Children whose mothers are depressed are more likely to suffer from anxiety, mental-health problems and disruptive behavior than those whose moms aren't. And if the mothers don't get better, these kids' problems often become worse, new research shows.
Conversely, however, children whose mothers are successfully treated for their depressive symptoms show significant improvements themselves — without any additional intervention or treatment of their own.
The study, available online today in the Journal of the American Medical Association, is the first, large-scale examination of the effects on kids when their mothers are treated for depression and scientifically monitored for a period of time. UT Southwestern Medical Center was one of several national sites participating in the study, which emphasizes the importance of evaluation and treatment of parental depression in an effort to help children and adolescents.
"The bottom line message is: 'Mothers who are depressed, go get treated for your depression. It will help not only you, but your child,'" said study co-author Dr. A. John Rush, vice chairman of clinical sciences and professor of psychiatry at UT Southwestern.
About one in 20 teens suffers from moderately severe to severe depression; it is one of the most common disorders of adolescence, according to the National Institute of Mental Health (NIMH). This means that in a high school population of 2,000 teenagers, 100 are likely to have a significant major depressive episode on any given day.
"Depression should not be taken lightly," said Dr. Madhukar Trivedi, study co-author and professor of psychiatry at UT Southwestern. "For kids' sakes particularly, we should be very aggressive in treating patients, particularly mothers. The more improved care we can provide to depressed mothers, the more benefit to their children."
Part of the largest national clinical trial on treatment for depression, called STAR*D (Sequenced Treatment Alternatives to Relieve Depression) — coordinated by UT Southwestern and funded by the NIMH — the mother-child study included more than 150 pairs of mothers and their children, who varied in age from 7 to 17. The mothers were treated for depression in eight primary-care and 11 psychiatric outpatient clinics across the country as part of the $35 million six-year STAR*D study.
Dr. Rush said mothers were studied rather than fathers because the rate of depression is higher in women than men, particularly in women of childbearing ages. Mothers are also more likely than fathers to bring their children in for assessments.
Children participating in STAR*D-Child were evaluated for depression at the beginning of the study and then reassessed after their mothers had been on antidepressant medications for three months. Many came into the study with significant problems - more than one-third had current psychiatric disorders including anxiety, depression and/or other disruptive behavior disorders. Almost half had a previous psychiatric disorder.
Three months later, kids whose moms remitted (or recovered from all depressive symptoms, based on a widely used measurement scale) showed an overall 11 percent decrease in rates of diagnoses for depression, as compared to an approximate 8 percent increase in rates of diagnoses in children of non-remitted mothers.
Of the children who were diagnosed with depression at the study's beginning, remission was reported in 33 percent of those whose mothers remitted, compared to only 12 percent remission rates in those whose mothers did not. Of the children with no diagnoses of depression at the study's onset, all children of remitted mothers remained symptom-free, while 17 percent of the children of non-remitted mothers acquired a diagnosis of depression during the three months.
Mothers who did not fully remit after three months, but did respond (showed a decrease in depressive symptoms by at least 50 percent) also had children who showed improvement. Additionally, when overall study results were analyzed based on mothers' educational levels, or both income and education, the statistics remained unchanged.
"A mother's depression does affect her kids," said Dr. Carroll W. Hughes, professor of psychiatry and rehabilitation counseling at UT Southwestern. "When she gets treated and gets better, lo and behold, her kids improve, too. A parent's depression not only has a strong impact on the family as a whole, but it often affects a child's functioning. It points out the need for parents to seek treatment for their depression."
The study's lead author, Dr. Myrna M. Weissman, as well as several other researchers are from Columbia University and the New York State Psychiatric Institute. Also included were researchers from Vanderbilt University; the University of North Carolina; the University of Michigan; the University of California, San Diego; Virginia Commonwealth University; Harvard University; and the University of Pittsburgh.
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