Concurrent Treatment of Depression in Parents and Adolescents: A Case Example

Family-Based Treatment for Anxiety, Depression, and ADHD for a Parent and Child

Children with mental illness commonly live with caregivers who suffer from mental illness. Integrated mental-health-treatment approaches can provide more convenient and comprehensive care for families. This case report describes family-based treatment (FBT) for one parent/child dyad. The parent was a 37-year-old female with a history of anxiety and major depressive disorder and concern for symptoms of attention-deficit/hyperactivity disorder (ADHD). The child was an 8-year-old female with generalized anxiety disorder and concern for ADHD and behavioral problems. The parent received individual cognitive behavioral therapy (CBT) and parent management training. The child received CBT. Both also received medication management. The FBT team met regularly for coordinated treatment planning. Self-reported assessments via the Child Behavior Checklist showed meaningful improvement; anxiety decreased to nonclinical range week 12 and depression decreased to nonclinical range week 8. Clinician assessments showed improvement for both patients. Though more time intensive, FBT can yield significant improvement, particularly for children. Pragmatic approaches to treatment planning are important to minimize barriers to FBT.

The longitudinal relationship between child emotional disorder and parental mental health in the British Child and Adolescent Mental Health surveys 1999 and 2004

BACKGROUND

Research suggests parental psychopathology has an adverse effect on child mental health. However, due to the interactional nature of parent-child relationships and with a high rate of emotional disorders reported in school-age children, it is important to know whether the effect is reciprocal.

METHODS

We explored the longitudinal relationship between child and parent mental health in the British Child and Adolescent Mental Health Surveys (N=7,100 child-parent dyads) and their three-year follow-ups. The Development and Well-Being Assessment with DSM-IV diagnostic criteria was used to measure child psychiatric diagnoses, while parental mental health was assessed using the General Health Questionnaire. Multivariable logistic regression was used to explore the longitudinal association between child emotional disorder and parent mental health.

RESULTS

Parents of children who had an emotional disorder at baseline were more likely to have poor mental health three years later compared with parents whose children had no psychiatric diagnosis (33.3% versus 16.7%; crude odds ratio=2.52; adjusted odds ratio=2.19, 95% CI=1.58 to 3.05, p<0.001). Children of parents with poor mental health at baseline were more likely to develop an emotional disorder three years later compared with children whose parents had good mental health (5.2% versus 2.5%; crude odds ratio=2.08; adjusted odds ratio=1.63, 95% CI=1.18 to 2.25, p=0.003).

LIMITATIONS

The findings of this research are limited by the survey data collected, the measures used and survey dropout.

CONCLUSIONS

We detected a bi-directional relationship between child and parent mental health, suggesting that effective intervention for one individual may benefit other family members.

Psychosocial risk factors associated with depressive symptoms among adolescents in secondary schools in mainland china: A systematic review and meta-analysis

BACKGROUND

The objective of the study is to systematically estimate the effect size of psychosocial risk factors for depressive symptoms among adolescents in secondary schools in mainland China.

METHOD

A literature search was conducted in both English and Chinese databases. This meta-analysis used a random-effects model to estimate the effect size.

RESULTS

Fifteen psychosocial risk factors were identified in a total of 164 articles. The results revealed the absolute value of effect size ranging from 0.16 to 0.43. Among them, poor parent-child communication (r = 0.43), negative life events (r = 0.40), academic pressure (r = 0.40), abuse (r = 0.33), poor family functioning (r = 0.33), bullying (r = 0.32), and poor family cohesion (r = 0.32) were associated with depression with a medium to large effect. Moderator analysis shows that grade, study quality, mean age, and gender were significant moderators of at least one factor for depression.

LIMITATIONS

Limitations included the heterogeneity which is largely unexplained, and the inability to investigate the interactions of different factors and to determine the direction of causal relationships between psychosocial factors and depression in the present meta-analysis.

CONCLUSIONS

This study suggests that family-related factors and school-related factors may be significantly associated with depressive symptoms in Chinese secondary school students. Further research is needed to develop effective strategies to modify these factors in depression prevention programmes.