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Hope H, Pierce M, Gabr H, Radojčić MR, Swift E, Taxiarchi VP, Abel KM. The causal association between maternal depression, anxiety, and infection in pregnancy and neurodevelopmental disorders among 410 461 children: a population study using quasi-negative control cohorts and sibling analysis. Psychol Med 2024; 54:1693-1701. [PMID: 38205522 DOI: 10.1017/s0033291723003604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND To address if the long-standing association between maternal infection, depression/anxiety in pregnancy, and offspring neurodevelopmental disorder (NDD) is causal, we conducted two negative-control studies. METHODS Four primary care cohorts of UK children (pregnancy, 1 and 2 years prior to pregnancy, and siblings) born between 1 January 1990 and 31 December 2017 were constructed. NDD included autism/autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, cerebral palsy, and epilepsy. Maternal exposures included depression/anxiety and/or infection. Maternal (age, smoking status, comorbidities, body mass index, NDD); child (gender, ethnicity, birth year); and area-level (region and level of deprivation) confounders were captured. The NDD incidence rate among (1) children exposed during or outside of pregnancy and (2) siblings discordant for exposure in pregnancy was compared using Cox-regression models, unadjusted and adjusted for confounders. RESULTS The analysis included 410 461 children of 297 426 mothers and 2 793 018 person-years of follow-up with 8900 NDD cases (incidence rate = 3.2/1000 person years). After adjustments, depression and anxiety consistently associated with NDD (pregnancy-adjusted HR = 1.58, 95% CI 1.46-1.72; 1-year adj. HR = 1.49, 95% CI 1.39-1.60; 2-year adj. HR = 1.62, 95% CI 1.50-1.74); and to a lesser extent, of infection (pregnancy adj. HR = 1.16, 95% CI 1.10-1.22; 1-year adj. HR = 1.20, 95% CI 1.14-1.27; 2-year adj. HR = 1.19, 95% CI 1.12-1.25). NDD risk did not differ among siblings discordant for pregnancy exposure to mental illness HR = 0.97, 95% CI 0.77-1.21 or infection HR = 0.99, 95% CI 0.90-1.08. CONCLUSIONS Maternal risk appears to be unspecific to pregnancy: our study provided no evidence of a specific, and therefore causal, link between in-utero exposure to infection, common mental illness, and later development of NDD.
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Affiliation(s)
- Holly Hope
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Hend Gabr
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Mathematics, Insurance, and Statistics, Faculty of Commerce, Menoufia University, Shebeen El-Kom, Menoufia, Egypt
| | - Maja R Radojčić
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Eleanor Swift
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Vicky P Taxiarchi
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Karaca A, Şener DK, Kundakçi N. Being a child of a parent with a diagnosis of schizophrenia or bipolar disorder: A qualitative study. Arch Psychiatr Nurs 2024; 50:94-99. [PMID: 38789240 DOI: 10.1016/j.apnu.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/21/2023] [Accepted: 03/10/2024] [Indexed: 05/26/2024]
Abstract
Children of people with a diagnosis of schizophrenia or bipolar disorder encounter great difficulties in coping with the symptoms of the disorders. The study was conducted to determine the feelings, opinions, life experiences, and needs of the children of parents with a diagnosis of schizophrenia or bipolar disorder. This is a descriptive study conducted using the in-depth interview design, a qualitative method. The sample consisted of 19 children who agreed to participate in the study with parental consent. Data were collected using a personal information form and a semi-structured qualitative interview form. The data were analyzed using the thematic analysis method. As a result of the thematic analysis, five main themes were obtained: Parents from children's eyes, living with parents, social pressure, coping strategies, this life with one word. The study concluded that children of parents followed up for schizophrenia or bipolar disorder struggle with many individual and social difficulties. These children have feelings of fear, embarrassment, or anger with this life experience; encounter social exclusion; and are overwhelmed with heavy responsibilities at an early age. Their coping strategies can be maladaptive, such as smoking or alcohol consumption, thinking of eloping, becoming introverted, and so on.
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Affiliation(s)
- Aysel Karaca
- School of Health, Nursing Department, Düzce University, Konuralp campus, 81600 Düzce, Turkey
| | - Dilek Konuk Şener
- School of Health, Nursing Department, Düzce University, Konuralp campus, 81600 Düzce, Turkey.
| | - Necla Kundakçi
- Ankara Yıldırım Beyazıt University Institute of Health Sciences, Ankara, Turkey
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Nevriana A, Kosidou K, Hope H, Wicks S, Dalman C, Pierce M, Abel KM. Parental Mental Illness and the Likelihood of Child Out-of-Home Care: A Cohort Study. Pediatrics 2024; 153:e2023061531. [PMID: 38312009 DOI: 10.1542/peds.2023-061531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVES To detail the relationship between parental mental illness and the likelihood of out-of-home care (OHC) among their children, and to identify factors which modify this relationship. METHODS Using Swedish national registers, children born in 2000 to 2011 (n = 1 249 463) were linked to their parents. Time-dependent parental mental illness (nonaffective and affective psychosis, substance misuse, depression, anxiety and stress, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism, and intellectual disability), was identified through International Classification of Diseases codes. RESULTS After adjustment for socioeconomic factors, children living with mentally ill parents were 4 times as likely to be placed in OHC than children without (95% confidence interval [CI] 4.24-4.61). The highest hazard ratio (HR) was in the youngest children aged 0 to 1 year (5.77, 95% CI 5.42-6.14), exposed to maternal illness (HR 4.56, 95% CI 4.37-4.76), and parental intellectual disability (HR 4.73, 95% CI 4.09-5.46). Children with parental mental illness with multiple risk factors were at particularly high risk. Compared with children without parental mental illness, and those with university-educated parents, children whose parents had mental illness and only had education to age 16 had a 15 times higher risk of OHC (95% CI 13.75-16.54). CONCLUSIONS Children with parental mental illness are considerably more likely to be removed from home into care during childhood, particularly during the first year of life and if they are from socially disadvantaged families. Greater knowledge of these risks should lead to increased support for vulnerable new families.
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Affiliation(s)
- Alicia Nevriana
- Department of Global Public Health
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kyriaki Kosidou
- Department of Global Public Health
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Holly Hope
- Centre for Women's Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Susanne Wicks
- Department of Global Public Health
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Matthias Pierce
- Centre for Women's Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Kathryn M Abel
- Centre for Women's Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, United Kingdom
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Seo A, Chang AY. A systematic review of the social impact of diseases in Nordic countries. Scand J Public Health 2024:14034948231217365. [PMID: 38166481 DOI: 10.1177/14034948231217365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
BACKGROUND We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases. METHODS A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring. RESULTS A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts. CONCLUSIONS The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.
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Affiliation(s)
- Ahreum Seo
- Department of Public Health, University of Southern Denmark, Denmark
| | - Angela Y Chang
- Danish Institute for Advanced Study, University of Southern Denmark, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Denmark
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Waldmann T, Schaible J, Stiawa M, Becker T, Wegscheider K, Adema B, Wiegand-Grefe S, Kilian R. The cost-utility of an intervention for children and adolescents with a parent having a mental illness in the framework of the German health and social care system: a health economic evaluation of a randomized controlled trial. Child Adolesc Psychiatry Ment Health 2023; 17:141. [PMID: 38129868 PMCID: PMC10740235 DOI: 10.1186/s13034-023-00693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Children of families with a parent with a mental illness have an increased risk of developing social and mental health problems resulting in decreased quality of life. Therefore, children and adolescents living in families with a parent with mental illness are regarded as a target group for preventive interventions. To date, only a few economic evaluation studies for interventions directed at preventing the intergenerational transmission of mental health problems exist. In this investigation we estimated the cost utility of an intervention for the support of children and adolescents with a parent having a mental illness from the perspective of the German health and social care system. METHODS We randomly assigned a total of 214 families with 337 children and adolescents to the intervention (INT) group (108/170) or the control (TAU) group (106/167). Families in the intervention group received on average eight intervention sessions (50-90 min) over 6 months. We estimated total cost of illness by means of the Children and Adolescent Mental Health Service Receipt Inventory (CAMHSRI) over 24 months. For the estimation of Quality-Adjusted Live Years (QALYs) we applied the KIDSCREEN-10. For estimating the incremental cost-utility of the intervention compared to treatment as usual we used the net-benefit approach. RESULTS We estimated the annual cost of illness amounting to € 3784.59 (SD € 8581.11) in the TAU group and € 3264.44 (SD € 9431.89) in the INT group. The annual cost difference between INT and TAU was € - 516.14 (SE 1124.95) which was not significant (p ≤ 0.05). We estimated the average QALY to be 0.759 (SD 0.073) in the TAU group and 0.763 (SD 0.072). The QALY difference between INT and TAU was 0.0037 (SE 0.0092) which was not significant (p ≤ 0.05). The incremental cost utility ratio (ICUR) indicated that the gain of one additional year in full health by means of the intervention was associated with the saving of € 139.49. However, the stochastic insecurity of the ICUR did not allow a unique decision about the cost-utility of the intervention. CONCLUSIONS More information on the economic value of the intervention for families with a parent with mental illness in comparison to treatment as usual in Germany is needed. TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT02308462; German Clinical Trials Register: DRKS00006806.
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Affiliation(s)
- Tamara Waldmann
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
| | - Jochen Schaible
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
- Abteilung für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, ZfP Südwürttemberg, Ravensburg, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Leipzig, Germany
| | - Karl Wegscheider
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Bonnie Adema
- Department for Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Silke Wiegand-Grefe
- Department for Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany.
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Osam CS, Hope H, Ashcroft DM, Abel KM, Pierce M. Maternal mental illness and child atopy: a UK population-based, primary care cohort study. Br J Gen Pract 2023; 73:e924-e931. [PMID: 37783510 PMCID: PMC10562998 DOI: 10.3399/bjgp.2022.0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/08/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The number of children exposed to maternal mental illness is rapidly increasing and little is known about the effects of maternal mental illness on childhood atopy. AIM To investigate the association between maternal mental illness and risk of atopy among offspring. DESIGN AND SETTING Retrospective cohort study using a UK primary care database (674 general practices). METHOD In total, 590 778 children (born 1 January 1993 to 30 November 2017) were followed until their 18th birthday, with 359 611 linked to their hospital records. Time-varying exposure was captured for common (depression and anxiety), serious (psychosis), addiction (alcohol and substance misuse), and other (eating and personality disorder) maternal mental illness from 6 months before pregnancy. Using Cox regression models, incidence rates of atopy were calculated and compared for the exposed and unexposed children in primary (asthma, eczema, allergic rhinitis, and food allergies) and secondary (asthma and food allergies) care, adjusted for maternal (age, atopy history, smoking, and antibiotic use), child (sex, ethnicity, and birth year/season), and area covariates (deprivation and region). RESULTS Children exposed to common maternal mental illness were at highest risk of developing asthma (adjusted hazard ratio [aHR] 1.17, 95% confidence interval [CI] = 1.15 to 1.20) and allergic rhinitis (aHR 1.17, 95% CI = 1.13 to 1.21), as well as a hospital admission for asthma (aHR 1.29, 95% CI = 1.20 to 1.38). Children exposed to addiction disorders were 9% less likely to develop eczema (aHR 0.91, 95% CI = 0.85 to 0.97) and 35% less likely to develop food allergies (aHR 0.65, 95% CI = 0.45 to 0.93). CONCLUSION The finding that risk of atopy varies by type of maternal mental illness prompts important aetiological questions. The link between common mental illness and childhood atopy requires GPs and policymakers to act and support vulnerable women to access preventive (for example, smoking cessation) services earlier.
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Affiliation(s)
- Cemre Su Osam
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester
| | - Holly Hope
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester
| | - Darren M Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Faculty of Biology, Medicine and Health, and National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester
| | - Kathryn M Abel
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, University of Manchester; Greater Manchester Mental Health NHS Foundation Trust, Manchester
| | - Matthias Pierce
- Centre for Women's Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester
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Judd N, Hughes K, Bellis MA, Hardcastle K, Amos R. Is parental unemployment associated with increased risk of adverse childhood experiences? A systematic review and meta-analysis. J Public Health (Oxf) 2023; 45:829-839. [PMID: 37253685 PMCID: PMC10687894 DOI: 10.1093/pubmed/fdad069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/21/2022] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Unemployment has adverse consequences for families and can put children at risk of harm. This study presents a systematic review and meta-analysis of global evidence on associations between parental unemployment and adverse childhood experiences (ACEs). METHODS Systematic literature searches across four databases identified cross-sectional, cohort or case-control studies measuring associations between parental employment and individual or cumulative ACEs in children. Available risk estimates were extracted and pooled odds ratios calculated using random-effects models. RESULTS Of 60 included studies, 37 provided risk estimates suitable for pooling across seven ACE types. Paternal/any parental unemployment was associated with a 29% increased risk of sexual abuse, 54% increased risk of neglect, 60% increased risk of physical abuse and around 90% increased risk of child maltreatment and parental mental illness. No associations were found between maternal unemployment and ACEs. Pooling estimates from representative general population studies also identified increased risk of child maltreatment with paternal/any parental unemployment (82%) but not maternal unemployment. CONCLUSIONS Children who grow up with parental unemployment can be at increased risk of ACEs. A combination of socioeconomic measures to increase employment opportunities and parental support targeting fathers and mothers may help break multigenerational cycles of abuse and deprivation.
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Affiliation(s)
- Natasha Judd
- Public Health Collaborating Unit, BIHMR, School of Medical and Health Sciences, Wrexham Technology Park, Bangor University, Wrexham LL13 7YP, UK
- Policy and International Health, WHO Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham Technology Park, Wrexham LL13 7YP, UK
| | - Karen Hughes
- Public Health Collaborating Unit, BIHMR, School of Medical and Health Sciences, Wrexham Technology Park, Bangor University, Wrexham LL13 7YP, UK
- Policy and International Health, WHO Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham Technology Park, Wrexham LL13 7YP, UK
| | - Mark A Bellis
- Policy and International Health, WHO Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham Technology Park, Wrexham LL13 7YP, UK
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
| | - Katie Hardcastle
- Policy and International Health, WHO Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham Technology Park, Wrexham LL13 7YP, UK
| | - Rebekah Amos
- Public Health Collaborating Unit, BIHMR, School of Medical and Health Sciences, Wrexham Technology Park, Bangor University, Wrexham LL13 7YP, UK
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Sigmund D, Loew V, Pawils S. Engaging Parents Affected by Mental Health Problems in Pediatric and Gynecologic Practices-Implications of the KID-PROTEKT Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1853. [PMID: 38136055 PMCID: PMC10741721 DOI: 10.3390/children10121853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
Children of parents with mental illness are at higher risk of developing cognitive, mental health or physical health difficulties. Previous studies have described several barriers for reaching parents with mental health problems (MHPs) and their utilization of psychosocial services. We conducted a cluster randomized controlled study in 24 pediatric and gynecologic practices to evaluate KID-PROTEKT, a psychosocial healthcare intervention that comprises a psychosocial assessment to identify families with psychosocial needs and refer them to support services. In this paper, we analyzed whether psychosocially distressed parents with additional MHPs (identified by the PHQ-9 and GAD-7) had higher support needs, could be referred to support and utilized it in comparison to parents with psychosocial burden only. In total, 178 pregnant women and mothers with psychosocial burden were included, of whom 55 had MHPs. Participants with MHPs were distressed in their relationships more often and medical staff rated their level of support needs higher compared to parents without MHPs. There were no significant differences between the groups regarding whether they were referred to support services or utilized the recommended services. All participants were most frequently referred to family or parent counseling/care or childcare assistance. The results indicate that despite existing barriers, parents with MHPs could be reached and identified by the KID-PROTEKT psychosocial assessment. A psychosocial intervention like KID-PROTEKT can help to provide support for mentally ill parents.
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Affiliation(s)
| | | | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (D.S.); (V.L.)
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Puchol-Martínez I, Vallina Férnandez Ó, Santed-Germán MA. Preventive interventions for children and adolescents of parents with mental illness: A systematic review. Clin Psychol Psychother 2023; 30:979-997. [PMID: 36997159 DOI: 10.1002/cpp.2850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Children of parents with mental disorders have a relatively high risk of developing a mental illness or behavioural disorder. OBJECTIVE The aim of this systematic review was to evaluate the efficacy of preventive psychotherapeutic interventions in children of parents with mental illness. In particular, the development of mental illness and/or psychological symptomatology in this population was assessed. METHOD This qualitative systematic review looked at interventions targeting children aged 4-18 years without a diagnosed mental disorder, alone or with their families, with a parent with a diagnosed mental disorder. The protocol was pre-registered in Open Science Framework. A total of 1255 references were retrieved from MEDLINE, PsychArticles, PsycINFO, Springer Link, Science Direct, Scopus and WOS databases, and 12 references from grey literature. This search was replicated by an external reviewer. RESULTS Fifteen studies involving 1941 children and 1328 parents were included. Interventions were based on cognitive-behavioural and/or psychoeducational components, including six randomized controlled trials. Internalizing symptomatology was assessed in 80% of the studies, externalizing and prosocial behaviour in 47%, and coping style in 33%. Only two studies measured the future risk of developing a mental disorder (ORs of 2.37 and 6.6). There was variability in the format of the intervention (group; family) as well as in the type of intervention and its duration (from one session to 12 sessions). CONCLUSIONS Interventions for children of parents with mental disorder were clinically and statistically significant, especially in preventing internalizing symptomatology at one-year follow-up, with effect sizes ranging from d = -0.28 to 0.57 (95% CI).
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Affiliation(s)
- Itzal Puchol-Martínez
- Escuela Internacional de Doctorado, Institute of Public and Occupational Health of Navarre, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Miguel A Santed-Germán
- Department of Personality Evaluation and Psychological Treatment, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Zechmeister-Koss I, Strohmaier C, Hölzle L, Bauer A, Goodyear M, Christiansen H, Paul JL. Economic Evaluation of Family-Focused Programs When Parents Have a Mental Health Problem: Methodological Considerations. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:704-711. [PMID: 36503037 DOI: 10.1016/j.jval.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES The nature of adverse effects of parental mental health problems and of the interventions to address them may require specific designs of economic evaluation studies. Nevertheless, methodological guidance is lacking. We aim to understand the broad spectrum of adverse effects from parental mental health problems in children and the economic consequences on an individual and societal level to navigate the design of economic evaluations in this field. METHODS We conducted a systematic literature search of empirical studies on children's adverse effects from parental mental illness. We clustered types of impact, identified individual and public cost consequences, and illustrated the results in an impact inventory. RESULTS We found a wide variety of short- and long-term (mental) health impacts, impacts on social functioning and socioeconomic implications for the children individually, and adverse effects on the societal level. Consequently, public costs can occur in various public sectors (eg, healthcare, education), and individuals may have to pay costs privately. CONCLUSIONS Existing evaluations in this field mostly follow standard methodological approaches (eg, cost-utility analysis using quality-adjusted life-years) and apply a short-time horizon. Our findings suggest applying a long-term time horizon (at least up to early adulthood), considering cost-consequence analysis and alternatives to health-related quality of life and quality-adjusted life-years as outcome measures, and capturing the full range of possible public and private costs.
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Affiliation(s)
| | | | - Laura Hölzle
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
| | - Annette Bauer
- London School of Economics, Care Policy and Evaluation Centre (CPEC), London, England, UK
| | - Melinda Goodyear
- Monash University Australia, School of Rural Health, Melbourne, VIC, Australia
| | | | - Jean L Paul
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
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Pierce M, Di Prinzio P, Dalman C, Abel KM, Morgan VA. Hospital inpatient admissions of children of mothers with severe mental illness: A Western Australian cohort study. Aust N Z J Psychiatry 2023; 57:528-536. [PMID: 35642532 DOI: 10.1177/00048674221100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Children of parents with mental illness face a number of adversities, potentially contributing to poor health. AIM The aim of this study was to quantify the association between maternal severe mental illness and children's hospital admissions. METHOD Record linkage cohort study of 467,945 children born in Western Australia between 1 January 1980 and 31 December 2001. Follow-up was from age 28 days until fifth birthday. Linked registers captured information on potential confounders. Rate ratios and adjusted rate ratios measured relative change in the numbers of admissions and total days of stay, while rate differences measured absolute change in outcomes. Cause-specific increases were calculated for ICD-9 chapters and for 'potentially preventable' conditions. RESULTS After adjusting for potential confounders, children of mothers with severe mental illness had a 46% relative increased rate in hospital admissions (95% confidence interval = [38%, 54%]) and an absolute increase in 0.69 extra days in hospital per child, per year (95% confidence interval = [0.67, 0.70]). The relative increase in admissions was greatest in the child's first year of life (adjusted rate ratio = 1.76, 95% confidence interval = [1.64, 1.88]; rate difference = 0.32, 95% confidence interval = [0.30, 0.34]). Rates of admissions were increased for a range of causes, particularly injuries, infections and respiratory disease, and for conditions classified as 'potentially preventable'. CONCLUSION Children of mothers with severe mental illness have a substantial excess in hospital use compared to children of well mothers. This vulnerable group should be targeted with interventions to avert preventable morbidity and premature mortality in later life.
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Affiliation(s)
- Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Greater Manchester Mental Health Trust, Manchester, UK
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
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12
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Bolbocean C, Rhidenour KB, McCormack M, Suter B, Holder JL. COVID-19 Induced Environments, Health-Related Quality of Life Outcomes and Problematic Behaviors: Evidence from Children with Syndromic Autism Spectrum Disorders. J Autism Dev Disord 2023; 53:1000-1016. [PMID: 35672615 PMCID: PMC9172988 DOI: 10.1007/s10803-022-05619-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/29/2022]
Abstract
Between July 2020 and January 2021, 230 principal caregivers completed a questionnaire to measure proxy-assessed health-related quality of life outcomes (HRQoL), behavioral outcomes in children with syndromic autism spectrum disorders and COVID-19 induced changes to lifestyle and environments. HRQoL and behavioral outcomes reported earlier during the pandemic were generally worse compared to those reported later. COVID-19 induced reduction to a caregiver's mental health appointments, and hours spent watching TV were associated with decreases in HRQoL and increased the likelihood of problematic behaviors. Increasing time outdoors and time away from digital devices were positively associated with HRQoL and behaviors and might protect children from COVID-19 induced restrictions.
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Affiliation(s)
- Corneliu Bolbocean
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | | | - Maria McCormack
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St. Suite 925, Houston, TX, 77030, USA
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Bernhard Suter
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J Lloyd Holder
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund St. Suite 925, Houston, TX, 77030, USA
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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13
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Li B, Almquist YB, Liu C, Berg L. Disentangling the multigenerational transmissions of socioeconomic disadvantages and mental health problems by gender and across lineages: Findings from the Stockholm Birth Cohort Multigenerational Study. SSM Popul Health 2023; 22:101357. [PMID: 36846629 PMCID: PMC9947103 DOI: 10.1016/j.ssmph.2023.101357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023] Open
Abstract
There is a paucity of research examining the patterning of socioeconomic disadvantages and mental health problems across multiple generations. The current study therefore aimed to investigate the interconnected transmissions of socioeconomic disadvantages and mental health problems from grandparents to grandchildren through the parents, as well as the extent to which these transmissions differ according to lineage (i.e., through matrilineal/patrilineal descent) and grandchild gender. Drawing on the Stockholm Birth Cohort Multigenerational Study, the sample included 21,416 unique lineages by grandchild gender centered around cohort members born in 1953 (parental generation) as well as their children (grandchild generation) and their parents (grandparental generation). Based on local and national register data, socioeconomic disadvantages were operationalized as low income, and mental health problems as psychiatric disorders. A series of path models based on structural equation modelling were applied to estimate the associations between low income and psychiatric disorders across generations and for each lineage-gender combination. We found a multigenerational transmission of low income through the patriline to grandchildren. Psychiatric disorders were transmitted through both the patriline and matriline, but only to grandsons. The patriline-grandson transmission of psychiatric disorder partially operated via low income of the fathers. Furthermore, grandparents' psychiatric disorders influenced their children's and grandchildren's income. We conclude that there is evidence of transmissions of socioeconomic disadvantages and mental health problems across three generations, although these transmissions differ by lineage and grandchild gender. Our findings further highlight that grandparents' mental health problems could cast a long shadow on their children's and grandchildren's socioeconomic outcomes, and that socioeconomic disadvantages in the intermediate generation may play an important role for the multigenerational transmission of mental health problems.
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14
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Bell MF, Glauert R, Roos LL, Wall-Wieler E. Examining the relationship between maternal mental health-related hospital admissions and childhood developmental vulnerability at school entry in Canada and Australia. BJPsych Open 2023; 9:e29. [PMID: 36715086 PMCID: PMC9970171 DOI: 10.1192/bjo.2022.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND It is well established that maternal mental illness is associated with an increased risk of poor development for children. However, inconsistencies in findings regarding the nature of the difficulties children experience may be explained by methodological or geographical differences. AIMS We used a common methodological approach to compare developmental vulnerability for children whose mothers did and did not have a psychiatric hospital admission between conception and school entry in Manitoba, Canada, and Western Australia, Australia. We aimed to determine if there are common patterns to the type and timing of developmental difficulties across the two settings. METHOD Participants included children who were assessed with the Early Development Instrument in Manitoba, Canada (n = 69 785), and Western Australia, Australia (n = 19 529). We examined any maternal psychiatric hospital admission (obtained from administrative data) between conception and child's school entry, as well as at specific time points (pregnancy and each year until school entry). RESULTS Log-binomial regressions modelled the risk of children of mothers with psychiatric hospital admissions being developmentally vulnerable. In both Manitoba and Western Australia, an increased risk of developmental vulnerability on all domains was found. Children had an increased risk of developmental vulnerability regardless of their age at the time their mother was admitted to hospital. CONCLUSIONS This cross-national comparison provides further evidence of an increased risk of developmental vulnerability for children whose mothers experience severe mental health difficulties. Provision of preventative services during early childhood to children whose mothers experience mental ill health may help to mitigate developmental difficulties at school entry.
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Affiliation(s)
- Megan F Bell
- School of Population and Global Health, University of Western Australia, Western Australia; School of Psychological Science, University of Western Australia, Western Australia; and Telethon Kids Institute, University of Western Australia, Western Australia
| | - Rebecca Glauert
- School of Population and Global Health, University of Western Australia, Western Australia; and Telethon Kids Institute, University of Western Australia, Western Australia
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Canada
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15
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Kageyama M, Sakamoto T, Kobayashi A, Hirama A, Tamura H, Yokoyama K. Childhood Adversities and Psychological Health of Adult Children of Parents with Mental Illness in Japan. Healthcare (Basel) 2023; 11:healthcare11020214. [PMID: 36673582 PMCID: PMC9859196 DOI: 10.3390/healthcare11020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
In this study, we seek to clarify whether the present-day experience of psychological distress among adults whose parents suffered from mental illness is related to their childhood experiences of abuse and neglect and their provision of emotional care for their parents during their school-age years. To this end, a web-based cross-sectional study was conducted. A total of 120 participants over the age of 20 who attended a self-help group responded (50% response rate); of these, 94 had a parent diagnosed with a mental illness, and these participants were included for data analysis purposes. Of the 94 respondents, 65 (69.2%) were highly distressed, as measured by a Kessler (K) 6 measure of ≥5. A logistic regression analysis revealed that the experience of providing emotional care for parents during school-age childhood was significantly related to high levels of distress in adulthood (OR = 3.48; 95% CI 1.21-9.96). For children of parents with mental illnesses, the effects of providing emotional care for parents during childhood may include long-term psychological distress. For this reason, mentally ill parents raising children need visiting community nurses or other professionals to provide emotional care on behalf of their children.
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Affiliation(s)
- Masako Kageyama
- Institute of Advanced Co-Creation Studies, Osaka University, 1-7 Yamadaoka, Suita 565-0871, Osaka, Japan
- Correspondence: ; Tel./Fax: +81-6-6879-2553
| | - Taku Sakamoto
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Ayuna Kobayashi
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Akiko Hirama
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Hiroyuki Tamura
- KODOMO-PEER Tonoxbuilding, 3-5-1 Hirata, Ichikawa 272-0031, Chiba, Japan
| | - Keiko Yokoyama
- Department of Nursing, Faculty of Nursing, Yokohama Soei University, 1 Miho-cho, Yokohama 226-0015, Kanagawa, Japan
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16
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Pearson RJ, Grant C, Wijlaars L, Finch E, Bedston S, Broadhurst K, Gilbert R. Mental health service use among mothers involved in public family law proceedings: linked data cohort study in South London 2007-2019. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2097-2108. [PMID: 35294976 PMCID: PMC9477900 DOI: 10.1007/s00127-022-02221-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Mental health problems and substance misuse are common among the mothers of children who experience court-mandated placement into care in England, yet there is limited research characterising these health needs to inform evidence-based policy. In this descriptive study, we aimed to generate evidence about the type, severity, and timing of mental health and substance misuse needs among women involved in public family law proceedings concerning child placement into care ('care proceedings'). METHODS This is a retrospective, matched cohort study using linked family court and mental health service records for 2137 (66%) of the 3226 women involved in care proceedings between 2007 and 2019 in the South London and Maudsley NHS Mental Health Trust (SLaM) catchment area. We compared mental health service use and risk of dying with 17,096 female-matched controls who accessed SLaM between 2007 and 2019, aged 16-55 years, and were not involved in care proceedings. RESULTS Most women (79%) were known to SLaM before care proceedings began. Women had higher rates of schizophrenia spectrum disorders (19% vs 11% matched controls), personality disorders (21% vs 11%), and substance misuse (33% vs 12%). They were more likely to have a SLaM inpatient admission (27% vs 14%) or to be sectioned (19% vs 8%). Women had a 2.15 (95% CI 1.68-2.74) times greater hazard of dying, compared to matched controls, adjusted for age. CONCLUSION Women involved in care proceedings experience a particularly high burden of severe and complex mental health and substance misuse need. Women's increased risk of mortality following proceedings highlights that interventions responding to maternal mental health and substance misuse within family courts should offer continued, long-term support.
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Affiliation(s)
- Rachel J. Pearson
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH UK
| | - Claire Grant
- Department of Epidemiology and Public Health, UCL Institute of Epidemiology and Health, London, WC1E 7HB UK
| | - Linda Wijlaars
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH UK
| | - Emily Finch
- Southwark and Addictions Directorate, South London and Maudsley NHS Foundation Trust, London, SE5 8RZ UK
| | - Stuart Bedston
- Centre for Child and Family Justice Research, Lancaster University, Lancaster, LA1 4YW UK
| | - Karen Broadhurst
- Centre for Child and Family Justice Research, Lancaster University, Lancaster, LA1 4YW UK
| | - Ruth Gilbert
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH UK
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17
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Loudon E, Davidson G, Higgins K, Grant A. PROTOCOL: The support needs of families living with parental mental illness: A qualitative systematic review. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1267. [PMID: 36909885 PMCID: PMC9455750 DOI: 10.1002/cl2.1267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: To review existing qualitative research on the experiences of families living with parental mental illness from the perspective of (i) children, (ii) parents who have a mental illness) and (ii) the well parent. To synthesise qualitative evidence on the experience of living with parental mental illness and the experience of and attitude towards services from the perspective of (i) children, (ii) parents who have a mental illness and (ii) the well parent in order to develop the understanding of the needs of families and the implications for service provision.
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Affiliation(s)
- Emma Loudon
- Queen's Community and Place, School of Social Science, Education and Social WorkQueen's University BelfastBelfastUK
| | - Gavin Davidson
- School of Social Sciences, Education & Social WorkQueen's University BelfastBelfastUK
| | - Kathryn Higgins
- Queen's Community and Place, School of Social Science, Education and Social WorkQueen's University BelfastBelfastUK
| | - Anne Grant
- School of Nursing and MidwiferyQueen's University BelfastBelfastUK
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18
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Garosi A, Sunhary de Verville PL, Etchecopar-Etchart D, Richieri R, Godin O, Schürhoff F, Berna F, Aouizerate B, Capdevielle D, Chereau I, Clauss-Kobayashi J, Dorey JM, Dubertret C, Coulon N, Leignier S, Mallet J, Misdrahi D, Passerieux C, Rey R, Szoke A, Urbach M, Leboyer M, Llorca PM, Lançon C, Boyer L, Fond G, Andrieu-Haller C, Aouizerate B, Berna F, Blanc O, Bourguignon E, Capdevielle D, Chereau-Boudet I, Clauss-Kobayashi J, Coulon N, Dassing R, Dorey JM, Dubertret C, Esselin A, Fond G, Gabayet F, Jarroir M, Lacelle D, Leboyer M, Leignier S, Llorca PM, Mallet J, Metairie E, Michel T, Misdrahi D, Passerieux C, Petrucci J, Pignon B, Peri P, Portalier C, Rey R, Roman C, Schorr B, Schürhoff F, Szöke A, Tessier A, Urbach M, Wachiche G, Zinetti-Bertschy A. The impact of parent history of severe mental illness on schizophrenia outcomes: results from the real-world FACE-SZ cohort. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01449-x. [PMID: 35852617 DOI: 10.1007/s00406-022-01449-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
Parent history of severe mental illness (PHSMI) may have long-term consequences in adult offspring due to genetic and early environmental factors in preliminary studies. To compare the outcomes associated in subjects with PHSMI to those in patients without PHSMI. The participants with schizophrenia and schizoaffective disorders were recruited in the ongoing FACE-SZ cohort at a national level (10 expert centers) and evaluated with a 1-day-long standardized battery of clinician-rated scales and patient-reported outcomes. PHSMI was defined as history of schizophrenia or bipolar disorders in at least one parent and was included as explanatory variable in multivariate models. Of the 724 included patients, 78 (10.7%) subjects were classified in the PHSMI group. In multivariate analyses, PHSMI patients had a better insight into schizophrenia and the need for treatment and reported more often childhood trauma history compared to patients without PHSMI. More specifically, those with paternal history of SMI reported more severe outcomes (increased childhood physical and emotional abuses, comorbid major depression and psychiatric hospitalizations). PHSMI is associated with increased risk of childhood trauma, major depressive disorder and psychiatric hospitalization and better insight in individuals with schizophrenia. Specific public health prevention programs for parents with SMI should be developed to help protect children from pejorative psychiatric outcomes. PHSMI may also explain in part the association between better insight and increased depression in schizophrenia.
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Affiliation(s)
- A Garosi
- Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - P L Sunhary de Verville
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France.,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003, Clermont-Ferrand, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron, France.,Department of Psychiatry, Faculté de Médecine, AP-HP, Louis Mourier Hospital, Université Paris Diderot, Sorbonne Paris Cité, Inserm U894, Colombes, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France.,INRA, NutriNeuro, University of Bordeaux, U1286, 33076, Bordeaux, France.,CNRS UMR 5287-INCIA, Pessac, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - D Etchecopar-Etchart
- Fondation FondaMental, Créteil, France.,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - R Richieri
- Fondation FondaMental, Créteil, France.,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - O Godin
- Fondation FondaMental, Créteil, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France.,INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, 75013, Paris, France
| | - F Schürhoff
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - F Berna
- Fondation FondaMental, Créteil, France.,INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - B Aouizerate
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,INRA, NutriNeuro, University of Bordeaux, U1286, 33076, Bordeaux, France
| | - D Capdevielle
- Fondation FondaMental, Créteil, France.,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003, Clermont-Ferrand, France
| | - J Clauss-Kobayashi
- INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - J M Dorey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron, France
| | - C Dubertret
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Faculté de Médecine, AP-HP, Louis Mourier Hospital, Université Paris Diderot, Sorbonne Paris Cité, Inserm U894, Colombes, France
| | - N Coulon
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - S Leignier
- Fondation FondaMental, Créteil, France.,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - J Mallet
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, Faculté de Médecine, AP-HP, Louis Mourier Hospital, Université Paris Diderot, Sorbonne Paris Cité, Inserm U894, Colombes, France
| | - D Misdrahi
- Fondation FondaMental, Créteil, France.,Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France.,CNRS UMR 5287-INCIA, Pessac, France
| | - C Passerieux
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - R Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron, France
| | - A Szoke
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - M Urbach
- Fondation FondaMental, Créteil, France.,Centre Hospitalier de Versailles, Service de psychiatrie et d'addictologie adulte, le Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone veil, Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - M Leboyer
- Fondation FondaMental, Créteil, France.,Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Creteil, France
| | - P M Llorca
- Fondation FondaMental, Créteil, France.,CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003, Clermont-Ferrand, France
| | - C Lançon
- Fondation FondaMental, Créteil, France.,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - L Boyer
- Fondation FondaMental, Créteil, France.,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - G Fond
- Fondation FondaMental, Créteil, France. .,Faculté de Médecine-Secteur Timone, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
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Nevriana A, Pierce M, Abel KM, Rossides M, Wicks S, Dalman C, Kosidou K. Association between parental mental illness and autoimmune diseases in the offspring - A nationwide register-based cohort study in Sweden. J Psychiatr Res 2022; 151:122-130. [PMID: 35477076 DOI: 10.1016/j.jpsychires.2022.04.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/04/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023]
Abstract
Mental illness has been previously linked with autoimmune diseases, yet the associations between parental mental illness and offspring's risk of autoimmune diseases is largely unknown. We conducted a population-based cohort study of 2,192,490 Swedish children born between 1991 and 2011 and their parents to determine the associations between parental mental illness and risk of autoimmune diseases among the offspring. Time-dependent diagnoses of parental mental illness (psychosis, alcohol/drug misuse, depression, anxiety, eating disorders, personality disorders, attention deficit hyperactivity disorder, autism spectrum disorder) and offspring autoimmune diseases (type 1 diabetes (T1D), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus, psoriasis, multiple sclerosis, inflammatory bowel disease (IBD), coeliac disease) were identified from inpatient/outpatient healthcare visits. Associations were measured by hazard ratios (HRs) adjusted for potential confounders. Overall, parental mental illness was associated with a small increase in risk of offspring's autoimmune diseases (HR 1.05, 95% CI 1.02-1.08). However, parental common mental disorder (anxiety/depression) was associated with higher risk of JIA, psoriasis, and T1D (HR T1D 1.11, 95% CI 1.01-1.22), while maternal psychosis with reduced risk of coeliac disease (HR 0.68, 95% CI 0.49-0.95) and paternal alcohol/drug misuse with reduced risk of IBD (HR 0.80, 95% CI 0.64-0.99). Maternal eating disorders were associated with a markedly increased risk for T1D (HR 1.41, 95% CI 1.05-1.89). Further studies are needed to confirm these findings and to understand underlying mechanisms. There is a need for greater clinical awareness about potential risk of JIA, psoriasis, and T1D among children of parents with common psychiatric morbidity.
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Affiliation(s)
- Alicia Nevriana
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, United Kingdom
| | - Marios Rossides
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, 171 76, Stockholm, Sweden; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden; Department of Respiratory Medicine and Allergy, Theme Inflammation and Ageing, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Susanne Wicks
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Center for Epidemiology and Community Medicine, Stockholm Region, 104 31, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Center for Epidemiology and Community Medicine, Stockholm Region, 104 31, Stockholm, Sweden
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden; Center for Epidemiology and Community Medicine, Stockholm Region, 104 31, Stockholm, Sweden
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20
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Heuckendorff S, Johansen MN, Overgaard C, Johnsen SP, Thomsen JL, Fonager K. Six-year-old children had greater risks of functional gastrointestinal disorders if their parents had mental health conditions. Acta Paediatr 2022; 111:2029-2037. [PMID: 35726689 PMCID: PMC9546162 DOI: 10.1111/apa.16459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 05/25/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
Aim This study examined any associations between parents' mental health conditions and hospital diagnoses of functional gastrointestinal disorders (FGIDs) in offspring at the age of six. We also examined any associations between children who met these criteria and attended routine Danish preventive child health appointments. Methods Nationwide registers identified all children born in Denmark from 2000 to 2011 and parents' mental health conditions. Negative binomial regression analyses estimated the incidence rate ratios (IRRs) with 95% confidence intervals (CIs) of children receiving their first hospital diagnosis for an FGID at the age of six. Results We identified 750,379 children and 38% had at least one parent with a mental health condition: 24% were minor, 12% were moderate, and 2% were severe. These children faced a higher risk of an FGID diagnosis than children whose parents did not have mental health conditions. The IRRs were highest for maternal exposure: minor (1.35, 95% CI 1.29–1.42), moderate (1.58, 95% CI 1.48–1.67) and severe (1.58, 95% CI 1.38–1.81). Attending routine preventive child health examinations was associated with a higher risk of FGIDs associated with parents' mental health conditions. Conclusion Paediatric FGIDs were associated with parents' mental health conditions, especially mothers, and attending routine preventive child health examinations.
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Affiliation(s)
- Signe Heuckendorff
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark.,Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Charlotte Overgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Denmark
| | - Janus Laust Thomsen
- Department of Clinical Medicine, Aalborg University, Denmark.,Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Kirsten Fonager
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Denmark
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21
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Asthma and early smoking associated with high risk of panic disorder in adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 2022; 57:583-594. [PMID: 34279695 DOI: 10.1007/s00127-021-02146-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Studies have reported a strong link between asthma and panic disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and panic disorder during adolescence and early adulthood. METHODS A total of 162,766 participants aged 11-16 years were categorized into asthma and nonasthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant's gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and panic disorder. RESULTS Our findings revealed that asthma increased the risk of panic disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.70, 95% CI 1.28-2.26). Hospitalizations or visits to the emergency department for asthma exhibited a dose-response effect on the panic disorder (adjusted HR: 2.07, 95% CI 1.30-3.29). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for panic disorder (adjusted HR: 4.95, 95% CI 1.23-19.90). CONCLUSIONS Patients newly diagnosed with asthma had a 1.7-times higher risk of developing panic disorder. Smoking during late childhood or adolescence increased the risk for developing the panic disorder in patients with asthma.
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22
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Thorup AAE, Gantriis DL, Greve AN, Henriksen MT, Zahle KK, Stadsgaard H, Ellersgaard D, Burton BK, Christiani CJ, Spang K, Hemager N, Jepsen JRM, Plessen KJ, Nordentoft M, Mors O, Bliksted V. Exploring protective and risk factors in the home environment in high-risk families - results from the Danish High Risk and Resilience Study-VIA 7. BMC Psychiatry 2022; 22:100. [PMID: 35139818 PMCID: PMC8827286 DOI: 10.1186/s12888-022-03733-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/26/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Exposure to inadequate home environment may put the healthy development of familial high-risk children at risk. This study aimed to investigate associations between risk factors and an adequate home environment of children having a parent diagnosed with schizophrenia or bipolar disorder. METHODS From a cohort of 522 children, data from 463 7-year-old children was included. Of these 172 children had familial risk for schizophrenia, 109 children had familial risk for bipolar disorder, and 190 were population-based controls. As part of a comprehensive battery, all participants were assessed with the Middle Childhood-Home Observation for Measurement of the Environment Inventory (MC-HOME Inventory) measuring the quality of the home environment. RESULTS When analyzing all families together, we found that having a parent diagnosed with schizophrenia would have a negative impact on the home environment (ß = -1.08; 95% CI (-2.16;-0.01); p = 0.05), while familial risk for bipolar disorder did not show significant predictive value. Being a single caregiver and child having experienced severe life events from ages 4 to 7 showed significant negative impact, while child having a mental illness diagnosis did not. Being a female caregiver, good social functioning of the caregiver, high child IQ and not being a single caregiver were found to predict positive values for the home environment. We found similar results when analyzing caregivers with and without a diagnosis separately. CONCLUSIONS Knowledge of what predicts good home environment should be used to inform development of early interventions for families at risk.
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Affiliation(s)
- Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark. .,Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Maria Toft Henriksen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Kate Kold Zahle
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Henriette Stadsgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Ditte Ellersgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Centre for Neuropsychiatric Schizophrenia Research & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Jerlang Christiani
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,CORE Copenhagen Research Unit, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Katrine Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,CORE Copenhagen Research Unit, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.,CORE Copenhagen Research Unit, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.,Centre for Neuropsychiatric Schizophrenia Research & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Copenhagen, Denmark.,CORE Copenhagen Research Unit, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Kerstin J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, University of Copenhagen, Copenhagen, Denmark.,Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,CORE Copenhagen Research Unit, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
| | - Vibeke Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Skejby Psychiatry, Aarhus, Denmark
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23
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Mahumud RA, Dawson AJ, Chen W, Biswas T, Keramat SA, Morton RL, Renzaho AMN. The risk and protective factors for suicidal burden among 251 763 school-based adolescents in 77 low- and middle-income to high-income countries: assessing global, regional and national variations. Psychol Med 2022; 52:379-397. [PMID: 34269168 DOI: 10.1017/s0033291721002774] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adolescent suicide is a global public health concern and the second leading cause of adolescent death worldwide. This study aimed to estimate the burden of adolescent suicidal behaviours and its association with violence and unintentional injury, psychosocial, protective, lifestyle and food security-related factors amongst school-based adolescents across 77 countries in the six World Health Organization (WHO) regions. METHODS This study comprised a sample of 251 763 adolescents drawn from the latest Global School-based Student Health Survey of school-based adolescents, aged 11-17 years, across 77 countries. Logistic regression analyses were employed to estimate the adjusted effect of independent factors on adolescent suicidal behaviours. RESULTS The population-weighted 12-month prevalence of suicidal ideation (SI), suicidal planning (SP) and suicidal attempts (SA) amongst school-based adolescents was 18, 18 and 16%, respectively. Adolescent suicidal behaviours (i.e. SI, SP and SA) were respectively associated with being physically attacked, physical fighting, high levels of anxiety, feeling lonely, being bullied, lack of parental support, poor peer support, not having close friends and high levels of sedentary behaviours. Overall, these associations also extended to the context of food insecurity across regions and country income groups, where the magnitude of association slightly varied from odds ratios of 1.25 times to 3.13. CONCLUSIONS The burden of school-going adolescent suicidal thoughts, suicide planning and suicide attempts is of particular concern in low-resource countries. Comprehensive suicide prevention programmes for school-going adolescents in LMICs are needed that address socio-cultural inequities related to violence and unintentional injury, social support and psychological factors, protective, and lifestyle-related factors.
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Affiliation(s)
- Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW-2006, Australia
- School of Social Sciences, Western Sydney University, Penrith2751, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD-4350, Australia
| | - Angela J Dawson
- Faculty of Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
| | - Tuhin Biswas
- Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, QLD 4068, Australia
| | | | - Rachael Lisa Morton
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW-2006, Australia
| | - Andre M N Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne3004, Australia
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24
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The sexual and reproductive health of women with mental illness: a primary care registry study. Arch Womens Ment Health 2022; 25:585-593. [PMID: 35366692 PMCID: PMC9072520 DOI: 10.1007/s00737-022-01214-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/11/2022] [Indexed: 11/09/2022]
Abstract
The purpose of this study is to characterise the sexual and reproductive health risks associated with mental illness among women. This was a retrospective cohort study of 2,680,149 women aged 14 to 45 years in the Clinical Practice Research Datalink, a UK primary care register, linked to 1,702,211 pregnancies that ended between the 1st January 1990 and 31st December 2017. Mental illness was identified in primary care and categorised into the following: common mental illness (depression/anxiety); addiction (alcohol/drug misuse); serious mental illness (affective/non-affective psychosis); other mental illness (eating/personality disorders). Logistic regression estimated the association between mental illness and subsequent risk of recurrent miscarriage and termination. Cox proportional hazards estimated the association between mental illness and time to gynaecological diseases, sexually transmitted infections, reproductive cancers, cervical screen, contraception and emergency contraception. Models were adjusted for calendar year, year of birth, smoking status and ethnicity, region and index of socioeconomic status. Compared to women without mental illness, exposed women were more likely to experience recurrent miscarriage (adjOR = 1.50, 95%CI 1.41 to 1.60), termination (adjOR = 1.48, 95%CI 1.45 to 1.50), gynaecological diseases (adjHR = 1.39, 95%CI 1.37 to 1.40), sexually transmitted infections (adjHR = 1.47, 95%CI 1.43 to 1.51), reproductive cancers (adjHR = 1.10, 95%CI 1.02 to 1.19), contraception (adjHR = 1.28 95%CI 1.26 to 1.29) and emergency contraception (adjHR = 2.30, 95%CI 2.26 to 2.34), and less likely to attend for cervical screening (adjHR = 0.91, 95%CI 0.90 to 0.92). Currently, the sexual and reproductive health needs of women with mental illness are unmet representing significant health inequalities. Clinicians must create opportunities to engage with women in primary care and mental health services to address this gap.
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25
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Heuckendorff S, Johansen MN, Overgaard C, Johnsen SP, Kelly Y, Fonager K. Parental mental health, socioeconomic position and the risk of asthma in children-a nationwide Danish register study. Eur J Public Health 2021; 32:14-20. [PMID: 34893814 PMCID: PMC8807069 DOI: 10.1093/eurpub/ckab205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Parental mental illness affects child health. However, less is known about the impact of different severities of maternal depression and anxiety as well as other mental health conditions. The objective of this study was to examine the impact of different severities of maternal and paternal mental health conditions on child asthma. Methods This nationwide, register-based cohort study included all children in Denmark born from 2000 to 2014. Exposure was parental mental health conditions categorized in three severities: minor (treated at primary care settings), moderate (all ICD-10 F-diagnoses given at psychiatric hospital) and severe (diagnoses of severe mental illness). The children were followed from their third to sixth birthday. Child asthma was identified by prescribed medication and hospital-based diagnoses. Incidence rate ratios were calculated using negative binomial regression analyses. Results The analyses included 925 288 children; 26% of the mothers and 16% of the fathers were classified with a mental health condition. Exposed children were more likely to have asthma (10.6–12.0%) compared with unexposed children (8.5–9.0%). The three severities of mental health conditions of the mother and the father increased the risk of child asthma, most evident for maternal exposure. Additive interaction between maternal mental health conditions and disadvantaged socioeconomic position was found. Conclusion We found an increased risk of asthma in exposed children, highest for maternal exposure. Not only moderate and severe, but also minor mental health conditions increased the risk of child asthma. The combination of mental health condition and disadvantaged socioeconomic position for mothers revealed a relative excess risk.
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Affiliation(s)
- Signe Heuckendorff
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Danish Center for Clinical Health Services Research (DACS), Aalborg University, Aalborg, Denmark
| | | | - Charlotte Overgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Søren Paaske Johnsen
- Department of Clinical Medicine, Danish Center for Clinical Health Services Research (DACS), Aalborg University, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Yvonne Kelly
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Kirsten Fonager
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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26
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Hope H, Osam CS, Kontopantelis E, Hughes S, Munford L, Ashcroft DM, Pierce M, Abel KM. The healthcare resource impact of maternal mental illness on children and adolescents: UK retrospective cohort study. Br J Psychiatry 2021; 219:515-522. [PMID: 35048862 PMCID: PMC8387858 DOI: 10.1192/bjp.2021.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The general health of children of parents with mental illness is overlooked. AIMS To quantify the difference in healthcare use of children exposed and unexposed to maternal mental illness (MMI). METHOD This was a retrospective cohort study of children aged 0-17 years, from 1 April 2007 to 31 July 2017, using a primary care register (Clinical Practice Research Datalink) linked to Hospital Episodes Statistics. MMI included non-affective/affective psychosis and mood, anxiety, addiction, eating and personality disorders. Healthcare use included prescriptions, primary care and secondary care contacts; inflation adjusted costs were applied. The rate and cost was calculated and compared for children exposed and unexposed to MMI using negative binomial regression models. The total annual cost to NHS England of children with MMI was estimated. RESULTS The study included 489 255 children: 238 106 (48.7%) girls, 112 741 children (23.0%) exposed to MMI. Compared to unexposed children, exposed children had a higher rate of healthcare use (rate ratio 1.27, 95% CI 1.26-1.28), averaging 2.21 extra contacts per exposed child per year (95% CI 2.14-2.29). Increased healthcare use among exposed children occurred in inpatients (rate ratio 1.37, 95% CI 1.32-1.42), emergency care visits (rate ratio 1.34, 95% CI 1.33-1.36), outpatients (rate ratio 1.30, 95% CI 1.28-1.32), prescriptions (rate ratio 1.28, 95% CI 1.26-1.30) and primary care consultations (rate ratio 1.24, 95% CI 1.23-1.25). This costs NHS England an additional £656 million (95% CI £619-£692 million), annually. CONCLUSIONS Children of mentally ill mothers are a health vulnerable group for whom targeted intervention may create benefit for individuals, families, as well as limited NHS resources.
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Affiliation(s)
- Holly Hope
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK,Correspondence: Holly Hope.
| | - Cemre Su Osam
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Evangelos Kontopantelis
- Division of Informatics, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Sian Hughes
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK; and Population Health Analysis, Department of Health and Social Care, UK
| | - Luke Munford
- Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Darren M. Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Kathryn M. Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK; and Greater Manchester Mental Health NHS Foundation Trust, UK
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27
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Robinson N, Bergen SE. Environmental Risk Factors for Schizophrenia and Bipolar Disorder and Their Relationship to Genetic Risk: Current Knowledge and Future Directions. Front Genet 2021; 12:686666. [PMID: 34262598 PMCID: PMC8273311 DOI: 10.3389/fgene.2021.686666] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/20/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia (SZ) and bipolar disorder (BD) are severe psychiatric disorders which result from complex interplay between genetic and environmental factors. It is well-established that they are highly heritable disorders, and considerable progress has been made identifying their shared and distinct genetic risk factors. However, the 15-40% of risk that is derived from environmental sources is less definitively known. Environmental factors that have been repeatedly investigated and often associated with SZ include: obstetric complications, infections, winter or spring birth, migration, urban living, childhood adversity, and cannabis use. There is evidence that childhood adversity and some types of infections are also associated with BD. Evidence for other risk factors in BD is weaker due to fewer studies and often smaller sample sizes. Relatively few environmental exposures have ever been examined for SZ or BD, and additional ones likely remain to be discovered. A complete picture of how genetic and environmental risk factors confer risk for these disorders requires an understanding of how they interact. Early gene-by-environment interaction studies for both SZ and BD often involved candidate genes and were underpowered. Larger samples with genome-wide data and polygenic risk scores now offer enhanced prospects to reveal genetic interactions with environmental exposures that contribute to risk for these disorders. Overall, although some environmental risk factors have been identified for SZ, few have been for BD, and the extent to which these account for the total risk from environmental sources remains unknown. For both disorders, interactions between genetic and environmental risk factors are also not well understood and merit further investigation. Questions remain regarding the mechanisms by which risk factors exert their effects, and the ways in which environmental factors differ by sex. Concurrent investigations of environmental and genetic risk factors in SZ and BD are needed as we work toward a more comprehensive understanding of the ways in which these disorders arise.
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Affiliation(s)
| | - Sarah E. Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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28
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Racine N, Hetherington E, McArthur BA, McDonald S, Edwards S, Tough S, Madigan S. Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis. Lancet Psychiatry 2021; 8:405-415. [PMID: 33773109 PMCID: PMC8824360 DOI: 10.1016/s2215-0366(21)00074-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. METHODS In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. FINDINGS Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35·21%, 95% CI 32·48-38·04) and anxiety symptoms (31·39%, 28·76-34·15) than at all previous data collection timepoints. The mean depression score (8·31, 95% CI 7·97-8·65) and anxiety score (11·90, 11·66-12·13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5·05, 4·85-5·25; mean anxiety score 9·51, 9·35-9·66), 5-year timepoint (mean depression score 5·43, 5·20-5·66; mean anxiety score 9·49, 9·33-9·65), and 8-year timepoint (mean depression score 5·79, 5·55-6·02; mean anxiety score 10·26, 10·10-10·42). For the within-person comparisons, depression scores were a mean of 2·30 points (95% CI 1·95-2·65) higher and anxiety scores were a mean of 1·04 points (0·65-1·43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. INTERPRETATION Compared with previous estimates, the prevalence of maternal depression and anxiety among mothers in a Canadian cohort increased during the COVID-19 pandemic. Financial support, childcare provision, and avoiding the closure of schools, might be key priorities for preventing future increases in maternal psychological distress. FUNDING Alberta Innovates Health Solutions Interdisciplinary Team, Canadian Institutes of Health Research, Alberta Innovates, and Alberta Children's Hospital Foundation.
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Affiliation(s)
- Nicole Racine
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Erin Hetherington
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Brae Anne McArthur
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheila McDonald
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarah Edwards
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Lesinskiene S. An Exploration of the Possibilities of Current Mental Health Services to Tackle Transgenerational Effects of Parental Mental Illnesses on Offspring Adjustment in Lithuania. Front Psychiatry 2021; 12:764394. [PMID: 34777066 PMCID: PMC8586550 DOI: 10.3389/fpsyt.2021.764394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022] Open
Abstract
The topic of mental health and mental disorders is very sensitive and delicate in families and the society. Stigma is one of the main reasons for little help-seeking for mental disorders. Transgenerational effects of mental disorders is the utmost sensitive theme that brings difficulties for service organization and research. By emphasizing the importance of the effects of parental mental illnesses on the health of offspring and their adjustment, together with sharing the international experience between professionals, both the administration of services and society could provide opportunities for further positive change in this little-studied but utmost actual field. There is still a lack of appropriate long term systematic programs and ways to overcome complex organizational challenges. Sharing international experience and research could help find ways that best fit the situations in each country. After a descriptive analysis of the current system of mental health services in Lithuania, opportunities were sought to meet the needs of children and adolescents whose parents have mental disorders by ensuring their healthy psychosocial development. Child and adolescent psychiatry services are a more favorable and less stigmatized area in Lithuania than adult psychiatry, so assistance and specialized programs for children of parents with mental health problems could be organized using the country's relatively well-developed network of child and adolescent psychiatric and pediatric services. For such a small country with limited resources, there could be a possibility to use and strengthen the existing network of services together with finding opportunities for mixed models of financing and cooperation with non-governmental initiatives and organizations. A unique network of primary mental health outpatient centers that provide services for adults and children/adolescents could serve as a reasonable basis for the systematic implementation of specialized programs and initiatives in this field. This network is still not adequately used in the organization of mental health prevention, early intervention, and complex treatment services for the children of parents with mental illness.
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Affiliation(s)
- Sigita Lesinskiene
- Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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