Antenatal depression predicts depression in adolescent offspring: Prospective longitudinal community-based study

Institute of Psychiatry, King's College London, UK.
Journal of Affective Disorders (Impact Factor: 3.38). 08/2008; 113(3):236-43. DOI: 10.1016/j.jad.2008.05.018
Source: PubMed


Depression is familial. Evidence shows that untreated postnatal depression is associated with adverse outcomes for the child. Few studies have traced prospectively the course of maternal depression through pregnancy, the postnatal period and the following 16 years in relation to adolescent offspring depression.
The sample was recruited from two general practice antenatal clinics. Of 151 mother-child dyads followed from pregnancy to 16 years, information on the course of maternal depression and on depression in adolescent offspring was available for 127 (84%).
Two-thirds (82/125) of the women had been depressed during the 17-year time period, with the majority (54/82) experiencing more than one episode. A third of the women were depressed in pregnancy (41/124). Over half of these women (23/41) had consulted a doctor about their mental health prior to being pregnant and almost 90% (35/39) had further episodes during the child's lifetime. 14% (18/127) of the adolescent offspring were diagnosed with a depressive disorder at 16 years. Every depressed adolescent had been exposed to maternal depression. The risk of depression for the 16-year-olds exposed to antenatal depression was 4.7 times greater than for offspring not so exposed. The effect of antenatal depression was mediated by repeated exposure.
The number of study participants is small and limited to an inner-city population. Only depression spectrum diagnoses in the adolescent offspring have been considered.
Detection of depression in pregnancy identifies mothers at risk of further depressive episodes and a group of children who are at risk of depression in adolescence.

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    • "offspring more vulnerable to mental health disorders later in life (Halligan et al., 2007; O'Donnel et al. 2014; Pawlby et al., 2009; Pearson et al., 2013, Santos et al., 2014; Talge et al., 2007). Finally, a positive correlation between maternal and paternal depression has been demonstrated, emphasizing that AD is not merely a women's issue but is a problem that affects entire families (Escriba-Àguir and Artazcoz, 2011; Paulson and Bazelmore, 2010). "
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    ABSTRACT: Antenatal depression (AD) can have devastating consequences. No existing scales are specifically designed to measure it. Common practice is to adapt scales originally developed for other circumstances. We designed this study to validate and determine the psychometric values for AD screening in Brazil. We collected clinical and socio-demographic data in the second gestational trimester. The following instruments were also administered during that period: MINI-PLUS, EPDS, BDI and HAM-D. At the time of assessment, 17.34% of the patients were depressed, and 31.98% met the diagnostic criteria for lifetime major depression. All instruments showed an area under the curve in a receiver operating characteristic analysis greater than 0.85, with the BDI achieving a 0.90 and being the best-performing screening instrument. A score ≥11 on the EPDS (81.58% sensitivity, 73.33% specificity), ≥15 on the BDI (82.00% sensitivity, 84.26% specificity) and ≥9 on the HAM-D (87.76% sensitivity, 74.60% specificity) revealed great dichotomy between depressed and non-depressed patients. Spearman׳s rank correlation coefficients (ρ) among the scales had good values (EPDS vs. BDI 0.79; BDI vs. HAM-D 0.70, and EPDS vs. HAM-D 0.67). This study was transversal, assessing only women in the second gestational trimester. Results may be applicable only to the Brazilian population since psychometric properties may vary with the population under study. Major depression can amplify somatic symptomatology, affecting depressive rating scale data. AD is highly prevalent in Brazil. To address the problem of under-recognition, physicians can use the EPDS, BDI and HAM-D to identify AD. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 02/2015; 178:12-17. DOI:10.1016/j.jad.2015.02.003 · 3.38 Impact Factor
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    • "Depression in mothers during pregnancy and the postnatal period can not only substantially affect the quality of life for mothers, but also have wide-ranging adverse impacts on their offspring. Studies evidence the negative impact of perinatal depression on children and their higher risk of developing emotional, behavioural and intellectual problems (Murray & Cooper, 1997; Essex et al. 2001; Hay et al. 2001; Marchand et al. 2002; Grace et al. 2003; McMahon et al. 2008; Fihrer et al. 2009; Pawlby et al. 2009; Velders et al. 2011). Maternal depression, particularly during pregnancy and in the postnatal period, can contribute to intergenerational transmission of socio-economic disadvantage , making an impact on the child's quality of life and future life prospects, including in the labour market (Johnston et al. 2011). "
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    • "2010; Pawlby et al., 2009), and can have synergistic effects with childhood maltreatment on adolescent psychopathology (Pawlby et al., 2011; Plant et al., 2013). Pawlby and colleagues (2011) concluded that maternal cumulative stress is a key factor in predicting adolescent antisocial behavior, and it is postulated that interventions which ameliorate the decreased maternal care and/or endocrine changes in the CSS F1 dams may prevent the attenuation of social investigation reported in the current study of the CSS F2 offspring. "
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