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Cited by 651Child and Adolescent Psychosocial and Emotional DevelopmentMaternal Mental Health During Pregnancy and PostpartumFamily Support in Illness

Remissions in Maternal Depression and Child Psychopathology: A STAR*D-Child Report

Weissman, Myrna M., Pilowsky, Daniel J., Wickramaratne, Priya J., Talati, Ardesheer, Wisniewski, Stephen R., Fava, Maurizio, Hughes, Carroll W., Garber, Judy +8 more·2006·JAMA
DOI 10.1001/jama.295.12.1389
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Abstract

CONTEXT: Children of depressed parents have high rates of anxiety, disruptive, and depressive disorders that begin early, often continue into adulthood, and are impairing. OBJECTIVE: To determine whether effective treatment with medication of women with major depression is associated with reduction of symptoms and diagnoses in their children. DESIGN: Assessments of children whose depressed mothers were being treated with medication as part of the multicenter Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial conducted (between December 16, 2001 and April 24, 2004) in broadly representative primary and psychiatric outpatient practices. Children were assessed by a team of evaluators not involved in maternal treatment and unaware of maternal outcomes. Study is ongoing with cases followed at 3-month intervals. SETTING AND PATIENTS: One hundred fifty-one mother-child pairs in 8 primary care and 11 psychiatric outpatient clinics across 7 regional centers in the United States. Children were aged 7 to 17 years. MAIN OUTCOME MEASURES: Child diagnoses based on the Kiddie Schedule for Affective Disorders and Schizophrenia; child symptoms based on the Child Behavior Checklist; child functioning based on the Child Global Assessment Scale in mothers whose depression with treatment remitted with a score of 7 or lower or whose depression did not remit with a score higher than 7 on the Hamilton Rating Scale for Depression. RESULTS: Remission of maternal depression after 3 months of medication treatment was significantly associated with reductions in the children's diagnoses and symptoms. There was an overall 11% decrease in rates of diagnoses in children of mothers whose depression remitted compared with an approximate 8% increase in rates of diagnoses in children of mothers whose depression did not. This rate difference remained statistically significant after controlling for the child's age and sex, and possible confounding factors (P = .01). Of the children with a diagnosis at baseline, remission was reported in 33% of those whose mothers' depression remitted compared with only a 12% remission rate among children of mothers whose depression did not remit. All children of mothers whose depression remitted after treatment and who themselves had no baseline diagnosis for depression remained free of psychiatric diagnoses at 3 months, whereas 17% of the children whose mothers remained depressed acquired a diagnosis. Findings were similar using child symptoms as an outcome. Greater level of maternal response was associated with fewer current diagnoses and symptoms in the children, and a maternal response of at least 50% was required to detect an improvement in the child. CONCLUSIONS: Remission of maternal depression has a positive effect on both mothers and their children, whereas mothers who remain depressed may increase the rates of their children's disorders. These findings support the importance of vigorous treatment for depressed mothers in primary care or psychiatric clinics and suggest the utility of evaluating the children, especially children whose mothers continue to be depressed.

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  • Untreated PPD seems to have negative consequences for both infants and mothers.

    “Untreated PPD seems to have negative consequences for both infants and mothers.”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [14]

  • Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers, compared to mothers without PPD, include poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.

    “Nonsystematic reviews have indicated that the risks to children of untreated depressed mothers (compared to mothers without PPD) include problems such as poor cognitive functioning, behavioral inhibition, emotional maladjustment, violent behavior, externalizing disorders, and psychiatric and medical disorders in adolescence.5,10–17”

    From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [14]

  • Maternal remission from depression within 3 months was associated with significant decreases in mood symptoms of their children at 7-17 years of age.

    “It is encouraging that maternal remission from depression within 3 months was associated with significant decreases in the mood symptoms of their children at 7–17 years of age (Weissman et al., 2006), suggesting that research that relates brain function to mood and may help determine treatment is worthwhile.”

    From The human parental brain: In vivo neuroimaging (2011) · cites this paper as Weissman et al., 2006

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Authors
Weissman, M. M., Pilowsky, D. J., Wickramaratne, P. J., Talati, A., Wisniewski, S. R., Fava, M., Hughes, C. W., Garber, J., Malloy, E., King, C. A., Cerda, G., Sood, A. B., Alpert, J. E., Trivedi, M. H., Rush, A. J., & STAR*D-Child Team, F. T.
Affiliations
New York State Psychiatric Institute (US)
Corresponding author
Weissman, Myrna M.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2006-03-22
Volume
295
Issue
12
Pages
1389
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.295.12.1389
OpenAlex
W1499200300
Cited by
9
References
43
Citations by year
2023: 1 · 2021: 1 · 2016: 1 · 2015: 2 · 2014: 1
FWCI
0.36
Type
journal article
Language
en
Open access
closed
Locations
JAMA (publishedVersion)
Funders
National Institute of Mental Health (R01MH063852, N01‐MH‐90003, K02MH066249)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords
maternal depression, depression remission, child psychopathology, intergenerational transmission of depression, antidepressants, STAR*D trial, childhood anxiety disorders, disruptive behavior disorders, child functioning

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