDRs of probands affected by MDD or BD to population incidence rates or controls (Hillegers et al., 2005; Schreier et al., 2006). (v) Forty-one publications did not report data point estimates of the effect measure, or were reported without p values, CIs or raw data, from which the effect measure could be calculated (Andreasen et al., 1987; Brent et al., 2004; Chang et al., 2000; Dienes et al., 2002; Dierker et al., 1999; Eley et al., 2004; Ferro et al., 2000; Gershon, 1982; Giovanni et al., 2010; Grigoroiu- Serbanescu et al., 1989; Grove et al., 1987; Hillegers et al., 2005; Kaufman et al., 1998; Kendler et al., 1997; Kessler et al., 1998; Lavori et al., 1987; Levinson et al., 2003; Li et al., 2008; Lieb et al., 2002; Marazita et al., 1997; Martinez-Devesa et al., 2007; McGuffin et al., 1988; McMahon et al., 1995; Merikangas et al., 1988; Mitchell et al., 1989; Moberg, 1991; Mojtabai, 2005; Murray et al., 2011; Olino et al., 2008; Orvaschel, 1990; Peterson et al., 1982; Ryan et al., 1992; Singh et al., 2007; Stevenson et al., 2010; Thorndike et al., 1996; Todd et al., 1994; Tozzi et al., 2008; Wals et al., 2003; Wals et al., 2004; Weissman et al., 1984a; Wickramaratne and Weissman, 1998). (vi) Wickramaratne and Weissman (1998) duplicated cases reported in two later studies, respectively (Beardslee et al., 1996; Wickramaratne et al., 2000), which were subsequently excluded because they did not report the outcomes of interest. "
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    ABSTRACT: Background To conduct a meta-analysis to estimate the incidence of major depressive disorder (MDD) and bipolar disorder (BD) in first-degree relatives (FDRs) of probands affected by MDD or BD. The risk for MDD in FDR of BD probands and vice versa is also investigated. Methods A systematic review of case-control and cohort studies, which were published between 1977 and 2012; reported relative risks (RR) or odd ratios (OR) or equivalent raw data; made an explicit distinction between MDD and BD; used operational diagnostic criteria; and reported systematic proband recruitment and ascertainment of relatives. Studies were obtained by electronic MEDLINE and EMBASE searches and hand-searching. Estimates were derived from pooled data using random effects methods. Results Of an initial sample of 241 articles, 22 were eligible for inclusion. For FDRs of one proband with MDD compared to healthy control probands, estimates for MDD were OR=2.14 (95% CI 1.72–2.67), increasing to OR=3.23 (95% CI 2.11–4.94) for two MDD probands. For FDRs of one BD proband compared to healthy control probands, estimates for BD were OR=7.92 (95% CI 2.45–25.61), and OR=6.58 (95% CI 2.64–16.43) for FDRs of two BD probands. Conclusions These findings support previously published data indicating strong familiality for both MDD and BD. Data will be useful in providing individuals with a family history of MDD or BPD with tailored risk estimates.
    Journal of Affective Disorders 04/2014; 58:37-47. DOI:10.1016/j.jad.2014.01.014 · 3.38 Impact Factor
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