Children of currently depressed mothers

A STAR*D ancillary study

Daniel J. Pilowsky, Priya J. Wickramaratne, A. John Rush, Carroll W. Hughes, Judy Garber, Erin Malloy, Cheryl A. King, Gabrielle Cerda, A. Bela Sood, Jonathan E. Alpert, Stephen R. Wisniewski, Madhukar H. Trivedi, Ardesheer Talati, Marlene M. Carlson, Harry Hong Liu, Maurizio Fava, Myrna M. Weissman

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Objective: To assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD). Method: Treatment-seeking mothers with a current DSM-IV diagnosis of MDD and with at least 1 child 7 to 17 years old were assessed during a major depressive episode (MDE). For each mother, 1 child was assessed (if a mother had more than 1 child, 1 was randomly selected). Maternal features assessed for this study were history of MDEs, severity of current MDE, comorbid conditions, depressive symptom features, and social functioning. Children were assessed for selected psychiatric diagnoses (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]), psychopathologic symptoms and social functioning (Child Behavior Checklist), and global functioning (Children's Global Assessment Scale). Data were gathered from December 2001 to April 2004. Results: A large proportion (72%) of mothers were severely depressed (17-item Hamilton Rating Scale for Depression score ≥ 22). About a third (34%) of children had a current psychiatric disorder, including disruptive behavior (22%), anxiety (16%), and depressive (10%) disorders. Nearly half (45%) had a lifetime psychiatric disorder, including disruptive behavior (29%), anxiety (20%), and depressive (19%) disorders. Atypical depressive features in the mother were associated with a 3-fold increase in the odds of having a child with depressive (OR = 3.3 [95% CI = 1.2 to 9.5]; p = .02) or anxiety (OR = 2.6 [95% CI = 1.1 to 6.9]; p = .03) disorders. A history of maternal suicide attempts and the presence of comorbid panic disorder with agoraphobia were associated with a 3-fold increase and an 8-fold increase in the odds of depressive disorders in the offspring, respectively. The final model showed significant associations (p ≤ .05) between the following characteristics of maternal depression and offspring disorders: maternal comorbid panic disorder with agoraphobia and offspring depressive and anxiety disorders, maternal irritable depression and offspring disruptive behavior disorders and any disorder, and maternal substance use disorders and any disorder. Conclusions: Children of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.

Original languageEnglish (US)
Pages (from-to)126-136
Number of pages11
JournalJournal of Clinical Psychiatry
Volume67
Issue number1
StatePublished - Jan 2006

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Mothers
Depression
Attention Deficit and Disruptive Behavior Disorders
Depressive Disorder
Therapeutics
Agoraphobia
Panic Disorder
Anxiety Disorders
Psychiatry
Anxiety
Major Depressive Disorder
Psychopathology
Child Behavior
Risk-Taking
Checklist
Mood Disorders
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Suicide
Substance-Related Disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Pilowsky, D. J., Wickramaratne, P. J., Rush, A. J., Hughes, C. W., Garber, J., Malloy, E., ... Weissman, M. M. (2006). Children of currently depressed mothers: A STAR*D ancillary study. Journal of Clinical Psychiatry, 67(1), 126-136.

Children of currently depressed mothers : A STAR*D ancillary study. / Pilowsky, Daniel J.; Wickramaratne, Priya J.; Rush, A. John; Hughes, Carroll W.; Garber, Judy; Malloy, Erin; King, Cheryl A.; Cerda, Gabrielle; Sood, A. Bela; Alpert, Jonathan E.; Wisniewski, Stephen R.; Trivedi, Madhukar H.; Talati, Ardesheer; Carlson, Marlene M.; Liu, Harry Hong; Fava, Maurizio; Weissman, Myrna M.

In: Journal of Clinical Psychiatry, Vol. 67, No. 1, 01.2006, p. 126-136.

Research output: Contribution to journalArticle

Pilowsky, DJ, Wickramaratne, PJ, Rush, AJ, Hughes, CW, Garber, J, Malloy, E, King, CA, Cerda, G, Sood, AB, Alpert, JE, Wisniewski, SR, Trivedi, MH, Talati, A, Carlson, MM, Liu, HH, Fava, M & Weissman, MM 2006, 'Children of currently depressed mothers: A STAR*D ancillary study', Journal of Clinical Psychiatry, vol. 67, no. 1, pp. 126-136.
Pilowsky DJ, Wickramaratne PJ, Rush AJ, Hughes CW, Garber J, Malloy E et al. Children of currently depressed mothers: A STAR*D ancillary study. Journal of Clinical Psychiatry. 2006 Jan;67(1):126-136.
Pilowsky, Daniel J. ; Wickramaratne, Priya J. ; Rush, A. John ; Hughes, Carroll W. ; Garber, Judy ; Malloy, Erin ; King, Cheryl A. ; Cerda, Gabrielle ; Sood, A. Bela ; Alpert, Jonathan E. ; Wisniewski, Stephen R. ; Trivedi, Madhukar H. ; Talati, Ardesheer ; Carlson, Marlene M. ; Liu, Harry Hong ; Fava, Maurizio ; Weissman, Myrna M. / Children of currently depressed mothers : A STAR*D ancillary study. In: Journal of Clinical Psychiatry. 2006 ; Vol. 67, No. 1. pp. 126-136.
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abstract = "Objective: To assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD). Method: Treatment-seeking mothers with a current DSM-IV diagnosis of MDD and with at least 1 child 7 to 17 years old were assessed during a major depressive episode (MDE). For each mother, 1 child was assessed (if a mother had more than 1 child, 1 was randomly selected). Maternal features assessed for this study were history of MDEs, severity of current MDE, comorbid conditions, depressive symptom features, and social functioning. Children were assessed for selected psychiatric diagnoses (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]), psychopathologic symptoms and social functioning (Child Behavior Checklist), and global functioning (Children's Global Assessment Scale). Data were gathered from December 2001 to April 2004. Results: A large proportion (72{\%}) of mothers were severely depressed (17-item Hamilton Rating Scale for Depression score ≥ 22). About a third (34{\%}) of children had a current psychiatric disorder, including disruptive behavior (22{\%}), anxiety (16{\%}), and depressive (10{\%}) disorders. Nearly half (45{\%}) had a lifetime psychiatric disorder, including disruptive behavior (29{\%}), anxiety (20{\%}), and depressive (19{\%}) disorders. Atypical depressive features in the mother were associated with a 3-fold increase in the odds of having a child with depressive (OR = 3.3 [95{\%} CI = 1.2 to 9.5]; p = .02) or anxiety (OR = 2.6 [95{\%} CI = 1.1 to 6.9]; p = .03) disorders. A history of maternal suicide attempts and the presence of comorbid panic disorder with agoraphobia were associated with a 3-fold increase and an 8-fold increase in the odds of depressive disorders in the offspring, respectively. The final model showed significant associations (p ≤ .05) between the following characteristics of maternal depression and offspring disorders: maternal comorbid panic disorder with agoraphobia and offspring depressive and anxiety disorders, maternal irritable depression and offspring disruptive behavior disorders and any disorder, and maternal substance use disorders and any disorder. Conclusions: Children of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.",
author = "Pilowsky, {Daniel J.} and Wickramaratne, {Priya J.} and Rush, {A. John} and Hughes, {Carroll W.} and Judy Garber and Erin Malloy and King, {Cheryl A.} and Gabrielle Cerda and Sood, {A. Bela} and Alpert, {Jonathan E.} and Wisniewski, {Stephen R.} and Trivedi, {Madhukar H.} and Ardesheer Talati and Carlson, {Marlene M.} and Liu, {Harry Hong} and Maurizio Fava and Weissman, {Myrna M.}",
year = "2006",
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TY - JOUR

T1 - Children of currently depressed mothers

T2 - A STAR*D ancillary study

AU - Pilowsky, Daniel J.

AU - Wickramaratne, Priya J.

AU - Rush, A. John

AU - Hughes, Carroll W.

AU - Garber, Judy

AU - Malloy, Erin

AU - King, Cheryl A.

AU - Cerda, Gabrielle

AU - Sood, A. Bela

AU - Alpert, Jonathan E.

AU - Wisniewski, Stephen R.

AU - Trivedi, Madhukar H.

AU - Talati, Ardesheer

AU - Carlson, Marlene M.

AU - Liu, Harry Hong

AU - Fava, Maurizio

AU - Weissman, Myrna M.

PY - 2006/1

Y1 - 2006/1

N2 - Objective: To assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD). Method: Treatment-seeking mothers with a current DSM-IV diagnosis of MDD and with at least 1 child 7 to 17 years old were assessed during a major depressive episode (MDE). For each mother, 1 child was assessed (if a mother had more than 1 child, 1 was randomly selected). Maternal features assessed for this study were history of MDEs, severity of current MDE, comorbid conditions, depressive symptom features, and social functioning. Children were assessed for selected psychiatric diagnoses (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]), psychopathologic symptoms and social functioning (Child Behavior Checklist), and global functioning (Children's Global Assessment Scale). Data were gathered from December 2001 to April 2004. Results: A large proportion (72%) of mothers were severely depressed (17-item Hamilton Rating Scale for Depression score ≥ 22). About a third (34%) of children had a current psychiatric disorder, including disruptive behavior (22%), anxiety (16%), and depressive (10%) disorders. Nearly half (45%) had a lifetime psychiatric disorder, including disruptive behavior (29%), anxiety (20%), and depressive (19%) disorders. Atypical depressive features in the mother were associated with a 3-fold increase in the odds of having a child with depressive (OR = 3.3 [95% CI = 1.2 to 9.5]; p = .02) or anxiety (OR = 2.6 [95% CI = 1.1 to 6.9]; p = .03) disorders. A history of maternal suicide attempts and the presence of comorbid panic disorder with agoraphobia were associated with a 3-fold increase and an 8-fold increase in the odds of depressive disorders in the offspring, respectively. The final model showed significant associations (p ≤ .05) between the following characteristics of maternal depression and offspring disorders: maternal comorbid panic disorder with agoraphobia and offspring depressive and anxiety disorders, maternal irritable depression and offspring disruptive behavior disorders and any disorder, and maternal substance use disorders and any disorder. Conclusions: Children of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.

AB - Objective: To assess the current and lifetime prevalence of psychiatric disorders among children of currently depressed mothers and to assess the association of clinical features of maternal depression (i.e., severity, chronicity, and clinical features) with child psychopathology. Mothers were participants in the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multisite trial, designed to compare effectiveness and acceptability of different treatment options for outpatients with non-psychotic major depressive disorder (MDD). Method: Treatment-seeking mothers with a current DSM-IV diagnosis of MDD and with at least 1 child 7 to 17 years old were assessed during a major depressive episode (MDE). For each mother, 1 child was assessed (if a mother had more than 1 child, 1 was randomly selected). Maternal features assessed for this study were history of MDEs, severity of current MDE, comorbid conditions, depressive symptom features, and social functioning. Children were assessed for selected psychiatric diagnoses (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version [K-SADS-PL]), psychopathologic symptoms and social functioning (Child Behavior Checklist), and global functioning (Children's Global Assessment Scale). Data were gathered from December 2001 to April 2004. Results: A large proportion (72%) of mothers were severely depressed (17-item Hamilton Rating Scale for Depression score ≥ 22). About a third (34%) of children had a current psychiatric disorder, including disruptive behavior (22%), anxiety (16%), and depressive (10%) disorders. Nearly half (45%) had a lifetime psychiatric disorder, including disruptive behavior (29%), anxiety (20%), and depressive (19%) disorders. Atypical depressive features in the mother were associated with a 3-fold increase in the odds of having a child with depressive (OR = 3.3 [95% CI = 1.2 to 9.5]; p = .02) or anxiety (OR = 2.6 [95% CI = 1.1 to 6.9]; p = .03) disorders. A history of maternal suicide attempts and the presence of comorbid panic disorder with agoraphobia were associated with a 3-fold increase and an 8-fold increase in the odds of depressive disorders in the offspring, respectively. The final model showed significant associations (p ≤ .05) between the following characteristics of maternal depression and offspring disorders: maternal comorbid panic disorder with agoraphobia and offspring depressive and anxiety disorders, maternal irritable depression and offspring disruptive behavior disorders and any disorder, and maternal substance use disorders and any disorder. Conclusions: Children of mothers in the midst of a current MDE are at high risk for disruptive behavior and anxiety disorders. The elevated risk of psychopathology among children of depressed mothers may recommend assessment of these children when clinically suggested. Children of depressed mothers with comorbid panic disorder with agoraphobia are at high risk for depressive and anxiety disorders and deserve special attention from clinicians.

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