Relational trajectories in families with parental mental illness: a grounded theory approach

Association of parental mental illness with anxiety and depression in adulthood: The role of potentially contributing factors

OBJECTIVE

Children of parents with a mental illness (COPMI) are at risk of developing mental disorders in adulthood, especially anxiety disorders and depression. The role of the family environment and demographic factors as related to adult anxiety and depression is insufficiently understood. We examined potentially contributing factors in the associations between a COPMI background with anxiety and depressive symptoms in adulthood.

METHOD

Cross-sectional general population-based study. Instruments were the General Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) and a questionnaire to evaluate self-reported history of a COPMI background and family-related experiences (CEPMIF). Multiple regression analyses were used to examine the role of demographic and family-related factors in the association of a self-reported COPMI background with the level of anxiety and depressive symptoms.

RESULTS

Of the 942 participants (mean age 48.1 (SD = 16.2) years; 53.7 % women), 116 (12.3 %) had a COPMI background. A COPMI background was associated with higher levels of anxiety and depressive symptoms. Within individuals with a COPMI background, relationship problems within the family were associated with elevated levels of anxiety and depression.

LIMITATIONS

The cross-sectional design does not allow for causal inferences, COPMI background was based on participant's self-report, and the type of parental mental disorder was not considered.

CONCLUSIONS

Adults with a COPMI background have higher levels of anxiety and depressive symptoms. Dysfunctional family relationships during childhood were associated with the severity of mental health problems of adults who grew up with a mentally ill parent. There is a need for targeted interventions for adult COPMI.

Review of Male and Female Care Needs in Schizophrenia: A New Specialized Clinical Unit for Women

Women with schizophrenia require health interventions that differ, in many ways, from those of men. The aim of this paper is to review male and female care needs and describe a newly established care unit for the treatment of women with schizophrenia. After reviewing the literature on the differentiated needs of men and women with schizophrenia, we describe the new unit’s assessment, intervention, and evaluation measures. The program consists of (1) individual/group patient/family therapy, (2) therapeutic drug monitoring and adherence checks, (3) perinatal mental health, (4) medical liaison, (5) suicide prevention/intervention, (6) social services with special focus on parenting, domestic abuse, and sexual exploitation, (7) home-based services, (8) peer support, (9) occupational therapies (physical activity and leisure programs), and (10) psychoeducation for both patients and families. Still in the planning stage are quality evaluation of diagnostic assessment, personalized care, drug optimization, health screening (reproductive health, metabolic syndrome, cardiovascular health, cancer, menopausal status), and patient and family satisfaction with services provided. Woman-specific care represents an important resource that promises to deliver state-of-the-art treatment to women and, ideally, prevent mental illness in their offspring.

Psychological and physical wellbeing in adults who grew up with a mentally ill parent: A systematic mixed-studies review

OBJECTIVE

Genetic vulnerability factors and adverse childhood experiences (ACE) are associated with an increased risk of psychopathology and other adverse health outcomes across the lifespan. However, less is known about how childhood experiences of parental mental illness affect psychological and physical wellbeing in adulthood. This review synthesizes research on the consequences of growing up as a child of a parent with mental illness (COPMI) for adult psychological and physical wellbeing.

METHODS

A systematic review was conducted following PRISMA guidelines using a mixed-method-studies approach to enable evaluation of the broad array of research designs (Prospero registration #CRD42020221983).

RESULTS

Qualitative studies (k = 10; N = 361) revealed that a COPMI background is associated with substantial psychological challenges in adulthood. Quantitative studies (k = 21; N = 865.402) suggested that COPMI are at increased risk of adult psychopathology, including anxiety and depressive disorders, suicidality, somatoform disorders, substance abuse, but also general medical morbidity and mortality.

CONCLUSIONS

Growing up with a mentally ill parent is associated with adverse psychological and physical outcomes in adulthood, but the evidence-base is limited. Longitudinal studies are needed that go beyond establishing genetic and environmental risk factors to further evaluate how a COPMI background influences wellbeing in adulthood and which targeted clinical interventions could be developed.

Chinese mothers' experiences of family life when they have a mental illness: A qualitative systematic review

The challenges experienced by families in western countries, where a parent has a mental illness, are well established. However, research documenting the experiences of Chinese families with parental mental illness appears limited. This study aimed to systematically review qualitative research about the experiences of families, living in mainland China, Hong Kong, Macao, and Taiwan, where parents have a mental illness. Eight databases were comprehensively searched, along with manual search of reference lists. The identified studies were critically appraised and analysed using a thematic synthesis approach. Ten papers were identified, with nine investigating mothers' experiences, one focusing on children's experiences, and none reporting on fathers' experiences. Subsequently, only papers presenting mothers' experiences were included for thematic synthesis. Five primary themes were identified including managing parenting in the context of mental illness; failure to meet one's expectations of motherhood; being burdened by others' expectations; stigma from self, others and service providers; and support obtained and needed. Similar to western mothers, Chinese mothers struggled to balance the demands of parenting and their illness, and experienced stigma associated with being a parent with a mental illness. Western and Chinese mothers' experiences differ in regard to the influence of parents-in-law and the division of domestic labour. Future research might investigate Chinese mothers with various mental health diagnoses, the perspectives of Chinese fathers with a mental illness, and the children in these families.