Verdeli Helen, Ferro Tova, Wickramaratne Priya, Greenwald Steven, Blanco Carlos, Weissman Myrna M
Divisions of Child Psychiatry and Clinical and Genetic Epidemiology, New York State Psychiatric Institute, Columbia University, New York, New York 10032, USA.
Depress Anxiety. 2004;19(1):51-8. doi: 10.1002/da.10139.
Numerous studies have shown that depression is highly familial and impairing and that a history of depression in a parent is the strongest risk factor for depression in a child. Many of the parents in these studies have never received sustained treatment despite histories of recurrent depression. None of the studies have examined the effects of maternal symptom remission on offspring symptom or functioning. We sought to determine the feasibility of treating depressed mothers who brought an offspring for the treatment of depression and to examine the relationship between improved maternal depression and symptomatic improvement and social functioning in their offspring. Nine mothers bringing their offspring for treatment of depression, and who were evaluated and found to be currently depressed, completed a 12-week open trial of interpersonal psychotherapy. Mothers and their depressed offspring were assessed by independent evaluators at weeks 0, 6, and 12 for depressive symptomatology and social functioning. Although the rates of depression were high among the mothers, few eligible mothers agreed to participate. Of the 12 who entered treatment, 9 (75%) completed it. Mothers and offspring improved with regard to depressive symptomatology and global functioning over the course of the trial. Improvement in maternal depression was significantly associated with improvement in offspring functioning but not symptom reduction. Improvement of maternal depression may be associated with improved outcomes in depressed offspring. However, it is difficult to engage depressed mothers in treatment for themselves if they come to the clinic to bring their child for treatment of depression. It may be more feasible to study the effect of improved maternal depression on offspring by sampling depressed mothers coming for their own treatment and then assessing their children over the course of maternal treatment.
大量研究表明，抑郁症具有高度的家族遗传性且会造成损害，父母有抑郁症病史是孩子患抑郁症的最强风险因素。这些研究中的许多父母尽管有复发性抑郁症病史，但从未接受过持续治疗。没有一项研究考察过母亲症状缓解对后代症状或功能的影响。我们试图确定治疗带着后代前来治疗抑郁症的抑郁母亲的可行性，并考察母亲抑郁症改善与后代症状改善及社会功能之间的关系。九位带着后代前来治疗抑郁症且经评估发现目前患有抑郁症的母亲，完成了一项为期12周的人际心理治疗开放试验。在第0、6和12周，由独立评估人员对母亲及其抑郁的后代进行抑郁症状和社会功能评估。尽管母亲中抑郁症发病率很高，但很少有符合条件的母亲同意参与。在12位开始治疗的母亲中，9位（75%）完成了治疗。在试验过程中，母亲和后代在抑郁症状和整体功能方面均有改善。母亲抑郁症的改善与后代功能的改善显著相关，但与症状减轻无关。母亲抑郁症的改善可能与抑郁后代的更好结局相关。然而，如果抑郁的母亲是为了带孩子来治疗抑郁症而前来诊所，很难让她们为自己接受治疗。通过对前来接受自身治疗的抑郁母亲进行抽样，然后在母亲治疗过程中评估她们的孩子，来研究母亲抑郁症改善对后代的影响可能更可行。
